Urgent need for overhaul of services

TODAY’S report on the staggering cost of keeping a single child in residential care under “special arrangements” is particularly disturbing because many State residential care centres, built at enormous expense, are half-empty.

No less worrying is the revelation that the use of “special arrangements” contravenes the recommendations of the Irish Social Services Inspectorate (ISSI), the national body responsible for inspecting State residential childcare centres.

Incredibly, the ISSI cannot inspect private facilities contracted to health boards to provide special care for children. But despite repeated calls to give the inspectorate teeth by putting it on a statutory footing, it remains largely an administrative body.

The nationwide investigation by the Irish Examiner found the country’s health boards are paying between €10,000 and €20,000 a week to fund the care of individual children whose needs are not being met in the mainstream system.

In many instances, they have emotional and behavioural difficulties resulting from trauma, neglect or deprivation.

At a time when regional health boards are facing radical reform, there is a glaring need to overhaul the State childcare service. The key question is whether the existing system is capable of delivering the best results either for the children, the workers who care for them, or the taxpayer who foots the bill.

Overall, health boards are forking out a whopping €85 million a year to fund special residential care of fewer than 600 children. Yet an expert in the field says two high support and one special care unit in the eastern region are never full.

It is hard to disagree with the contention that if the system was working properly, there would be no need for “special arrangements”. Bluntly put, children should be cared for in costly State units which are chronically under-used.

The unavoidable conclusion, spelled out by the ISSI, is that a clear need exists for a full review of the special care service for which health boards are paying through the nose.

The primary concern of the inspectorate is for the children in care and especially the risk of the system being misused.

Thus, in individual cases where the care of a child is handed over to private companies, it is absolutely essential to ensure they operate to the same high standards expected from residential services run by the health boards.

One of the biggest problems arising from the regime of “special” care is that, apart from having contact with staff, the child is effectively alone. Obviously, when it comes to developing normal relationships, that scenario cannot be helpful to say the least.

Lack of adequately trained staff is yet another critical problem. If anything, instead of getting better, that situation is deteriorating. For three years, the number of staff with recognised qualifications has continued to fall. Only one in five staff members now has the level of training demanded by the Department of Health.

Making a bad situation worse, almost half of all staff involved in childcare are unqualified for the challenge of working with emotionally disturbed children.

The Coalition should stop sitting on its hands, put the ISSI on a statutory footing, and implement the major Government report on professionalism in social care which is gathering dust on a department shelf.