Agenda for children services: policy handbook

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The Agenda forChildrens Services:A Policy Handbook

Ofce o the Minister or ChildrenDepartment o Health and Children


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The Agenda forChildrens Services:A Policy Handbook

Oce o the Minister or Children

Department o Health and Children

December 2007


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Copyright Minister or Health and Children, 2007

Oce o the Minister or ChildrenDepartment o Health and ChildrenHawkins HouseHawkins StreetDublin 2Tel: +353 (0)1 635 4000Fax: +353 (0)1 674 3223E-mail: [email protected]: www.omc.gov.ie

Published by The Stationery Oce, Dublin

ISBN: 978-1-4064-2031-9Prn: A7/1892

All rights reserved. No part o this publication may bereproduced, stored in a retrieval system, or transmitted,in any orm or by any means, electronic, mechanical,

photocopying, recording or otherwise, without the priorpermission in writing o the copyright holder.

For rights o translation or reproduction, applications should bemade to the Head o Communications, Oce o the Minister orChildren, Hawkins House, Hawkins Street, Dublin 2, Ireland.


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Contents

Foreword by the Minister or Children v

A word rom stakeholders, children and young people vi

1 Aimsandobjectives 2How best to use this handbook 8

2 Promotinggoodoutcomesorchildrenandyoungpeople 12

3 Servicecharacteristicsneededtoachievegoodoutcomes 161. Connecting services with amily and community strengths 17

2. Ensuring quality services 20

3. Opening access to services 23

4. Delivering integrated services 26

5. Planning, monitoring and evaluating services 28

4 Gettingtheretogether 34Concentric circles o responsibility and delivery 34

Shared style o working 35

5 Keyconceptsorasharedlanguage 38

Useul publications and websites 42


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iv


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v

I am delighted to welcome the publication o this national policy document, The Agenda for

Childrens Services. It is an exciting and challenging time or all o us whose work concerns the

lives o children in Ireland. Never beore has there been such a concerted ocus on children,

their needs and what we as a society should do to respond to those needs.

The establishment o the Oce o the Minster or Children (OMC) within the Department

o Health and Children in 2005 was an expression o the Governments wish to advance

the agenda in relation to childrens services and represented a major milestone in theimplementation o the National Childrens Strategy. As Minister or Children, I attend Cabinet

meetings, thus enabling a direct input on childrens issues at Cabinet level. My Oce is

a rst in terms o public service management, in that three policy divisions in three

dierent Government departments are co-located together or the purpose o achieving

betters outcomes or children. The mandate given to the OMC is recognised in the current

social partnership agreement, Towards 2016. This agreement tasks the OMC with enabling all

parts o the public service management to work strategically together, at national and local

levels, so as to achieve more eective and ecient delivery o childrens services.

An important aspect o this policy document, The Agenda or Childrens Services, is the

emphasis placed on the role o amilies and communities in the lives o our children. Toooten in the past, services were provided to our children and young people in isolation rom

their amilies and communities. This was, and is, to the detriment o all concerned. The

inclusion o amilies, extended amilies and local communities, where possible, in services

or children goes a long way to ensuring that these services are actually responding to the

needs o the child and ensures that they continue to be eective in the long term, even

when direct intervention rom State or voluntary agencies has ceased.

This policy document builds on existing policies and places them in a ramework to assist

policy-makers, service managers and ront-line sta in meeting the needs o children and

their amilies. The Agenda is directing us all in a new way o working with children, their

amilies and communities, to ensure that our services are evidence-based, accessible,eective and sustainable. The inclusion o refective questions or the dierent levels o

practitioners is, in my view, a simple, yet eective way o ensuring that The Agenda is a

working tool or us and not just another policy document. It is the intention that The

Agenda serves as a broad statement o principles or all services concerned with children.

More specic policies in relation to certain aspects o services will be published at a later

stage.

I am condent that this document will assist all o us in our ongoing eorts to provide a

happy, healthy, sae, secure and participative environment or all our children and young

people.

BrendanSmith,TD

Minister or Children

Foreword

by the Minister for Children


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A word from stakeholders,

children and young people

ExtractsromquotesreceivedinthepublicconsultationontheNationalChildrens

Strategy,2000-2010

Id like to turn back the clocks o all the children in care so that they would

never have to go into care in the rst place.

Is Ireland a good place to grow up? Yes, i you are rom a loving amily, with

a decent income, supportive network and nice community However, i you

are less well o, have medical, learning or emotional needs, and the amily

situation is unstable or plagued by drink, drugs or depression, things are quite

dierent.

The needs o the child must be catered or in a holistic sense. The emotional,

physical, educational, societal and cultural needs should be looked at in the

context o the amily and community. The creation o building-up a sense o

belonging, o being a valued member o the community, should be incorporatedinto all services.

Id like there to be a real choice o placements or each child and young

person that is suitable to their needs.

It is welcome that the task o integration and partnership is being increasingly

identied as an intrinsic part o the work o State agencies and their sta, and

not an add-on.

vi


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Section1


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Aims and objectives

The purpose o this document is to set out the strategic direction and key goals o public

policy in relation to childrens health and social services in Ireland. (The term children is

used here to cover everyone under the age o 18 years.) Its aim is to assist policy-makers,

managers and ront-line practitioners to engage in reective practice* and eective

delivery, to be inormed by best Irish and international evidence, and to identiy their own

role within the national policy ramework.

This document is part o a undamental change now underway in how Government policyin relation to children is ormulated and delivered. The National Childrens Strategy or

the period 2000-2010 was the rst document to give clear expression to a commitment

to enhancing the status and improving the quality o childrens lives through integrated

delivery o services in partnership with children, young people, their amilies and their

communities (see Box 1). This commitment was both evidence-based and outcomes-

ocused*, is in line with the 1989 United Nations Convention on the Rights o the Child

(see Box 2) and refects best practice internationally and across the island o Ireland (see

Useul publications and websites at the end o this document). A range o policy documents

have reinorced these commitments over the years (see Box 3).

The ocus oThe Agenda or Childrens Services is on the key messages o existing policies inrelation to children. Together, these promote:

a whole child/whole system approach to meeting the needs o children;

a ocus on better outcomes or children and amilies.

In this context, supporting amilies is identied as the central concern underlying all

childrens health and welare services, whether aimed at prevention, early intervention,

hospital services, protection or out-o-home care. An objective oThe Agenda or Childrens

Services is to provide the means or operational managers and ront-line sta, particularly

in the Health Service Executive (HSE), to direct and evaluate their delivery o services

to children and their amilies against this strategic direction. A second objective is to

encourage all Government departments and agencies to adopt this approach in their policy

considerations and their services regarding children.

Box1:TheVision

An Ireland where children are respected as young citizens with a valued

contribution to make and a voice o their own; where all children are cherished and

supported by amily and the wider society; where they enjoy a ulflling childhood

and realise their potential.

Our Children Their Lives

TheNationalChildrensStrategy(2000),p.10

*Denitions o words highlighted in bold and ollowed by an asterisk (*) in the text are given in Section 5, Key concepts or a

shared language.


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Box2:UnitedNationsConventionontheRightsotheChild

RespectorchildrenasaglobalidealhasbeenafrmedbytheUnitedNations

ConventionontheRightsotheChild(UN,1989).TheUNGeneralAssembly

unanimouslyadoptedtheConventionontheRightsotheChildon20November

1989anditenteredintoorceorbecamelegallybindingonStatesPartiesin

September1990.IrelandratifedtheConventionin1992.

TheConventionspellsoutthebasichumanrightstowhichchildreneverywhereare

entitled.Theseare:

therighttosurvival;

therighttothedevelopmentotheirullphysicalandmentalpotential;

therighttoprotectionrominuencesthatareharmultotheirdevelopment;

therighttoparticipationinamily,culturalandsociallie.

TheConventionprotectstheserightsbysettingminimumstandardsthat

governmentsmustmeetinprovidinghealthcare,educationandlegalandsocial

servicestochildrenintheircountries.

TheConventiondefnesachildasapersonbelowtheageo18,unlessthelawsoaparticularcountrysetthelegalageoradulthoodasyoungerthan18.

TheguidingprinciplesotheConventionare:

allchildrenshouldbeentitledtobasicrightswithoutdiscrimination(Article2);

thebestinterestsothechildshouldbetheprimaryconcernodecision-

making(Article3);

childrenhavetherighttolie,survivalanddevelopment(Article6);

theviewsochildrenmustbetakenintoaccountinmattersaectingthem

(Article12).

In2005,IrelandsubmitteditsSecondReportontheimplementationothe

ConventiontotheUNCommitteeontheRightsotheChild(NCO,2005;or

urtherinormation,seewww.omc.gov.ie).


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Box3:ProgrammeoHealthandSocialServicesReorm

(ull details o publications on pages 42-44)

The National Childrens Strategy:

Our Children Their Lives (2000)

This strategy sets out a series o

objectives to guide childrens policy over a

10-year period. It identies six principlesto guide all actions to be taken and it

proposes a more holistic way o thinking

about children.

Quality and Fairness A Health System

for You(2001)

This strategy sets out overarching

goals and a programme o investment

and reorm or a 10-year period or thehealthcare system. It envisages cross-

disciplinary collaboration to achieve

new standards, protocols and methods.

Primary Care A New Direction(2001)

This document sets out a blueprint

or the planning and development o

primary care services over a 10-year

period. It proposes the introduction o an

interdisciplinary team-based approach on

a phased basis.

Transormation Programme 2007-2010

(2006)

This document was developed or all

sta working or the Health Service

Executive (HSE). It has six priorities,

which include the development o

integrated services; the conguration oservices to deliver optimal and eective

results; the implementation o standards-

based perormance measurement and

management; and the engagement o all

sta in transorming health and social

care. These priorities will be addressed

through 13 dierent Transormation

Programmes, which ocus on improving

the services that patients, clients and

carers receive, and on improving the

HSEs inrastructure and capability toprovide and support those services.

National Action Plan or Social

Inclusion 2007-2016: Building an

Inclusive Society(2007)

This plan, complemented by the social

inclusion elements o the National

Development Plan 2007-2013,

Transforming Ireland A Better Quality of

Life for All (2007), sets out how the social

inclusion strategy will be achieved over

the period 2007-2016. The new strategic

ramework acilitates greater coordination

and integration o structures and

procedures across Government at national

and local levels, as well as improved

reporting and monitoring mechanisms. The

plan includes specic targets and actions

relating to children.

A Vision for Change Report of the

Expert Group on Mental Health Policy

(2006)

This report proposes a ramework o mental

health service delivery with the service

user at its centre. It details a series o

actions or developing a comprehensive

person-centred model o mental health

service provision, including the urtherdevelopment o community-based,

multidisciplinary teams.


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Reach Out Irish National Strategy for

Action on Suicide Prevention 2005-2014

(2005)

This strategy builds on the work o the

National Task Force on Suicide (1998). It sets

out an evidence-based, pragmatic approach

or prioritising actions to be taken over the

next 5 to 10 years in order to eect real

change. The strategic ramework sets out

a partnership approach between statutory,

voluntary agencies, community groups and

individuals, supported by Government.

Disability Act 2005: Sectoral Plan or

the Department o Health and Children

and the Health Services(2006)

The ocus o the Disability Act 2005, a

key element o the Disability Strategy, is

on mainstreaming and social inclusion

and is given particular emphasis

through the Sectoral Plans provided or

under the Act. The plan sets out actions

or the Department o Health and

Children, the Health Service Executive

and other statutory bodies.

National Drugs Strategy 2001-2008

(2001)

This strategy is based on our pillars

supply reduction, prevention, treatment

and research and approximately 100

actions have been identied or a number

o Government departments, including

Health and Children.

Report o the Working Group on the

treatment o under-18 year-olds

presenting to treatment services with

serious drug problems(2005)

This report is an important element

o the Drugs Strategy and sets out

ways to achieve the recognition o an

individuals drug misuse and appropriate

interventions. It emphasises the need

or a multidisciplinary approach. It

recommends a our-tiered model o service

delivery, which provides a realistic,

fexible and adaptable ramework.

Report of the Working Group on Foster Care:

A child-centred partnership(2001)

This report sets out good practice guidelines

and recommendations or the development

o oster care services in Ireland to meet the

needs and demands o children, their amilies

and oster carers.

Childrens Health First Internationalbest practice in tertiary paediatric

services: Implications or the strategic

organisation o tertiary paediatric

services in Ireland(2006)

This report was commissioned to advise

on the strategic organisation o tertiary

paediatric services or Ireland that would

be in the best interests o children. The

conclusion o the report is that compelling

evidence exists or one national tertiary

paediatric centre based in Dublin. The

proposed assessment criteria or planning

such a centre include providing a patient-

and amily-ocused environment and services.

A Strategy or Cancer Control in Ireland

(2006)

This strategy sets out uture

recommendations or the provision o

cancer services. It acknowledges the good

perormance o Ireland in relation topaediatric oncology and recommends that

this be maintained.


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Children First: National Guidelines for the

Protection and Welfare of Children(1999)

These guidelines were developed to

support and guide health proessionals,teachers, Garda and others who come in

contact with children through sporting,

cultural, community and voluntary

organisations. The report provides people

with a set o sound principles and good

practice guidelines.

Report on the Youth Justice Review

(2005)

This report aims to identiy the

leadership and coordination mechanismsnecessary or eective service delivery

or children appearing beore the Courts.

It emphasises the need or the justice,

health and education systems to work

eectively together to achieve better

outcomes or children.

Review o the National Health

Promotion Policy 2000-2005(2005)

This review establishes the progress

made to date in implementing theobjectives o the 2000-2005 National

Health Promotion Strategy, in addition

to identiying the areas where progress

has yet to be made and making

recommendations or urther action.

Youth Homelessness Strategy(2001)

This strategy sets out specic actions or key

stakeholders, e.g. HSE, Education. The goal

o the strategy is to reduce and i possibleeliminate youth homelessness through

preventative strategies and to ensure

that a comprehensive range o services

are available or those homeless children,

aimed at re-integrating them back into their

communities as quickly as possible.

Breasteeding in Ireland A fve-year

Strategic Action Plan(2005)

This action plan sets out time-

ramed targets and actions to provide

lead agencies with a template or

implementation, aimed at greatly

improving breasteeding rates in Ireland.

Strategic Task Force on Alcohol,

Second Report 2004(2004)

This report sets out recommendations

aimed at enhancing societys capacity

to prevent and respond to alcohol-related harm, to achieve WHO targets

and or early intervention to ensure

eective treatment to reduce high

risk and harmul drinking and alcohol-

related problems.


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It is anticipated that The Agenda or Childrens Services will serve as a broad policy

ramework document, which will enable, as required, the development o new or revised

Government policies in specic areas o childrens services. These new or revised policies

will set out detailed actions and will be developed in consultation with operational

managers and ront-line sta and, where appropriate, with Government departments and

the wider public service, the voluntary sector and with children, young people and their

amilies and communities.

Considerable work was done by the National Childrens Oce (the NCO, incorporated in

2005 into the Oce o the Minister or Children, the OMC) to realise the three central

goals o the National Childrens Strategy, namely:

children will have a voice;

childrens lives will be better understood;

children will receive quality support and services to promote all aspects o their

development.

The Oce o the Minister or Children (OMC) is now driving that work urther orward rom

within the Department o Health and Children. It does this through developing policy on

childrens health and welare, contributing to the development o early years educationand youth justice policy, and generally promoting the interests o children across all

Government departments and within the wider society (see Box 4). Further momentum or

change was generated by the Departments review in 2004-06 o Family Support Services,

which involved a signicant amount o consultation, analysis and strategic thinking on

how best Government can deliver quality services to support all aspects o childrens lives

(Department o Health and Children, 2007a, b and c).

Box4:RoleotheOfceotheMinisterorChildren

Inordertobringgreatercoherencetopolicy-makingorchildren,theGovernment

establishedtheOfceotheMinisterorChildren(OMC)in2005.TheOMCisanintegralpartotheDepartmentoHealthandChildren.Itsocusison

harmonisingpolicyissuesthataectchildreninareassuchasearlychildhood

careandeducation,youthjustice,childwelareandprotection,childrenandyoung

peoplesparticipation,researchonchildrenandyoungpeople,andcross-cutting

initiativesorchildren.TheOMCsupportstheMinisterorChildrenindrivingthe

implementationo:

theNationalChildrensStrategy(2000-2010);

theNationalChildcareInvestmentProgramme(2006-2010);

policyandlegislationonchildwelareandchildprotection;

theChildrenAct,2001andtheChildCareAct,1991.

TheOMCalsomaintainsageneralstrategicoversightobodieswithresponsibility

ordevelopinganddeliveringchildrensservices.


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A signicant programme o reorm has taken place in health and social services in recent

years with the establishment o the Health Service Executive (HSE) and its national and local

structures. In this reormed organisational context, underpinned by the HSEs Transormation

Programme 2007-2010, a real opportunity exists to shape service development and delivery

so that national policy can be eectively translated into improvements in the lives o

children and their amilies (HSE, 2006a). In addition to the National Childrens Strategy, a

series o sectoral plans, strategies, policies and legislation are in place (see Box 3). These

include the Disability Act 2005: Sectoral Plan (Department o Health and Children, 2006a);

A Vision or Change: Report o the Expert Group on Mental Health Services (Government

o Ireland, 2006); Primary Care A New Direction (Department o Health and Children,

2001a); Childrens Health First International best practice in tertiary paediatric services

(HSE/McKinsey & Company, 2006b). These strategies and policies are not only specic and

detailed in their ocus on the services that are required or meeting particular needs; they

also recognise the needs o the whole child and the requirement or integrated service

design and delivery within the whole system.

The energy and commitment that so many people, adults and children, have invested in

these policy developments, together with the skills and resources now committed to the

daily delivery o services to children across the ull range o their needs, have created a

momentum or change to better the lives o all children and young people. The inclusion

o the needs o children as part o the liecycle approach adopted in the current national

agreement, Towards 2016, is an indication o the heightened policy prole now accorded to

children by both Government and the social partners. The challenge now is to ensure that

this signicant policy advance at national level is translated into good outcomes that can

be seen in the day-to-day lives o children themselves. The Agenda or Childrens Services is

a tool to assist in that task.

How best to use this handbookThe Agenda or Childrens Services is not to be regarded as a static document, but as an

active policy tool. In order to advance needs-led, outcomes-ocused* services, a set

o key concepts (see Section 5), explanatory rameworks (see Figures 1-6) and refective

questions (see Boxes 5-9) are provided. These have been developed to support, respectively,

those involved in service delivery, management and policy-making. Working through these

key concepts, explanatory rameworks and refective questions, sta at all levels o the

health and social services system should be able to actively engage in delivering services

that express both the general thrust o national childrens policy and the specic policies

relevant to their area o work.


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These materials should orm the basis or reectivepractice* at the level o the organisation,

group, proessional, team and individual, and serve as a basis or discussions at seminars,

conerences, service reviews and case discussions. The materials have been designed or

photocopying and scanning, and or the creation o interactive media. In this way, The

Agenda or Childrens Services aims to enable everyone involved in childrens services to

take personal responsibility or advancing the national goal o needs-led, evidence-based

services that promote good outcomes or children.

Figure1:UsingThe Agendatocreateawholechild/wholesystemapproachtopromoting

betteroutcomesorchildren

Underminingcircumstances

andlieevents Betteroutcomes

Pooreroutcomes Prevention Earlyintervention Communityserviceprovision

Out-o-homecare Protection

Reducethequalityothelivesochildren,

amiliesandcommunities

Enhancingthestatusandimproving

thequalityochildrenslivesthroughstrongandhealthyamiliesand

communities


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Section


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1

At the core oThe Agenda or Childrens Services is the promotion o what we want or our

children good outcomes: the best possible conditions, situations and circumstances to

live their lives to their ull potential. Outcomes are about both what is happening nowin

childrens lives and what may happen or them in the uture. Outcomes address both the

being and the becoming o childhood. Although there is considerable consensus about

the types o outcomes that are desirable or children across the various dimensions o their

lives and considerable understanding about how to achieve them, there continues to be

many dierent ways in which these outcomes are described. As a way o ensuring a common

language o outcomes within childrens services, The Agenda draws together the various

types o outcomes ound in contemporary childrens policy and presents them here as a

single list o 7 items:

The7NationalServiceOutcomesorChildreninIreland

healthy,bothphysicallyandmentally

supportedinactivelearning

saeromaccidentalandintentionalharm

economicallysecure

secureintheimmediateandwiderphysicalenvironmentpartopositivenetworksoamily,riends,neighboursandthecommunity

includedandparticipatinginsociety

These 7 National Service Outcomes or Children are intentionally ramed as active, strengths-

based and positive. Childrens services aimed at promoting these outcomes need to recognise

that not only do children need active support but that children are themselves resilient*

active participants in their own lives and the lives o those caring or them.

As set out in Figure 2, it is the pursuit o better outcomes that should drive the ormulation

o policy and it is the expression o policy within services that then ensures the desired

outcomes are achieved. It is the successul combination o policy and services that achieves

good outcomes. Achieving good outcomes requires that policy-makers, planners, service

managers and ront-line sta all take responsibility to work towards them. This requires

understanding and committing to the 7 National Service Outcomes or Children and to

ensuring that sectoral plans and strategies, and organisational priorities all contribute to

their attainment.

Particular outcomes must be the ocus o particular services good health requires medical

services and health promotion; educational achievement requires schools; being sae rom

abuse requires child protection services; being secure in the immediate and wider physical

environment requires an active local authority and active community policing. But alongside

this is a shared responsibility refecting the complex overlapping task o achieving good

outcomes or children. Ensuring that services take into account the whole child and benet

Promoting good outcomes

for children and young people


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1

rom the range o available services requires a shared perspective. Where appropriate, there

needs to be joint working through the identication o lead responsibility towards specied

outcomes. This is necessary rom senior levels in the Departments o State through to the

interagency planning, service-level agreements and integrated service delivery to individual

children and their amilies.

Figure2:Betteroutcomeswhenpolicy-makersandserviceprovidersworkstrategically

together

Joined-up whole system government at national and local level has been identied in the

report by the National Economic and Social Council, entitled The Developmental Welare

State, as central to the reorm and development o Irelands social policies (NESC, 2005).

Commitments in relation to the children liecycle in the current national agreement, Towards

2016, refect this imperative: or example, multisectoral Childrens Services Committees are

to be established in each county. The OMC has adopted the lead role in the childrens

policy arena, taking responsibilities in child welare and protection, childcare, early years

education, youth justice and the National Childrens Strategy. But the achievement o the

7 National Service Outcomes or Children requires an even wider and deeper engagement

by all departments, agencies and services with responsibility, however limited, or children.

To support the achievement o whole system delivery, new interdepartmental, cross-agency

and multidisciplinary ways o working will be needed. The Childrens Services Committees,

mentioned above, may represent a way orward in this regard.

POLICYSERVICES

OUTCOMES

aspiredor

achieved


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Throughensuring the policy, organisational support and practice methods that promote

a wholechild/wholesystemapproach*, better outcomes or children can be achieved.

Children and amilies should be able to expect that whatever the ocus o the service they

are receiving (e.g. prevention, early intervention, community services, hospital services,

protection or out-o-home care), they will experience it as:

whole child/whole system ocused;

accessible and engaging; coherent and connected to other services and community resources;

responsive to their needs;

staed by interested and eective sta;

culturally sensitive and anti-discriminatory.

Standards or some childrens services have been developed and good practice service models

have been identied in many areas. All service providers should aim to meet these standards

where they apply and to meet the targets, aims and outcomes o the identied good practice

models (or examples,see Useul publications and websites).

1


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Section


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In order to promote the 7 National Service Outcomes or Children, services need to strive to

achieve 5 essential characteristics:

1. Connecting with amily and community strengths.

2. Ensuring quality services.

3. Opening access to services.

4. Delivering integrated services.

5. Planning, monitoring and evaluating services.

Achieving these qualities requires constant attention. To help ensure this happens, each o

the 5 characteristics is discussed in the ollowing pages and linked with a set o refective

questions which those involved in service delivery might ask themselves. There are separate

questions or policy-makers, or HSE senior managers and or ront-line service managers and

practitioners (see Boxes 5-9).

Central Government cannot, and should not, direct the day-to-day judgements and activities

o childrens services sta. It is, however, essential that sta at all levels play their role in

delivering on the strategic direction and standards o service that Government, through the

HSE, sets out. The refective questions posed or each o the 5 characteristics are intended

to promote the whole child/whole system delivery approach at the heart o present-day Irish

childrens policy. By considering these questions, sta at all levels can audit or themselves

and or others how closely they are complying with the direction o national policy. Refecting

on their answers will not only encourage closer compliance across all services and between

services, but also identiy best practice and the barriers to achieving it. It will also encourage

innovative thinking and problem-solving.

1

Service characteristics

needed to achieve good outcomes


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Connecting services with family

and community strengths

Ensuring that children and young people receive the support they need when they need it is

the central challenge or childrens services. This requires that ormal services connect with

and promote the networks o inormal support that surround children and young people (see

Figure 3). Supporting and complementing the many ways in which the immediate amily

protects and cares or children is the central unction o child health and child welare

services.

This is easier to achieve with some amilies than others. Social exclusion is a major barrier toeective support and needs to be directly addressed through targeting need and developing

and delivering culturally competent services. Eective protection o children and young

people at risk or in crisis, as well as the promotion o all childrens well-being, requires

working in partnership with amilies. Retaining the trust o amilies is the key. With regard

to children with disabilities, it also requires careul handling o sometimes complex ethical

and legal considerations relating to consent. This is particularly important when dealing

with those who are most vulnerable and those children and amilies who are most dicult

to engage. In child health and welare, there is now a clear recognition that eective

support or amilies requires universal provision, plus, within that, the targeting o services

to children and amilies at risk o social exclusion, in line with the NESCs report on the

Developmental Welare State (NESC, 2005).

Figure3:Acuppedmodeloamilysupport

MEETINGCHILDRENSNEEDS

Child/Young Person

Immediate Family

(inormal support)

Wider Family/Friends(inormal supports)

Community

(inormal support)

Community/Voluntary/Statutory

agencies and organisations

(ormal services)

National Government

(policy/legislation)

1

1


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The support that children receive rom other inormal sources beyond their immediate amily

also needs to be recognised the wider amily, riends and community. There is strong

evidence that or children in adversity it is these inormal networks that are the key sources

o help and yet they are oten overlooked by proessionals. Help rom these networks can be

available on a 24-hour basis in a less stigmatising ashion and can be very cost-eective.

They operate in the immediate world o the children and young people. They should

always be considered by proessionals and services as a major resource or assessment and

interventions. This applies in every situation o child health and welare service provision

whether the aim is prevention, early intervention, community services, hospital services,

child protection or out-o-home care.

Services need to identiy, understand and optimise the strengths within the inormal

networks o which children are a part whilst not ignoring the limitations and the harm

that amilies, neighbourhoods and communities can hold or children. At all levels o policy-

making, management and practice, there needs to be an explicit and active commitment

towards utilising amily, riends and community in working with children. This requires

much greater innovative thinking in assessing, using and resourcing inormal networks o

support so as to benet rom their strengths whilst recognising their limitations.

1


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All those involved in service development and delivery need to work together towards

constantly raising the quality o practice. This requires ront-line sta, service managers and

others to ensure that the services they provide are matched to SMARTplanning* or better

outcomes, in line with ormal quality standards and accreditation requirements where these

exist. (SMART is an acronym or activities that are specic, measurable, attainable, relevant

and time-based.) This requires ensuring services are eective and ecient in meeting

specied outcomes and that needs are clearly matched to appropriate services. Standards

need to be applied to both services and to outcomes.

Achieving quality child health and welare services requires that service delivery is based on

the accurate identication o need matched to service design and intervention. Thus, beore

any intervention is made, services need to be able to demonstrate how they have identied

the needs o amilies in particular areas, in particular categories or individually, and that

subsequent delivery o services is geared toward the outcome o meeting identied needs.

It is also essential that consideration is given to what other services have to bring to the

process o assessment, intervention and evaluation. In cases where the child or the amily is

already engaged with multiple services, clear processes or communication and collaborative

working between agencies must be agreed and put into practice. Within this context, it is

incumbent on proessionals and services to uphold the rights o children and amilies in

particular, the rights o children as outlined in the UN Convention on the Rights o the Child

(see Box 2).

As part o developing a needs-led service, proessionals must retain a ocus on the

inclusiveness o children and amilies as central players in the design, implementation and

evaluation o services. This involves working in partnership with service users i.e. the

service users having their say on both their needs and on the services and ways o working

that they see as best meeting their needs. Working in partnership must involve children

as much as it does the adults who care or them. It also requires ront-line proessionals

exercising their proessional judgements and working these into agreements about needs,

services and outcomes with service users. This process o engagement, between sta

delivering services and amilies using them, needs to be recorded over time, through the

stages o assessment, design, implementation and evaluation o outcomes.

0

Ensuring quality services

2


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Box

6:Refectivequestionson(2)Ensuringqualityservices

Que

stionsabout:

Quest

ionsor

POLICY

-MAKERS

Questionsor

HSESENIORMANAGERS

Questionsor

FRONT-LINESERVICEMANAGERSANDPRACTITIONERS

SMA

RTworking

tow

ardsoutcomes

Ismypolicyocusedonachieving

clearoverarchin

goutcomesor

children?

Whataretheou

tcomesorwhichmy

departmenthas

leadresponsibility?

Aretheseoutcomesachievableand

measurable?

Whatarethestructures,processes

andtimetablesthatareinplaceto

achievetheseoutcomes?

Arethepolicyspecicsorwhich

Iamr

esponsibleconsistentwith

theachievementotheagreed

outcomes?

Areservic

esdesignedtoocusonthe

achievementoparticularoutcomesinline

withTheAgendaforChildrensServices?

Howandtowhatextentcanitbe

demonstratedthatthedesiredoutcomesare

beingach

ieved?

Areservic

esorganisedsoastoencourage

andacilitatecollaborationwithothers?

Whatspecicoutcomesorchild

renismywork

currentlyocusedon?

DoIconsiderthewholechild,i.e.

theimportance

ooutcomesotherthanthoseI

amd

irectlyseeking

toachieve?

HowcanImeasureitheserviceisachievingsuch

outcomes?

Withwhoma

ndinwhatwaysam

Icollaborating

withotherservicestoidentiya

nddeliveronthose

outcomes?

InwhatwaysamI

workinginpartnershipwith

amiliestoidentiyanddeliveronthoseoutcomes?

Qua

lityassurance

Whatramework

sareinplace

toinormt

hede

velopmento

qualitystandard

s,havingregard

tobestpractice

andinternational

experience?

Doesthepolicy

rameworkor

whichIamr

esp

onsibleencourage

corporateserviceplannersand

ront-linestatooptimiseavailable

resourcesandpromoteearly

intervention?

IsthepolicyclimateIamh

elpingto

createencouragingoinnovationin

supportingamilies?

Whatarethequalitystandardsagainstwhich

servicede

sign,andtheimplementation

opolicythroughservicedelivery,

is

happening?

Inwhatw

ayscanitbeshownthatservices

areworkin

gecientlyandeectively?

DoestheorganisationalclimateIam

helpingto

createencourageinnovationin

servicede

signanddeliverywithinanoverall

ramework

oasharedstyleoworkingand

anapproa

chosupportingamilies?

DoIseek

todisseminatesuchinnovation

widely?

Whatarethequalitystandardsa

gainstwhichIam

measuringdeliveryoservices?

AmI

makingthebestuseothe

resourcesIhave

atmydisposal?

DoIconsiderinnovativewaysodeliveringa

qualityservice?

1


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Box6:Refectivequestionson(2)Ensur

ingqualityservices

Questionsabout:

Question

sor

POLICY-M

AKERS

Questionsor

HS

ESENIORMANAGERS

Questionsor

FRONT-LINESERVICEMANAGERSAND

PRACTITIONERS

Needs

-led

servic

es

Isthepolicyrame

workdesigned

aroundmeetingtheidentiedneeds

ospeciccategoriesoamilies?

Whatarethestructuresand

processesinplace

toacilitate

participationbych

ildrenand

amiliesinpolicyd

evelopmentand

implementation?

Aretheremeasures

inplaceby

whichIcanidentiytheimpacto

theparticipationb

ychildrenand

amiliesontheorma

ndnatureo

policy?

Aretheservicesdesignedandorganised

aroundmeet

ingtheneedsoserviceusersin

awaythatk

eepstheprincipleosupporting

amiliesinocus?

Areservices

ullyinclusiveothevoiceand

expertiseo

thechildrenandamilieswho

utilisethem?

Towhatexte

ntcanIenhanceservice

participation

bychildrenandamilies

intermsoa

ssessment,deliveryand

evaluation?

Istherethe

capacityorjointneedsanalysis

andplanningacrossservicesandsectors?

HowdoIassessneedsandwhodo

Iworkwith

todothis?

HowdoIkeeptheprincipleosup

portingamilies

asakeyconsiderationinrelationt

oneed?

HowdoImatchidentiedneedto

planningand

deliveringservice?

InwhatwayscanImeasuretheeective

involvementochildrenandtheiramiliesinthe

processoassessment,planning,interventionand

evaluation?


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Health and social care services or children do not exist as an alternative to the care

and concern that generally only amilies and communities can provide in a sustained and

eective manner. Services exist to complement, reinorce and extend the capacity o amilies

and communities. Just as amilies meet the ull range o children and young peoples needs

(emotional, intellectual, social, cultural and material), so too must there be a wide range

o services available to children and those who care or them. These need to be provided at

a series o levels o need and matched services, (see Figure 4). Families with more complex

needs require more complex services, or which the State must take greater responsibility.

Figure4:Levelsatwhichamiliesneedsupport

Source: Adapted rom Hardiker et al (1991)

In Figure 4, Level1 provides open access support to amilies (such as public health nurse

or GP services) and health promotion and inormation services (such as advice on good

nutrition). By contrast, Level2 support, while still provided to amilies at their request,

is targeted by assessment o need and mandated by the State as part o its responsibility

towards supporting amily lie. At Level3, support is better described as intervention to

Opening access to services

3

Intensiveandlong-termsupportandrehabilitation

orchildrenandamilies

Servicesorchildrenandamilieswithseriousdifculties,includingrisko

signifcantharm

Supportservicesorchildrenandamiliesinneed

Universalservicesandcommunitydevelopmentavailabletoallchildrenandamilies

LEVEL4

LEVEL3

LEVEL2

LEVEL1


31/54

indicate that the voluntary element is gone because severe and established diculties

placing children at risk have been assessed and work with the amily is mandated by law,

oten through the Courts. At Level4, the need within a amily is so acute or the coping

capacity so weak that children and young people have to be placed in medium or long-term

out-o-home care. Work at Level 4 is also about lowering the level o need and/or improving

coping so that re-engagement with services at the lower levels can become sucient.

The closer services are to providing or the sel-assessed needs o amilies and children, themore likely they are to be accessed. Services need to be primarily ocused at Level 1 and be

provided on an open access basis as part o community development. Not every amily will

want to use these services, but should have access to them. Services, just like amilies, must

meet childrens need or protection rom harm as well as or promoting their well-being and

development (e.g. education, play/leisure, built environment, child protection). Services

must also be able to meet dierent levels o need and have a special responsibility where

the level o need is greatest (e.g. acute illness, disability, school reusal, law breaking,

homelessness, rural isolation, ethnic/cultural dierence and poverty). Every eort should

be made to provide easy access to services through outreach to individual children, their

amilies and their communities. This requires making available non-stigmatising, multiple

access points. Services also need to make ull use o collaborative cross-reerrals.


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Most Government departments and their agencies have children among those who benet

rom their services. Many children will receive a range o these services and oten their

needs will cross departmental boundaries. Children need to be seen as at the centre o

these services. There is now widespread recognition that just as children live their lives

in the round, so too must the services be holistic in their orientation and t together

in an integrated ashion. This whole child/wholesystem* approach ensures that the

eectiveness o any particular service benets rom being reinorced and complemented by

other services working together, or and with children. Each agency has a responsibility to

articulate and act on its own goals in regard to the shared outcomes and be clear as to how

it can demonstrate that this is being done.

Working together can ensure a clearer ocus and more accurate targeting o services. It can

also make or more cost-eective delivery through avoiding duplication, combining impact

and getting synergy through the sharing o inormation and the cross-ertilisation o ideas.

Conusion and duplication can be reduced and more impact achieved to ensure good outcomes

or children. Integration needs to occur at the policy, planning and commissioning levels,

so that opportunities are provided or conjoint interagency working, including delivering

specic packages o care.

Delivering integrated services

4


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Box

8:Refectivequestionson(4)Deliveringintegratedservices

Que

stionsabout:

Questionsor

POLICY-MAKERS

Questionsor

HSE

SENIORMANAGERS

Questionsor

FRONT-LINESERVICEMANAGERSAN

DPRACTITIONERS

Strategically

integrated

services

Doesmydepartmentspolicy

explicitlysupportintegrated

serviceplanning

anddesign?

DoIcollaborate

withpartnersin

otherdepartmen

tsinprovidinga

wholechild/wh

olesystempolicy

ramework?

Domyorgan

isationalstructuresand

processesen

couragejoined-upworking

acrossservic

esandsectorsbasedonparity

oesteem?

Whatincentives,includingnancial,arein

placetopromotejointplanning,service

designandd

elivery?

Areleadagenciesidentiedtodealwithkey

issues?

Areservicesdeliveredinawaythatrefecta

commitmenttothebasicvaluesan

dstrategic

objectiveoawholechild/wholes

ystemperspective?

Isthereanaccessiblelocalregisterotherangeo

availableserviceseducational(sc

hool,colleges),

medical(primarycareunits,

hospit

als)andsocialcare

(ater-schoolschemes,amilycentres,socialservices)

whichproessionalscanusetoassistamiliesto

accessservices?

Doorumsexistlocallyorbringing

togethersta

roma

crossservicesandsectorsto

shareknowledge

andexpertise,soastoencouragec

ooperativeworking

withanemphasisonamiliesinth

ecommunity?

Integratedcase

management

Doesmydepartmentspolicy

promoteintegra

tedcase

managementat

thelevelo

servicedelivery?

Isthereanintegratedhumanresources

ramework(i

ncludingtraining)tosupport

theintegrati

onoservices,which

includesutilisingtheresourceoamily

andcommun

itiesorassessmentand

interventions?

Doinormati

onandcommunication

systemsacilitatecross-serviceandsector

communication?

Docasemanagementproceduresan

dprocessesbring

togetherallthosepeoplewhohave

somethingto

contributetounderstandingandre

spondingtothe

needsoparticularchildren?

Whatarethebarrierstointegrated

casemanagement

andhowcantheybeovercome?


35/54

This document is about how policy and services can result in the achievement o outcomes

or children. It implies an iterative, rational cycle involving planning, implementation,

ongoing monitoring and evaluation. As Figure 5 shows, policy-makers and service providers

must start with the desired outcomes or children and then build planning, implementation,

monitoring and evaluation processes rom there.

A undamental requirement or this approach is to establish an agreed set o indicators by

which the achievement o outcomes or children can be assessed. In addition, indicators arerequired to assess the strategies, inputs, processes and activities that are used in achieving

these outcomes. Critically, indicators are required at both policy and implementation levels

within an integrated ramework. Higher level policy outcomes and indicators rame and are

ormed by outcomes and indicators at the implementation level (as illustrated in Figure 5).

Figure5:Monitoringandevaluationcycle

Planning, monitoring

and evaluating services

5

Inevitably, such a simplied model as shown in Figure 5 masks the complex reality o

deciding and agreeing outcomes and indicators, at policy and implementation level, either

within a single policy domain or in relation to multi-sector outcomes. To help with that,

this document sets the overall ramework in the 7 high-level National Service Outcomes or

Children. The next task is or departments, agencies, services and projects to work out what

are the most appropriate indicators o outcomes or which they are responsible, either solely

or in partnership with others. Implicit in this is the need to nd a way to work eectivelyin partnership, in the wider context o joined-up government.

Indicators

7NationalService

OutcomesorChildren

ImplementandMonitor

PlanEvaluate


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In all this, robust inormation systems are a key ingredient in helping dene outcomes

and making plans to meet them; or monitoring the implementation o policies, programmes,

services and projects; and or asking clear evaluation questions about whether or not the

intended outcomes have been achieved. All recent national policy documents relating to

children refect a commitment to quality inormation systems. Clear inormation based on

relevant indicators allows or progress to be monitored over time and an evaluation to be

made o whether things are getting better or children or not. Such inormation requires the

establishment o baselines, where none exist, and the routine collation and evaluation o

inormation generated in the course o service delivery, along with commissioned strategic

research.

Some o the criticisms o inormation systems and data requirements in the past were that

there was no clarity as to why particular inormation was needed and or what it would be

used. Perhaps more signicantly, there was no transparent process o giving eedback on the

analyses o data provided or the implications o such analyses. For inormation recording to

be meaningul locally, such practical useulness, locally on site, regionally and nationally

must be readily apparent to service managers and practitioners. Inormation systems and

recording must be supportive o refective services and refective practitioners, as well as

meeting national planning and accountability unctions.

A urther criticism o inormation systems is their tendency to be just about numbers.

Approaches to planning, implementing, monitoring and evaluating services need to be

underpinned by a value commitment to listening to what children and their amilies think

about the services they receive and what these services mean to them. The important

role o such qualitative data must be acknowledged alongside appropriate quantitatively

based judgements. The two types o inormation need to be combined in both routine

administrative data systems and commissioned strategic research in order to achieve useul

monitoring and evaluation o the achievement o outcomes or children.

The Department o Health and Children is currently preparing drat legislation to give astatutory ramework to the Health Inormation Strategy.


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Section


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Concentric circles of responsibility

and delivery

The direction o services outlined here cannot be achieved without clear assignment o

Departmental responsibilities. Recognition must be given to the specic requirements and

dierences between those services that are universal and those that are tightly targeted,

between those that are supportive and those that are custodial. Each will have its ownpolicy and organisational ocus and concerns. However, these must be supplemented by

partnership structures and a shared pursuit o the whole child/whole system approach (see

Figure 6).

The Oce o the Minister or Children (OMC) will direct these partnerships in the areas that

it has direct responsibility or and promote them in other areas that are relevant to its work.

The OMC has responsibility to ensure that priority is given to those most in need, while at

the same time ensuring that children and amilies with less pressing needs are also able to

access appropriate support and services.

Figure6:Spheresoresponsibility

Getting there together

The OMC will ensure that there is a coordinated business plan or childrens services, based

on the strategic plans and annual business plans o various Government departments and

agencies providing services to children. This will be used to direct action towards achieving

the 7 National Service Outcomes or Children, to monitor progress towards their achievement

and to seek solutions to identied barriers and unresolved issues. This will require the

promotion o a common language. At the same time as providing specic direction, the

OMC (in line with the NESCs concept o a DevelopmentalWelareState*) will ollow the

principle osubsidiarity*, respecting the contributions made by the variety o stakeholders

at their dierent levels in the system and in ways that t their particular policy and

organisational ocus and concerns. The key goal o the OMC is to engage all those who have

a contribution to make.

OfceotheMinisterorChildren

Societyasawhole

DepartmentoHealthandChildren

HSE

Localchildrensservicesagencies

Agenciesthatimpactonchildrenslives

OMC


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Shared style of working

In order to implement any policy in the eld o human services, it is essential to be aware

that uniormity in the design o interventions does not equal uniormity in the practice

o workers. Just as individual services can dier according to dierences in location and

the nature o the target population, so too can individual work practices dier, with the

personal practice style o some workers managing to achieve more than others, irrespective

o training or resources. In order to address this aspect o delivering better services, a

shared style o working needs to be promoted. Underpinned by core practice values and

implemented through a set o principles, such shared working can be applied among

proessionals on an interdisciplinary and interagency basis and, more importantly, between

proessionals, children, amilies and communities.

Also within this context, there is a need or greater partnership between State services and

the voluntary and community child care sectors. Moving away rom a pure purchaser provider

model to joint working on a reciprocal basis o accountability and joint management will

help lead toward the goal o better services or children and amilies. This requires agencies

and sta to develop and maintain audits o practice through sel-appraisal* processes,

combining agreed practice standards and methods to measure compliance with them.

Although these will be specic to dierent agencies and to dierent sta, there is a set o

10 practice principles that can act as a common underpinning o a shared style o working

or everyone contributing to achieving the 7 National Service Outcomes or Children. These

principles are:

Working in partnership with children, amilies, proessionals and communities.

Needs-led and striving or the minimum intervention required.

Clear ocus on the wishes, eelings, saety and well-being o children.

Refects a strengths-based/resilience* perspective.

Strengthens inormal support networks.

Accessible and fexible, incorporating both child protection and out-o-home care. Facilitates sel-reerral and multi-access reerral paths.

Involves service users and ront-line providers in the planning, delivery and evaluation

o services.

Promotes social inclusion, addressing issues o ethnicity, disability and rural/urban

communities.

Measures o success are routinely built into provision so as to acilitate evaluation.

These principles have currency at individual and agency level, and across ront-line

management and policy contexts. They provide the last piece o the shared approach being

promoted in this document as a means o ensuring that all sta involved in developing

and delivering childrens services are able, by acting together, to maximise their individualcontributions to The Agenda or Childrens Services.


43/54


44/54

Section


45/54

One aspect o ensuring that everyone involved in childrens services is pulling in the same

direction is to develop a shared language, one that can be used across the wide range o

occupations and proessions involved. This shared language is not in opposition to the

particular perspectives and specialist terms associated with the dierent occupations and

proessions. It is a basic language or sharing and refecting on how the goals and activities

set out in this document are being developed and implemented.

The terms below have been highlighted throughout the main text o this document as key tounderstanding the way in which Government policy requires services to be developed. Brie

explanations are provided or each, outlining how they are to be understood in the context

o childrens services.

DevelopmentalWelareState: A perspective that sees the goal o State provision as the

development o capacity within individuals, amilies, communities and the economy.

Evaluation: The systematic investigation o the eectiveness o services using social

research methods.

Evidence-basedservices: Those services and interventions that have been developed on

the basis o the best available scientic research evidence.

Familysupport: Activities or amilies that are developmental (e.g. parenting or the rst

time), compensatory (e.g. helping a child cope with a disability) and/or protective (e.g.

ensuring saety o a young person).

Interagency and cross-sectoral working: Proactive coordination o services between

agencies that have their own specic ocus (e.g. health, social care, education or social

welare) and that are located within dierent service sectors, i.e. the statutory, voluntary,

community, not-or-prot and commercial sectors.

Monitoring: The ongoing assessment o services to ensure that they are reaching the

populations they aim to serve and that they are being implemented according to their

original design and to quality standards.

Needs-led: An approach to service development and delivery in which the primary ocus is

always on the physical, intellectual, emotional or social development needs o children.

Outcomes-ocusedapproach: Working towardsachieving an articulated expression o well-

being or children, which provides all agencies with the opportunity to contribute.

Participation: An approach which sees those accessing services as having the right to a

signicant role in the planning, implementation and evaluation o such services.

Partnershipworking: The negotiation and decision-making processes and practices required

by service users and proessionals to achieve ull participation by service users and which

ensure the ull cooperation between agencies in meeting the needs o service users.

Key concepts for

a shared language


46/54

Progressiveuniversalism: A perspective that combines universalism with the targeting o

resources on those that have special needs or support or protection; in other words, help

to all and extra help or those who need it most.

Reectivepractice: Checking and changing practice in the light o learning rom past

experience (refection-on-action) through improvisation during the course o interventions

with and or children and amilies (refection-in-action).

Resilience: Good outcomes or a child and/or or his or her amily in spite o serious threats

to adaptation or development.

Sel-appraisal: A process to sel-audit and monitor worker style and intervention processes

against a set o service/agency standards.

SMART planning: Scheduling work activities that are specic, measurable, attainable,

relevant and time-based.

Social inclusion: Overcoming barriers and reducing inequalities between the least

advantaged groups and communities and the rest o society by recognising the potential o

those who are marginalised and opening up opportunities or that potential to be realised.

Subsidiarity: The decentralised organisation o services with the aim o ensuring that

resources, authority and responsibility are kept as close to the point o their use as

possible.

Targetedservices: Those services that are developed or use by specic subgroups within a

general population or towards a particular area o social need.

Universalservices: Those services that are accessible to all members o a population.

Wholechild/wholesystemapproach: Provision o services in ways that recognise the

extent o childrens own capacities, the multiple interlinked dimensions to their lives andthe complex mix o inormal and ormal supports that they draw upon.


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Usefulpublicationsand websites


49/54

Commission on the Family (1998) Strengthening Families or Lie: Final Report to the Minister

or Social, Community and Family Aairs. Dublin: The Stationery Oce.

Department o Community, Rural and Gaeltacht Aairs (2001) National Drugs Strategy

2001-2008. Dublin: The Stationery Oce.

Department o Health and Children (2007a) Promoting the Well-being o Families and Children:

A Study o Family Support Services in the health sector in Ireland. Dublin: The StationeryOce.

Department o Health and Children (2007b) A Census o Family Support in Ireland: Results

o a census o Family Support Services which were unded by the Health Boards in 2002.

Dublin: The Stationery Oce.

Department o Health and Children (2007c) Family Support in Ireland: Denition and Strategic

Intent. Dublin: The Stationery Oce.

Department o Health and Children (2006a) Disability Act 2005: Sectoral Plan or the

Department o Health and Children and the Health Services. Dublin: Department o Health

and Children.

Department o Health and Children (2006b) A Strategy or Cancer Control in Ireland. Dublin:

The Stationery Oce.Department o Health and Children (2005a) Review o the National Health Promotion Policy

2000-2005. Dublin: The Stationery Oce.

Department o Health and Children (2005b) Breasteeding in Ireland A ve-year Strategic

Action Plan. Dublin: The Stationery Oce.

Department o Health and Children and HSE (2005c) Report o the Working Group on the

treatment o under-18 year-olds presenting to treatment services with serious drug

problems. Dublin: The Stationery Oce.

Department o Health and Children (2004) Strategic Task Force on Alcohol. Second Report

2004. Dublin: The Stationery Oce.

Department o Health and Children (2001a) Primary Care: A New Direction. Dublin: The

Stationery Oce.

Department o Health and Children (2001b) Quality and Fairness A Health System or You.

Health Strategy. Dublin: The Stationery Oce.

Department o Health and Children (2001c) Report o the Working Group on Foster Care A

Child-centred Partnership. Dublin: The Stationery Oce.

Department o Health and Children (2001d) Youth Homelessness Strategy. Dublin: The

Stationery Oce.

Department o Health and Children (2000) The National Childrens Strategy: Our Children

Their Lives. Dublin: The Stationery Oce.

Department o Health and Children (1999) Children First: National Guidelines or the

Protection and Welare o Children. Dublin: The Stationery Oce.Department o Justice, Equality and Law Reorm (2005) Report on the Youth Justice Review.


Department o Social and Family Aairs (2007) National Action Plan or Social Inclusion

2007-2016: Building an Inclusive Society. Dublin: The Stationery Oce.

Department o the Taoiseach (2006) Towards 2016: Ten-year Framework Social Partnership

Agreement 2006-2015. Dublin: The Stationery Oce.

Government o Ireland (2007) Transorming Ireland A Better Quality o Lie or All: Ireland

National Development Plan 2007-2013. Dublin: The Stationery Oce.

Government o Ireland (2006) A Vision or Change: Report o the Expert Group on Mental

Health Policy. Dublin: The Stationery Oce.

Government o Ireland (2001) Children Act, 2001. Dublin: The Stationery Oce.

Government o Ireland (2000) Education (Welfare) Act, 2000. Dublin: The Stationery Oce.

Government o Ireland (1991) Child Care Act, 1991. Dublin: The Stationery Oce.


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Government o Ireland (1975) Law Reorm Commission Act, 1975. Dublin: The Stationery

Oce.

Hardiker, P., Exton, K. and Barker, M. (1991) Policies and Practices in Preventative Care.

Aldershot: Avebury.

HSE (2006a) Transormation Programme 2007-2010. Naas: Health Service Executive.

HSE/McKinsey & Company (2006b) Childrens Health First International Best Practicein Tertiary Paediatric Services: Implications or the Strategic Organisation o Tertiary

Paediatric Services in Ireland. Naas: Health Service Executive.

HSE, National Suicide Review Group and Department o Health and Children (2005) Reach

Out National Strategy or Action on Suicide Prevention 2005-2014. Dublin: Health

Service Executive.

HM Treasury (2003) Every Child Matters. Norwich: HMSO.

Kutash, K., Duchnowski, A.J. and Lynn, N. (2006) School-based Mental Health: An empirical

guide or decision-makers. Gainesville, FL: University o Florida.

Laming, Lord (2003) The Victoria Climbi Inquiry: Report o an inquiry by Lord Laming.

London: HMSO.

Mental Health Commission (2006a) Quality Framework or Mental Health Services in Ireland.Dublin: Mental Health Commission.

Mental Health Commission (2006b) Code o Practice relating to admission o children under

the Mental Health Act, 2001. Dublin: Mental Health Commission.

McKeown, K. (2001). Fathers and Families: Research and refection on key questions. Dublin:

The Stationery Oce.

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McKeown, K., Haase, T. and Pratschke, J. (2001) Springboard: Promoting amily well-being

through Family Support Services. Dublin: The Stationery Oce.

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supporting amilies: The role o Family Support Services. Dublin: The Stationery Oce.

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health or children. Dublin: Best Health or Children.

National Conjoint Child Health Committee (2001) Get Connected Developing an adolescent-

riendly health service. Dublin: Best Health or Children.

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partnership with amilies. Dublin: Best Health or Children.

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NDA (2003) Towards best practice in provision o health services or people with disabilities in

Ireland. Dublin: National Disability Authority.NESC (2005) The Developmental Welare State, Report No. 113. Dublin: National Economic

and Social Council.

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good practice. Dublin: The Stationery Oce.

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Our Pledge: A 10-year strategy or children and young people in Northern Ireland,

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UNICEF (2007) Child Poverty in Perspective An Overview o Child Well-being in Rich Countries,

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health, Evidence-based Mental Health, No. 8, pp. 60-62.

WHO (2005) European strategy or child and adolescent health and development. Geneva:

World Health Organization, Regional Oce or Europe.York, A. and Kingsbury, S. (2007) The 7 HELPFUL Habits o Eective CAMHS and the Choice

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Websites

www.dohc.ie Department o Health and Children

www.hse.ie Health Service Executive

www.omc.gov.ie Oce o the Minister or Children

Department o Health and Children

www.orygen.org.au ORYGEN is a specialist youth mental health service

in Australia

www.childrensdatabase.ie Oce o the Minister or Children

www.mhcirl.ie Mental Health Commission

www.nda.ie National Disability Authority

www.camhsnetwork.co.uk Child and Adolescent Mental Health Services in UK

www.youngminds.org.uk National charity in UK


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Documents

Agenda for children services: policy handbook