Sunday 18 August 2019

Child protection isn't cheap, but the mess at Tusla runs deeper than money

Too many State agencies look unfit for purpose, but there's no point pretending there are easy solutions, writes Eilis O'Hanlon

RESPONSE: Katherine Zappone, Minister for Children and Youth Affairs, commissioned the report into Tusla after the false allegations made against Maurice McCabe. Photo: Gareth Chaney Collins
RESPONSE: Katherine Zappone, Minister for Children and Youth Affairs, commissioned the report into Tusla after the false allegations made against Maurice McCabe. Photo: Gareth Chaney Collins

Eilis O'Hanlon

The headline over the latest report into the mismanagement by the State of children at risk read: "Tusla doesn't work efficiently with gardai in abuse probes." The headline could just as easily have been abbreviated to three words: "Tusla doesn't work."

Or perhaps, to be slightly less harsh, four: "Tusla doesn't work efficiently."

The child and family agency will no doubt question that gloomy conclusion, pointing to some of the more positive aspects of the 308-page report released last week by HIQA, the independent Health Information and Quality Authority tasked with driving "continuous improvement in Ireland's health and social care services".

The report does say that Tusla has "a clear strategic direction and long-term vision"; it also says the organisation "responded appropriately to children who were judged to be at immediate and serious risk of harm". It was only those who were not deemed to be in imminent danger who "may have remained at risk" because of the agency's failings.

Is anyone genuinely surprised, though, to find that another agency of the State is failing to fulfil its allotted duties? From faked breathalyser tests by An Garda Siochana to the scandal surrounding cervical screening programmes, it's not simply that individual mistakes have been made, but that the structures tasked to deal with basic problems look increasingly unfit for purpose.

Time and again, we've been here before. A 2015 report by HIQA into baby deaths at Portlaoise's Midland Regional Hospital found that senior corporate management at the HSE was partly to blame for the failings that led to those tragedies.

The HSE's response was to complain that the report would "shatter confidence" in the organisation, and it even considered going to court to halt publication.

All too often this is how closed bureaucratic institutions work - or, rather, don't.

One thing that immediately jumped out of last week's news reports was the anonymous "sources" insisting that Tusla would be seeking additional funding to apply the recommended changes in the HIQA report. Budget 2018 already allocated an additional €40m to Tusla, bringing the annual budget up to €750m. That was in addition to an increase of €37m in Budget 2017 and €38m in Budget 2016.

Responding to Budget 2018 last autumn, Tusla agreed that it was a "significant increase" and would "enable Tusla to respond to increased demands on the agency, progress key service developments and expand the provision of community-based supports".

How much more money does Tusla need just to meet some fairly modest definitions of efficiency? That was one of the lessons of the HIQA report into Midland Regional Hospital too. In both cases, a lack of resources cannot explain why basic procedures are flouted.

Protecting at risk children cannot be done on the cheap. There are chronic shortages of social workers in Tusla, as last week's report openly acknowledges, which means that many children are not getting, and are not likely to get any time soon, the help they so desperately need.

But the failings identified in the report are not fundamentally about Tusla's inability to meet growing demands. It's about the way that the cases with which it's already dealing are handled. It shouldn't and doesn't cost any more to do that existing job right than to do it wrong.

This report was ordered by Children's Minister Katherine Zappone following the discovery that a false allegation of sexual assault of a child against Garda Maurice McCabe had been passed on to gardai by Tusla.

One doesn't need to buy into wilder conspiracy theories that Tusla deliberately allowed false allegations against an innocent man to be circulated to discredit the whistleblower not to see this as exposing deeper flaws within the system.

The false rape allegation was included in the Maurice McCabe file as a result of a cut and paste error by the social worker involved. There was sufficient evidence of this mistake to clear it up on a number of subsequent occasions, but it stayed on the record.

All these were basic errors of judgment and competence. They wouldn't have been fixed by greater resources because it was about individual social workers mishandling the cases before them. Faults identified by the HIQA report include similarly inadequate record keeping and communication. This is entry level stuff.

There were also too many irregularities in how social workers handled allegations. The report makes it plain: "Inconsistencies in safety-planning practice by Tusla for children meant that while some children were adequately safeguarded, others at potential risk were not".

How would greater resources, however necessary they might be, have fixed that problem? Or indeed fix it in future? The same applies to historic cases of abuse, where the report finds there was no "standardised approach to direct and guide staff in case management, leading to variation in practice and delays".

Once again, all the money in the world would not have prevented some children falling through the gaps, because those variations in practice would have persisted. They're laced into the system.

All too often, throwing more money at a problem has been regarded as a "one size fits all" solution when it's more often a substitute for the deeper cultural changes that are needed.

It recalls the way in which Government ministers patted themselves on the back and decided that they'd fulfilled their duty by getting the referendum passed to include children's rights in the Constitution back in 2012.

And it wasn't only politicians. That referendum allowed all of us to pretend we'd done our bit, done enough.

The creation of Tusla was meant to be a way of passing along responsibility for child protection to a new body that would suddenly make everything right. That kind of magical thinking still persists.

It's particularly frustrating to hear opposition politicians pontificate about the situation last week, as if they have all the answers. No they don't. They'd have it believed that these things wouldn't happen under their watch. Yes they would. The instruments of the State need to be as efficient as possible, but they can only ever clean up so much of the mess that dysfunctional families leave in their wake.

Once that problem was dumped on the Church's doorstep, now it's left to social workers. It hasn't got any easier, and Opposition politicians do a disservice to the complexity of the situation by pretending otherwise.

They're equally as guilty when it comes to settling for second best.

Sunday Independent

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