AN INVESTIGATION BY the Ombudsman for Children’s Office (OCO) has found that a boy with profound disabilities was left waiting to be discharged in hospital for more than two years after Tusla and the HSE were unable to secure care for him. 

A report into the case of the child, known as Jack, was launched after the a hospital team raised concerns about how long it was taking for him to be allowed to leave hospital.

The OCO investigation singled out administrative shortcomings by the two agencies, with Ombudsman for Children, Dr Niall Muldoon citing “unacceptable delays and mismanagement” of care for the child.

The report found that Tusla discriminated against the child on grounds of disability after failing to assist in providing care to him, and that the HSE later placed him in a host family without any legal or formal framework.

Jack suffered brain damage and significant life-changing injuries in a road traffic accident abroad when he was aged three in 2016, which resulted in him requiring 24-hour care.

Following the accident, his mother returned to Ireland with him and he was admitted to hospital immediately.

But despite being cleared by his doctors to be discharged from hospital in 2017, Jack remained living between different hospital settings for two-and-a-half years.

In January 2018, the OCO was alerted to Jack’s case after being contacted by a hospital multi-disciplinary team concerned about the lack of exit plan in place for him.

While an OCO preliminary examination was ongoing, a referral was made to Tusla by a medical social worker when Jack’s mother expressed concern that she would not be able to properly look after him at home.

However, the referral was rejected by Tusla on the grounds that there were no child protection concerns and the issue was a matter for the HSE alone.

In February of this year, the HSE placed Jack in the care of a host family, allowing him to attend school where he has two classmates.

‘Negative impact’ on Jack’s life

The OCO made a number of findings into the handling of Jack’s care by the HSE and Tusla during its investigation, including that there are another 356 children with disabilities waiting for an appropriate living arrangement.

In particular, it found that the administrative actions of both Tusla and the HSE had a “negative impact” on the boy’s life.

It also pointed to “systemic failures” by the HSE to provide adequate services to children like Jack, who were living with disabilities in inappropriate settings.

The report further found that Tusla’s conclusion that Jack’s needs were solely a matter for the HSE was “improperly discriminatory” on the grounds of disability.

And it said Jack’s eventual placement with a host family by HSE Disability Services was made “without any legal or formal regulatory framework or proper authority”.

Commenting on the report’s findings, Dr Niall Muldoon said it made for “grim reading”.

“The tragedy of Jack’s accident and subsequent life changing injuries for both the little boy and his family, was compounded by unacceptable delays and mismanagement of his care by the State, which was supposed to have his best interests at heart,” he said.

“The OCO believes that if the HSE and Tusla had worked together at an early stage Jack may have had the opportunity, with adequate support, to grow up with his family.

“It is the view of the OCO that every child should have the right to grow up with their families or in a home setting, and that no child should forfeit that right due to a lack of resources, services or proper co-ordination by State services.”

The report also made a number of recommendations, including that HSE Disability Services should immediately and systemically review all cases where a child remains in hospital settings beyond their medical need.

It also recommended that Tusla should issue immediate guidance to all social work areas that child protection and welfare referrals about children with disabilities must be assessed and managed the same as other referrals.

And it stated that HSE Disability Services should conduct a national review of the current need for alternative care for children with disabilities whose parents or carers are assessed as being either unwilling or unable to provide for their ongoing care.