Sunday, May 3, 2009

Children and Parents Caught in HSE-created nightmare

I would encourage everyone reading this post to check the comments below. As one of the commentators puts it, the reason these comments are unsigned is because HSE has created such an atmosphere of intimidation, that people forced to deal with it are concerned about the reprisals against their cases. This is truly despicable.

This post is not about economics, though my old prof Gary Becker might disagree... It is about a monumental screw up that is our system of family support and the horror of the HSE monopoly in adoption process administration. And it makes me absolutely sick to think that there are thousands of couples in this country - either in the process of adoption or thinking about starting on that long road - who are being failed by the HSE, the Irish state and our politicians.

Here is the story.

Over the last 5 years almost 75% of all inter-country adoptions into Ireland came from three countries: Russia, Vietnam and China. Several of my friends have happily adopted kids from all three of these countries, giving both the adoptive parents and the children a real future as families. At present some 1,000 Irish families are seeking to adopt from Russia and Vietnam.

By my personal experience of seeing homeless kids in Russia, I know that there are tens of thousands of small children without parents in Russia who are facing years of hardship and very few opportunities to have a successful, fulfilling life. They need love, they need a family, and they need a chance to have a future.

Thus, in harsh econospeak - there is supply and demand. In human terms, the future of kids and adoptive parents is at stake here.
You can - and should - get the feel for the issue of human hurt and suffering this HSE-screw up is causing here.

The interim bilateral agreement between Ireland and Vietnam expired on May 1 this year - another present of this Government, on top of higher tax levies, stolen mortgage relief and extorted child benefits, that came our way that day. No new agreement has been signed or, as far as we know, even prepared. The Irish authorities, also to the best of our knowledge, are the sticking point here, despite the fact that they knew of the expiry date well in advance. Irish authorities have managed to send a lowly case worker to Vietnam to sort out the issue of a new agreement - a bizarre twist of protocol and managerial logic. Instead of a decision maker, we sent a clerk.

Now, Russia - as the adoption country - has been also shut down because HSE cannot be bothered to adhere to the legal conditions imposed by the Russian authorities on adopting countries. The procedure is a simple one and a logical one. As a part of the adoption process, Russians would like to know that the kids are doing well in their families and in the new country. Thus, the adopting country is required to submit updates on the kids conditions, health, etc. In the case of Ireland-Russia adoption process, this procedure has been in place for 4 years. However, this year, the HSE - the organization with a state-run monopoly power in the adoption process - simply failed to deliver such reports.

In my conversations with the office of Barry Andrews, Minister for Children, I was unable to obtain a clear (let alone convincing) explanation as to what exactly has happened, but to the best of my understanding, HSE simply failed to collect post-adoption reports and send them to Moscow. My conversation with a contact in HSE revealed that they simply "couldn't be arsed to follow up on the process". Just like that - 'we didn't feel like doing it'... And when I suggested to Barry Andrews' office that there should be someone responsible for the mess, the story got even more confusing. I was told that HSE is not even sure it can compel the parents (at the first mention) or its own social case workers (at the second mention) to collect such reports. Not even sure? Four years after the condition was imposed and after three years of complying with the condition?

Here is what we should know and yet we do not know (courtesy of the HSE, Dept of Health, Adoption Board and so on):
  • We have no idea how many post-placement reports are outstanding in the case of Russia;
  • We have no idea if HSE is even doing anything to rectify the situation (Russian authorities have told me - and I have no reason to question their sincerity - that Russia is ready to restore full adoption process with Ireland as soon as the post placement reports are delivered. HSE cannot tell me anything!);
  • Is there an actual copy of a legal agreement with Russia in existence and if yes, why is it not posted on the HSE and Adoption Board websites? Why are the prospective and adoptive parents not given a copy of such an agreement as it stipulates their fundamental rights and duties?
  • Is Ireland ever going to conclude bilateral agreement on adoption with Russia? Will Ireland be in a position to renew the expired bilateral agreement with Vietnam?
  • Why there has been no high level delegation to Vietnam to renew the bilateral agreement?
  • Why doesn't the Adoption Board extend the validity of adoption applications while this mess continues, so that prospective parents whose declarations expire during the time it takes HSE to get its head out of its posterior are not required to go through a renewal process again?
The bigger problem, however, is that under the current system the HSE - that impenetrable fortress with a formidable 125-strong disinformation department (PR & Media Relations that is) - is a monopoly gatekeeper to the process of parent assessment. Thus, intimidation, veiled threats, delays, and now outright failure to comply with international standards and, potentially, law - all are the norm for the ways in which HSE runs its fiefdom.

Clearly, there is an argument to be made here, that what Ireland needs is a well-regulated, competitive system for assessment and processing of adoption cases. In other countries, such a system exists. Hence, for example, the same Russian document that blacklists HSE also blacklists some privately run organizations operating the adoption system in the US. Of course, American adoptive parents have a choice to continue with the adoption process via another agency. Irish adoptive parents have only one choice of waiting for the demi-Gods of HSE to, as I put it earlier, pull their head out of their postrerior.

At the rollercoster site: here, you can find an open letter on the issue (search for the post by blmf ID:- 27687 Date:- 02/05/2009 15:14). I would suggest we all send a copy to that list of our TDs.


Anonymous said...

Dr Gurdgiev : thank you for giving not just your personal perspective on this but, as ever, placing things into a broader context
The situation is worse than you play out however. HSE is not quite a monopoly. It is for applicants. Thats right, this is still run on sectarian lines. Noncatholic christians can go to PACT. PACT (p as in protestant...) are subject to the same rules and regs, including the post placement return, as HSE. They manage to do it.
As ever, where there is a monopoly it will abuse....

TrueEconomics said...

Indeed, PACT is actually not on the list of organizations black listed by the Russian Authorities as they manage to fully comply with the adoption process requirements. However, as far as I understand parents who are going through HSE cannot simply switch into PACT. Another issue to be raised with the politicos is why not?

Anonymous said...

I don't think you can compare pact with the hse. Its not like for like. Very few people go through pact to adopt, the majority go through hse so it would be very easy for pact to keep on top of ppr's. Not that thats any excuse. I also believe Russia are trying to stamp out independant adoptions and of course this is the perfect chance for them to do that.

Anonymous said...

Pact was set up in the 50's, to counsel pregnant women within the protestant community, and for the adoption of children into protestant families, as at the time the RC church controlled the state, and most of the children were adopted by RC families etc. Obviously there was a need for protestant girls who considered adoption for their babies, an organisation that offeres support, counselling and if that was the decision to place those infants with protestant families as the mother may have wished.

It is a charity, and only in the past 10 or so years has dealt with intercountry adoption. It is also a service offered to couples, and there is no fee involved. Couples have to go on a waiting list the same as in the HSE. However, only one of the couple needs to be of one of the protestant faiths. However it is not simply a case of switching from the HSE to pact, as both are operating under the same guidelines, however the waiting is little shorter as there are not as many prtestant or interchurch couples applying.

Thy follow the exact same framework as the HSE and the Adoption Board guidelines. However they are strict about the post placement reports. Couples have to sign a letter promisisng to do the reports in a timely fashion, I think they even have to sign an affadavit re same.

It is much smaller organisation, and maybe that is why things are more strictly controlled.

I am not sure that I think having private agencies is the way to go though, as that is kind of setting us up in the same way as America, and that to leads to problems and can be rife with ethical concerns.

Anonymous said...

Anonymous said...

HSE couples and adoptive parents sign an affadavid also. Indeed the HSE sign a letter of committment (or apparently a letter of "if we can be arsed" )

And dont confuse please "private" with "competition". PACT is a charity; theres no reason why, for instance, Barnardo's couldn't do the assessments and charge the cost and no more. For some reason (wonder why...) since 1952 every single attempt to set up a nondenominational or latterly non health board/hse assessment system has been stymied.

TrueEconomics said...

Per two comments above. When I say 'private' I do not necessarily mean 'for profit' - it can be an NGO (though most our NOGs are not independent from the state, so there is a risk of collusion). What is important is that there is competition and that people can have a choice both at the initiation stage of the process and later, should any problems with their chosen provider emerge, to migrate seamlessly to other agency.

Anonymous said...

sorry, yes I probably did pick up on the private aspect etc.... I guess I am a little defensive as lots of people seem to think that Pact is a private agency which show preference to protestant couples and that fees arte involved.

Yes, Barnardos or cunamh etc could do the assessments in much the same way, under the same guidelines as the HSE, and as far as competition is concerned then couples could choose which avenue to go down.
However, I cannot imagine the HSE letting up on this, and if there were no fees involved then it would have to be a charity based, or non profit organisation, and not sure that there is an incentive for that from the govt point of view??

It seems to me that the govt want to put prospective couples off Intrwountry adoption in the first place, so that in itself seems to be the problem!

Anonymous said...

Thank you for raising this issue. Having been in "the system" over the last five years, I think it is fair to say that myself and my husband are at the end of our tether. We open every aspect of our lives - down to the most intimate detail - to the various agencies of the Department of Health in the hope of eventually being able to adopt a child only to find that due to sheer incompetence the Bi-Lateral Agreement with Vietnam has been allowed to lapse and we have no idea when, or even if, it is going to be re-ratified.

I really never felt true despair until this week. The is that the Minister, The Department of Health and Children, the HSE and the Adoption Board all hide behind meaningless statements but demonstrate no true commitment towards sorting out this mess.

I don't know why I'm surprised. It was another blunder in a Dublin public hospital that rendered me infertile in the first place.

The Department of Health has quite literally blighted our lives.

Anonymous said...

If you're going to talk about adoption in supply and demand terms, you should be aware that the 'demand' for children is greater than the 'supply'. This gives rise to the danger of corruption in the adoption process, as a market is created by wealthy western parents competing to adopt.

TrueEconomics said...

Anonymous, I guess I am being an economist here with supply/demand stuff... But you are wrong about the supply being substantially less than demand. Naturally it is not, but due to artificial constraints set up on both sides of the adoption process border, supply is indeed extremely restricted.

Here is what I mean. My summer house outside Moscow is near a large highway with a big market on one side of the road. There are hundreds homeless kids living around the market. In the city, I live not far from a large orphanage - actually a very clean, very well maintained building set in a lovely park with always very polite children there. I am sure all of these kids long to have home and family.

Of course, not all kids can be adopted - Kenyan glue children are one example where toxic damage done to these children is irreversible. But there are tens of millions of children without parents around the world suitable for adoption. Unless there are more parents than that wishing to adopt, the shortage of supply is not demand-driven, but state-created.

To reduce incentives for corruption and income-related inequality of access to adoption, we precisely need more providers of adoption services - properly and strictly regulated, controlled, monitored - competing for a chance to help families unite.

Do tell me if I am wrong here...

Anonymous said...

Dear Dr. Gurdgiev,

Thank you for your clear and informed analysis of this dismal situation. Your comments reaffirm everything we have felt on an intellectual and emotional level in dealing with the HSE. During five years of enduring this dysfunctional, patronising shambles that passes for 'professional' adoption services, I'm amazed that the HSE adoption service's ineptitude has been so thoroughly 'normalised' and 'rationalised' in Ireland that no 'professional' journalist has managed to state these glaringly obvious deficiencies, in any Irish newspaper, until now.

Unfortunately because of who we are forced to deal with I have to sign off here anonymously

TrueEconomics said...

As per comment that Russians are trying to cut independent adoption services: I do not know if they do or not. I know two things:

1) Russians are very sensitive about adoptions from abroad -for two reasons: one is concern for children safety (there were several cases of child neglect, endangerment and at least two cases of children deaths in recent past); another is the reason of national pride - addressing this sensitivity, Russians require some safe-guards, e.g. post-adoption reports. I think that is reasonable and does not signal their bias against independent adoption agencies that are licensed in the West;

2) Russians are very anxious to restore normal operating conditions with Ireland - they are, to the best of my knowledge, dispatching a fact-finding and case assistance mission from Moscow to Dublin which is due to arrive today to help HSE sort out the exact issue at hand.

Now, this might not be the evidence pro or against their willingness to expand independent adoption services (either inside Russia or outside), but it is worth remembering that adoption sending countries are internationally under scrutiny for potential 'child exporting' and Russians have good internal and international reasons to keep standards high.

This said, I doubt they would have a problem with properly licensed Irish NGOs or private service providers, as long as HSE/DofChildren/Adoption Board is properly licensing them, supervises their operations and enforces standards.

Of course, were I in the Russian Government place, I would ask a legitimate question whether, in light of the current events, the HSE is capable of providing such supervision at all.

Then, again, as an Irish taxpayer and health insurance holder, I am asking the same question in a different context every time I encounter Irish health system.