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Thursday 30 November 2023 Dublin: -1°C

Ombudsman criticises HSE and TUSLA over care for children with disabilities

The collaboration between the HSE and Tusla is still of concern, the ombudsman said.

THE CHILDREN’S OMBUDSMAN has criticised the HSE and Tusla over a lack of supports provided to children living with moderate to severe disabilities in state care. 

In 2018, the ombudsman Niall Muldoon received a complaint over a reported lack of supports being provided by the agencies in relation to a young girl – known as Molly – who had been diagnosed with Down Syndrome and Autism.  

In a report at the time, a number of recommendations were made to both State organisations, who were advised to ensure changes would be made to address the shortcomings within one year of its issuance. 

These included both the HSE and TUSLA carrying out a systemic review of supports being provided, engaging with relevant government departments to address the concerns and providing additional respite care to Molly. 

However, in an update published today, the ombudsman said “some definite progress” was made in relation to Molly’s case but that there were outstanding concerns for the other 483 children in state care who have been diagnosed with a moderate or severe disability. 

Muldoon said there wasn’t enough collaboration between the HSE and Tusla to address the needs of children with these disabilities at both local and national level, while concerns were raised for the pace of the joint protocol implementation process.

The Joint Protocol for Inter-agency Collaboration was developed to encourage cooperation between the HSE and Tusla and to ensure efficient measures were introduced for the benefit of children in care. 

“The working relationship between Tusla and the HSE, and the impact that this is having on the care of children with disabilities who are in care, is still of concern,” he said. 

“Notable progress has been made in implementing the Joint Protocol for Interagency Collaboration, which has been in force since March 2017.

“There is, however, much progress to be made from the HSE’s perspective, and in the interaction between the two agencies,” he added. 


The ombudsman also highlighted the “financial challenges” experienced by foster carers including Molly’s foster parents, and reiterated the need for a review of the financial payments made to families of children with these types of disabilities. 

“Molly’s foster carers continue to face financial challenges. For example, when Molly was placed in a residential centre for two weeks for an assessment, her carer’s Foster Care Allowance was deducted for these two weeks. 

“This was despite the fact that they transported her to and from the residential unit, and visited her there. 

“Tusla’s business case in relation to enhanced payments for foster carers of children with a moderate or severe disability, which they committed to in 2018, is outstanding, and respite for the children affected remains a problem.

“While there has been improvements in how all adults involved with Molly are working together, Molly’s foster carers told us they did not always feel listened to about Molly’s education and her new feeding program,” he added. 

“While it is important to acknowledge the progress that has been made especially for Molly herself, we feel that not enough has changed since the publication of Molly’s case in 2018.”

In a statement to RTÉ, the HSE said it welcomed the update from the ombudsman and that it was working closely with Tusla. 

Meanwhile, Tusla told RTÉ it has provided a “very comprehensive, diverse and effective range of additional services” to Molly and her foster carer since last year.

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