Brian Cowen famously described the Department of Health as Angola, which makes you wonder what country child and family services represents.
Traditionally, it has had a shortage of resources, it has typically been either misunderstood or ignored, it has sparked horror stories, and sometimes the information linked to it has been a little unreliable. Could it be North Korea?
Jokes aside, it’s been rough terrain. Gordon Jeyes brought his smooth Scottish burr to the post of National Director of Child and Family Services within the HSE three years ago and has now moved to the position of head of the new Child and Family Agency. The buck now stops with him, and while he is a consummate media performer, it’s perhaps not surprising that he bristles a little when queried about the shortcomings — perceived or otherwise — in a system that many people believe is still in need of serious repair.
He says the current 17 secure care places are now “working well within the constraints that we have” and that changes in infrastructure and legislation would improve the situation further. Yet the numbers still cause him some aggravation. Just prior to Christmas, Senator Jillian Van Turnhout claimed that there were 16 children awaiting a secure care place. This came just weeks after the HSE announced it was going to close Rath na nÓg, a high support centre in Co Monaghan. The announcement coincided with the publication of a severely critical report on Rath na nÓg by the Health Information and Quality Authority (HIQA).
Gordon Jeyes says now that the decision to close the facility had already been taken as the failings in Rath na nÓg had already become apparent to him and other senior personnel in child and family services. Yet — directly or indirectly — he also came in for some criticism when inspectors decried the decision to lock the doors of the centre at night, and in the view of HIQA create a potential fire hazard.
The report also prompted grumblings from people working in the system that if the children in Rath na nÓg were so difficult to handle, they should really have been in secure care. In other words, you could add those children to the others on the waiting list — except according to the CFA chief executive, there is no real waiting list.
“I think the number is about right... and I think it would be dangerous to be planning on the basis of locking more children up,” he says. “Some of those in the so-called figures you are counting are already in remand. I think that we need a more holistic approach in order that we have a more seamless service for all children who have for their own good, a brief period where they are deprived of their liberty.”
While drawing a distinction between those in secure care and those on remand — welfare versus criminal — later on, he says that it is a “lottery” which side of the line some children happen to land. “A personal view, as opposed to a chief executive’s perspective, is that should be much more seamless,” he says. “I think that the detention schools should be directly within this agency, I think it is a lottery that the distinction between whether or not young people are getting support as a consequence of the criminal justice system or the child welfare system, it’s the same young people, so if we distinguish as we are trying to do at the moment, between their needs, which is our side of the house, and their deeds the justice side of the house, we are not meeting all of their needs.”
It’s not his only vision.
“This is a bit more radical and personal,” he begins. “I think the age of criminal responsibility should be 18. Now, I can just hear the shock, horror across the country, and clearly for very serious crimes — murder, rape, aggravated assault and those sort of things — you would exempt those, but the argument is always put that we don’t want them going through the criminal justice system because it gives them a criminal record. There is an easy answer to that: for a whole list of offences, small, petty offences, growing up offences, at 18, you wipe the slate clean. If they don’t have a full set of rights they shouldn’t have the full set of responsibilities. We should have a holistic approach where needs and deeds are dealt with together.”
When it comes to infrastructure, the proposed doubling of the number of secure care places is essential. “Is 17 [places] sufficient? Obviously I don’t think so, that’s why we are planning to expand, and by the beginning of 2016 we will have twice as many places.”
Referring to recommendations by the London-based Potential Organisation in a report carried out for the HSE in 2012, he says the system should have a single admission system “with many exit points”, adding that the presence of ACTS (Assessment, Consultative and Therapeutic Service) teams in the care system “has made a big difference”.
Ensuring a broader range of skills within the staff detailed to the units and trimming the massive legal costs associated with secure care and high support placements — including those that send children overseas — are among the agency’s other priorities.
“I am confident we can substantially reduce legal costs but it’s not going to happen overnight,” he says. “For the first time, in 2014 as an independent legal entity, we are responsible for our own legal costs. There was a flaw, and HSE recognises that, in the previous design, where throughout the HSE people spent the money — we all like spending other people’s money, and therefore the budgetary control was not what it should be.”
He believes the child care system was “too reactive” to the courts, creating a vacuum that was filled by lawyers. “Until fairly recently, there was a perceived lack of leadership and clarity around children’s services.
“The system became far too adversarial,” he continues. “Lawyers move in and it becomes a technical discussion.” The need for “fundamental system design” incorporates plans for greater use of mediation and arbitration. The CFA does not currently have a head of legal services so they are taking a more hands-on role when it comes to writing the cheques.
One recent example surprised him: a difficult but uncontested case in which the guardian ad litem — the person designated to represent the voice of the child in legal proceedings — had employed a solicitor and a senior counsel.
“In an uncontested case,” he booms, with obvious exasperation. “We are really engaged at the moment in mutually assured destruction. You bring out three big lawyers, I’ll bring out four and we’ll face each other down. Other than the most extreme, difficult circumstances, I will not use SC in district court.”
On overseas placements, most Irish children are currently in St Andrew’s Healthcare in Northampton, a mental health facility that is regularly touted as providing the kind of advanced services that are unavailable in this country. “It is already public knowledge that the mental health services for adolescents in this country needed to be developed,” he says. “When I arrived here first, to my shock and horror, in two thirds of the country, child and adolescent mental health teams would not take 16 and 17 year olds, considering them adults, and adult teams would not take them, considering them children. That is no longer the case.”
That’s one positive change, but it’s obvious he would like to see more. He says on more than one occasion that mental health “is not my area”, but you get the feeling that while it might not be his area, he would like more input. Mental health is quite obviously central to those cases which are deemed so severe they must be dispatched to a facility in the English midlands. It also prompts questions as to why certain locations overseas seem to be in vogue, and others fall out of fashion. For example, five years ago a facility called Hasela Gotland, on a Swedish island, was being used by the HSE. A newspaper article by SC Emer Woodfull, outlined both its high success rate and its relatively inexpensive cost. So why isn’t it being used now?
“There was consideration given at one time as to whether we should take a commissioning approach to places abroad because of the point you have made,” he says, “but to formalise arrangements was thought of as almost institutionalising it and being counter-productive to planned expansion [in the domestic system]. So to that extent it is on a case-by-case basis.”
Kibble, outside Glasgow, features in these pages, as does Boys Town in America. Mention of the latter doesn’t go down too well. “I don’t like the model in Boys Town and I think we happen to be an island so we talk about going overseas, but it’s one thing to be going into the neighbouring country, it’s another thing to be going four and a half thousands miles [away],” he says.
“I don’t want to start touting around Europe for the cheapest, most effective place,” he says. “I think we should be relying on ourselves and where that is not possible, our nearest neighbours.”
Yes, there are aftercare responsibilities to young people who have been on an overseas placement and who, on turning 18 return to that country, he says, and yes, the system here will be improved.
And no, he was not wrong to back the decision — a decision not initially taken by him, he says — to lock the doors of Rath na nÓg last year, a move which drew opprobrium from HIQA. “There is a lot of misunderstanding,” he says, pointing out that three staff had been paid at the facility to keep watch all night, every night, with neither bedroom doors nor corridor doors locked. “If our own children are misbehaving, we ground them, don’t we?
“The fundamental right of the child is to be safe and protected and that overrides their right to wander freely. As their corporate parent, it is not an unreasonable expectation for me to expect my children to be in bed at night, from 10 til 8 in the morning.”
As for the Irish children still residing overseas, that will change, he says — but not immediately.
“The vast majority of Irish young people should be able to get the services they require in Ireland. I envisage we will get to that point in the next few years, there will always be exceptions to that [effect] because we are quite a small country.”
Probably not North Korea, then, but whatever the country, regime change can be a slow process.
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