Health watchdog says child care is dictated by cost

THE care of troubled children is being decided on the basis of cost rather than what is in their best interests, according to the authority responsible for standards in the health service.

The Health Information and Quality Authority (HIQA) said in its annual report that children under the age of 12 were being kept in residential centres, something it says is inappropriate.

The main reason for this was to save money, it said.

“The placement of children aged 12 and under in residential centres did not reflect best practice,” it said.

“Decisions to seek a residential placement for many of the children were strongly influenced by limited resources rather than consideration of each child’s best interest.

“There was retrospective justification by some social workers and their managers whereby children were believed to be well placed even though residential care was not the initially preferred option,” it added.

HIQA was summarising a number of reports published by the Social Services Inspectorate (SSI) in the past year. These had looked at the care provided at community care centres, special care units, foster homes and State-run residential centres.

HIQA said the Health Service Executive had to act on the recommendations of the SSI to gather complete information on each individual child and ensure they are getting the most appropriate setting.

It made its comments in its first annual report since it was established by Health Minister Mary Harney in May 2007.

The report revealed that in its first six-and-a-half months the authority spent €5.6 million, 40% on staff costs.

In a busy first year it was called on to investigate two cancer misdiagnosis scandals and it produced reports on these last spring.

Chairman Pat McGrath said in areas of childcare services, hospital hygiene and cancer care it had made its presence felt.

“Over the period of this report, the authority has already commenced two major investigations into the provision of care to patients, two health technology assessments, completed the National Quality Standards for residential care settings for older people and undertaken and published a report into the care of children aged 12 and under,” he said.

The report also discusses other areas where it hopes to see improvement, including communication within the medical services, and it is working to standardise terminology among practitioners to minimise misunderstanding between people reviewing patient files.

The report said that after the authority spent 2007 assessing how information is shared and gathered within the health services, it will be looking to see improvements in the future.

“Timely, accurate and comprehensive information on the availability, accessibility, effectiveness and efficiency of our health services is fundamental to a reliable and safe healthcare system.

“Having good information and using it well are key to good decision-making, ultimately leading to improved services,” it said.


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