A little boy with profound disabilities bounced between different hospitals for more than two years because the HSE and Tusla both failed to come up with plans to facilitate his needs.
An investigation by the Ombudsman for Children’s Office (OCO) found that during this period, the boy was essentially isolated from contact with other children, rarely saw his younger sister, contracted an infection while in hospital and had to be placed in a single room.
At one point, he was returned to hospital having spent time in a children’s specialist community respite setting and "in the weeks that followed ... was crying constantly".
The report is published on Thursday by the OCO and finds the administrative actions of both the HSE and Tusla had a negative impact on the boy's life.
Jack – not his real name – is now eight-years-old but was just three when he was involved in a serious road traffic accident in another country, resulting in a brain injury and other life-changing injuries. He requires full assistance with all aspects of his daily care and responds to his mother’s voice, music and LED lighting.
In April 2017, Jack’s mother discharged him from hospital abroad and brought him back to Ireland, where he was immediately admitted to hospital. The following January, the OCO received a complaint from members of the multi-disciplinary team (MDT) in the acute paediatric hospital where Jack was an inpatient, concerned about the delays in getting services for him by the relevant HSE Disability Service, so he could leave hospital.
Jack’s mother said she was concerned she wouldn’t be able to properly look after him at home and so a referral was made to Tusla by a medical social worker, seeking its help.
Further referrals to Tusla by a medical team followed, but these were ultimately rejected by Tusla on the grounds that they were solely a matter for the HSE.
According to the OCO report: "After Jack was deemed medically ready for discharge from hospital in August 2017, he remained living between two hospitals and a specialist community respite setting for two and half years due to the failure of the HSE Disability Services and Tusla, the Child and Family Agency, to work individually and together to meet his needs.
"The OCO believes that if the HSE and Tusla had worked together at an early stage Jack may have had the opportunity, with adequate support, to grow up with his family.
Even if it was not possible for him to return home, he could have been moved sooner to a more homely environment and even gone to school."
The report also found that Jack’s eventual placement with a host family by the HSE Disability Services "was made without any legal or formal regulatory framework or proper authority".
It also highlighted "systemic failures by the HSE to provide adequate support and services to children like Jack"; there were a further 356 children with disabilities in need of a residential placement, it said.
It also said Tusla should have completed an initial assessment on Jack and his family and that the refusal to do was "unduly informed by Jack having a disability" and discriminatory.
The CEOs of the HSE and Tusla said they fully accepted the OCO recommendations and now had protocols in place to avoid any repeat situations from occurring. Tusla CEO Bernard Gloster admitted there had been "significant shortcomings" in the case.
The Ombudsman for Children, Dr Niall Muldoon, said: "Sadly, we are aware of other parents of children with disabilities who have left their children in a variety of settings such as Emergency Departments, disability respite centres and schools in a desperate attempt to force the State to provide much-needed services.
"This is profoundly wrong, particularly against the backdrop of Ireland's ratification of the United Nations Convention on the Rights of People with Disabilities in 2018."