Child Care (Amendment) Bill 2009 – Seanad Bill amended by the Dail – Report and Final Stages

20th July 2011

I am pleased this Bill strengthens the powers of the newly-established Department of Children and Youth Affairs. Last week, the Minister referred to the unsatisfactory situation in 2010 when an independent review group on child deaths, established by the then Minister of State with responsibility for children and youth affairs, Barry Andrews, was furnished with preliminary information by the HSE but refused access to individual cases files. This was due to legal concerns identified by the HSE on the provision of information to the group. It is vital to the success of the new Department and both natural and obvious that the Minister for Children and Youth Affairs is given direct access to files as she needs them in a safe and proper way, bearing in mind the sensitive nature of some of the information required. This will help her ensure full accountability in the arena of child protection.

Strengthening the powers of the new Department is also important in ensuring consistency in the collection of child protection data from around the country. This is the best way to ensure that a consistent threshold is maintained with regards to children being taken into care.

As the Minister outlined in the past week, there is a big job ahead in strengthening child protection systems. The new Department will have an agency dedicated to family and children services. This will remove the child protection component out of the ambit of the HSE which will re-balance that dynamic and power more favourably towards the new Department.

This Bill is an important step towards strengthening child protection systems. I note the Minister will introduce legislation later this year to create the new child welfare and support services agency. I offer her our support on this as it is in all our interests to bring it forward as quickly as possible. I hope the legislation is comprehensive to allow for the proper lines of accountability at administrative, executive and political levels to ensure the failings that occurred in the setting up of the HSE in that regard are not repeated.

This is the appropriate time to comment on special care orders. This element of the Bill, which relates to special care orders, is highly positive and pertinent. It also relates to one of most serious of all State powers, namely, the power to detain a child in a centre such as Ballydowd. This power must always be used with the utmost care and in absolute deference to the rights of each individual child.

A previous issue of concern was that the relevant provisions of the Child Care Act 1991 were not operational. As a result, it fell to the High Court to hear applications for special care orders. I welcome the provision to afford to the Health Service Executive the power to apply to the High Court for a special care order for a child. I am pleased the previous ambiguity has been removed and the Bill sets out in unequivocal terms the processes to be followed by the HSE. These include the steps to be taken from the initial consideration of the child for special care, the application for the order, the hearing of the case, the granting of the order and the care of the child under the order through to the discharge of the order. I also welcome the role the Health Information and Quality Authority will have in this respect as a result of the amendments proposed by the Minister.

Although I support the Bill, I am concerned about the failure to address the issue of after care. I am aware this issue has been debated extensively but this legislation remains a missed opportunity. I am concerned that an amendment has not been included to make the provision of after care an automatic legal entitlement where a child has an identified need. The obligation to provide after care should be clearly stated in law. When the State assumes parental responsibility for a child in care there should be a corresponding obligation on the State, within legislation, making it crystal clear what are the State’s obligations, including the obligation to ensure the child is cared for and not abandoned when he or she turns 18 years of age.

I listened intently to the Minister’s comments on after care in the Dail last week. Research reports have continually shown that children leaving care need support, as confirmed again by a recent report by Empowering People in Care, EPIC, formerly the Irish Association of Young People in Care, IAYPIC. An amendment to legislation on the issue of after care has been sought by many organisations, including Barnardos. It is also one of the primary demands of the action for after care coalition. While I am aware the Minister intends to return to the issue of after care and much work is being done on it, an opportunity has been missed to address the issue in this legislation.

Order of Business, 21 June 2011

21st June 2011

My first question is on special needs assistants because the lack of clarity is deeply worrying. We know the important role special needs assistants play. If we looked at it in a purely fiscal way we would see that we save money in the long term by supporting children in the early years to mainstream education. Special needs assistance was an indication of a major move from an old Ireland where we hid our problems behind closed doors but instead we have become a society of which we all wish to be a part. It is very important that we get clarity around special needs assistants and that children are allowed to be educated together as we would hope them to grow up in society together.

Second, I ask that the Minister for Children and Youth Affairs would update us on the national vetting bureau Bill and her intention to put the Children First guidelines on a statutory basis. That is often talked about but as we know reports will be forthcoming, not least the Cloyne report. It is a serious discussion because we make the statement that we should put the Children First guidelines on a statutory basis but in terms of the way we will do that this House could play a role in framing that.

My third question is on youth mental health. There are many actions in this area but they are not often co-ordinated among Departments. We should consider a debate to examine the various aspects of youth mental health, not just in terms of hospital beds but in schools also and the long waiting lists for children to be seen after a teacher has identified a need.

Criminal Justice – Female Genital Mutilation – Bill 2011 – Second Stage

2 June 2012

I thank the Minister for his comprehensive presentation of the Bill. I am delighted that we are discussing this legislation, which is the first measure on which I have shared my views. As previous speakers have said, this is a positive step and I hope the Bill will be passed without delay so it can be placed on the Statute Book. While my comments are aimed at strengthening and improving the Bill, I will be giving it my full support. I wish to thank the Children’s Rights Alliance, AkiDwA, Amnesty International Ireland and other NGOs for their briefings. I also acknowledge the leading and supportive role played by Senator Bacik on this important matter.
We all recognise the horrors of FGM as a gross violation of human rights, as well as being a critical issue concerning children’s rights and child protection. FGM has real implications for children living in Ireland today.

Families in Ireland from FGM practising regions have reported serious pressures from overseas families to bring their daughters back to have the procedures carried out. This Bill must make it abundantly clear that Ireland will not tolerate this practice. It must be passed to bring Ireland into line with the majority of European countries but, most importantly, it will help families and parents to counter pressure to submit their daughters to FGM. It should act as a deterrent to the continuation of the practice and deliver a clear preventative message.

I will use my time to focus on the Bill. As Senators, it is our duty to make this Bill as strong as possible. There are three important areas that I propose should either be amended or clarified. The first in regard to defences. I am extremely concerned about section 2 in terms of defences, which seems to allow for a surgical operation unnecessary for the protection of her physical or mental health. This is not an acceptable defence and should be removed. We know that FGM has no health benefits and involves removing and or damaging healthy and normal body tissue. I am also concerned that mental health could be used as a defence by a parent or guardian to remove a child from Ireland to undergo FGM abroad. If such a defence is used, that is tantamount to saying that FGM must be performed to ensure the mental health and wellbeing of a girl but I do not know how this could be used in a country like Ireland where FGM is deemed totally unacceptable. The use of such a defence effectively links mental health to culture, yet the Bill elsewhere rightly states that the defence of culture cannot be used.

The second issue I would like to mention, which several colleagues raised, is that of extra-territoriality. I welcome the inclusion of the vital principle of extra-territoriality, making it an offence for an Irish citizen or a person ordinarily resident in Ireland to commit or attempt to commit an act of FGM in another country. I note the Minister’s comments on this important issue but I am still concerned. Currently, the FGM act must therefore be illegal in the jurisdiction where the act takes place for it to be an offence. I am concerned about the issue of dual criminality, which the Minister has raised. This is an issue on which we need to send a very strong message to the effect that, regardless of the other country’s legal stance, in Ireland it is illegal and it must be illegal for a person to take a child to any other country. This to me is as important as terrorism and I would like that issue to be re-examined.

The third issue is in regard to the definition in the Bill on which many speakers have commented. The definition is close to the World Health Organisation’s definition, which the Minister referenced. I question why we would not use the World Health Organisations definition to ensure that it is abundantly clear.
I fully support the Bill, as drafted, but we could go further and send a very strong message.

EESC – Alcohol related harm – Opinion of the Rapporteur, Ms. van Turnhout

European Economic and Social Committee

Alcohol related harm

Brussels, 30 September 2009

of the
European Economic and Social Committee
How to make the EU strategy on alcohol related harm sustainable, long-term and multisectoral (Exploratory opinion)


Rapporteur: Ms van Turnhout

In a letter dated 18 December 2008, in the context of the forthcoming Swedish Presidency of the European Union, the Swedish Minister for European Affairs asked the European Economic and Social Committee to draft an exploratory opinion on the following subject:

How to make the EU strategy on alcohol related harm sustainable, long-term and multisectoral.

The Section for Employment, Social Affairs and Citizenship, which was responsible for preparing the Committee’s work on the subject, adopted its opinion on 1 September 2009. The rapporteur was Ms van Turnhout.

At its 456 plenary session, held on 30 September 2009 and 1 October 2009 (meeting of 30 September 2009), the European Economic and Social Committee adopted the following opinion by 128 votes to 5 with 4 abstentions.


* *

1. Summary and recommendations

1.1 Drawn up in response to a request by the Swedish Presidency to the EESC, this exploratory Opinion focuses on how to make the EU strategy on alcohol related harm sustainable, long-term and multisectoral . The goal of the Swedish Presidency is to support the implementation of the horizontal EU alcohol strategy and the establishment of long-term preventive work at both EU and national level.

1.2 This Opinion builds on the previous EESC Opinion on alcohol related harm, which looked at five priority themes: protecting children; reducing alcohol related road accidents; preventing alcohol related harm among adults and in the workplace; information, education and raising awareness; and common evidence base .

1.3 The Opinion highlights the following four priorities of the Presidency:

– the impact of advertising and marketing on young people;
– the influence of price on the development of damage;
– children in focus – specifically foetal alcohol spectrum disorder and children in families; and
– the effects of harmful alcohol consumption on healthy and dignified ageing.

to achieve a comprehensive approach, all of the themes dealt with in both opinions and other relevant matters should be taken together.

1.4 Drinking patterns vary significantly across countries, but most consumers drink responsibly most of the time (see 3.2) . Having said that, the EESC is concerned that 15% of the EU adult population are estimated to drink at harmful levels on a regular basis, and that children are the most vulnerable to the harms caused by alcohol. Policy measures should be designed to reach those already drinking at harmful levels.

1.5 Alcohol marketing is one of the factors that increases the likelihood that children and adolescents will start to use alcohol, and will drink more if they are already using alcohol. Given this, the EESC calls for a reduction in the exposure of children to alcohol marketing.

1.6 Appropriately designed alcohol pricing policies can be effective levers in reducing alcohol related harm, particularly among low income and young people. The EESC believes that regulation governing the availability, distribution and promotion of alcohol is needed; self-regulation in this area is not enough.

1.7 To raise awareness about the risk of Foetal Alcohol Spectrum Disorder (FASD), the EESC supports national and EU level awareness-raising campaigns.

1.8 The EESC believes that more information is needed about the effects of harmful alcohol consumption on healthy and dignified ageing at an EU level.

1.9 The EESC recognises that alcohol policies should be comprehensive and include a variety of measures for which there is evidence of reducing harm.

2. Background

2.1 The European Union has competence and responsibility to address public health problems related to harmful and hazardous alcohol use on the basis of article 152 (1) of the Treaty , which states that Community action shall complement national policies.

2.2 Following the Council Recommendation of 2001 on the drinking of alcohol by young people , it invited the Commission to follow and assess developments and the measures taken, and to report back on the need for further actions.

2.3 In its Conclusions of June 2001 and of June 2004, the Commission was invited to put forward proposals for a comprehensive Community strategy aimed at reducing alcohol-related harm which would complement national policies .

2.4 In 2006, the Commission adopted the Communication: An EU Strategy to support member states in reducing alcohol related harm . It aims to “map actions” put in place by the Commission and Member States, and explains how the Commission can further supports and complements national health policies. The EESC believes that the Communication falls far short of a ‘comprehensive strategy’ as it does not provide a comprehensive and transparent analysis of all the relevant policy areas and of the difficulties some Member States have experienced in maintaining quality public health alcohol policies due to EU market rules . The Strategy also fails to acknowledge that alcohol is a psychoactive drug, a toxic substance when used to excess, and, for some, an addictive substance.

2.5 The European Court of Justice has repeatedly confirmed that reducing alcohol related harm is an important and valid public health goal, using measures deemed appropriate and in accordance with the principle of subsidiarity .

2.6 The EESC acknowledges the work performed by all relevant stakeholders within the European Alcohol and Health Forum since its launch in 2007. The EESC welcomes similar developments at local levels.

3. Overview of harmful effects

3.1 Globally, the European Union is the region where most alcohol is consumed, with 11 litres of pure alcohol consumed per person each year . Overall consumption declined between the 1970s and mid-1990s, since when it has remained relatively stable; however there are still differences between countries in terms of both consumption and harm, also in terms of the form the harm takes ; however, harmful drinking patterns remain significant .

3.2 Most consumers drink responsibly most of the time. However, the EESC is concerned that 55 million adults in the EU (15% of the adult population) are estimated to drink at harmful levels on a regular basis . Harmful alcohol consumption is estimated to be responsible for approximately 195 000 deaths a year in the EU due to accidents, liver disease, cancers and so forth. Harmful alcohol use is the third biggest cause of early death and illness in the EU .

3.3 The EESC believes that harmful alcohol consumption by individuals is not a problem that develops in isolation, but rather one that can have a variety of causes including poverty, social exclusion, family environment, and work-related stress.

3.4 While different cultural habits related to alcohol consumption across Europe exist, it can also be observed that different cultural habits related to harmful and hazardous alcohol consumption, including among children and adolescents, exist . The EESC urges the Commission and the Member States to take account of these national and local patterns when defining policies.

3.5 Children are particularly vulnerable to harms caused by alcohol. It is estimated that in the EU 5 to 9 million children in families are adversely affected by alcohol. Alcohol is a causal factor in 16% of cases of child abuse and neglect, and an estimated 60 000 underweight births each year are attributable to alcohol .

3.6 Harmful alcohol consumption can cause harm not only to the individual but also to third persons. Alcohol-related harm should also be addressed in the workplace, in the framework of health and safety regulations, which is primarily the responsibility of the employer. Workplace alcohol policies could help reduce alcohol-related accidents, absenteeism and increase working capacity. The EESC urges employers, trade unions, local authorities and other relevant organisations to closely cooperate and to undertake joint actions to reduce alcohol-related harm in workplaces.

3.7 Alcohol is an important commodity in the Europe creating jobs, generating revenue through taxes and contributing to the balance of trade. However, harmful alcohol drinking also affects the economy, due to increased health care and social costs, and loss of productivity. The cost of alcohol related harm to the EU’s economy was estimated at EUR 125 billion for 2003, equivalent to 1.3% of GDP .

4. The impact of advertising and marketing on young people

4.1 The EESC urges the Commission to acknowledge the WHO European Charter on Alcohol adopted by all EU Member States in 1995 and, in particular, the ethical principle that all children and adolescents have the right to grow up in an environment protected from the negative consequences of alcohol consumption and, to the extent possible, from the promotion of alcoholic beverages.

4.2 The EU Council recommendation urged Member States to establish effective mechanisms in the field of promotion, marketing and retailing and to ensure that alcohol products were not designed or promoted to appeal to children and adolescents.

4.3 Binge drinking by young adults (15-24 years) is a growing concern at EU and Member State level; 24% of drinkers in this age group reported binge drinking at least once a week in 2006 . Beer (40%) and spirits (30%) are the most often consumed alcoholic drinks among teenagers , followed by wine (13%), alcopops (11%) and cider (6%). Alcohol sales promotions such as “happy hour” and “two for one” promotions also increase alcohol consumption and the likelihood of binge drinking among youth . As a step forwards, the stricter enforcement of legal drinking age by authorities is required.

4.4 Alcohol advertising and marketing are influential in shaping young people’s attitudes to and perceptions of alcohol, and encouraging positive expectations of alcohol use amongst young people . A review of longitudinal studies by the Science Group of the European Alcohol and Health Forum found “consistent evidence to demonstrate an impact of alcohol advertising on the uptake of drinking among non-drinking young people, and increased consumption among their drinking peers. This finding is all the more striking, given that only a small part of a total marketing strategy has been studied” .

4.5 The EESC is concerned that alcohol marketing attracts underage drinkers , and draws attention to consistent findings that exposure to television and sponsorship that contains alcohol predicts the onset of youth drinking and increased drinking .

4.6 The WHO Expert Committee considered that “voluntary systems do not prevent the kind of marketing which has an impact on younger people and that self-regulation seems to work only to the extent that there is a current and credible threat of regulation by government” .

4.7 Actors in the alcohol beverage chain have declared their willingness to be more proactive in enforcing regulatory and self-regulatory measures . They have a role in working together with the Member States to ensure their products are produced, distributed and marketed in a responsible manner, contributing to reduce alcohol related harm.

4.8 The Audiovisual Media Services Directive helps set minimum standards for alcohol advertising. It specifies that “[…]alcohol advertisements shall […] not be aimed specifically at minors, shall not link the consumption of alcohol to enhanced physical performance, social or sexual success and shall not claim that it is a stimulant, a sedative or a means of resolving personal conflicts” . The EESC believes that this Directive alone is not sufficient to fully protect children from alcohol marketing.

4.9 The EESC urges that a reduction in the exposure of children to alcohol products, advertising and promotions be stated as a specific objective by the Commission, and that tighter regulation in this area be introduced.

5. The influence of price on alcohol related harms

5.1 There is increasing pan-European interest in measures to combat alcohol related harms. Alcohol is an important commodity in Europe, creating jobs, generating revenue through taxes and contributing to the EU economy through trade. However, an estimated 15% drinks at harmful levels generating harm for individuals and societies. In 2003, the cost of alcohol misuse in the EU was estimated at EUR 125 billion, equivalent of 1.3% GDP .

5.2 Based on the RAND study, there is a trend across the EU towards more off-trade alcohol consumption, which tends to be cheaper than alcohol sold on-trade . However, it should be noted that the study focused only on off trade alcohol prices and did not compare off trade prices to on trade prices.

5.3 Studies show that alcohol became more affordable across the EU between 1996 and 2004, in some countries by more than 50% . Evidence shows that there is a positive relationship between alcohol affordability and alcohol consumption in the EU .

5.4 Young people are sensitive to alcohol price increases, which lead to reduced frequency of drinking among young people and, to smaller quantities drunk in each drinking event . However, other studies show that young people may turn to more harmful drinking patterns in response to price increase, e.g. pre-drinking where people consume cheaper alcohol at home before going out. This finding has important implications for alcohol policy in the EU, particularly given the increase in harmful youth drinking.

5.5 An estimated 3.8% of all global deaths and 4.6% of global disability-adjusted life-years are attributed to alcohol. There is a positive relationship between alcohol consumption and traffic injuries and traffic deaths . Alcohol is the sole cause of some diseases such as alcoholic liver disease and alcohol-induced pancreatitis, and is a contributory cause of other diseases and injuries (e.g. certain types of cancer, heart disease and strokes and liver cirrhosis) . Harmful alcohol consumption is a contributory factor for crime, violence and family deprivation, risky sexual behaviour and sexually transmitted disease .

5.6 It is estimated that across the EU heavy episodic drinking contributes to 2 000 homicides, 17 000 traffic deaths (or one in three of all traffic fatalities), 27 000 accidental deaths and 10 000 suicides .

5.7 Alcohol pricing policies can be effective levers in reducing alcohol related harms . The EESC nevertheless believes that pricing policy should be considered when developing strategies to address alcohol related harm in a long-term, sustainable and multi-sectoral way.

5.8 Alcohol policies should be comprehensive and include a variety of measures for which there is evidence of an impact in reducing harm, such as drink drive policies and primary health based interventions. The EESC recognises that no single measure can solve alcohol related harm.

5.9 The EESC believes that efficient enforcement of regulation governing the availability, distribution and promotion of alcohol is needed. Self-regulation in this area is part of the solution, but in itself not sufficient. Restrictions on sales below cost and on sales promotions should be possible without being trade restrictive or in contravention with EU law.

6. Children in focus – specifically foetal alcohol spectrum disorder and children in families

6.1 The destiny of Europe depends on a healthy and productive population. The evidence that a higher proportion of the disease burden from harmful and hazardous alcohol consumption is experienced by young people is therefore of grave concern to the EESC .
6.2 The Commission recognises that children have a right to effective protection against economic exploitation and all forms of abuse . The EESC strongly supports this position.

6.3 The EESC notes that harmful and hazardous alcohol consumption impacts negatively not only on the drinker but on people other than the drinker, especially in relation to accidents, injuries and violence. In families, the EESC recognises that the most vulnerable group at risk are children.

6.4 It is estimated that 5 to 9 million children in families are adversely affected by alcohol, that alcohol is a contributing factor in 16% of cases of child abuse and neglect, as well as contributing to an estimated 60 000 underweight births each year . Further negative effects for children include poverty and social exclusion, which can affect their health, education and well-being both now and in the future.

6.5 Domestic violence, a serious problem in many countries , is strongly linked to problems of heavy drinking by the perpetrator . While domestic violence can occur in the absence of alcohol, heavy drinking can contribute to violence among some people. A reduction in heavy drinking benefits the victims and perpetrators of violence, and the children living in such families.

6.6 Alcohol can affect children even before they are born. Foetal alcohol spectrum disorder (FASD) describes a continuum of permanent birth defects (physical, behavioural and cognitive) caused by maternal consumption of alcohol during pregnancy.

6.7 Awareness about FASD and its effects is low. Disseminating evidence-based examples of preventive programmes to reduce alcohol harm during pregnancy is critical. The EESC supports the use of targeted EU and national Government campaigns to raise awareness about the risk of FASD.

7. The effects of harmful alcohol consumption on healthy and dignified ageing

7.1 Older people are more sensitive to the effects of alcohol. Specific problems include balance and risk of falling and the onset of health problems that can make older people more susceptible to alcohol. About a third of older people develop drinking problems for the first time in later life, often due to bereavement, physical ill-health, difficulty getting around and social isolation .

7.2 Harmful alcohol consumption can affect older people’s mental health in the form of: anxiety, depression and confusion.

7.3 Alcohol Use Disorders are common among older people, particularly among males who are socially isolated, and living alone . Problematic alcohol use is associated with widespread impairments in physical, psychological, social and cognitive health. Around 3% of those over 65 years suffer from these disorders , though many cases may go undetected as diagnostic criteria and screening are directed at younger adults. However, treating older people for alcohol problems is often easier than treating younger adults.

7.4 Alcohol can add to the effects of some medications, and reduce the effects of others. Raising awareness among care professionals, informal carers and older citizens of potential interaction between medication and alcohol is important.

7.5 The EESC believes that more needs to be done to address the wellbeing of the ageing population in the EU, including information about the effects of harmful alcohol consumption on healthy and dignified ageing at an EU level.

Brussels, 30 September 2009.

The President
of the
European Economic and Social Committee

Mario Sepi