Forensic medical examiners for victims of child sex abuse, who run the only specialist clinic of its kind in Ireland, have withdrawn their services.
The move comes after the doctors discovered a clause in a new contract which means the HSE will not recognise the service as a professional medical entity, the doctors said.
Galway’s exemplar service, running since 2011 with a 24-hour rota and forensic paediatric expertise, has been running on “the same contracts used for plumbers” since it was set up, said Joanne Nelson, clinical director of the Galway Child and Adolescent Sexual Assault Treatment Service (CASATS), said.
Until the most recent contract was viewed in recent weeks, all those involved were dedicated to continuing the service.
Speaking on on behalf of all four CASATS forensic medical examiners, Dr Nelson said that a “very grave deficit” in the provision of medical indemnity insurance for the examiners means the doctors cannot continue in their roles.
“Given the absolute necessity and critical importance of a CASATS service being available to child victims, and in order to protect the nature of that service from being undermined by official indifference and inadequate governance and funding, it is with the deepest regret that the specialist examiners must contemplate the cessation the delivery of these services,” Dr Nelson said.
She said children who report sexual violence require timely access to specialised forensic medical care.
“That no 24-hour service existed in Ireland prior to 2011, and that no comparable service currently exists outside of the Western area, means that very many child victims of sexual violence, including those who have experienced rape, are not accessing appropriate services.
“This is an appalling situation and one that compounds Ireland’s already poor history in responding to child victims of sexual abuse.”
Four years after a HSE commissioned report called for urgent reform, forensic services in Ireland for child sex abuse victims are extremely limited for victims under the age of 14.
Outside of Galway, there is usually no dedicated forensic examiner on call.
Dr. Nelson said her team in Galway — the CASATS was set up in 2011 to offer a 24-hour service to children in West and Mid-West Ireland — has been called to examine children out of hours from Kildare, Westmeath, Louth, Offaly, Cavan,and other areas far remote.
Within the greater Dublin area, children under 14 who have reached puberty receive a service from the adult Sexual Assault Treatment Centre.
A spokesperson for the HSE said discussions with the four CASATS medical examiners regarding an extension of their existing contracts which have been ongoing for a number of weeks.
He said an agreement to a temporary extension had been reached prior to Christmas.
“However, an email from the medical examiners to the relevant referring agencies has indicated that they are not in a position to provide this service,” he said.
“The impediments that have been cited include medical indemnity. Arrangements have been put in place to ensure that full and appropriate indemnity is provided by the HSE for any care that might arise in the short term.”
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