Thousands of children may be at increased risk after missing routine public health development checks, according to a new investigation by the Ombudsman for Children’s Office. The findings raise serious concerns about how Ireland’s child health services are delivered and whether every family can access essential assessments before a child turns six.
What the investigation found
The children’s rights watchdog said the State has not ensured the effective delivery of universal public health development checks for all children under six. These assessments are carried out by public health nurses and are intended to identify possible developmental, health or support needs at an early stage.
The investigation focused on changes introduced to the Health Service Executive system in 2022. According to the Ombudsman for Children’s Office, those changes have contributed to some children missing the checks that should be available to them.
Families have contacted the watchdog over several years with concerns about the consequences of missed appointments. Their reports indicate that parents may be left uncertain about whether their child has received the appropriate assessment or what support is available when a check does not take place.
Why under-six health checks matter
Development checks provide an opportunity to monitor a child’s progress and identify issues that may require further assessment or intervention. They can also help connect families with health, educational or community services.
A missed appointment does not automatically mean that a child has a health problem. However, repeated gaps in routine monitoring can make it harder to recognise concerns at an early stage. This is particularly important where families are already facing barriers involving communication, transport, changing addresses or limited access to services.
Routine checks may help professionals consider areas such as:
- Physical growth and general health
- Speech, language and communication development
- Hearing, vision and other early indicators
- Social and emotional development
- Whether a family needs additional information or support
How changes to the HSE system affected access
The Ombudsman’s investigation linked the concerns to changes made to the HSE arrangements for public health development checks in 2022. The watchdog said the revised system has not delivered the universal service that children and families should be able to expect.
The findings are significant because universal health checks are designed to reach children across the country, rather than relying solely on parents to arrange private appointments or identify a concern themselves. When a system becomes difficult to navigate, families may not know who is responsible for contacting them or how to request a missed assessment.
The issue is therefore not limited to individual appointments. It also concerns the reliability of public services, communication with parents and the ability of the health system to track whether children receive appropriate care.
- The Ombudsman for Children’s Office investigated the delivery of public health development checks.
- The checks apply to children under six and are carried out by public health nurses.
- The investigation identified concerns following HSE system changes introduced in 2022.
- Families have raised concerns about children missing assessments.
What this means for families
Parents or guardians who believe their child has missed a routine public health development check should contact their local public health nursing service or the relevant HSE health office. They may wish to ask whether the child’s records show that the assessment took place and whether a replacement appointment can be arranged.
Families should keep a record of calls, messages and appointment details. If concerns remain unresolved, they can ask the HSE to clarify the next step and seek advice from relevant child and family support services.
Parents should also raise any immediate developmental or health concern with a GP, public health nurse or other qualified healthcare professional rather than waiting for a routine review. The watchdog’s findings concern gaps in service delivery; they do not replace individual medical advice.
Wider pressure on Ireland’s child health services
The investigation comes amid continuing public attention on access to healthcare and early supports for children. Developmental assessments can be particularly important for families seeking timely referrals or additional assistance, including support connected to speech and language, hearing, vision or education.
When universal checks are delivered consistently, they can provide a clear route for identifying needs and explaining available services. When appointments are missed or records are unclear, responsibility can shift onto families to chase information through a system that may already be difficult to understand.
The Ombudsman’s conclusions place responsibility on the State and the HSE to ensure that children’s rights are protected in practice, not only in policy. That includes reliable processes, clear communication and effective follow-up where a child does not receive an assessment.
What happens next?
The publication of the investigation is likely to increase pressure for a response from the HSE and the Department of Health. Families will want to know how many children have missed checks, how the gaps will be identified and what measures will prevent similar failures in the future.
Important questions include:
- How will the HSE identify children who were not offered or did not receive a check?
- Will families be contacted directly where records are incomplete?
- What arrangements will be put in place to provide outstanding assessments?
- How will performance be monitored across different areas of Ireland?
Until further official information is provided, families should seek clarification directly from local health services if they are unsure whether their child’s assessment has taken place.
Frequently asked questions
What are under-six public health development checks?
They are routine assessments carried out by public health nurses to monitor children’s development and identify possible health or support needs.
Who raised the concerns?
The concerns were set out in an investigation by the Ombudsman for Children’s Office, which said families had contacted it about children missing checks.
When were the HSE system changes introduced?
The investigation examined changes made to the HSE system in 2022.
What should parents do if a check was missed?
Parents should contact their local public health nursing service or HSE health office to confirm the child’s records and request advice about arranging an assessment.
Follow DailyDigest for further updates on public services, health policy and Ireland’s child welfare system.
Conclusion
The investigation into under-six health checks highlights a serious gap in Ireland’s public health system. Early assessments cannot support children effectively if families are not contacted, appointments are missed or follow-up is unclear. The immediate priority is to identify affected children and restore dependable access to checks. For parents, the clearest step is to contact local HSE services if they are unsure whether their child has received the assessment. This Breaking News story remains significant because universal child health monitoring is a basic safeguard for families across Ireland.