Executive Summary

Children First, National Guidelines for the Protection and Welfare of Children, was launched in September 1999. The Social Services Inspectorate (SSI) was asked to monitor the implementation of the guidelines. The monitoring exercise took place over a two year period and an interim report was issued in October 2001.

The health boards agreed with the Department of Health and Children key objectives for the implementation of Children First as part of their service plans for 2000 and 2001. The monitoring exercise measured progress against these objectives. The inspector met with representatives of each of the health boards and others involved in the implementation process and the health boards provided written information on their implementation activities.

There was a national strategy for the implementation of Children First. A National Implementation Group, made up of representatives of each health board and one from the Department of Health and Children, was set up in late 1999 to support the implementation process. It was later renamed the National Implementation Advisory Group (NIAG) to underline its advisory and supportive as distinct from executive role. It facilitated a joint approach to common problems experienced by the boards. In 2000 the Health Board's Executive Agency (HeBE) set up a Children First Resource Team. The Team worked closely with and reported to the NIAG and developed solutions to difficulties thrown up by the process of implementing Children First. Three health boards devised and implemented joint Garda/ health board training on behalf of the ten health boards.

The national strategy must be judged a success. It allowed, for instance, for a national solution to a problem in relation to the Child Protection Notification System (CPNS) rather than ten individual ones which would have fragmented the child protection system and undermined the raison d'etre of national guidelines. The strategy provides a useful, workable model that could be applied to other policy initiatives. It represented economical use of resources, prevented disparate and fragmented approaches to problems and it made the process of implementation more open and transparent than it would have been otherwise as each board had access to information about the other nine. The strategy could have been improved. The HeBE Team should have commenced work at the same time as NIAG. Greater clarity was needed from the outset in relation to the role and function of each of them and their relationship to each other.

Not all of the targets set out in the service plans were reached. Some of the reasons for this had to do with the health boards and some related to the guidelines. The Department of Health and Children provided extra funding for the implementation process. New Children First Officer posts were created. However, boards found it difficult to recruit the extra staff required and for some boards this problem was particularly acute. Boards were also struggling to deal with a number of new policy initiatives at the same time. Some aspects of the guidelines caused confusion. Much time and effort went into developing guidance to the operation of the CPNS until it was eventually accepted, early in 2002, that this aspect of the guidelines could not be brought into operation without further clarification. By the middle of 2002 this clarification had been agreed with the Department of Health and Children. Boards were then in a position to proceed with the introduction of the CPNS and this was due to happen in late 2002/ early 2003. The confusion over the role and function of the CPNS, and the delay in agreeing the need for further clarification, set back progress in the implementation of Children First.

Some boards made greater progress in implementing Children First than others. Indeed the record of some boards in relation to child protection training and information and advice given to voluntary and community groups is impressive. However, progress in relation to key areas such as Garda/ health board co-operation, child protection committees and planning for family support services has been slow and there is a need for more work at health board and at national level in order to implement these aspects of the guidelines. It is a matter of concern that both NIAG and the HeBE Resource Team are to be disbanded in early 2003, leaving no national infra-structure for the development of solutions to outstanding difficulties. SSI recommends that either current arrangements are allowed to continue for a time or that some alternative mechanism be put in place to further the implementation process and ensure a national response to outstanding issues.

After this report was completed SSI was informed of the following statement: The chief executive officers of the health boards and the ERHA have established a 'Conjoint Programme of Action for Children' which will integrate work in the areas of child health, child welfare, child and adolescent psychiatry and other areas of services relating to children. This programme will have the responsibility for ensuring that the outstanding issues relating to Children First are addressed.