Joined-up thinking and adherence to protocols needed to protect children

How many more reports will be written before the statutory services responsible for keeping children safe get their act together? The latest, an audit of the role of the Garda and its implementation of section 12 of the Child Act 1991, found that there was “little evidence that An Garda Síochána, Tusla and related agencies have developed formal structures to foster inter-agency co-operation”.

Given the plethora of reports that have been written on child protection over the past 25 years, all of which identified very limited partnership working between and within agencies, why has this problem not been solved?

Since the 1990s there have been 29 inquiries and reviews in response to serious abuse and/or deaths of children known to the statutory child protection services. There was also a study in 2013, published by the Department of Children and Youth Affairs, that looked at whether the 551 recommendations made in the 29 reports were implemented.

The study – an examination of recommendations from inquiries into events in families and the interaction those families had with State services, and their subsequent impact on policy and practice – found that effective interagency co-operation had not happened. The study examined five reports in detail: the Kilkenny Incest Investigation (1993), Kelly [Fitzgerald]: A Child is Dead (1996), the West of Ireland Farmer Case (1998), the Monageer Inquiry (2009) and the Roscommon Child Care Case (2010).

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Entirely separately

The investigation of the Kilkenny incest case found that all the agencies involved dealt with the case “entirely separately and without interdisciplinary communication and co-operation”. The Independent Child Death Review Group 2012 noted that the lack of interagency work “has emerged repeatedly in child protection reviews conducted in Ireland”.

The 2013 annual report from National Review Panel (NRP) of Tusla showed that in half the cases investigated, “an interagency meeting would have assisted in the compiling of information but was not held”. In the case of “Dara”, “interagency meetings were strained” and there were “different expectations held by each organisation [the Garda, social workers, two hospitals, the school, and mental health services] about the other and a lack of mutual agreement about responsibilities”. Fifty files were kept on “Yvonne” and the report noted that there were critical times when interagency meetings were necessary but were not convened.

Meanwhile, the report Changing Policing in Ireland: Delivering a Visible, Accessible and Responsive Service 2014 showed that information was not shared with other agencies, and that this "hindered partnership working".

Dr Helen Buckley, chairwoman of the NRP, said the 2017 reports “show evidence of an emerging and problematic gulf between health services and social work departments following the separation of child protection services from the HSE”. Jim Gibson, chief operations officer of Tusla, noted “a consistent theme emerging from case reviews is that services for children and young people could be improved if statutory agencies worked effectively together”.

Why is this not happening?

Different disciplines

The main reason is the way different disciplines are trained and on-the-job socialisation. People train and work with their own discipline, learning the jargon and “how we do things around here”. This creates silo cultures. The absence of partnership working is not just a problem in child protection services, but is evident throughout the whole public sector. In the health sector, professionals are constantly firefighting and obsessed with waiting lists. Nobody has time to look at the big picture, such as how to build better parents or why nearly 600,000 people need medical treatment.

All societal problems require partnership approaches or they will never be solved. There is no shortage of peer- reviewed research papers on how to partner effectively.

Leadership, trust and shared power are three of the most important ingredients of partnership working. The only way to get inter- and intra-agency working for children and families is to have protocols that must be followed whenever partnership is needed. Tusla and the HSE have a protocol for co-operation. Unfortunately, neither trust nor power is mentioned, so it is unlikely to work.

Pilots use protocols all the time to keep their planes and passengers safe. They get fired if they don’t follow those protocols meticulously. Maybe it’s time for the HSE and Tusla to adopt a similar approach.

International Men's Health Week runs from Monday, June 12th to Sunday, June 18th. Check out what's on at mhfi.org and the National Men's Health Action Plan: Healthy Ireland Men 2017-2021