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Dáil
‹ Leaders’ Questions.

Child protection and out-of-hours services

Summary

Ó Caoláin called for an inquiry into the Monageer tragedy and better-resourced social work and family-support services, including round-the-clock provision. The Taoiseach said an independent inquiry was agreed in principle and described work on a comprehensive out-of-hours service for children and families.

I join with other Members in extending my deepest sympathy to all those who have been bereaved by the tragedy in Monageer, County Wexford. The deaths of two young children and their mother and father represent an appalling tragedy. We offer our deepest condolences to all the bereaved, and especially the members of the Dunne and O'Brien families, on their great loss. We have to state very clearly that there are lessons to be learned from this tragedy and that it must result in action being taken. Each and every one of us must take on board the fact that people may be at risk in every community throughout the length and breadth of this State. Unless the required interventions are made, we will see tragic repeats of the events at Monageer.

Does the Taoiseach agree that a full and vigorous investigation is now needed and that such an investigation must incorporate a full examination of the role, responsibilities and responses of the Garda and the Health Service Executive? Does he acknowledge that the tragedy raises serious questions about the lack of resources for addressing mental health, suicide prevention and all the situations involving family and personal emergencies which can arise in our communities?

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Rory O'Hanlon An Ceann Comhairle Fianna Fáil

The Deputy's time has concluded.

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I am informed by people who have worked in the area of child protection that, because of an insufficiency of resources, they and their colleagues in social work teams have often been limited to fire-fighting responses when cases are referred to them. Is the Taoiseach aware that many professionals within social care teams who are doing support work under the aegis of the HSE have to prioritise on the basis of a weighed assessment of the cases that present and the queues for a response? Social workers are frequently in a position to respond urgently only where cases appear to be of an emergency nature. Unless trained professional assessments are properly available in every area, that apparent emergency requirement can easily be missed, understated or unnoticed, with often tragic results. What resources will the Taoiseach commit in terms of investing in mental health care and suicide prevention and to address the crises that can present for individuals and families——

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Rory O'Hanlon An Ceann Comhairle Fianna Fáil

I ask the Deputy to give way to the Taoiseach.

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——particularly in the type of case that has demonstrated such tragic consequences over the past several days?

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Deputy Ó Caoláin asked me a number of questions and it will be impossible to answer all of them. As I said earlier, I offer my profound sympathies at this terrible time to the community and to those who are directly related to Adrian and Ciara Dunne.

We discussed the tragedy this morning and agreed in principle to set up an independent inquiry to examine the full circumstances of this case. The nature and terms of reference of that inquiry will be decided as soon as the facts of the events have been established. The Minister of State at the Office of the Minister for Children, Deputy Brian Lenihan, has sought a report from the Health Service Executive and a meeting will take place later today between the Office of the Minister and the HSE. In so far as the Garda Síochána is concerned, the Garda Commissioner has appointed a senior officer from outside the area to investigate the circumstances surrounding the tragedy from its point of view. We should allow both these investigations to be conducted and take care that we do not rush to judgment about the case with the luxury of hindsight and in the absence of all the information. I do not want to add to the grief of the families and the communities involved by going into the details of a situation on which the information is incomplete.

We know from the HSE's preliminary report that as late as midday on Friday a public health nurse visited the family for a routine development check-up of the children and had no concerns regarding the family. The HSE has also stated that it had no child protection concerns in respect of the family. I do not want to comment any further until the facts are fully known.

On the broader question asked by Deputy Ó Caoláin with regard to the appropriate level of child welfare generally, the HSE's primary aim is to provide child welfare and protection services within the family context, with the option of taking children into care considered as a last resort. The circumstances of each individual case are investigated with the aim of providing the necessary support and care at any given time. The question of appropriate levels of intervention in families where concerns about risks are expressed is extremely complex and difficult. Over the past year or two, we have debated that issue in this House in regard to other cases. In the case under discussion, the HSE has provided a counselling service.

Many other issues arise in regard to the wider question. These include issues that have arisen in other cases, in respect of which a working group is almost finished its report. There has been a large increase in staffing levels in these areas. Issues also arise with regard to out-of-hours services and in other areas which I may address later.

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Does the Taoiseach not agree that social work of this kind cannot be organised and offered only on a nine-to-five basis? Is it not apparent from this and, indeed, the series of similar tragedies which have brought dark clouds over communities throughout this State that we need 24-seven cover throughout the areas of mental health and suicide prevention? This need has been expressed repeatedly. Does the Taoiseach agree that social work and family support teams must be fully resourced in terms of staffing and other facilities? What is he prepared to say this afternoon to confirm that he and this outgoing Government are going to do exactly that?

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Rory O'Hanlon An Ceann Comhairle Fianna Fáil

The Deputy's time has concluded.

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Over the past several months, I have heard from colleagues in various parts of the country. My colleague, the Wexford councillor, John Dwyer, and others have raised the issue of the absence of supports in their respective communities where cases such as this have arisen. They have highlighted it repeatedly, and that is on the record, yet here is another situation where the agencies entrusted to respond did not, on the evidence presented, act as they could and should have done.

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Rory O'Hanlon An Ceann Comhairle Fianna Fáil

The Deputy's time is concluded.

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There is a bounden duty to ensure that the agencies covered by the Children First guidelines, including the Garda Síochána, the Health Service Executive, schools and voluntary and youth work organisations, are resourced sufficiently to fulfil the role they must carry out. What is the Taoiseach prepared to do to ensure that this essential and very important area is properly resourced?

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Last year there was a lengthy series of discussions between the HSE and the Office of the Minister for Children and the national working group to review the recommendations on the provision of out-of-hours child care services. The issue was examined on a national basis. The working group, which comprises the HSE, the Garda Síochána and Focus Ireland, reported on a comprehensive out-of-hours service for children and families. It has been developing a new model. Under the Child Care Act the Garda has a role and there are protocols. I understand that there is a protocol in force in Wexford but not every area has one. That model has been developed.

On the second issue of what we are doing, we all know that suicide is a very serious social problem. Reach Out, the national strategy for action on suicide prevention, has developed four levels of action in recent years: a general population approach, a targeted approach, responding to suicide and information research. The National Office for Suicide Prevention oversees implementation of that strategy, co-ordinates suicide prevention activities across the State and does very good work. Suicide prevention is an integral part of mental health and primary care services, and general practitioners play a key role in that. Effective action to prevent suicidal behaviour requires the involvement and collaboration not only of GPs, but also mental health professionals such as psychiatrists, psychologists, nurses and social workers. They are all involved with vulnerable people.

Last year, over €26 million was provided to develop mental health services in line with A Vision for Change, the report of the expert group on mental health policy. A further €25 million was allocated this year to continue that development and funding was allocated specifically for prevention initiatives and research. Money was also made available to develop a national training programme to complete the availability of self-harm services through accident and emergency departments and to implement the national positive mental health awareness programme. In light of the increased information in recent years, interim targets have been set for a reduction in the number of suicides across the State among people involved in self-harm programmes.

Such efforts do not always prevent problems and in this case, as in others, we must consider precisely what happened, if there were shortfalls, what were they and if something was missed, why was that the case? All that must be taken into account in an examination of the matter. I am pointing out what is being done and resources are being invested to make things happen. I agree with the Deputy on the out-of-hours issue. It is self-evident that these services should be provided not only on a 9 a.m. to 5 p.m. basis. That is an issue of negotiation in building a new model.

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