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HSE has still not identified hundreds of children with disabilities in state care two years after OCO report

Molly Two Years On, a report by the Ombudsman for Children’s Office (OCO) will be published today (Thursday 23rd), outlining significant progress made to improve supports and services available to children with moderate to profound disabilities in the care of the state. However, the report also identifies substantial shortcomings, particularly on behalf of the HSE, who two years after the OCO first published Molly’s Case, still cannot agree with Tusla on the identity of these children. Therefore two years on, they still cannot adequately plan for their care.

Speaking ahead of the publication of Molly Two Years On, the Ombudsman for Children, Dr Niall Muldoon highlighted the progress that has been made in Molly’s case since 2018.

In 2018 we published Molly’s Case, an investigation we carried out about a child with a disability who is in foster care. Molly was born with Down Syndrome and severe autism. She was abandoned by her biological parents at birth. She is now 16 and has grown up with her foster family after being placed there soon after she was born. Molly is dependent on her foster carers for feeding, toileting, bathing, and dressing.

“When Molly’s foster carer came to us we found that neither the HSE nor Tusla saw Molly as a child in care and also a child with a disability. There was a lack of co-ordination which meant that services and supports provided by both organisations were insufficient. We also found that, according to Tusla there were 471 other children like Molly, yet neither Tusla nor the HSE had a good enough system in place to ensure adequate supports were being provided.

“When we published Molly’s case in 2018 both the HSE and Tusla made a number of significant and ambitious commitments. We revisited this case in 2019 but we were not satisfied with the progress made so we decided to give the HSE and Tusla another 12-months to fulfil their commitments.

“It is now 2020 and two years after Molly’s case was first published we are pleased to see that Tusla, in particular, has been extremely proactive in addressing the issues raised by Molly’s foster carers, and identifying other children who are in a similar position. Molly, who at one time was in danger of being transferred to institutional care, is still at home in a loving family environment, resulting in a saving of at least €90,000 per year for the exchequer. Both Tusla and Molly’s carers must be commended for this.

“There is no doubt that both the HSE and Tusla are working much more closely at a local level for other children like Molly and their families. Again, I welcome this. However, it is incomprehensible that two years on the HSE has still not managed to come to an agreement with Tusla to identify the children in state care nationally with moderate to profound disabilities. The HSE and Tusla have worked together to identify the children in this cohort who will turn 18 in 2019/2020 but cannot do the same for younger children. This suggests a focus on the financial implications to their budget, rather than a drive to plan for and provide the best care.

“It is imperative that every effort is made to support all the exceptionally committed foster carers that are looking after children with moderate to severe disabilities. Without their loving care and commitment these children would be facing a life in residential care. However, in order to provide the appropriate support there must be consensus among those involved as to who these children are.

“Molly’s case has been extremely important in shining a light on a small and extremely vulnerable cohort of children who were unrecognised within the system. These children are no longer invisible.

“However, as Ombudsman for Children, I do not believe that I can close this case satisfied that the situation has sufficiently improved for children with moderate to severe disabilities in the care of the state. It is my intention to submit a copy of this report to both the Oireachtas Joint Committee on Health and the Oireachtas Joint Committee on Children and Youth Affairs. In an effort to mirror the level of cooperation required for this case I will be urging the two committees to come together and review the report jointly so as to address the issues arising.”