Revelations of significant harm being done to children who were attending mental health services in south Co Kerry have been referred to An Garda Síochána for possible criminal investigation.
The Health Service Executive (HSE) said it had also sent all relevant information about failings at South Kerry Child and Adolescent Mental Health Services (Camhs) to the Medical Council, which has the power to sanction doctors found to have breached professional standards.
A review into issues in the region, published on Wednesday, found that hundreds of children received “risky” treatment from a junior doctor and that significant harm was caused to 46 of them.
Amid concerns that the practices revealed in the HSE report were not confined to Kerry, a nationwide audit of compliance with Camhs operational guidelines is to be carried out.
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Announcing the audit in the Dáil, Taoiseach Micheál Martin described the findings of the review as shocking, very serious and unacceptable.
He said an audit on prescribing practices will be conducted in respect of each of the 72 Camhs teams nationally and that the Government would look at “any further measures required”.
Serious harm
The review found 227 children were exposed to the risk of serious harm while they were under the care of the doctor, by way of issues such as sedation, emotional and cognitive blunting, growth disturbance, serious weight changes, metabolic and endocrinal disturbance, and psychological distress. Another 13 children were exposed to harm while under the care of other doctors, it found.
There was “clear evidence” of significant harm to 46 children whose files were reviewed, but this number is expected to increase as more information becomes available. This harm included production of breast milk, putting on a lot of weight gain, being sleepy during the day and raised blood pressure.
The review makes clear that concerns were raised about the doctor on numerous occasions but no effective action was taken until a new locum consultant highlighted his concerns in 2020. By that stage, the doctor had left the Camhs service. He no longer works for the HSE, but is registered with the Medical Council.
Mr Martin said children had been harmed by “a complete failure of clinical performance and oversight and the entire management of the service”.
“There was a systemic collapse here in terms of overall clinical governance and in terms of the overall management of the service,” he told TDs.
Disciplinary action
Asked whether the HSE planned to take disciplinary action against the junior doctor, or any other clinical or managerial staff, a spokeswoman said the report made it clear there were “very many factors at play”.
“The very fact that there are 35 recommendations shows that the issues are many and varied. It would be unfair of us as an organisation to single out any identifiable individual or individuals. We can’t undermine any other process that might be under way,” she said, adding that the HSE had passed “all relevant information” to the Medical Council and Garda.
The HSE also said “many things” had changed at South Kerry Camhs, even before the report was commissioned. There are more doctors and more administrative staff working in the service, and a consultant doctor from another Camhs service is providing extra cover.
However, just one permanent consultant has been appointed due to the difficulty of recruiting experienced staff.
One of the solicitors representing families impacted by the failings said the injured parties deserved an apology from the Taoiseach in the Dáil.
Parents deserved more than a “perfunctory” apology from the HSE, Padraig O’Connell said.
