ANALYSIS:A recent audit of social work files reveals the HSE is not able to ensure the safety of many children in its care, writes CARL O'BRIEN
IF THE Health Service Executive (HSE) was a parent, many of its children would be taken away and placed in care. That’s the only conclusion to be drawn from the monumental scale of failure uncovered in our child protection and social work services over recent months.
We know that hundreds of children are living with unapproved carers; that overworked social workers are unable to respond to thousands of cases of suspected abuse or neglect; that more than 100 vulnerable young people in care or in contact with social services have died of brutal causes such as suicide, drugs overdoses and unlawful killings.
But this, incredibly, is just part of the picture.
The traditional explanation from senior HSE managers is that these are a minority of children in residential care with the most troubled and difficult backgrounds.
The vast majority, so the argument goes, are in foster care which provides a stable and supportive setting which is overseen by teams of social workers and support staff.
As of today, much of this argument is demolished. An audit of social work files by the Health Information and Quality Authority (Hiqa) in two local health offices areas in Dublin – Dublin north central and Dublin north west – shows that hundreds of children in foster care are being failed by the HSE.
They show that some children with foster parents have been quietly forgotten about, with no visit from a social worker for 10 years or more; that crucial files relating to children in care are missing; that hundreds of child protection and welfare concerns have been unresolved.
The chaotic management of files in the two local health office areas give an indication as to how these failures have arisen. Hiqa inspectors found that in many cases files were missing, held randomly in different areas, incomplete or with incorrect names or dates of birth.
These are chilling findings. In essence, they point to the fact that the HSE is not able to safeguard and manage the safety of many children in its care.
There comes a tipping point where it is clear that the status quo cannot continue any longer; that the basic structures which have existed until now are no longer fit for purpose.
We are, by any objective assessment, reaching this stage with the HSE and its responsibility for child protection.
Let’s go back to the hypothetical point about what would happen if the HSE was a parent. The disturbing reality is that the HSE is, in many ways, a parent. It has a profound duty of care to the most vulnerable children in society.
The State’s obligations towards children who cannot be cared for by their families are clear and unambiguous.
The HSE has a positive duty under the Child Care Act 1991, to “identify children who are not receiving adequate care and protection” and to provide them with suitable protection.
It also has a range of statutory duties which emanate from this. These include, for example, ensuring children in care have regular contact with social workers, or that a child’s carers are properly assessed.
Hiqa’s audit of social work files shows the HSE has not been taking these duties seriously.
It found evidence that no less than 10 of these duties were being breached, along with evidence that another eight were potentially being breached.
The HSE says it is rectifying many of the findings and is in the process of undertaking a wide-ranging review of social services and how they are structured.
But the shelves of the executive and the Department of Health are creaking with reports and recommendations of what needs to be done to ensure the State provides better care and protection for vulnerable children.
They are to be found in the reports of the Kilkenny incest case, the Kelly Fitzgerald case in Mayo, the McColgan cases in Sligo, the Dunne family in Monageer and soon, we presume, the Roscommon abuse case.
Most of their recommended changes – better co-operation between State agencies, a standardised approach to dealing with abuse concerns, more emphasis on preventive measures – are marked by the same pattern of inaction.
Instead of more reviews, we need more radical steps. It is time that we need to look towards establishing a new agency or Government department responsible for child protection and other social services such as mental health and disability.
It should, as campaigners such as Fergus Finlay of Barnardos has suggested, have a full-time Cabinet minister to prioritise these issues and drive change. Above all, it needs to have the full support of Government from the Taoiseach down.
There are lessons for wider society, too. The hypocrisy of our society is revealed by the fact that we continue to tolerate the neglect and abuse of children on a daily basis, while we profess shock and horror at the revelations of abuse and neglect of children decades ago.
Political will is vital – but the force of this will is derived from the demands of the people who elect them.
Too many children suffered in the past in our industrial schools. How many more must suffer or even die today as a result of chaotic and underfunded child protection services?
Carl O'Brien is Chief Reporter of The Irish Times