A report on the "West of Ireland" sex-abuse case recommends legal changes to allow a child to be interviewed without parental consent. It also advises an interdisciplinary approach, for health boards to share information with teachers about children at risk.
The review group, set up in 1995 after the conviction of a "West of Ireland farmer" for abusing his children, examined the handling of the case by the North Western Health Board and the family GP. The report is expected to be published today.
Although the group's work focused on this case, it believes that most, if not all, of its recommendations should have national application. It acknowledges the "dramatic changes and improvements" brought about by the implementation of the 1991 Child Care Act, but says a review like this allows a look at the issues which remain to be addressed.
In strategic terms, it recommends an integrated and interdisciplinary approach from all health board sections and staff, the training of staff to recognise and deal with emotional abuse, and a formal out-of-hours service.
It also urges the Department of Health to provide a national perspective on classifying cases and assessing risk in its review of national guidelines, which is now going on. It recommends addressing the problem of the safety of board staff who may be subjected to abuse while pursuing their duties.
It also recommends exploring strategies for monitoring children thought to be at risk, including through schools, and monitoring remaining siblings at home when a child is taken into care.
Systematic contemporaneous notes should be taken, and a system of keeping hospital records which would identify children making repeated visits are suggested. Medical information should be exchanged between doctors, and the same people should participate in case conferences while the board is involved with a child or family, it says.
Although it acknowledges that there have been major improvements in child-protection legislation, the review group says that legal issues remain to be resolved. These include the rights of children and the right to interview and/or medically examine a child who is not in care without parents being present or giving their consent.
Teachers and doctors, as well as health board staff, should be trained so that they can deal with child abuse, it says.