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 Header Item Written Answers Nos. 200-206
 Header Item Health Services Provision
 Header Item Child Care Services Regulation
 Header Item Child Protection Issues
 Header Item Mental Health Services Provision
 Header Item Medical Aids and Appliances Provision
 Header Item Orthodontic Services Provision

Wednesday, 12 June 2013

Dáil Éireann Debate
Vol. 806 No. 2

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Written Answers Nos. 200-206

Health Services Provision

 200. Deputy Thomas P. Broughan Information on Thomas P. Broughan Zoom on Thomas P. Broughan asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if she will report on her Department's progress in establishing the National Assessment Consultation and Therapy Service; and if she will make a statement on the matter. [28346/13]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald I have requested the information from the HSE and I will revert to the Deputy when this information is to hand.

Child Care Services Regulation

 201. Deputy Willie Penrose Information on Willie Penrose Zoom on Willie Penrose asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if she will outline the changes she is proposing for the regulation of child care provided here including the reform of the inspection system, the linkage of grants and subsidies to the quality of childcare provided, the implementation of a sanction regime and the provision of significant investment in the National Early Years Strategy; and if she will make a statement on the matter.  [28350/13]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald Under the Child Care (Preschool Services) (No 2) Regulations 2006, the inspection of preschools is the responsibility of the Health Service Executive (HSE).

  It is important to realise that inspections alone are not the answer to improving quality. What is required is a multifaceted approach, and since this Government came to office we have been working to ensure issues relating to child protection and welfare are put front and centre. The establishment of a Department of Children and Youth Affairs was recognition of the huge body of work which needs to be done in this area.

  As Minister for Children and Youth Affairs, driving the early childhood care and education quality agenda is one of my key objectives. I believe we can achieve this objective by taking a number of steps in conjunction with the Department of Education and Skills, including the adaptation of the existing preschool inspection system to provide a more comprehensive and broader-based inspection regime for preschools, moving to a greater focus on outcomes for children.

  In support of this, a Joint Pilot Inspection of Early Years Services was carried out by Inspectors from the HSE and the Department of Education and Skills between September 2011 and May 2012. This pilot will inform the proactive approach being taken.

  The Programme for Government includes a commitment to improve the quality of the free Preschool Year and, by extension, the quality of all early childhood care and education, through the implementation of standards and by reviewing training options for the workforce.

  This commitment has always been a key priority for me.

This is why my Department and I have been progressing work on Ireland’s first-ever Early Years Strategy and this why we have been working on a comprehensive   Preschool Quality Agenda.

  We have identified a number of key areas of action which I believe need to be considered and addressed as a matter of urgency. These include introducing a registration system for all preschool services; taking steps to make the inspection system more consistent and more robust; publishing inspection reports on-line as soon as possible; ensuring appropriate action is taken in response to findings of non-compliance; increasing and widening the sanctions which can be taken for non-compliance.

  Registration of all childcare providers

  Work is already underway in the Child and Family Services area of the Health Service Executive (HSE) to introduce a registration system for preschool services. I understand this system will be in place for new services from the end of this year and will be phased in for existing services thereafter. This is an important development because it will move services from the current position, where they are required to notify the Preschool Inspectorate of their intention to open, to a requirement to be inspected and found satisfactory, before being permitted to open. All preschool services are currently required to pay an annual fee to the HSE of between €40 and €80. I am looking at increasing this fee. The additional funds raised will assist in improving inspection and supports for quality improvement.

  Publication of Inspection Reports

Parents will rightly demand and expect the highest standards and this will be a key factor in driving change in the sector. Publishing inspection reports is an essential step in ensuring high standards and accountability. All new inspection reports will be made available on-line from the HSE as a matter of urgency. All current   inspection reports will be made available on-line in 2014.

  Taking steps to make the inspection system more consistent and more robust

  We are working on developing a more robust, consistent and regular inspection system There has been a significant programme of work underway in the HSE over the past year to develop a single, consistent national inspection service (as opposed to 37 different local systems).

  We propose moving to a position where there is consistent and assured national target rate for the frequency of inspection of preschool services, while ensuring capacity for prioritisation based on risk assessment.   The HSE is currently reviewing the regional spread of inspectors with a view to identifying whether either additional resources or redeployment of existing inspectors is required to achieve this.

  Building on this work, officials of my Department and the Department of Education and Skills have been examining options to incrementally develop a more comprehensive and broader-based inspection regime for preschools; moving away from a narrow focus on compliance, and leading to a greater focus on children's outcomes, including educational development and child well-being. This work is being informed by the findings of the recent Joint Pilot Inspection carried out in a small number of settings by Inspectors from the Health Service Executive and the Department of Education and Skills.

  Ensuring appropriate action is taken in response to findings of non-compliance

  We are working to ensure consistent action is taken in response to findings of non-compliance. There must be a follow-through on inspections. Clearly, services which are found to be in serious breach of the Regulations will face closure and prosecution.   It is proposed to develop a protocol with the Preschool Inspectorate which will take a calibrated approach and which will enable more decisive action to be taken in response to non-compliance.

  Increased Sanctions for non-compliance

  My Department will also be undertaking a review of the penalties currently in place for breach of the Child Care (No. 2) Regulations 2006, as provided for under the Child Care Act 1991. The review will look at increasing the range and severity of the existing penalties including the actions which can be taken by Inspectors without recourse to court prosecution, as is currently the case.

Child Protection Issues

 202. Deputy Ciara Conway Information on Ciara Conway Zoom on Ciara Conway asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if her attention has been drawn to the fact that the Reception and Integration Agency’s child protection policy is based on centre staff who are not RIA employees relaying a concern to the designated child protection staff member rather than the families communicating their concerns directly to the Health Service Executive or an independent body; and if she will make a statement on the matter. [28393/13]

 203. Deputy Ciara Conway Information on Ciara Conway Zoom on Ciara Conway asked the Minister for Children and Youth Affairs Information on Frances Fitzgerald Zoom on Frances Fitzgerald if her attention has be drawn to the circumstances whereby the vast majority of parents in direct provision do not know their children’s rights and therefore do not know when their rights are violated in accordance with Children First guidelines and that they are afraid to make referrals because they may face repercussions such as transfers from one accommodation centre to another that is equally child unfriendly; and if she will make a statement on the matter. [28394/13]

Minister for Children and Youth Affairs (Deputy Frances Fitzgerald): Information on Frances Fitzgerald Zoom on Frances Fitzgerald I propose to take Questions Nos. 202 and 203 together.

In the first instance, I would like to clarify that the Reception and Integration Agency (RIA) is a functional unit of the Irish Naturalisation and Immigration Service (INIS), a division of the Department of Justice and Equality. RIA is charged with providing accommodation and ancillary services to asylum seekers, that is, adults and their children, under the Direct Provision system while their applications for asylum are processed. I am advised that Direct Provision centres are monitored three times a year, twice by Department of Justice staff and once by an external company.

The revised Children First: National Guidance for the Protection and Welfare of Children was published in July, 2011. The Guidance deals with the recognition, reporting and management of child welfare and safety concerns. It sets out a number of key messages relating to the duty to protect children and support their welfare. The scope of Children First extends beyond the reporting of suspected neglect, abuse and welfare concerns. It emphasises the importance of multidisciplinary, inter-agency working in the management of such concerns. Key to this is the sharing of information between agencies and disciplines in the best interests of children and the need for full co-operation to ensure better outcomes. It is important to stress that Children First was never intended to set out standards for care or enumerate the rights of children in Direct Provision facilities.

The HSE has advised me that concerns about the welfare, safety or well-being of a child in Direct Provision are reported to the HSE Children and Family Services, in line with Children First. Referrals include welfare concerns such as a parent being hospitalised, parental illness, a child being left unsupervised by an adult or mental health concerns regarding the parent, while a smaller number would relate to child protection concerns.

There is a specific unit within RIA -the Child and Family Services Unit - whose role is to manage, deliver, co-ordinate, monitor and plan all matters relating to child and family services for all asylum seekers residing in the direct provision system. This unit also links, where necessary, directly with an Garda Síochána.

I would like to assure the Deputy that I have had ongoing contact with my colleague, the Minister for Justice and Law Reform and that senior officials within my Department have engaged with the HSE, to ensure that children who residing in Direct Provision are afforded the same levels of welfare and protection that their counterparts in the wider community are afforded.

Mental Health Services Provision

 204. Deputy Kevin Humphreys Information on Kevin Humphreys Zoom on Kevin Humphreys asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly his plans to reform the law and policy on involuntary psychiatric admission; if will outline any recent changes in this area; the legislation that currently applies; and if he will make a statement on the matter. [28125/13]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The legislation which governs the involuntary admission of patients to approved centres is the Mental Health Act 2001. This Act is being reviewed at present in line with the commitment contained in the Programme for Government to review the Act "informed by human rights standards and in consultation with service users, carers and other stakeholders". The Government and I attach great importance to this review.

In June 2011, I established a Steering Group to oversee the first part of the review. The terms of reference for this phase required the Steering Group to review the provisions of the Act having regard to its general operation since its commencement and to take into account the extend to which the recommendations of 'A Vision for Change' could or should be underpinned by legislation and the provisions of the UN Convention on the Rights of People with disabilities. The Interim Report of the Steering Group on the Review of the Mental Health Act 2001 was published on 21 June 2012 and is available on my Department's website (www.doh.ie). The recommendations of the Interim Review have been well received by key stakeholders and fully endorsed the rights based approach to mental health law in addition to supporting the objectives of 'A Vision for Change' especially in relation to the promotion of community based mental health services. Changes to limit the number of people detained and to improve procedures and safeguards regarding their detention were also recommended and the need to strengthen provisions relating to children was also emphasised.

In August last year, I announced the membership of an Expert Group to carry out the second and substantive phase of the review which is principally tasked with fleshing out the Steering Group recommendations. The Group is comprised of 15 people in total and includes expertise from a range of professionals and key stakeholder organisations.

The Expert Group has met on a number of occasions since its formation and is continuing its deliberations. It is expected that the review will be completed this year.

Medical Aids and Appliances Provision

 205. Deputy Tom Fleming Information on Tom Fleming Zoom on Tom Fleming asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly if he will examine the referral for orthotic shoes in respect of a person (details supplied) in County Kerry. [28127/13]

Minister of State at the Department of Health (Deputy Kathleen Lynch): Information on Kathleen Lynch Zoom on Kathleen Lynch The Health Service Executive provides health and personal services such as those referred to by the Deputy. Accordingly the Department has asked the HSE to reply directly to you in relation to the individual you have outlined.

Orthodontic Services Provision

 206. Deputy Sean Fleming Information on Seán Fleming Zoom on Seán Fleming asked the Minister for Health Information on Dr. James Reilly Zoom on Dr. James Reilly when orthodontic treatment will be approved in respect of a person (details supplied) in County Carlow; and if he will make a statement on the matter. [28141/13]

Minister of State at the Department of Health (Deputy Alex White): Information on Alex White Zoom on Alex White The HSE provides orthodontic treatment to patients based on their level of clinical need. An individual's access to orthodontic treatment is determined against a set of clinical guidelines and priority is given to patients with greatest needs. The HSE has been asked to examine the specific query raised by the Deputy and to reply to him as soon as possible.


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