Four medical experts with the State’s only 24-hour treatment service for young victims of sexual assault have withdrawn their services after a breakdown in negotiations with the Health Service Executive.

“This was something we very much hoped to avoid,” said Dr Joanne Nelson, a founder of the Child and Adolescent Sexual Assault Treatment Service (Casats). Annual funding of €212,000 could have maintained the Galway-based unit but the HSE was unable to agree to this, she said.

The unit was established by Dr Nelson and Dr Roger Derham in 2011 to fill a gap where child victims of sexual violence were not being offered appropriate access to forensic medical care. Currently only people aged 14 and older can avail of support, examination and treatment at adult sexual assault and treatment units.

Four forensic examiners working with the service on temporary contracts had tried to put it on a long-term footing in discussions with the HSE late last year, and it almost closed two months ago due to a failure to provide the clinicians with medical indemnity.

Contracts extended

The HSE confirmed discussions with the four clinicians had “not been successful”.

“We have been informed by the clinicians that they are not prepared to sign the proposed contracts. Therefore we have no alternative but to advise agencies that would refer to the service that we can no longer accept referrals,” it said, adding that it would “continue to try and engage with the clinicians in a meaningful discussion”.

Dr Nelson said two of the main sticking points were the HSE’s failure to fund a clinical director and a “continued refusal” by it to recognise and fund examination of and support for children referred from Tusla and social services without active Garda involvement.

“Paediatric examiners have each requested 10 funded hours per month – as in 2.5 hours weekly – to ensure examination, documentation, communication and adequate follow-up for these children who attend the service,” she said.

“I have been informed that to implement the above measures will cost approximately €100,000 per annum – almost double the existing Casats service budget of approximately €112,000 per annum,”she said.

Dr Nelson said the HSE had made some “very positive steps” towards bringing the service in line with adult sexual assault treatment units. However, she said there was a “continued refusal by the HSE to recognise and fund integral components of a safe, quality assured and sustainable service”.

She said the service had, “despite limited resources and funding”, to “prop up deficits in other areas of the country, especially Dublin, where no out-of- normal-working-hours service exists”.

The Manuela Riedo Foundation and Children at Risk in Ireland initiated a crisis worker programme last year to support the service.