The Children’s Ombudsman has criticised the Health Service Executive and the child and family agency, Tusla, for failing to do enough to co-ordinate services for children with disabilities who are living in care.
The Ombudsman has published an update on recommendations made last year in the case of a teenager, known as ‘Molly’, who has been living in foster care since she was four months old.
She was born with Down syndrome and severe autism.
Ombudsman Niall Muldoon said that while "some definite progress" had been made since last year with regard to Molly’s case, he said "not enough had changed" for other children in the care system.
Mr Muldoon said he was still concerned about the working relationship between the HSE and Tusla, and was not satisfied that the agencies were working together effectively in the best interests of children.
The Ombudsman said Tusla had worked closely with Molly’s foster carers to ensure the supports she needed were put in place.
However, he said issues remained in relation to finances for her family and the level of responsibility her carers had in terms of her diet and education.
Mr Muldoon said it was not satisfactory that the HSE had no disability managers in place to undertake case management roles.
He added there was "still a long way to go" in terms of implementing the Joint Protocol for Inter-agency Collaboration, which came into force in March 2017.
The Ombudsman said it was "essential" that the working relationship between the HSE and Tusla improved so that children in State care could reach their full potential.
He said this could only be achieved if all the adults in these children’s lives worked together closely.
The Ombudsman’s office plans to keep monitoring Molly’s case over the next 12 months and to continue to engage with the two agencies.
Tusla has identified 483 children with a moderate or severe disability living in foster care placements, but the Ombudsman said there was no consensus with the HSE that this was the actual number.
He said this was because the two agencies had "failed to agree a common understanding of what was considered to be a child with a moderate or severe disability".
In a statement, the HSE welcomed the Ombudsman’s findings and said it had worked closely with Tusla to address the issues highlighted by Mr Muldoon's office.
It said a joint working protocol had been set up between the two agencies to promote the best interests of children and their families.
It said the HSE and Tusla had been reviewing the care needs of children identified by the Ombudsman since last year.
Tusla has also welcomed the Ombudsman’s findings. It says it has provided a "very comprehensive, diverse and effective range of additional services" to Molly and her foster carer since last year.
It said its collaboration with the HSE had been "excellent", and involved daily, weekly and quarterly meetings.
It did acknowledge, however, that there was still a "body of work yet to be completed" to assist all children with a moderate or severe disability living in foster care.
It said this work would be accelerated over the next 12 months.
Meanwhile, Minister for Health Simon Harris said that "Molly" had been let down because of "passing the buck between organisations".