CONCERNS HAVE BEEN raised that “vital” developmental checks are not being carried out on newborns due to a lack of public health nurses.
When a baby is born, developmental checks are carried out at regular intervals from immediately after birth throughout infancy.
During the baby’s first week, once they get home, a public health nurse visits and typically checks the baby’s weight and overall health.
The family’s GP will also carry out checks on the baby during this period.
The public health nurse is expected to carry out a developmental assessment when the baby is three months old.
However, some babies are not getting this assessment due to a shortage of public health nurses, prompting concerns there could be a delay in diagnosing certain conditions.
A number of parents have contacted the Ombudsman for Children’s Office (OCO) about the issue, saying their children’s health is being put at risk.
The HSE has confirmed that a “significant shortage” of public health nurses and healthcare assistants in various parts of Dublin means some children are not getting development assessments.
The issue of developmental checks for newborns being cancelled was previously raised by the OCO in 2022.
A ‘prioritisation process’ was implemented at the time, whereby babies in greater need were most likely to receive these assessments. However, some parents have questioned the criteria used to determine prioritisation.
In November 2022, Health Minister Stephen Donnelly cited the impact of the Covid-19 pandemic on staffing as the initial reason for this prioritisation process, as well as staffing shortfalls.
A spokesperson for the OCO yesterday confirmed to The Journal that the organisation has received a number of complaints about the issue in the last year.
“We remain concerned about the prioritisation framework in place for newborn babies’ developmental checks and our work on this issue is ongoing.
“Developmental checks present a window of opportunity to spot an issue early on, and by missing these checks there is a risk of exacerbating problems down the line in a system that is already under pressure, and struggling to cope with demand.”
The spokesperson said the OCO is particularly concerned that newborn babies in homeless or transitory accommodation may not have access to these “vital” checks.
“We know that not having a home and living in unsuitable accommodation can have a huge impact on children’s early development,” they added.
Dublin West TD Mark Ward raised the issue with the HSE again this month, after being contacted by a number of affected families.
In replies to a series of parliamentary questions asked by Ward, the HSE last week said its efforts to address staffing issues were affected by the “pause on recruitment” prior to it being lifted on 15 July.
“Unfortunately, the staff shortages have meant that some areas have moved to a Priority 1 (P1) service as per the National Caseload Prioritisation Procedure for the PHN Service.
This means that some services will not be provided, and this includes developmental checks.
In the replies, the HSE said parents “are advised of this at the first visit” and “provided with a letter outlining the current situation and of the resources available”.
However, some parents say they were not provided with this letter or information about other supports available to them.
Ward, Sinn Féin’s mental health spokesperson, said he knows of several families impacted by this.
He told The Journal: “I have had parents contact me from right across Dublin Mid West and there is a lack of public health nurse services for newborn children across the constituency.
“I have joined parents and made an official complaint to the Children’s Ombudsman.”
Ward said children’s brains “develop more in the first five years of their lives than at any other time”.
If children do not get the necessary development checks, something that might be missed could have a lifelong impact on them.
“We all hear about how early intervention is key, yet we have a situation here where children are not getting their developmental checks,” he added.
Fionn Bowe was born in January of this year. He was not premature but was born underweight and proceeded to lose more weight as a newborn. The exact cause was unclear.
“He was born at six pounds on the button – which for a male is is extremely low – and lost 10% [of his body weight],” Philip, Fionn’s dad, told us.
When he was six days old, a public health nurse visited the family home in Lucan and raised concern about his weight loss. However, Fionn’s parents said no follow-up care or advice was provided.
Worried about his health, Philip and his wife Kelly contacted their local GP clinic and Holles Street maternity hospital which both provided support.
Fionn’s parents assumed he would get his three-month developmental assessment, but said they were never contacted about it.
“It was a week past our three-month date and we hadn’t heard anything, so we started calling the clinic,” Philip told us.
He said they left multiple messages over the course of a week before a nurse called them back.
Philip said they were told that, due to staff shortages, Fionn would not get this three-month assessment – and possibly other future assessments – as other babies deemed to have greater needs were being prioritised.
Philip said Fionn was entitled to this check-up either way but, given his worrying weight loss, he was particularly in need of assessment.
“Fionn should have fallen into that prioritisation by being born in the second centile [underweight] and losing 10%,” Philip stated.
Fionn has had regular visits to his GP in recent months. He has started to gain weight and is doing much better overall.
Philip and Kelly are relieved his weight has now stabilised, but said they didn’t receive the help they needed.
Philip said it’s not right that children and parents in certain areas are not getting the support they need.
It’s a disadvantaged area, and those children are being left to start already further behind.
“All those checks are vital – and they’re not even just vital for the child.
“They’re vital for the parents to explain to them, ‘Oh, your child isn’t crawling. Have you tried this? Your child isn’t grasping. Have you tried using this toy?’ They’re all little tips that some people would really need.”
The Bowes have lodged a complaint with the HSE and the OCO.
When asked for comment, a spokesperson said the HSE is “aware of difficulties in relation to the recruitment and retention of public health nurses within the Dublin area, particularly in Dublin West”.
“In this area a number of short-term temporary solutions have been undertaken to prioritise resources.”
The spokesperson said these efforts include integrating services, reorganising work and redeploying staff.
“Where staff shortages arise, the HSE continues to prioritise and support patients who have the greatest need in the community,” a statement noted.
The spokesperson added that any parent who has concerns about their child’s development should contact their GP or Local Public Health Nursing service.
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