Address to Seanad Éireann by Ms Catherine McGuinness on Children’s Rights in Ireland

Thursday, 19th June 2014

“I welcome Judge Catherine McGuinness. It was a joy to listen to her, but her words have provided us with a stark reminder and challenged us in this House for work ahead. I note her work on the Children’s Rights Alliance Report Card, and she rightly pointed to the work of Tanya Ward, Maria Corbett and all the team at the Children’s Rights Alliance. She also pointed to work of the member organisations of the Children’s Rights Alliance which come together to provide evidence and put together the Report Card. I am delighted to welcome representatives of many of them to the Gallery. In fact, we could not fit them all in, so there are people in the wings waiting and listening. I could use up all my time listing every organisation, but I want to focus on some current issues. I want also to note the work being done by the Special Rapporteur on Child Protection, Geoffrey Shannon, and his annual report. His report and that of the Children’s Rights Alliance provide an invaluable tool for me as a legislator and policymaker. It is good to see that the state supports these initiatives.

The programme for Government 2011 to 2016 set out an ambitious reform agenda for children and family services. Senator Bacik has listed many of the things that have been accomplished since then. Equally, there are areas of concern that impact on the daily lives of children and we need to shine a light on those. As I am sure Ms McGuinness and my colleagues in this House will know, I am strongly committed to pursuing the gamut of children’s rights through my “senatorship”. We have had in this Senate excellent debates on children’s rights, most recently on beauty pageants and protecting childhood. In the autumn, we had a interesting debate on direct provision and valuing youth work. They were really good, informative debates and I pay tribute to my colleagues.

Other speakers have mentioned survivors. When I have met survivors over the years – we were campaigning before the children’s rights referendum became a reality – many said to me that the real testament would be to see children’s rights articulated in the Constitution of Ireland. Chief among the advancements that we have made was the passage of the children’s rights referendum on 10 November 2012. Unfortunately, the enactment of the amendment Bill, the will of Irish people, has been subject to lengthy postponement pending finalisation of the second part of a legal challenge by Mr. Justice McDermott in the High Court before a full appeal can proceed to the Supreme Court. The delay in the legal process is a source of frustration when I think of the body of legislation that has been passed since November 2011 that could have benefited from a constitutionally recognised best interests of the child principle. I also feel sadness when I think of the number of children of married parents, many of whom have spent the vast majority of their childhoods in the care system, who have now turned 18 since we voted as the people of Ireland and are eligible for adoption. Their rights have been expunged. It is my sincere hope that priority is given to the delivery of the judgment in the High Court, that the challenge will be given priority listing in the Supreme Court and that it is ruled upon as expediently as possible.

While Ms McGuinness is before us, I want to address two specific issues that are facing children today and seek her guidance. Chapter 5.4 of the Children’s Rights Alliance Report Card looks at children in detention. It states that, according to a communication that the alliance received from the Department of Children and Youth Affairs, 103 young people were detained on remand in 2013 for 138 different periods ranging from one day to several months. We have to bear in mind that a young person may be remanded more than once pending the outcome of proceedings. The number of children detained on remand, particularly the significant percentage of them who do not go on to receive a custodial sentence, raises serious concerns about Ireland’s compliance with the international and domestic principles of detention as a last resort for children, which incorporate a presumption against detention of children accused of criminal offences. I want to ask Judge McGuinness’s opinion on the practice of the Children Court of remanding children for assessment despite section 88(13) of the Children’s Act clearly stipulating that the court should not remand a child in detention on the basis solely of care or protection concerns. I want to ask her how the absence of a formal system of bail support and services in Ireland impacts on a child’s ability to meet their bail conditions, with the consequent risk of their receiving a custodial remand for failure to comply.

The second issue that I want to raise is that of direct provision, which Ms McGuinness mentioned. Chapter 6 of the Report Card opens with a piece by Dr. Liam Thornton entitled, “Closing Our Eyes: Irish Society and Direct Provision”. Dr. Thornton has done some excellent work, as have many NGOs such as the Irish Refugee Council and Doras Luimní. I put forward a motion on direct provision in this House last October. We were all at one on this issue. Unfortunately, the Minister then was not at one with us, but we will keep pursuing it and we have a very good Seanad cross-party group working on the issue. We know the high number of children who are in the 34 direct provision accommodation centres. Can Ms McGuinness give us advice on what immediate action could provide greater protection to children who are caught in the direct provision system? What could we do in the immediate future? All Senators in this House have agreed that such centres are not places for a child to be accommodated, especially beyond three-month or six-month period. I thank Ms McGuinness again for her address. She has given us many challenges.”

Full debate transcript available here

27 March 2014: Quarterly Meeting of the Joint Committee on Health and Children and the Minister for Children and Youth Affairs, Frances Fitzgerald TD

Questions submitted in advance by Senator Jillian van Turnhout and response received:

Question 9: Figures in relation to Special Care Placement.

Question 10: EU Commission Recommendation ‘Investing in Children: Breaking the cycle of disadvantage’.

Question 11: Amendment to Childcare Act 1991.

 

Question 9: Figures in relation to Special Care Placement

To ask the Minister for Children and Youth Affairs to provide the most up-to date figures on the following, in relation to Special Care Placements:

a)   What is the current waiting list for Special Care Placement?

As of 11th March 2014, there was one young person waiting for a special care placement. There have been ten admissions to Special Care since 1st January of this year.

 

b)   How many applications have been made to date since the beginning of 2013?

From 1st January 2013 to 5th March 2014 there were 116 special care applications – 22 of these applications were re-referrals.

 

c)    How many of these applications were successful?

Forty applications were successful, 27 were withdrawn or removed by the relevant Social Work Department, 46 were not approved and there were three in 2014 where further information had been sought and a decision has not yet been made. A Social Worker making an application for a Special Care place will also work to put in place other supportive mechanisms for the child while they await the outcome of the application. Where it is found that the alternative supports are meeting the needs of the child without the necessity of detaining the child for his/her own safety, the preference is to continue with the alternative programme. Where a child has been sentenced to detention in a Detention School, the child’s application for Special Care is withdrawn.

There is an appeals process available to Social Workers if they disagree with the decision where a child’s application to Special Care was unsuccessful. The Social Worker will also consider the Care Plan for the child and make other arrangements to find the most appropriate placement for that child. An unsuccessful application does not preclude the Social Work Department from applying at any other stage, especially in light of a child’s needs changing.

 

d)   How many State provided places are there in mainstream residential care and

e) How many are provided by Private Providers?

All Special Care placements in Ireland are operated by the Child and Family Agency and placements are under the direction of the High Court. There are no private providers of Special Care Services in Ireland, however some children with complex needs are placed out of State.

More generally, in December 2013 there were 142 Children’s Residential Centres in operation throughout the country; 47 of which were Agency-managed; 28 were run by the voluntary Sector; and 67 were operated by private providers.  These centres are typically found in domestic homes in housing estates, on the outskirts of towns and villages. The centres typically have between three and six children. These children are usually in their teens.  There is always some flux in placements available as services adapt to meet the needs of the resident children.

In December 2013, there were 356 children in care placed across the different types of residential care. Of these there were 143 children placed in the 67 privately run centres.

 

f)    What is the allocated budget for private provision?

The cost of the provision of mainstream residential placements in the privately-owned children’s residential centres for 2013 was approximately €50m. To date private placements have been commissioned on the basis of a child’s needs which will influence staffing ratio, the need for live-staff at night and additional supports to the child in the placement. There has been a consistent and predictable spend in respect of this type of residential provision, which reflects demand.

Significant work is under way within the Agency to secure the most appropriate and cost-effective care for children in the different settings in which they are accommodated. In early 2012 the HSE’s Children and Family Services undertook a tendering campaign to secure 80 places at a cost of €18.7 m per annum or €4,500 per place purchased for a two year period (extendible for a further two years if required). This arrangement will be for children whose needs can be met in a centre caring for 3 or 4 children. The process is now complete and contracts are currently being awarded in respect of 2014. It is estimated that the procurement arrangements utilised will reduce the spend in this area by €3.9m in 2014.

Any additional places that will be required will be purchased on an individual basis and in some cases may be more expensive where bespoke placements are commissioned for young people with particularly challenging needs.

The Agency has been working to increase value for money in this area by, as outlined above, seeking to promote cost effectiveness within the different options available and also moving to fostering where appropriate.

The Agency intends to undertake a centre activity audit of all aspects of residential care in 2014, and this will allow for a level of comparison of cost of placement across private and public group children’s centres and individual placement arrangements.

 

Question 10: EU Commission Recommendation ‘investing in children: breaking the cycle of disadvantage’.

To ask the Minister what action the Government is taking to implement the EU Commission Recommendation (20 February 2013) Investing in children: breaking the cycle of disadvantage, concerning child poverty and well-being and, having acknowledged that tackling poverty requires a whole-of-Government approach, will DCYA carry out a social impact assessment on any fiscal adjustments in Budget 2015 and onwards?

Ireland, led by the Department of Children & Youth Affairs (the first such Department in any EU member state), is committed to improving the lives and experiences of Ireland’s children and young people.

Many of the actions being implemented by this Government are in line with the EU Commission recommendation on ‘Investing in Children’ which was adopted by the Council of Ministers in 2013. These actions include:

·     Protecting and enhancing children’s rights on foot of the decision of the people in the Children’s Referendum 2012;

·     Improving child protection, welfare and family support services through the newly established Child & Family Agency;

·     Implementation of the recently-reviewed Youth Homelessness Strategy;

·     Continuing to be a world leader in both the areas of children’s participation (through the national Dáil na nÓg and local Comhairle na NÓg model); and childhood research (through the ‘Growing Up in Ireland’ longitudinal study and ‘State of the Nation’s Children’ reports).

Tackling Child Poverty

The EU recommendation on ‘Investing in Children’ includes a significant focus on tackling child poverty, referencing the ‘setting of national targets for reducing child poverty’ and access to quality services.

The draft National Policy Framework for Children & Young People, which is being prepared by my Department and which is due to be considered by Government shortly, currently includes a commitment to address child poverty.

With respect to services, my Department is responding through initiatives such as establishment of the Child & Family Agency (with an enhanced focus on prevention, early intervention and family support) and the roll-out of the €30m Area Based Childhood (ABC) Programme.

 

Early Years/Childcare

The EU recommendation on ‘Investing in Children’ recognises the importance of early childhood education and care. The EU Commission has set a target of member states having at least 95% of four year olds in pre-school. Ireland is in compliance with this target through provision of the free pre-school year.

The EU recommendation on ‘Investing in Children’ also recognises the importance of access to affordable childcare. In this context I announced a review of existing targeted childcare schemes to consider how best to structure future childcare support, to both support working families and to incentivise labour market activation, which could be expanded to more families as resources allow.

Delivering improvements in quality standards and staff qualifications is a critical precursor to any future expansion of universal childcare provision and/or Government supports. I have prioritised implementation of an eight-point Quality Agenda, and there has been significant and unprecedented progress in the implementation of this agenda over the past eight months. This will continue in 2014 with establishment of landmark new National Quality Support Service, which is being seen a significant development in the context of developing EU policy.

 

Social impact assessment

In February 2012, the Government decided to develop an integrated social impact assessment to strengthen implementation of the new national social target for poverty reduction and to facilitate greater policy coordination in the social sphere.

Work in the area of social impact assessment is being led by the Department of Social Protection. A social impact assessment of Budget 2014 was published in February 2014 by that Department.  My own Department liaises regularly with the Department of Social Protection to ensure a child-centred approach informs such assessments and consequently provides learning to use in the development of our policy and service responses for children.

 

Question 11: Amendment to Childcare Act 1991.

 

Can the Minister provide a timeline for the delivery of the legislation to amend the Child Care Act, 1991, to provide a statutory right to the preparation of an aftercare plan for eligible young people leaving care and will the Minister consider extending this statutory support to young people leaving detention, as they often present with very similar needs?

The amendment to the Child Care Act 1991 to strengthen the aftercare provisions for children in care was approved by Government on 25 February 2014 for publication, and has been submitted to this Committee for its consideration.

I understand that the Committee plans to consider the matter during the month of April. Following the Committee’s deliberations the text of the amendment may need to be refined in conjunction with the Office of the Parliamentary Counsel, after which a timeframe for the progression of the legislation will be discussed and agreed with the Houses of the Oireachtas. I am very appreciative of the work of the Joint Committee and the contribution of the members.

Regarding children leaving detention, on average approximately one third of such children normally would have care orders and so would, in the main, be required to have an aftercare plan prepared by the Child and Family Agency.

At present, the mechanism for supervision of a child post-release from a sentence of detention (other than those who were in the care of the Child and Family Agency) is by the Probation Service if the courts impose a “detention and supervision” (i.e. in the community) order at conviction stage. Extending the right to an aftercare plan to all children completing a sentence of detention would require significant and detailed examination by officials in the relevant units of my Department, and the relevant other Departments and agencies involved, before any recommendations in relation to the matter might be formulated.

25 July 2013: Quarterly Meeting of the Joint Committee on Health and Children and the Minister for Children and Youth Affairs, Frances Fitzgerald TD.

Question 3: Childhood Obesity

Question 4: National Consent Policy

Question 5: Counseling service for mothers

Question 3: Childhood Obesity

In light of the growing childhood obesity epidemic in Ireland and Government policy as set out in Healthy Ireland-A Framework For Improved Health and Wellbeing 2013-2025, to ask the Minister for Health why under the new Framework for Junior Cycle the status of physical education and SPHE (amongst others) has changed from a subject to a short course, thereby reducing recommended teaching time, and what will now be done under Healthy Ireland to ensure physical education and social, personal and health education in schools gets the priority they need?

I am aware that on 4 October 2012, the Minister for Education and Skills, Ruairí Quinn, TD, published A Framework for Junior Cycle which outlines his plan to reform the junior cycle in post-primary schools. I understand and am supportive of the overall vision being pursued with the framework and my Department will assist the Department of Education and Skills in achieving this vision. We believe that if the reforms are implemented as envisaged, they may increase student engagement with school due to the decreased emphasis on rote-learning and the broadening out of areas in which students can achieve recognition for their achievements. This will have a positive impact on health and wellbeing. I am aware that the Department of Education and Skills is supportive of health and wellbeing and I welcome the inclusion of wellbeing as one of the eight principles underpinning the Framework for Junior Cycle.
A position paper on Social Personal and Health Education and Physical Education has also recently been developed by a working group of relevant experts in the HSE which has been shared with the Department of Education and Skills. It is worth acknowledging that several health indicators in Ireland demonstrate positive trends in the health and wellbeing of adolescents in the last 10 years. Trends in the Health Behaviour of School-Aged Children Reports (ESPAD), for example, record declines in cigarette use, alcohol use, binge drinking and illicit drug use.

Research evidence from an international perspective points to the need to have comprehensive all-encompassing strategies for health behaviours which involve multiple settings, including the school setting, if progress is to made in improving health and wellbeing. Improvements in the trends on health behaviours are most marked since 2002/2003, the years that the SPHE programme was required in junior cycle. It is likely that the roll-out of the SPHE programme has had a positive influence on the health behaviour of young people.

Healthy Ireland which was launched in March contains a commitment to fully implement SPHE and PE and this was agreed with the Department of Education and Skills. As the Senator will be aware, Healthy Ireland contains a vision of an Ireland where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility.

Clearly, the creation of healthy generations of children, who can enjoy their lives to the full and reach their full potential as they develop into adults, is critical to the country’s future. Responsibility for prevention programmes cannot rest solely with my Department, the HSE or, indeed, the Department of Education and Skills but must be shared across Government Departments and all of society.

Officials in my Department will continue to meet with officials in the Department of Education and Skills to address issues of concern including these matters.

Question 4: National Consent Policy

What implementation plans are in place for the new National Consent Policy (May, 2013) for use in health and social care, particularly the education and training of staff who are expected to implement and deliver the policy

The HSE Consent Policy was developed by an advisory group and a wider stakeholder group. These groups included representatives of the staff who will use the policy on a day to day basis and the document reflects the needs of practitioners. The principle of consent and the knowledge of the importance of obtaining consent are expected of all staff employed or contracted by the HSE. Knowledge of the importance of consent is, and has long been, a professional requirement for health and social care professionals. Therefore the main focus of support for the policy is providing guidance rather than training and education of staff. At a local level there is a training requirement for new staff on local protocols and documents/forms used for consent, and this will continue.

The definitive document (HSE National Consent Policy) is in itself a guidance document and has been supplemented by the publication of a brief summary entitled ‘Seeking Consent: A Brief Guide for Health and Social Care Workers’. This provides practitioners’ guidance on how to use the policy in service settings.

To support staff in the hospital services the HSE will review the consent forms that currently exist for common procedures with the view to development of nationally agreed forms/templates. This will reduce variation in information provided and improve the quality of the consent process; and reduce training requirements as staff move around the system.

Children and Family services provide particular challenges in the area of consent. The Children and Families Services are developing an implementation plan to address particular requirements that arise in the delivery of services. The plan is being prepared at the moment.

Two service user guides have also been developed and published to help patients and service users understand the consent process and what they can expect from their healthcare provider and professional.

A log is maintained of all queries raised with the Quality and Patient Safety Directorate in regards to the use of the policy and these will inform the updating of the policy and other guidance as required.

Question 5: Counseling service for mothers.

Given that an estimated 28,500 women in Ireland are diagnosed with perinatal depression, post-natal depression and pregnancy or childbirth related post-traumatic stress disorder each year, to ask the Minister for Health what efforts are being made to tackle delays of 9 months and more for mothers to be seen by a professional counsellor in the public health care system?

Pregnant women access a range of services including primary care, obstetrics and ante-natal and post-natal services. If the individual herself, or any of the healthcare professionals caring for her during her confinement have a concern, they should first access their GP or Primary Care team in the normal way. Where an individual is assessed as requiring referral for specialist mental health services, their GP would refer to their local General Adult mental health service.

For women with a recognised mental health need, they may discuss the management of their pregnancy with their consultant psychiatrist as it may be necessary to alter their treatment programmes as some medications as contraindicated in pregnancy.

All community mental health teams would have experience of such presentations and collaborate with the obstetric services to ensure a safe delivery and appropriate aftercare.

For women with a previous history of post-natal distress or depression, there is an elevated risk of recurrence and this would be actively managed through high frequency review by the GP who assess when it would be necessary to engage with the specialist mental health services if at all.

Access to counselling for all medical card holders, including pregnant women, is now available through the Counselling in Primary Care Service. The detail of this new service and pathway of referral is attached in Appendix 1.

If an individual is being treated within the specialist secondary care mental health services and counselling is indicated clinically then the appropriate intervention by a trained health professional would be made available.

There are 123 General Adult Community Mental Health Teams nationally. The HSE, in its 2012 Service Plan, prioritised €35m and 414 WTEs for reinvestment in mental health to progress the objectives in the Programme for Government. One of these objectives was to enhance General Adult and Child and Adolescent Community Mental Health Teams.

The HSE, in its 2013 service plan intends to build on this investment with a further €35m to strengthen General Adult and Child and Adolescent Community Mental Health Teams.

In addition, there are three peri-natal Psychiatrists based at The National Maternity Hospital Holles St, The Coombe and Rotunda Maternity Hospitals reflecting the number of births at these centres each year.

Of the 414 posts allocated in 2012, 389 posts have either been filled, or under offer or awaiting clearance. These posts include multidisciplinary team members across all the health professions.

Of the 477 posts approved in 2013, 133 posts have been accepted by candidates. A further 16 offers have been made from existing panels. The HSE is establishing new panels and other arrangements to fill the remaining posts.

Currently, our mental health data system is a manual system and the information in respect of service users who may be pregnant is not captured nationally.

The Lancet

In July 2021, Jillian co-authored an article in the world-renowned medical journal “The Lancet”