Role of the health authorities:The South Eastern Health Board did not provide counselling or support to 10 school girls and their families after they reported allegations of abuse against a parish priest in Ferns, the inquiry has found.
It establishes that counselling was only offered by the health board through a public statement in 1995, some seven years after the alleged abuse of the girls by the then parish priest of Monageer, Fr Jim Grennan, in 1988.
This response has been criticised in the report as "inadequate and inappropriate".
The report also says the health board response was not consistent in all cases. After the 10 schoolgirls made their allegations against Fr Grennan, seven of them were interviewed and assessed. The health board informed the gardaí and church authorities.
However, in doing this, the board was acting outside its powers, the report finds.
"Although their intervention was well intended and undertaken with commendable expedition, it could not be classified as appropriate," it says.
This was because while health boards have an obligation to promote the welfare of children, the actual powers conferred on them to secure the protection of children are limited.
The report says the 1908 Children Act was the relevant legislation when most of the cases looked at by the inquiry arose.
This "Edwardian legislation" provided "limited protection" in that it "afforded no protection to children who had been abused otherwise than through neglect or abuse by parents or carers".
The report also states that health boards have no statutory power to obtain or seek a court order to prohibit a person suspected of abusing children from having contact with children.
"The health board does not currently have statutory powers to prevent a suspected abuser from acting in a capacity such as a teacher or sports coach or indeed a priest which would bring him or her into close contact with, and afford him or her ready access to, young people.
"Essentially it is a matter for parents and guardians to determine the school their children will attend or the sports facilities they should utilise," it says.
"The inquiry suggests that consideration should be given to conferring express power on the Health Service Executive to apply to a court of competent jurisdiction for an order prohibiting a named person from engaging in an activity which would give him a ready access to children at all, or otherwise on such terms that the court might direct," it adds.
Yet the Ferns report points out that there is still a duty on a health board under the 1991 Child Care Act to take appropriate action where a person it suspects of abuse plans to take up a position which may expose others to abuse without having "any express legislative powers" to do so.
This is an issue which the inquiry believes should be "carefully considered by the legislature".
It also says the first guidelines on procedures for identification, investigation and management of child abuse were issued by the Department of Health in 1987. The former Bishop of Ferns, Dr Brendan Comiskey, knew of them and was "informed by them in dealing with an allegation of child sexual abuse in 1990".
The guidelines stated that any person who knew or suspected that a child was being harmed or was at risk of abuse should convey this to the local health board.
In 1990, the report says, Dr Comiskey suggested that the parents of a victim who came to him with an allegation should speak to a GP who would then be obliged to report the allegation to the health board and through it, to the gardaí. This happened.
However, it says Dr Comiskey "did not believe it was appropriate to use these Department of Health guidelines in dealing with allegations received about priests where these allegations were made by adults.
"The guidelines do not deal with the issue of whether the reporting recommendation should vary if the victim is an adult at the time of making the report, but in circumstances where the perpetrator is still in a position to abuse children, the rationale for such reporting remains."
The report adds that South Eastern Health Board officials spoken to by the inquiry team "were not aware of any formal policy having been adopted by the health board regarding adult complaints".
It says there was much closer exchange of information between the health board and gardaí since the mid-1990s.