Thursday, 17 December 1981
Seanad Eireann Debate
Mrs. G. Hussey: In raising this matter of child abuse on the Adjournment I do so fully aware to the fact that for many years the care and attention of society in general towards the children of the nation has been defective. This has led to a great deal being written and spoken in recent years, culminating in the report of the Task Force on Child Care Services.
Perhaps unfortunately, there has been an impression abroad that a great deal of talk and a great volume of documentation amount to action. This is a common confusion which, perhaps, may have  arisen in the question of child care. It is obvious why I consider this matter of public concern and suitable for early raising in this House. The country read with enormous shock, and indeed an amount of anger, of a particularly tragic case recently which involved the short and very brutalised life of an innocent baby. It is natural that this kind of affront to the normal loving care which is children's right should give rise to such anger and, indeed one might use the word anguish, if the reaction of many people who contacted me is to be described accurately.
It is very important, therefore, that we should look at the question of physical child abuse. It is, alas, a feature of family life which is especially horrible to us but it is part of a general malaise in a family caused by a great many stress-related factors. There are a great many other areas which might be described as child abuse also, such as emotional deprivation and other forms of neglect. But in this instance we are concentrating on physical child abuse. Part of the revulsion which is felt at the recent tragedy stems not only from the deed itself but from an almost subconscious realisation that many so-called normal people — and I suppose most of us would consider ourselves normal people — might, in some circumstances, be counted among the numbers of child abusers. There is a line between so-called normal physical chastisement and excessive punishment which amounts to abuse. That line can be blurred quite easily and tragically and this could happen quite quickly. In passing, let me say that a major step forward was made by the abolition of corporal punishment in schools.
Child abuse is a matter of great concern and people are asking as a result of the recent case how one can prevent such a thing happening again. No matter how much we strive there will be tragedies of this nature — we will never manage to eliminate this kind of tragedy totally — but we must continually strive towards a situation where such tragedies will be minimised. It has been said to me by experienced people in this field that the only way in which we could ensure that  no parent would ever inflict such gross abuse on a child would be to remove thousands of children from thousands of homes in Ireland where clear indications of grave risk exist. It may seem an enormity to say this but it seems to be the only solution to the problem of so many children in Irish society. There is no doubt that there are a great many families at risk.
Dr. Paul McQuaid and Imelda McCarthy published a document in the Irish Journal of Medical Science in January 1981. In it they identified certain families that are at risk, for example, families where there is marital and social instability, where there is a history of maternal psychiatric treatment, where there is paternal unemployment, where there are criminal or prison records, where there is a high rate of general mobility. All of these factors are distinguishing features of the families of injured children. At a later point in that document they talk about marital instability leading to separation, psychiatric disorders, higher rates of unemployment, instability and lack of cohesion in the life style of battering families. They are recognisable features which seem to be present in far too great numbers.
In 1977, the Department of Health issued a memorandum on non-accidental injury to children. That phrase “non-accidental injury” always strikes me as being particularly chilling. The Department of Health issued this memorandum as a result of a great deal of pressure and publicity mounted by north Dublin Social workers and the ISPCC. This memorandum amounts to guidance for health personnel and health agencies on the identification, management and prevention of this problem. It sets out to try to tackle the whole area.
At this point I would ask the Minister if she is satisfied that these guidelines, which seem to be excellent in themselves, are being observed fully and if she will assure the House that an investigation into their operation will be carried out immediately if she is not satisfied.
Dr. McQuaid and Dr. McCarthy also point out that there is no official research being undertaken into the whole area of  non-accidental injury to children. They call for a national epidemiological research programme which, in layman's language, means a research programme into this feature.
I would like to turn to the Task Force on Child Care Services. This task force included in their report a section on non-accidental injury which they very firmly placed as part of the general area of deprivation of children. In treating non-accidental injury to children they laid great stress on a new structure of child care authorities in each health board area which would deliver and coordinate the services presently available at local level and emphasised that this co-ordination is obviously vital. The report stressed continually the role of a new body, the Child Care Authority, in their observations on this section; that the emphasis must be on helpful accessible approach: that parents in families at risk would see a child care authority as being helpful, as being a body which the family could approach before the stress factors became so acute as to result in non-accidental injury or other form of gross neglect.
It worries me that there should be a rather Pavlovian reaction to tragedies like this. It seems that people wish to assuage a certain guilt, which we all must feel when something like this happens, by trying to find a scapegoat or scapegoats. We must be extremely careful in our approach to a problem like this which will not be solved by simply dumping a general guilt on to a particular section. Social workers should not be asked to carry the burden of society's responsibilities towards neglected or under-privileged families.
It is important that the Minister tell us at what point her deliberations are on the implementation of the recommendations of the Task Force on Child Care Services. It is relevant at this point to refer to a document published by Dr. Charles Mollan on 13 August entitled The Welfare of Children. Dr. Mollan is a well known, concerned expert person in this whole field. What he says places a burden of responsibility on the Minister and indeed on all of us on this side of the House. He  says that for the first time a Government in Ireland have come into power with a significant part of their programme devoted to the welfare of children and to improvements in the law and services for them and have a mandate from the electorate to improve the position of children in Ireland. That is, in one way, a glowing tribute. In another way it places a great deal of responsibility on us.
There are two items I would like to mention. Dr. Mollan and others in the task force mention neighbourhood resource centres or community resource centres where stress must be on the community's involvement in self-help, in communication, where the social worker would be more of a facilitater generally, where there would be a great deal of toing and froing and contact, thus reducing the stress load on families at risk. I would like to call for the establishment of a 24-hour telephone service somewhat along the lines of the Samaritans because I believe that not only do neighbours, friends and concerned relatives need somebody to contact all the time, but parents who themselves feel that they might be at risk of battering their children would have someone to contact. I believe that should be set up.
Finally, the Minister is aware of course that there have been calls for an inquiry. Is there enough information available to the Minister to enable her to proceed with legislation to deal with this kind of tragedy or does she believe that some kind of public inquiry would be useful? A public inquiry is only justified if it is going to be useful. Does she believe that there should be some kind of public inquiry to help her to formulate legislation and to help to educate the community generally? This tragedy has given us a guideline that something must be done in response to the many calls and to further the great deal of work which has been done in the area of child care. I look forward to the Minister letting us know what the position is in this whole area so that the many people in Ireland who have been so deeply concerned at these latest tragedies will know what is being done in their name to alleviate the problems.
Minister of State at the Department of Social Welfare (Miss Flaherty): I share the concern expressed by the Senator about the need to protect young children from a type of brutality evidenced by recent court cases. The Senator raised a number of issues. I will give a general indication first of the current situation and the provisions that are available at the moment. The general policy at present towards children at risk is to help them and their parents as far as possible without breaking up the family. This relates to the area of concern which Senator Hussey mentioned, the need for family support services, and this is something the Department would emphasise now and would wish to emphasise in the future.
Studies of non-accidentally injured children indicate that the parents have personal and social problems because of their own deprived and violent backgrounds, alcoholism, current stresses of unemployment, poor housing or difficulties in communicating with one another. This is a wider challenge to us all and certainly involves much more than the Department of Health. It involves the response this Government have undertaken in another area by their commitment to the alleviation of this type of deprivation. That direction of prevention is one that the Department wishes to concentrate on in a very particular way because relief at the points of stress is one way of preventing further situations such as we have read about recently. An obvious preventive to that kind of violence is the provision of assistance. Health boards currently provide family support systems in the family's own home; the social worker service is available in dealing with matters related to child care, finance and home management; the home help service can intervene and support a family at particular times. Health boards also assist in the provision of day care services.
While there is a certain amount being done in that area there is clearly a need for much greater development. There are huge areas that are inadequately provided for at present. With the commitment to the new legislation in the next  session there will be a commitment for finances to develop this sort of support service.
That is the wider area, but when we come to the problem of specific cases and detecting incidents the situation is less clear, the directions are less clear. The Department of Health circulated the detailed guidelines referred to by the Senator, which have in fact been updated since then into a 1980 version. They are very specific and clear and there is firm satisfaction that they are available to the medical profession. In the past year the figures of reports show 271 cases and 90 of those cases were confirmed as in fact cases of child battering.
There is certainly room for extending the knowledge of these guidelines among the general public because the community themselves often come in contact with children who may be at risk and it would be extremely important that they should be aware also of the person who would ultimately take responsibility. In addition to these detailed guidelines a shortened version has been printed and is circulated to hospitals every six months to coincide with the change of junior medical staff. These guidelines provide guidance for health personnel who come in contact with children in the course of their work in the detection and management of non-accidental injury to children.
The responsibility for monitoring this information when it is gathered and coordinated rests with the director of each community care area to whom all notifications of cases are made. While this system seems to be reasonably effective at present obviously the incident of which we read recently indicates that there is need for further examination and the Department of Health are keeping the situation under constant review. The latest statistics available on detection are that of the 271 suspected cases reported in 1980, which is the last full statistical year, 90 were confirmed.
The Department and the health boards run into difficulties in that the existing legal remedies for protecting children at risk are not entirely satisfactory. We intend to improve this situation under the  proposed new children's legislation being prepared in the Department and which we hope to present to the House in the next few months. Let me say what the specific provisions in the Bill will be. The general intention is to strengthen the position of health boards regarding access to homes where non-accidental injury is suspected and to streamline procedures for removal of children from homes where such suspicions are confirmed. The process by which a health board can intervene at present is extremely difficult and tends to be reached only in very much of a crisis situation. The health board has no direct right to enter. It only has the right to bring the matter to the attention of the Garda. The initiative must be taken by the courts or the Garda. This is obviously an inadequate situation. It is a situation which we propose to change. There are difficulties in relation to the parental rights, but the problem in this area seems to come down on one level to the powers of intervention and the method of intervention. The concern here would be to allow intervention at an earlier stage, an uncritical stage and, again, moving towards the prevention situation.
This change in law does not guarantee anything and if we deal with the specific cases about which there has been a request for an inquiry, the director of community care in the area has given me at this stage a preliminary report subject to sending on the full report which is available to him plus the book of evidence in the court case. The preliminary report indicates that in one family there had been no previous indications, no warning signals. They had not come in contact with the health services in any way. There was no point at which the health service had come in contact with them. In the other case there was constant surveillance as a result of previous incidents and superficial reports indicate that a medical examination took place only three weeks before the child was tragically killed and that the child was healthy and well.
This would indicate that we need to examine again our general guidelines for  intervention and this would be extremely important. The question of an inquiry is one which I would leave open at this stage until I have a chance to look at the full reports and the evidence. At this stage it is impossible to say definitely but if, at that point, an inquiry would seem to be beneficial because there are questions that remain unanswered, it will be considered. The indications at present are that one family was being regularly supervised by the health services. In that case the question arises as to whether we need to watch for different warning signals. Certainly there is room for examining that situation. The general intention is that every effort will be made to extend and improve services.
The fact that we are currently bringing in legislation to establish the Child Care Authority would I hope, help to concentrate what are at present fragmented efforts in the area of child care. Bringing together all the organisations at present working under different departments in the area of child care may help to focus on problem families and problem children at an earlier stage, will concentrate the efforts on one authority, will give the responsibility to a specific authority which will be the Child Care Authority established in each health board area. Hopefully, this authority will have power to intervene in cases of emergency and stress and will also concentrate on developing the maximum support services to prevent such cases occurring.
There have been two very moving tragedies and I wish to assure all present that the concern expressed by this motion and by calls from other members of the Government for inquiries is being treated seriously. Following the inquiries, which are under way, if there is need for further action, it will be taken. The commitment is there to wider action in the area of the Child Care Authority and at present we are proposing that that legislation will become law in the next session of this House. At that stage we will be glad of the detailed contribution of every Member of both Houses in the processing of legislation that will strengthen our powers to react to such situations and to develop the maximum preventive services  to prevent these situations occurring again.
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