When the interests of service providers take precedence over the rights and needs of their clients, public trust is undermined. This divergence in priorities took dramatic form in the CervicalCheck scandal. But its effects on the lives of vulnerable adolescents, as outlined in successive reports by the Ombudsman for Children Niall Muldoon, have yet to be addressed.
Muldoon's frustration over the sub-standard services being provided by the HSE to suicidal children comes though in his annual report. He itemises a shortfall in the number of consultant psychiatrists; the persistence of nine-to-five service contracts and an absence of out-of-hours emergency care in seven counties. Poor administration is not confined to medical care. An Oireachtas committee was told on Wednesday that psychiatric services in Wexford and Waterford would be withdrawn because of resignations arising from unsafe working conditions and outdated buildings.
Mental health services have traditionally been treated as a poor relation in terms of HSE funding. Recently, the agency focused on providing suicidal care for adults in acute hospitals, with a promise to eventually include children under 16. The inadequacy of this response is clear from the fact that the Ombudsman received 57 complaints involving poor care for suicidal children. The majority of child protection and welfare complaints, however, related to waiting times for psychological and speech and language services.
The failure of State agencies, Tusla and the HSE, to adequately consider the best interests of children in making and implementing policy decisions, was a criticism in the report. And while the Ombudsman called for greater co-operation between the agencies, without ministerial and political pressure administrative boundaries are unlikely to give way to child-centred objectives.
Last year, the Ombudsman was allowed to examine the treatment of children in 27 direct-provision and in three emergency reception and orientation centres. His findings were unsurprising. He expressed concern about the financial hardship facing asylum-seeking families on a meagre State allowance and the adverse impact such inappropriate environments have on children. There was, he believed, a reluctance by asylum seekers to complain, lest they be transferred to another centre or face worse living conditions. An absence of statutory regulations on how such centres should operate; a lack of inspection regimes and variations in the quality of care and accommodation were all criticised.
Additional funding will be required for child-related health services. More importantly, however, priority must be given to the needs of service recipients, rather than to the demands of administrators.