Thousands of children may be at greater risk of delayed support after missing developmental health checks, according to a new investigation by the Ombudsman for Children’s Office. The report raises urgent concerns about access to public health nurse assessments across Ireland and the effect on children’s developmental, behavioural, emotional and wider health needs.
What happened in this Breaking News report?
The Ombudsman for Children’s Office found that the State has not ensured the effective delivery of universal public health developmental checks for every child under six. The investigation focuses on changes introduced to the Health Service Executive system in 2022.
Those changes replaced universal access with a prioritisation model. The system is operating to different extents across five of Ireland’s six health regions, meaning access and delivery can vary depending on where a family lives.
The watchdog warned that children who do not receive the checks may have developmental, behavioural, emotional or health needs identified later than they should be. Early identification can be important when children require additional assessment, intervention or support services.
Why the checks matter for children and families
Public health nurses carry out developmental assessments during the early years of a child’s life. These checks are designed to monitor progress and help identify concerns that may need further attention.
Ombudsman for Children Niall Muldoon said the first years of childhood are essential for development and described the universal checks as a critical part of early-years healthcare in Ireland.
The report follows concerns raised with the Ombudsman for Children’s Office by families who were worried about the consequences of missed appointments. Some parents feared that delays could affect their children’s development or their ability to access appropriate supports later.
How many children may be affected?
The investigation said there is no complete, readily available national dataset showing how many children have missed their developmental checks. That lack of information makes it difficult to measure the full scale of the problem or compare performance across regions.
Figures provided by Minister for Health Jennifer Carroll MacNeill in response to a parliamentary question indicated that approximately 14.2 per cent of children did not receive the recommended nine- to 11-month developmental assessment within the expected timeframe in 2025.
With about 54,000 births registered in 2025, the Ombudsman estimated that this could represent roughly 7,700 babies. The report also identified local blackspots where the situation appears to be more serious.
Key facts
- The system for under-six developmental checks changed in 2022.
- Universal access was replaced by prioritisation in most health regions.
- About 14.2 per cent of children reportedly missed the nine- to 11-month check within the recommended timeframe in 2025.
- The HSE has accepted the findings and plans to create a national oversight group.
Children in temporary accommodation face particular concerns
The Ombudsman highlighted children living in emergency accommodation and those in the International Protection system as being particularly vulnerable to missed checks.
Families moving between accommodation locations may find it harder to maintain contact with the relevant public health nurse or local health service. Changes in address, uncertainty about services and the temporary nature of living arrangements can all create barriers to continuity of care.
The report said special arrangements are needed so that children in these circumstances can still access developmental checks, regardless of where they are living at a particular time.
Ombudsman makes four recommendations to the HSE
The children’s rights watchdog made four recommendations aimed at improving access, accountability and data collection within the public health nursing system.
- Create a national plan: The HSE should establish a plan under the National Healthy Childhood Programme to ensure all children receive their developmental checks.
- Support children in temporary accommodation: Special arrangements should be introduced for children living in emergency accommodation or within the International Protection system.
- Strengthen safeguarding responsibilities: The child protection and safeguarding role of public health nurses should be reinforced.
- Improve national data: A national system should be developed to collect data and monitor child health services delivered by public health nurses.
The recommendations are intended to address both immediate access problems and the wider lack of reliable information about how the system is performing.
HSE accepts findings and promises national oversight
The Health Service Executive has accepted the Ombudsman’s findings. It has committed to establishing a national oversight group to oversee implementation of the recommendations.
The next stage will be important for families and health professionals. The effectiveness of the response will depend on whether the HSE can improve access across regions, identify children who have missed appointments and provide a clear way to measure progress.
For parents and guardians, the report does not indicate that a missed check automatically means a child has an undiagnosed condition. It does, however, underline the importance of contacting the relevant public health nursing service if a developmental assessment has not taken place or if a parent has concerns about a child’s health or development.
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Frequently asked questions
What are under-six developmental health checks?
They are assessments carried out by public health nurses during a child’s early years to monitor development and identify potential health, behavioural or emotional concerns.
Why are some children missing checks?
The Ombudsman’s investigation links the issue to changes introduced by the HSE in 2022, when universal access was replaced with a prioritisation system in most health regions. Regional differences and limited national data make the precise causes difficult to assess.
Which children may be most at risk?
The report specifically identifies children living in emergency accommodation and those in the International Protection system as being at particular risk because of the instability and movement associated with their living arrangements.
What should parents do if a check was missed?
Parents or guardians who are concerned should contact their local public health nursing service or relevant HSE team to ask about arranging an assessment. They should also raise any immediate developmental or health concerns with a GP or appropriate healthcare professional.
Why this matters for Ireland’s children
The findings place early-years healthcare, public health nursing capacity and child safeguarding at the centre of Ireland’s current health debate. A universal programme can only work effectively when families can access it consistently and when national services can demonstrate where gaps exist.
The HSE’s planned oversight group now faces the task of turning the recommendations into measurable improvements. Better data, targeted support for vulnerable families and reliable regional access will be central to restoring confidence in the system.
This Breaking News report highlights a clear takeaway: every child should have a fair opportunity to receive timely developmental checks, and Ireland’s public health system must be able to show whether that is happening.