Reform Programme for Children

General

  1. 2011 saw the introduction of a number of significant changes in respect of children and family services in Ireland. Key milestones included the appointment of a Minister for Children and Youth affairs with full status at Cabinet, together with the establishment of a new Department of Children and Youth Affairs. There now falls under the Department’s remit a range of agencies including both the HSE Children and Family Services; the Irish Youth Justice Service; the Family Support Agency and the National Education and Welfare Board.
  1. The Reform Programme underway is focused on the full integration of children’s policies and services under the Department as well as the establishment of a new standalone Child and Family Support Agency, the core of which will be the existing HSE Child and Family Services.
  1. This Reform Programme contains a number of critical elements:-
  • The establishment of the new Agency
  • The transition of existing HSE and FSA services into the new Agency
  • The continued implementation of the HSE Child and Family Change Programme incorporating seven strands of activity
  • The consideration of further rationalisation of services under the new agency.
  • The development of appropriate legislative proposals to give effect to Reform changes proposed.
  1. The Department is being assisted by a Task Force appointed by the Minister to advise the Department on a number of aspects of the Child and Family Support Agency including, inter alia, the services to be included in the new Agency, governance arrangements, organisational design, service delivery model and resource allocation model etc.
  1. The Department has identified the need for current reforms to take full account of and be guided by the full strategic range of reforms envisaged in the programme for government including:
  • Machinery of government changes
  • The wider reform of the health sector
  • The programme of public sector reform including issues relating to conditions of service and shared services.
  1. Given the wider reform programme it is important that the Child & Family Support Agency is established in full cognisance of government views regarding structure and governance especially as the Children & Family Services is scheduled for transfer of function from the Health Service Executive by January 2013. This will require key policy decisions to be made for the purposes of legislation to be made early in 2012.
  1. In taking forward measures to ensure greater consistency and clear lines of professional accountability in each of the disciplines currently within the HSE and other existing interfaces, it will be important for the revised service design to provide responses which:
  • Anticipate and describe the requisite interfaces;
  • Put in place creative, effective solutions to ensuring that children and parents are at the centre of the service delivery model – regardless of where services are being provided.
  1. The wider HSE reform programme is a critical backdrop to these developments. Regardless of the final formulation of structural arrangements for the HSE, the development of new Agency will require the consideration of measures to integrate care pathways for children and their families; and support inter and intra professional practice development in respect of existing Children & Family Services, Mental Health & Disability Services, Primary Care and Public Health.

Change underway inHSE Child and Family Services

Introduction

  1. On January 10th 2011, at the direct request of government, HSE appointed Ireland’s first National Director for Children & Family Services. In 2011, the National Director assumed full accountability for all aspects of children and family services albeit through the regional directors of operations and the area and general managers and not directly through professional children & family managers and principal social workers.
  1. The publication of the HSE Service Plan 2012 contained, for the first time, a dedicated subhead for Children and Family services has been established in the HSE Vote. The composition of this subhead/budget will be agreed by the departments of Children and Youth Affairs, Health and the HSE in advance of the publication by Government of the Revised Estimates for the Public Service. It is envisaged that the dedicated budgetary provision for Children and Family services will bring greater transparency and control to budgetary management and will pave the way for the establishment of the new Child and Family Support Agency in 2013.

Vision, Values and a Sense of Direction

  1. The inheritance at the start of 2011 was characterised as focused on issues of capability, capacity and credibility. Service reputation and morale had been badly affected by reports from HIQA, the Ombudsman for Children and the Rapporteur. This has been reinforced in specific inquiries some covering church matters such as Ferns, Murphy and Ryan while others identified failings in particular cases most notably Roscommon but also elsewhere. The first task was the production of a single coherent change programme which captured the full range of challenges and set out a strategic approach to making the changes necessary to meet past criticisms of the system and prepare for the future demands.
  1. A considerable change programme is already being implemented by the National Director within HSE Child and Family Services aimed at strengthening organisation capacity, business processes and systems. These developments are also an integral part of preparations for the new stand alone Agency. Key elements include:
  • Continuing the major cultural change required for the delivery of child centred, transparent, quality assured, professionally reflective and accountable services to children and their families.
  • Implementing consistent child protection procedures in line with the revised national guidelines - Children First, 2011 – National Guidance for the Protection and Welfare of Children.
  • Continuing the reforms necessary to provide safer, more reliable and effective services for children in care.
  • Continuing implementation of the Ryan Report.
  • Workforce development and improved collaboration with the community and voluntary sector.
  1. The Change Programme agreed 5 key outcomes:
  • To protect and safeguard children by promoting whole child, whole system approach to meeting their needs
  • To support children to make good, well informed decisions about their health
  • To set high achievement standards for all
  • To promote a recognition of the role and contribution of children in the community
  • To work with others to protect children from poverty and equip them for life as economically independent adults.
  1. In taking this forward a wide ranging workforce development programme was considered essential in articulating a value base for organisational change covering:
  • The creation of a workforce with the right skill set for the task of working with the most difficult to reach families in a complex society
  • Fitting the skill set to the agreed priorities at time of restricted and diminishing resources
  • A coalition of staff from different roles and working circumstances engaged in a common purpose and with shared understanding
  • A base on which to build and publish clear and consistent policy and procedures
  • Clear processes to match applicants to the organisation selected and self selecting according to a shared value base
  • The provision of practical steps to become a safe employer (as a precursor to soft vetting)
  1. Taking forward the key outcomes with the right organisational base has necessitated 3 specific requirements:
  • The support and permission of the community
  • Well defined local mechanisms for accountability to ensure focused, disciplined relationships among all those promoting the welfare of children
  • High support to enable high challenge within clear lines of management and accountability. Thus providing strategy and policy on a nation wide basis but with decisions and practice taken forward at the most local, practical level.

Progress in 2011

  1. A major Change Programme was initiated in 2011 to facilitate a portfolio management approach for all projects undertaken within Children and Family Services and to support a strategic review of services on an ongoing basis.
  1. Full support for the re-editing and reissuing of Children First: National Guidance for the Protection and Welfare of Children (2011) and detailed discussions with trade unions and the voluntary and community sector to ensure full support and consistent application.
  1. The commissioning, production and publication of a child protection handbook entitled Child Protection and Welfare: Practice Handbook to reinforce consistency, summarising key learning from internal inquiries and international best practice to inform the actions and practice of front line practitioners.
  1. A certification process has been undertaken to ensure that all HSE child protection social workers have read, received and understood Children First and the Handbook. 94% of HSE child protection social workers have completed certification. The vast majority of the remaining 6% were on maternity leave and sick leave during the certification process and are due to receive training in early 2012.
  1. The national procedures and standard forms were developed for Children and Family Social Work Departments in 2010 by a working group of experienced practitioners from all grades. Standards procedures for referral and assessment were implemented in all 32 HSE Local Health Offices/17 HSE Areas during 2011.
  1. The recruitment, selection and appointment of Regional Directors and Area Managers for Children and Family Services has led to the establishment of a direct line of professional accountability from national director to regional directors to area mangers in each of the 17 HSE Areas.

Priorities for 2012

  1. Taking all necessary steps to improve child protection in Ireland is not incompatible with increased financial discipline and more effective budget development.
  1. The risks to the establishment of effective services for children and families include the hidden costs of disaggregating from a larger organisation, the increased demands as a consequence of population increase, more consistent application of Children First and, in due course, legislation. In addition, there is a need to address systemic overspends in Children & Family Services. These overspends are due to a combination of a lack of financial control and increased external demands placed on Services. The CSO Population and Migration Estimates (2010) estimate that there has been a 21% increase in the number of births in Ireland between 2006-2010. This has led to an increased demand for HSE Children and Family Services. For example, there has been a 23% increase in referrals to HSE Social Work Departments and a 17% increase in children in care over the same time period (2006-2010). As for many other areas in the public sector at this time, the budget allocation does not reflect this increased demand and the reality is that resource base will be under significant pressure in the years to come.
  1. With the HSE currently, the focus of Children & Family Services is on core services as it becomes fit for purpose to transfer to the Children & Families Support Agency.
  • Cooperating parents who voluntarily seek assistance because of particular temporary pressures on their family
  • Coerced parents who need compulsory, non-negotiable support from social work usually supported by a supervision order to ensure children are at home and safe.
  • Corporate parent role to provide the best possible services for the 6,250 children who at any one time are in the care of the state.
  1. This focus will be on:
  • A review of grants to voluntary and community sector to ensure support is prioritised according to need
  • The reform and rationalisation of the child protection notification system as a child protection register to target support on families to help them to stabilise and to keep their children out of care
  • The establishment of a new service delivery model to ensure each concern raised with the service gets a response which is efficient, effective and proportionate
  • The redesign of high tariff alternative care.
  1. In the medium term activity should focus on:
  • Reforming of the relationship with the courts and the guardian ad litem
  • Promoting a system that is independent, rigorous and at all times putting the best interest of the child first
  • Reforming Youth Justice incorporating HSE special needs and high support.
  • Continuing the reform and renewal of foster care arrangements recognising the different arrangements and different demands in response to different needs.

Towards 2013 – Establishment of the new Agency on a Statutory Basis

  1. The Programme for Government gives an undertaking to “fundamentally reform the delivery of child protection services by removing child welfare and protection from the HSE and creating a dedicated Child Welfare and Protection Agency, reforming the model of service delivery and improving accountability to the Dáil.” The Programme for Government also notes that: “Real reform of the public sector will require a commitment from the whole of government to become more transparent, accountable and efficient”.
  1. The Minister for Children & Youth Affairs established a Task Force to advise her Department in regard to the necessary transition programme to establish a Child & Family Support Agency. The Taskforce has been in situ since September 2011 and is considering a wide range of issues relating to the set-up of the new Agency. It will be advising the Department of Children and Youth Affairs over the coming months on matters including, inter alia, a vision for the new agency; appropriate service responsibilities; governance arrangements; organisational design and operating child welfare and protection service model; an implementation plan for the transfer of services; the main priorities for the first 12 months of operation of the Agency; and the core interagency, statutory or professional relationships which need to be maintained or provided.