A High Court judge yesterday remarked on what he saw as a situation of near chaos surrounding provision of psychiatric and psychological services for disturbed children detained at the new "state-of-the-art" Ballydowd special care unit in Lucan, Co Dublin.
Mr Justice Kelly referred to bureaucratic wrangling, "hit and miss" arrangements, confusion over catchment areas and endless unsuccessful attempts over nine months to have the Eastern Regional Health Authority issue a contract of service to a psychiatrist.
He warned the South-Western Area Health Board (in whose area the Ballydowd unit is located) that he might no longer make orders sending children to the unit unless he got "watertight guarantees and enforceable undertakings" that the children would receive any psychiatric, psychological or other therapeutic services they required.
Mr Patrick MacEntee SC, for the board, said that, with goodwill, the situation was capable of being rectified. The judge said it would have to be before he made any orders sending children to Ballydowd.
Eight children are detained at Ballydowd and it is expected that the number will rise to 16 in September. The unit has a total of 24 places, but it is unclear when the remainder will become available.
Yesterday the judge heard extensive evidence in relation to what outside psychiatric and psychological services are available to children at Ballydowd, there being no such in-house services at the unit. The evidence was given after the judge had expressed concerns about delays in making available outside psychiatric and psychological services to an 11-year-old boy who has a rare cancer condition but is said to be doing well medically at this point.
The boy has been detained at Ballydowd for about six months and the judge was told yesterday that his mother, while believing that the staff of the unit were excellent and that the boy had made some progress while there, now wants him returned home. She also wants him to resume therapeutic services at a clinic in his home area.
In evidence yesterday, Dr Paul McCarthy, a consultant child and adolescent psychiatrist and a member of the board of Ballydowd, said it was "grossly unfair" to suggest that the boy had received no therapy since arriving at Ballydowd.
Dr McCarthy said psychiatric and psychological back-up to Ballydowd was being provided by a consultant child psychiatrist who was in situ for some weeks now but had been waiting for nine months for an ERHA contract of appointment.
