Answering it requires negotiating a maze of personnel, procedures, offices and oversight agencies that is at times so confusing, it is almost understandable that Tracey got lost in the mix.
The first on the scene when concerns about a child’s welfare are raised with the Health Service Executive is a social worker, followed by a duty team leader, a principal social worker and, where the child is deemed in need of intervention, a childcare manager.
At this stage, the child gets a designated social worker who will ideally remain constant throughout their engagement with the HSE, although heavy workloads, retirements, resignations, illness and other absences mean in reality social workers change over time.
The team devises a strategy to protect and support the child at home if possible but if concerns continue or increase, they may seek a court order to take the child into care – usually with extended family members, foster families, residential care homes or a series of all three.
If none of these work and the child is deemed at very serious risk, the team takes the last resort step of applying for a placement in a secure setting – a locked facility.
The application is made to the National Special Care Admission and Discharge Committee, which assesses the individual case and the availability of placements. Applications are also referred to the Children Acts Advisory Board (CAAB) for an independent view.
The CAAB, formerly the Special Residential Services Board, was only set up in 2007, but last month it was subsumed it into the Office for the Minister for Children. It is not clear yet if the change will affect its functions.
Once the application is approved and a place is found in a secure unit – which are very scarce – the social work team goes to court to seek approval to place the child there. Their day-to-day care is then the responsibility of the unit staff although the social worker stays in touch.
HIQA, the health standards and inspection body, has responsibility for inspecting the units.
If concerns about a child continue long term, or escalate, a case review panel may convene in the child’s local health area to see what more can be done.
If the team needs more resources – for specialist therapy or a placement abroad for example – they need the backing of their local health manager who is answerable to a general manager who reports to one of the country’s four regional directors of operations.
They report to the HSE’s national office where Aidan Waterstone is head of alternative care services, reporting to Phil Garland, the assistant national director for children and families.
Phil Garland reports to Laverne McGuinness, one of the HSE’s two national directors of the Integrated Services Directorate, who in turn reports to chief executive, Brendan Drumm.
Minister for Children Barry Andrews has a child welfare and protection policy unit, which is responsible for policy and legislation and for monitoring the HSE’s implementation of policy.
The question that remains is how so many people in so many agencies with so many powers still failed to protect one child.