HSE report criticises state of child protection

AN UNPUBLISHED Health Service Executive (HSE) report has been released by Fine Gael TD Alan Shatter, who says it “clearly states that the entire childcare protection service is dysfunctional”.

The report, prepared by PA Consulting Group for the HSE in October last year, was described as a “management tool” by Minister of State for Children Barry Andrews, who denied it had been covered up.

The document cites “significant anxiety” within the HSE and external agencies about how Children First, the framework governing child protection in Ireland, is being implemented.

Mr Shatter said yesterday he believed the report should have been in the public domain and Mr Andrews would have to reveal when its recommendations would be implemented. “The report clearly states that the entire childcare protection service is dysfunctional, that there’s a lack of any managerial expertise at the time when the report was published,” he said.

Mr Andrews acknowledged there were problems in the implementation of Children First but insisted the report had not been suppressed. “It was never intended for publication because it’s a management tool . . . it’s part of the change agenda. To characterise it as it was today, as some evidence of cover-up . . . is sheer nonsense,” Mr Andrews said.

He did not challenge the more serious issue, “which is that we haven’t succeeded in implementing Children First”.

Mr Andrews said in the Dáil earlier there was not enough reference to child protection at the highest levels of the HSE. “I’ve never heard Brendan Drumm give a speech about child protection and I believe it’s something the new HSE CEO will have to take on at the highest level.”

A HSE spokeswoman said engagement with staff unions to implement the recommendations had not been possible due to industrial action.

However, she said a position of assistant national director in the HSE with responsibility for children and families social services was established as part of the implementation of the report, and Phil Garland was appointed in November 2009.

Mr Garland insisted there was “no secrecy” about the report. “As a consultative document, it contributed to the overall process of major reform which is currently under way but such significant changes cannot be delivered overnight.”

Fianna Fáil TD Mary O’Rourke yesterday told the Dáil that Mr Andrews had a budget that could be used to hold a referendum on children’s rights.

Ms O’Rourke chaired the cross-party committee that produced the report in February proposing a referendum.

MAIN FINDINGS

INSPIRING CONFIDENCE IN CHILDREN AND FAMILY SERVICES REPORT:

GOVERNANCE AND MANAGEMENT STRUCTURE

The current roles and responsibilities are unclear and overly complicated.

The structure needs to be leaner, more transparent, with clear lines of responsibility and accountability and line of sight from frontline services to senior management.

This is essential for effective collaboration across agencies and services.

OVERALL STRATEGY AND SERVICE MODEL

There is an urgent need to develop a service model for child protection that focuses on outcomes for children. It should be based on national policy and legislation as well as wider experience.

SERVICE DELIVERY

There are critical issues in service delivery that undermine confidence in and the competence of the delivery system. These include unnecessary variation in practice, uneven collaboration between services and agencies, inadequate supports for social workers, unco-ordinated interaction

with the courts service and unclear responsibility for budgets and resources.

How the Health Service Executive interacts with the courts is a flashpoint of systemic weaknesses, exposing key deficits in how it provides child protection.

PERFORMANCE MANAGEMENT

The service is missing key elements of an effective performance framework.

The available child protection data provides a good foundation for a future performance management infrastructure.

RECOMMENDATIONS

* Develop a strategic and coherent service model.

* Deliver child-centred services consistently.

* Develop an intelligence-led system.

* Develop a clear management structure.

* Implement change of HSE child protection services using a co-ordinated project management approach.

* Review of professional supervision.