Twenty-two children and young people died last year while being monitored by welfare agencies or in the care of Tusla. That figure has remained broadly constant over the past seven years.
The National Review Panel (NRP) examines cases where children under 18-years-of-age were involved in serious incidents or died while in the care of the State. More than half of the reported fatalities in 2017 arose from natural causes or road traffic and other incidents. Three deaths were attributed to “unknown causes”; three to suicide; two to homicide and one to a drugs overdose.
Five years on from the establishment of the child protection agency Tusla, the NRP panel of experts drew attention to “continuing communications difficulties” between the HSE’s public health nursing service and Tusla’s social work departments.
It also pointed to the need to improve assessment practices involving physical abuse, as well as domestic violence and substance abuse.
Poor communications have bedevilled the HSE since its inception. This must change if a more holistic and effective child protection system is to emerge. While the establishment of a nationwide drugs liaison midwife service is not in Tusla's remit, the NRP noted with approval that it took every opportunity to support such a development.
It went on to recommend that formal channels be established and maintained between Tusla and the public health nursing service.
Examining the circumstances surrounding the death of a young man who had died from a drugs overdose while in the care of Tusla, the NRP found that management of the case had been “inadequate at times”. Suitable placement and education had not been available to meet his early needs and this had led to “crisis management at the expense of a more strategic approach”.
As with acute hospital care, once social services became involved, there was evidence of “some very good practices”. But these departments remained under serious pressure, with high referral rates and staff shortages impacting on their services. A sadly familiar picture.