HSE failures put children at risk, says report

The HSE did not always formally notify gardaí of cases where children may have been physically or sexually abused, a report published by the health watchdog has claimed.

The Health Information and Quality Authority (Hiqa) report, An Inspection of the HSE Child Protection and Welfare Service in the Carlow/Kilkenny Local Health Area, found that while overall services for children were safe, there was a litany of shortcomings that could place vulnerable children at risk.

Yesterday, Epic (Empowering People in Care) said the report, the first under new powers available to Hiqa, was “alarming” and “very concerning”.

The report found:

- In some cases, social workers waited for confirmation of abuse before notifying gardaí, with inspectors concerned “this could hinder a Garda investigation and present a risk to children as information might not be shared at a critical early stage”;

- Some referrals remained on a “duty list” and were not prioritised, with the risk some children would be overlooked;

- Hospital staff told inspectors that referrals about child welfare were thrust back to them in acknowledgement letters;

- There was a waiting list for assessments, including initial assessments, of some children with 178 referrals on a duty list in cases where the risk potential was unknown;

- Of 1,156 referrals, 644 were recommended for assessment of which fewer than half were carried out. Only 56 were completed within the recommended timeframe;

- The area’s child protection notification system (CPNS) did not comply with Children First guidelines and had omissions, such as only two of three children in one family listed on the system;

- The system had not been updated for almost two months at the time of the inspection and was not available on a 24-hour basis;

- Of 87 children on the CPNS, there was no system to determine which of those cases needed to be reviewed;

- Not all children had allocated social workers;

- Not all serious incidents were reported in a timely manner to the HSE’s national office — one case was not referred due to “an oversight”;

- Staff files needed updating and 40% of staff files audited did not contain the requisite garda vetting;

- The information dataset in the area was incomplete on two occasions.

Across 27 separate standards grouped under six themes, 18 were “met in part” while nine were “not met”.

Jennifer Gargan, Epic director, said of the report: “I think it is very worrying. When you get into the detail it is quite alarming. It does raise questions if this is happening in other areas.”

She said numerous reports had shown how children can “fall through the cracks” and said the “same issues” kept coming up, namely “around practice and a failure to learn lessons”.

In response to the failings and shortcomings, the HSE has set deadlines for changes to be implemented in the local health area. Some of the issues should already have been addressed while the deadline for others are coming up in June and July.

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