Social services inspectors have expressed concern at the high use of physical restraint and detention of children in the care of health authorities.
In its annual report for 2005, the Social Services Inspectorate said that seven out of 13 high support units for young people with emotional and behavioural problems did not meet the required standard of care.
In total there were just over 5,000 children in care. The vast majority were in foster care (84 per cent) - in line with Government policy - while 9 per cent were in residential care. There are a total of 141 residential centres caring for 442 children and adolescents.
Most children in residential centres were in their teens, although about 100 children were 12 years of age or younger.
Different trends in the care of children were evident in different regions. The highest proportion of children in care was in the greater Dublin area (61 per 10,000 of the population) and the lowest in the west (32 per 10,000).
The proportion of children in foster care was lowest in Dublin (76 per cent of children in care), while the figure was closer to 90 per cent in other areas.
The report said this "inequity in the care experience" indicated that where a child lived was a significant factor in determining what kind of care placement was provided.
The inspectorate said these issues needed to be addressed by the Health Service Executive (HSE) and recommended a range of changes to the way it allocates resources and develops policies.
Inspections of the 13 high support units - specialist services for young people with emotional and behavioural problems - showed high use of restraint and detention in some units, according to the report.
The report described this as "an unacceptable and ineffective approach" and recommended that the HSE develop guidelines on the best and most appropriate use of these units.
It also issued recommendations on care planning, monitoring the use of physical restraints, and providing clear guidance to staff on the circumstances in which they have authority to detain children.
Overall, it found that one high support unit provided an excellent service, another five provided a good service, while seven did not provide a service of the required standard.
The inspectorate also voiced its unease at standards in children's centres in the former south western area health board, which serves parts of Dublin, Kildare and Wicklow.
These related to a high proportion of young children under 12 in care; poor care planning; poor physical accommodation; and failure to respond to complaints.
This former health board area had one of the highest number of children's residential centres in the country. However, it did not have the management resources of areas with few centres.
In another area of concern, the inspectorate expressed unease that there were no inspections of residential services for children with disabilities.
While the Minister for Health has pledged to establish such inspections, the inspectorate said it regretted the delays.
