Child development checks being missed

Vital childhood developmental checks are slipping through the cracks as public health nurses struggle to cope with an increasing clinical case load, it has emerged.

The Oireachtas committee on health and children heard a strong argument yesterday for a dedicated child health workforce from the head of the Institute of Community Health Nurses.

Institute director Mary O’Dowd said there was evidence that routine childhood screenings were getting lost through the cracks due to a 25% rise in the clinical caseload of public health nurses in the last three years.

“The clinical caseload has increased with more people receiving nursing care at home. That is how it should be, but we also need to invest in child health services.

“At the moment we do everything from the cradle to the grave, so it is very difficult to meet all the requirements of the care groups. If we are to deliver really good child health services on time, we need a dedicated child health workforce to do that.”

Ms O’Dowd said gaps and challenges remained in the implementation of Best Health for Children, a programme that was first published in 1999 and revisited in 2005.

“This programme sets out a clear evidence-based health programme for preschool and primary school children,” she said.

However, a HSE performance report published in December showed a variation of between 38% and 100% of children who received their seven-to-nine month screening on time.

She said recommendations made in 2005 for school health screening were not uniformly implemented. There are no national key performance indicators relating to the delivery of the school health nursing service.

Ms O’Dowd said there was a need for designated school health teams for screening, health, wellbeing, surveillance, and promotion: “Every child has a right to be afforded a high-quality, equitable community health nursing service. There are many children in the community who require specialised care and have difficulty accessing services.”

However, despite the variations highlighted in previous reports, many inequities still remained in the quality of the service.

HSE regional director of Operations West, Integrated Services Directorate, John Hennessy, said there were just over 2,000 public health nurses.

He said 70 public health nurses and 37 registered general nurses would be recruited to primary care teams in a number of areas under the 2013 service plan to address considerable variations in ratios of healthcare professionals to populations.