A child who made allegations of sexual abuse was forced to wait two months before she was examined by a medical specialist, a damning report has found.
The Ombudsman for Children exposed a string of failures within the Health Service Executive (HSE) in its handling of an 11-year-old girl, who claimed she was repeatedly violently raped and assaulted with a knife over an eight-month period.
Ombudsman Emily Logan said a breakdown in communication between the HSE and the child's mother prevented the authority fulfilling its duties, which adversely affected the child's recovery.
"By the time the child saw a medical specialist it was a two-month delay, which is very significant given the trauma this child had and the trauma for the family," Ms Logan said.
The alleged sexual abuse took place between December 2006 and July 2007.
The HSE sourced a male specialist to examine the child following a request from her mother in February 2007.
The mother claimed she had specifically requested a female medical specialist, insisting the girl would find it troubling to be examined by a man.
She felt it should be carried out as a matter of urgency, fearing her daughter may have needed treatment as a result of the alleged sexual abuse.
The HSE was unable to appoint a female specialist due to what it described as a lack of resources, and the girl was forced to wait more than two months before a woman doctor was available to examine her.
The ombudsman's investigation, which was sparked following a complaint from the family in 2009, found the HSE had failed to allocate a social worker to the child.
It also found it did not provide psychological or therapeutic services, and failed to acknowledge, consider or address the views of the child, which were expressed through her mother.
The ombudsman said the executive also failed to arrange an early face-to-face meeting with the girl and described its record-keeping as poor.
"The period following a disclosure of alleged sexual abuse by a child is very traumatic for both a child and his or her family," Ms Logan said.
"It is imperative that HSE staff communicate clearly and in a compassionate way with parents at this extremely stressful time."
Ms Logan said the HSE had described the child's mother as "difficult" and "challenging", and claimed the girl's wish not to be interviewed on her own had hampered its efforts.
The ombudsman said she believed the executive allowed its disputes with the mother to get in the way of its administration of vital supports.
"What I am saying, as Ombudsman for Children is that is not good enough," Ms Logan said.
"It's not OK to say this child's parent is difficult so we can't work with her. They should have been able to deal with her."
The ombudsman has made 10 recommendations to the HSE - one of which relates specifically to the girl, who is now 17, and the services she still requires.
She demanded it explain how the new Child and Family Agency deals with families following abuse claims.
Her recommendations are:
:: The HSE continues to engage with the girl and her mother in order to assess the her current needs and provide appropriate therapeutic services;
:: The HSE prioritises direct contact with children;
:: The HSE informs and educates parents of children making disclosures of alleged sexual abuse about the full range of services available to them;
:: The HSE has face-to-face contact with families;
:: The HSE allocates a social worker to complex cases;
:: The HSE improves record-keeping;
:: The HSE sets case management goals;
:: The HSE streamlines the system for organising medical examinations;
:: The HSE reviews availability, accessibility and gender balance of physicians qualified to carry out medical examinations;
:: The HSE continues to work towards a systemic joint approach with An Garda Siochana for cases of suspected abuse.
The ISPCC urged the HSE and the new Child and Family Agency to take immediate action to ensure that adequate and timely responses and 24-hour supports are provided to children and their families.
"The Child and Family Agency must ensure that all staff are trained and supported to adequately respond to families following disclosures of alleged abuse including through the provision of practical, accessible and timely information," the children's charity said in a statement.
Later, the HSE said it accepted the ombudsman's recommendations and is in the process of implementing them.
In a statement, it said its services and provisions in relation to child sex abuse have improved since the girl's allegations were first reported in 2006.
This includes the assignment of extra social workers and new 24-hour dedicated sexual assault treatment units with access to female consultants.
The HSE said it also follows Ireland's national guidelines for the safety and well-being of children - Children First, which was published in 2011.
"Standardised business processes for social workers have been introduced to ensure a consistent national response to reports of child abuse," the statement said.
"The HSE works in partnership, under agreed protocols, with An Gardai Siochana to ensure that allegations of child abuse are investigated in accordance with statute and in compliance with Children First.
"The HSE is committed to supporting those affected to resolve any outstanding issues they may have and will not be commenting further at this time.
"The HSE offers counselling, support, and services to anyone who has disclosed alleged abuse and liaises with other statutory agencies and relevant organisations to protect children at all times."