Opening up a hidden world

IN May 2009, the Health Service Executive faxed a letter to members of its own staff advising that seven teenage boys attending school in Dublin were to be moved at short notice to alternative accommodation.

The boys, all separated children seeking asylum, were in the care of the HSE and were living in a privately-run hostel in Dublin city.

They were fifth-year students who were hoping to continue their Leaving Certificate studies in the same school. This hope was shattered with the arrival of the faxed letter, sent to HSE project workers.

The letter advised that the boys, who were no longer minors, would have to move out of Dublin, as there were no placements available in adult accommodation services.

The project workers, whose role was to work with and develop support plans to improve the boys’ lives, were not consulted about the transfer date, which was set for one week after the boys finished their fifth-year exams. They were so unhappy with the HSE’s failure to discuss the date with them that they made reference to it in 10 separate reports over a period of 10 months. This was necessary, they said, because the HSE continued to set transfer dates without reference to project workers and, ostensibly, without any regard for the boys’ educational needs.

The HSE’s disengagement from the reality of the lives of those in their care is reflected in a number of reports compiled by project workers tasked with inspecting the six Dublin hostels used to house separated children seeking asylum. For instance, in one hostel, project workers wrote about the difficulty of young mothers accessing education. “There is no funding from community welfare officers to pay for creches. The maximum the CWO could pay for a creche is €50 per week. The average fee for a creche in the Tallaght area is €165 per week. Even though most of the young mothers are enthusiastic to return to school... lack of funding placed a huge hindrance.”

In another hostel, young Iraqi boys, who had talked about suicide after their applications for asylum were rejected, were without social care workers in the hostel. Project workers frequently warned about the unsuitability of hostel accommodation for vulnerable children.

Unbelievably, none of the hostels had qualified childcare workers and very few staff had any training in Children First, the national guidelines for the welfare and protection of children. Girls in one hostel had previously been trafficked for prostitution and project workers were concerned it could happen again.

In a separate hostel, girls were permitted to attend all-night vigils in alternative Christian churches. Permission to attend one such church was withdrawn on foot of notification of child protection concerns. Initially, however, the pastor of the church had told project workers he would send a church member each month to collect some of the girls and return them once the vigil was over at 2am. “He could not give us the particular name of who would drive the girls as this would change from week to week. He agreed to contact us with the driver’s name each month. He also agreed to contact us if the girls had any problems while in his church or if they did not attend a vigil,” project workers wrote, indicating the girls were effectively in the pastor’s care once they left the hostel. Subsequently project workers wrote: “Information gathered has since queried the child protection concerns at the church. Until further clarification can be obtained, no further night vigil permissions will be granted for this church.”

When asked by the Irish Examiner why vulnerable girls were allowed attend night vigils in the first place, the HSE said it “monitors the whereabouts of all children in care (in as much as is feasibly possible) to ensure their health, safety and welfare” and it “complies with the Child Care Regulations with regard to religious upbringing of children in care”.

At the same hostel, room searches were undertaken by project workers because of a concern that some girls were involved in prostitution. A search unearthed two laptops, a mobile and a diary detailing payments to someone. Gardaí were called in. Only then were the girls in question given a social worker.

Hostels were heavy on security cameras and buzzers, but light on staff and supervision. In one hostel where girls had been trafficked, up to 18 teens were looked after by one or two staff. Inspectors repeatedly criticised the staff/child ratio but no one seemed to act upon it.

The Iraqi boys, who had spoken of feeling suicidal, had only security staff for company in the evenings, even though project workers said there was a “major need” for around-the-clock social care workers. One centre had no care staff overnight leaving “a totally inadequate level of supervision”, project workers said. It had also been left unsupervised at weekends.

Structurally, it was in poor condition: dampness was an ongoing issue, and well below acceptable health and safety standards. There was no central fire alarm. In the event of fire, staff would have to knock on doors to alert residents. Project workers repeatedly warned of the dangers of this.

It seems separated children seeking asylum — among the most vulnerable in society — were particularly poorly looked after.

One of the most depressing aspects of the reports was the sustained failure of those in charge to take any remedial action or to act in any way upon the recommendations designed to improve the children’s lives. This was despite project workers repeating on a monthly basis, in some cases for up to three years, the need for certain changes.

For example, in one complex, project workers had requested showers for individual apartments “as a matter of urgency” since March 2007, but nothing had happened. Equally depressing was the lack of social or cultural outlets for the teenagers, the reliance on the goodwill of others or on charities to fund outings, the difficulty in accessing education, the absence of study rooms or desks despite repeated requests, the daily boredom of lives.

The information gleaned from these reports is not in the public domain and was obtained by the Irish Examiner under Freedom of Information legislation.

This lack of transparency is in direct contrast to the approach taken by a second inspection body, the Health Information and Quality Authority (HIQA). It inspects HSE-run homes and publishes all of its findings.

It has done so since 1999, when it was known as the Social Services Inspectorate. The HSE, which didn’t even include the six Dublin hostels in its registration and inspection service, has never placed its reports in the public domain.

In relation to the hostels, the HSE relied on regular reports from project workers. Despite initially telling the Irish Examiner these reports were available on request from local area health offices, this proved not to be the case.

Last year, recognising the necessity of providing a public account of the service provided to children in the care of the state, Children’s Minister Barry Andrews said by the end of 2010, HIQA would have responsibility for all children’s residential care homes, and would oversee a registration and inspection process.

This would include homes for children with a disability, which, astonishingly, are not subject to inspection. However this plan was subsequently put on hold to allow HIQA first focus on inspecting the HSE’s child protection services after it highlighted deficits in the area to Mr Andrews.

The upshot is the HSE continues to inspect non-statutory child care homes and the public is no wiser as to the findings.

As per the recommendations of the Ryan Report Implementation Plan (which came in the wake of the Ryan Report, set up to investigate the abuse of children in institutions in the state), the HSE has now ended, most recently last December, its contract with the six hostels referred to in the reports.

This is in line with the introduction of a policy, Equity in Care.

However, the HSE was anxious the location of the hostels not be revealed because although minors were transferred to residential care or foster care settings, there is a worry that those now over 18 are still in the area, and may be at risk from pimps or trafficking.

A spokesperson for the HSE said there was “anecdotal evidence” to suggest youngsters may have built up support networks in the hostel areas.

The Irish Examiner also obtained a number of reports in relation to HSE-supported accommodation for homeless teens in Munster, which remain open. Despite the fact that some of these young people displayed formidable emotional and behavioural problems, not all staff had training in even the basics, that is Children First. In two homes, just one care staff was on duty at night.

In one unit, a young girl’s uncle came to pick her up, along with two other residents, to help with an attempted break-in at a business premises. In the same unit, a male was discovered being let out of the premises by a young girl having spent the night after gaining access through an upstairs window. On one occasion, the whereabouts of a young person was unknown and on other occasions, youngsters were discharged to B&Bs.

The reports released to the Irish Examiner highlight serious shortcomings in the treatment of children in state care and the failure of the HSE to fulfil its statutory duty to “promote the welfare of children in its area who are not receiving adequate care and protection”, particularly evident in its failure to register the hostels.

However, steps are under way to improve the state’s performance, particularly with the involvement of HIQA. In addition, last year saw plenty of political pressure for additional investment in this area, not least following HSE confirmation that 37 children had died in state care in the previous decade and 151 children — who had at some point been in contact with HSE child protection or social services — had died in the same timeframe.

To show how serious it is about reforming its services, the HSE appointed Gordon Jeyes as new national director of children and family services, a man with an impressive track record in children’s services in Britain. Phil Garland, appointed assistant national director the previous year, is now tasked with overseeing the implementation of Children First.

Regardless of who is in charge, there has to be greater transparency. The Government made a commitment in the Ryan Implementation Plan that all state settings in which children are cared for should be inspected and Mr Andrews made the point that the value of inspection was “dependent on the degree to which recommendations are implemented”. However, without publication of all inspection reports, the public at large remains largely in the dark as to whether recommendations are acted upon.

In the meantime, a decade after its publication, the vision of the National Children’s Strategy remains just that ... a vision: “An Ireland... where all children are cherished and supported by family and the wider society; where they enjoy a fulfilling childhood and realise their potential.”