SERVICES FOR children who are sexually abused are no further on in many parts of the country than they were 30 years ago, despite the revelations contained in a number of reports including that of the Ryan commission, a consultant paediatrician has said.
Dr Joanne Nelson, who is based in Galway, said there was still no rostered out-of-hours forensic examination service anywhere in the State for children who had been sexually assaulted. Around- the-clock services were provided however for adults, she added.
Dr Nelson and Dr Roger Derham, also a forensic examiner, have been voluntarily providing an out-of-hours forensic service for a number of years for children who are assaulted in the west and midwest, but they have now told the HSE they are no longer prepared to do so because of the HSE’s unwillingness to fund the service around the clock.
They plan to withdraw their expertise on December 19th and will no longer provide forensic examinations during normal working hours or out of hours.
Dr Nelson said it was totally unacceptable that different standards applied to adults and children who are sexually assaulted.
If a 23-year-old was raped they would be seen within two hours, according to SATU (sexual assault treatment unit) standards, but if a three-year-old was raped on a Friday they may wait a minimum of 60 hours and probably much longer for a service, which was discriminatory, she said.
“Children are getting second-rate services if any service at all,” Dr Nelson added.
“I don’t understand how the HSE and the Department of Justice can get away with it when children have been abused in Ireland for so long. I don’t know why more people are not jumping up and down about it.”
Between January and August this year, 37 children aged 0-17 years were seen by herself and Dr Derham, she said, after they were sexually assaulted or suspected of having been sexually assaulted. Two-thirds of them were under 10.
This meant they were seeing on average one child a week but Dr Nelson believed they would be seeing twice this number if it was advertised as a 24-hour service, with staff rostered around the clock to provide it.
There seemed to be some ignorance among social workers and gardaí about how quickly a forensic and full medical examination should be progressed when children were sexually assaulted and what an early examination could add to the child’s overall management.
“So there are a cohort of children that are not being examined as they should be and, if they do make a complaint, it’s unlikely it will go to court without the proper evidence behind it,” Dr Nelson said.
“Every minute lost means DNA evidence is lost.”
Dr Derham, in a letter to the HSE West last week, said he was withdrawing his expertise “with a heavy heart” because the HSE would not fund the service on a rostered 24-hour basis.
HSE West had suggested gardaí fund the service outside normal working hours, which was an “offensive proposal”.
HSE West, in response, said the existing paediatric forensic medical examination service, which is moving from the Bon Secours Hospital in Galway to the city’s adult SATU later this month, would initially be provided during core working hours “with consideration to providing a 24-hour service explored in the context of funding available in 2011”.
It claimed the number of children requiring assessment over the past three years from Clare, Limerick, north Tipperary, Galway and Roscommon was 44.
Dr Nelson, meanwhile, in a recent letter to the HSE, said it was obscene to suggest children who were sexually assaulted could, in the absence of a dedicated out- of-hours forensic service, attend GPs or hospital emergency departments as these lacked facilities and expertise.
A proper out-of-hours service would cost just €150,000 to €200,000 a year, she estimated.