Delay in child’s medical assessment could have serious consequences – 2019vol1#12

The District Court ibn a rural town expressed concern about a delay in obtaining a medical assessment of a pre-school child, whose symptoms indicated a potentially serious condition. The child’s older sibling had a congenital condition which started with similar symptoms.

The court had heard four months previously that there were concerns regarding A’s physical symptoms and there was an eight to nine month waiting list for medical assessment. The child had been in foster care on a full care order for 18 months. On the previous court date the court directed that the CFA prioritise the medical assessment of A and also secure play therapy for the child. Both parents were legally represented and present. There were two witnesses, a social worker and a GAL.

A’s older sibling had a congenital condition which started with symptoms similar to what A was experiencing. The GAL sought and was granted a further direction from the court for the CFA to secure an MRI test for A.

GAL: “Simply put, the child could have irreparable damage to his organs if [there is not] early intervention.”

An MRI was the definitive test required, the GAL told the court, adding that A’s condition was distressing for him. A was in an excellent foster placement and he was being supported by his foster parents and his needs were being met, the GAL told the court. The judge heard that a referral for an MRI had been made the previous working day by the child’s GP on the request of the CFA social worker and the direction of the court. A was now on a waiting list and could be eight or nine months waiting for the MRI.

Judge: “But a referral only last Friday to hospital doesn’t suggest you’re on the ball. [You] need to keep nagging, a gnat in an ear. Do you want me to be that gnat? I want action and an explanation from the doctor [of why] this is on the long finger [and him to be made] aware of the judge’s interest.”

Access was happening monthly at the maternal and paternal grandparents’ homes for the mother and every six to eight weeks for the father, the court heard. The mother’s solicitor said his client opposed the presence of the father’s partner at access and the father’s solicitor told the court the reality was the relationship between the parents was over and his client was agreeable to sitting down and discussing the issue with the social work department. Access needed to be reviewed in terms of the children’s needs and the parents’ needs, the GAL told the court. The parents had missed some access, and this caused confusion for A.

“Play therapy was crucial for access” the GAL said. The social worker told the court a play therapist had been identified and there was agreement to start play therapy.

This was one of twelve child care cases, and one of 16 cases overall, heard by the District court in this town that day.

Other cases

In another case the court granted an application for the extension of an ICO for three months concerning two young children. The parents consented to the application. The court also lifted the in-camera rule to release the mother’s parental capacity assessment to a psychologist for the purposes of assessing the mother, who recently had had a third child. Both parents were present.

At the outset of the hearing the judge observed there was a lot of repetition in the CFA social work report and asked if this could be avoided as he had spent most of his weekend reading such reports. The judge also noted that proceedings had commenced in February 2015 and he was still dealing with the matter four years and one month later.

Originally there had been a supervision order for 12 months and a referral of the mother to counselling. In 2018 there had been an emergency care order. On the last court date, the mother’s psychological assessment had not started.  “Looks like the matter is going from the frying pan into the fire,” the judge said. There were 64 judges to serve 26 counties, the judge said, and cases needed to move expeditiously.

The judge asked the social worker about a concrete plan regarding play therapists and the mother’s psychological assessment. The court heard that a psychologist had been identified to do an in-depth assessment and play therapists had been lined up but that the lifting of an in-camera rule was necessary to allow the mother’s parental capacity assessment and counselling reports to be released to the psychologist.

The judge asked whether the previous parental capacity assessment was of any benefit if an in-depth psychological assessment was now being done. The previous assessment was from a practical perspective and this assessment was more cognitive, the social worker said.

The judge invited the father, who was not legally represented, to ask questions about any further matter. The father told the court he had fortnightly access but wanted an increase in this. He had written letters to the CFA, and met the social workers outside the court, but he did not know that he had to ask the court about access, the father said. He had no objection to a psychological assessment. The father also said he wanted to apply for guardianship. “There is nothing to prevent you bringing this application,” the judge told the father.

The judge extended the interim care order for three months on the consent of the parents.

He advised the father to write to the CFA seeking a parental capacity assessment and psychological assessment and to use the time wisely before the next court date in seeking legal aid.

In another case a section 18(2) care order was extended for two months on consent to facilitate the reunification of a primary school age child with her mother. Both parents were present and legally represented. The father was brought from prison custody to court accompanied by a prison officer.

The CFA solicitor said her instructions were to keep the reunification plan before the court on a monthly basis until full reunification. The reunification plan over a 12-week period had started, the court heard. The child was having increased unsupervised access with her mother at her mother’s house. This had been increased to three days a week and one overnight. “Access workers and social workers were dropping in. The foster carers were reporting progress and no negative reactions [for the child]” the social worker said. “Reunification is important, but also detachment from foster carers is also important,” the social worker told the court.

The mother’s solicitor told the court his client was happy with the schedule of increased access and three weekly meetings. “She was conscious it is a process, but [it] is going well,” the mother’s solicitor said. The father’s solicitor told the court his client was supportive of reunification with the mother if it was in the child’s best interests. The court heard the father was kept updated with photographs and meetings.

“Reunification appears to be going well,” the judge told the court and the matter was put in for the following month.