Replies to LegCo questions
LCQ1: Residential child care services
Following is a question by the Hon Cyd Ho and a reply by the Secretary for Health, Welfare and Food, Dr Yeoh Eng-kiong, in the Legislative Council today (June 23):
Question:
It was reported that a child, who had been placed in a residential nursery since birth before she was returned to the custody of her family at the age of two, died last year at home allegedly because of abuse by her parents, just nine weeks after she had returned home. In this connection, will the Government inform this Council:
(a) of the number of cases, in the past three years, in which children were provided with the residential child care service through the central referral system and, among them, the number of those involving child abuse, the whereabouts of the children after they ceased to receive the service as well as the number of cases in which children who became victims of child abuse again after ceasing to receive the service;
(b) whether social workers are deployed to follow up the situation of the children after they have ceased to receive the service; if so, of the ratio between the social workers and the children and how long the social workers will continue to follow up their cases, as well as the average time the social workers spend every month on meeting the children and their parents respectively; and
(c) of the services or mechanisms currently in place to protect the children who have ceased to receive the service from being abused; regarding the child abuse cases involving children who have ceased to receive the service and have subsequently been placed under the care of their families, whether the Social Welfare Department(SWD) will convene case conferences to review the problems identified in the course of handling the cases, so as to improve the relevant child protection services or mechanisms; if not, the reasons for that?
Reply:
Madam President,
(a) According to the Central Referral System for Residential Child Care Services (CRSRC) maintained by the SWD, there were 1,556, 1,678 and 1,689 admissions into residential services in 2001-02, 2002-03 and 2003-04 respectively, due to different reasons such as family relationship problems, parental conflicts, lack of adequate care, or behavioural problems. Among these cases, 156, 171 and 155 were identified as child abuse cases in 2001-02, 2002-03 and 2003-04 respectively, which made up around 9 per cent to 10 per cent of the total admission caseloads over these three years.
There were 1,406, 1,546 and 1,515 discharge cases in 2001-02, 2002-03 and 2003-04 respectively. Among these cases, around 62 per cent were discharged for home restoration. Around 28 per cent were discharged for alternative placement for different reasons, such as the children involved exceeded the age limit for the particular types of service units; or their behavioural or adjustment problems warranted a transfer to other service units. The remaining 10 per cent were discharged for other reasons such as adoption, hospitalisation, overseas study, or attainment of adult status at 18 years old.
As regards the number of children who were abused after they had stopped receiving residential service in the past three years, SWD had carried out a snapshot fact-finding exercise. As at June 14, 2004, four children had been abused after being discharged home from residential care, out of around 1,300 active child abuse cases currently being handled by the Family and Child Protective Services Units (FCPSUs) of SWD (some of these cases were transferred to FCPSUs by other service units after the abuse incidents).
(b) A continuum of services is available to assist the children and their families who make use of residential child care services. The welfare needs of each child requiring residential service are closely looked after by the social workers of the relevant casework units (such as Family Services Centres/Integrated Family Service Centres, Medical Social Services Units, FCPSUs) run by SWD or non-governmental organisations.
After a child's admission for residential service, the responsible social worker will work closely with the residential care staff and other related professionals (such as school teachers, psychiatrists and clinical psychologists) to ensure that the child can benefit from residential service. The social worker will also monitor the child's relationship with the parents and/or other family members during the child's separation from them, and render appropriate assistance (such as counselling on parent-child relationship) to the child's family with a view to formulating a feasible discharge plan for the child.
If and when a child ceases to receive the residential service, the subject social worker will continue to follow up the case to safeguard the best interest of the child by conducting home visits and physical contacts with the child. The duration of follow-up and the frequency of the social workers' contacts with the child and his/her family members vary from case to case, having regard to relevant considerations such as the child's conditions at home and the level of support required by the parents or other family members responsible for taking care of the child. With regard to the social worker to child ratio, as mentioned above, the cases discharged from residential service are followed up by social workers from different service units depending on the situation of the individual case. Given that the provision of manpower in the service units vary; and the number of children served by each service unit differ and may change from time to time, there is no fixed ratio covering the number of cases followed up by one social worker. The fundamental principle is that every case will be followed up by social workers and the care and attention rendered is in tandem with the specific needs of each child.
(c) A child receiving residential service will only be discharged home when there is evidence showing that the child can adequately be taken care of by his/her family members. The responsible social worker will also provide follow-up service in the form of home visit, office interview and collateral contact with concerned parties (e.g. relatives, school personnel, etc.) to keep in view the child's conditions at home and render assistance to his/her family to ensure proper care of the child. The supervisor of the social worker will also oversee the handling of individual cases. If a child is suspected of being abused, immediate and decisive action will be taken and these include convening of multi-disciplinary case conference on child cases to decide on the nature of the suspected abuse incident(s) and formulate a feasible welfare plan for the child.
When there is any incident involving death or serious injury of children being handled by SWD service units, internal review will be conducted by senior officers in SWD. As I have explained in this Council on May 12, 2004, the Director of Social Welfare is examining the proposal of setting up post-event multi-disciplinary review committees on child abuse cases in which family violence has caused serious injuries or deaths for the purpose of identifying improvements in the light of the recent events, and the related technicalities such as when and how such post-event committees should be convened, having regard to relevant considerations, including the need to ensure that the investigation conducted by the Police and any subsequent court proceedings would not be prejudiced during the process.
Furthermore, a number of key initiatives are being taken with a view to facilitate early identification and handling of suspected child abuse cases, such as strengthening the multi-disciplinary training programmes, reviewing the Procedures for Handling Child Abuse Cases and commissioning a study on child abuse and spouse battering to enrich and update our understanding of the problems which would shed light on the development of strategies and services to combat family violence.
Ends/Wednesday, June 23, 2004
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