The Ombudsman's charge against a health board of destroying three children's chances of a 'normal' upbringing with foster parents ignores the complexity of the case, writes Paul Cullen
Good versus bad is one of journalism's staples, and it's clear that Ombudsman Emily O'Reilly hasn't forgotten this from her days as a reporter.
This week it was the turn of an unidentified health board to be "monstered" by the Ombudsman in a highly critical report prompted by a complaint made by a couple who sought to foster three sibling children.
"Warm-hearted would-be foster parents frustrated by penny-pinching bureaucrats" is one possible headline a journalist might have used to catch the flavour of her report; "Orphan kids' hopes wrecked by health board foot-dragging" is another.
"I don't tend to get emotionally involved in cases I deal with, but I found this one particularly heartbreaking," O'Reilly told RTÉ radio on Thursday. "This story is about how the actions of a health board effectively destroyed the possibility that was there in the lives of three children to be taken from residential care and brought up in a normal family home."
Accusing a health board of destroying the prospects of three child citizens of having a "normal" upbringing is a serious charge, and not one contained in the body of her report. The picture drawn is of a black-and-white case where the health board repeatedly failed in its duty and caused immense suffering for both the children and their would-be foster parents.
But are things that simple? Are family issues ever that simple? A reading of the report shows this to be a complex case with many turns, and, on the basis of the limited information published in the report, it is difficult to sustain the Ombudsman's charge.
The facts are as follows: the three children were put into care in 1997, after their mother died. Their father was unable to look after them and consented to them being placed in residential care. In 2000, they were fostered by an aunt and uncle, but this arrangement broke down a year later.
Arrangements were then discussed about their adoption by the couple, who would later complain to the Ombudsman. The woman was a temporary childcare worker in the home where the children were originally cared for, and she had formed a strong bond with them. It seems the social workers agreed that the woman would receive the normal fostering allowance plus €380 a week to allow her to give up her job without financial loss. The couple believed they had a long-term agreement, but in fact, health board managers sanctioned it for just three months.
The couple, who had been renting a one-bed apartment, bought a four-bed house to prepare for the children's arrival. However, four days before they were due to arrive, in August 2001, the children's aunt and uncle changed their minds and said they wished to continue minding the children.
The health board decided it had no choice but to leave the children with their relatives. The couple, having bought a house and she having given up her job, found themselves in difficult financial circumstances.
The woman got her job back, but within a year the children's placement with their relatives was in crisis. Social workers contacted the couple again and they agreed to foster the children, provided they received the normal allowances plus the replacement of the woman's salary, which now amounted to €700 a week.
The board agreed to make a decision within six weeks, but 11 months passed before the couple was told such discretionary payments were no longer being made.
On foot of the couple's complaint in 2003, O'Reilly found in their favour, ordered the board to pay them €5,000 for their time, trouble and stress, and suggested communications be re-established.
The Health Service Executive (HSE) accepted her findings and the couple said they would foster the children.
But, as O'Reilly put it this week, there was to be no "happy-ever-after" ending in this case. By now, the eldest girl regarded residential care as home, and she declined to leave, so all three siblings remain in care. In the meantime, their father has died.
Even this brief summary demonstrates the complexities of this case. Twice the children's relatives offered themselves as foster parents, leaving the social workers with little choice but to place them with their relatives.
"The general practice is to try and find a relative to foster, because it is more likely to succeed and less traumatic for the child," comments one experienced social worker. "Sometimes this doesn't happen because, for example, the child has specific needs or the non-relative foster parents are particularly experienced."
The report doesn't make clear why it took the board 11 months to tell the couple it wouldn't be paying the woman's salary in addition to the normal allowances for fostering. But whatever the reason for the delay, the amount of money was considerable - about €750 a week in allowances for the three children plus salary-in-lieu of €700, a total of about €75,000 a year.
"This could have set difficult precedents for the health board," says one social policy expert. "How could it justify paying one rate to one set of foster parents, and another, higher rate to a different set? They would have been hammered in an equality tribunal."
O'Reilly counters that "there is always discretion" in these cases. "The fact that the HSE ultimately agreed to my recommendations shows there was at least the possibility of placing the children with the couple.
"It's just a pity that it didn't happen a few years ago."
It is health board policy to prefer placing children in "traditional family structures" rather than a home, she points out; residential carers come and go, while foster families can provide continuity, even after a foster child turns 18.
The Ombudsman's report (which itself took almost two years to complete) shines a welcome light on the forgotten world of fostering. According to the Health Service Executive, of the 5,300 children in care at the end of 2006, 4,600 were in foster care.
Prof Robbie Gilligan, of TCD's school of social work, says we know little about the outcomes for children who have been in care, though the initial results of research he is carrying out indicate that children in long-term foster care do quite well.
There is no indication yet as to how children in residential care get on, but the traditional image of forbidding orphanages behind high red-bricked walls is long out-of-date. Very often, children are accommodated in regular houses for four to six people in the community; to suggest these children are getting a less than "normal" upbringing begs the question of what constitutes normal in today's world.
For Gilligan, this story shows there wasn't sufficient focus on the needs of the children in the decisions made. "If you approach things with an unswerving focus on the needs of children, you tend to be flexible and imaginative. Sometimes people get diverted from this by short-term issues like saving a few bob."