European Child Guarantee: Analysing the extent to which children in Ireland have access to key services

Laurie Reilly, Dr Maria Pierce, Professor Michelle Norris, and Dr Laura Foley, UCD Geary Institute for Public Policy

Key words: early childhood, care, children, education, nutrition, housing, healthcare

A pdf version of this paper is available here.

Introduction

On 14 June 2021, the Council of the European Union adopted a Recommendation establishing a “European Child Guarantee”, which aimed to prevent and tackle social exclusion by guaranteeing effective access to six key services for “children in need”. These include effective and free access to four services: i) high-quality early childhood education and care (ECEC); ii) education and school-based activities; iii) at least one healthy meal each school day; and iv) healthcare. In addition, it includes effective access to two services: i) healthy nutrition; and ii) adequate housing.

This paper analyses the extent to which children living in low-income households in Ireland have effective (or effective and free) access to these six services, all of which are primarily or solely regulated at the national level. Our analysis shows that there are several obstacles that impede effective access to the aforementioned services, including financial barriers, issues with housing supply, and strains on the healthcare system.

Much of our analysis is based on a report that we compiled for the European Commission, as part of the European Social Policy Analysis Network. The full report is available to download here. Additionally, we include some information relating to Budget 2024 (announced on 10 October 2023).

Early Childhood Education and Care (ECEC)

In terms of the European Child Guarantee, effective and free access to early childcare is not provided to all children in Ireland. According to the 2022 Census, about one-third of children aged under 15 in Ireland receive some form of childcare[i], with crèches and similar facilities constituting the most common type of childcare provider for pre-school aged children (56%). Almost one in three of those in childcare in this age group attended for 11-20 hours a week (CSO, 2023). There are significant barriers that impact participation in ECEC, which in turn have wider societal effects. Childcare costs in Ireland are among the highest in the OECD (OECD, 2020) and these costs have been found to be a key factor driving the low levels of participation in education, training, and employment for mothers (Paull, 2021).

One policy response to tackling financial barriers to ECEC is the National Childcare Scheme (NCS). The scheme provides two subsidies: a universal subsidy and a means-tested income-assessed subsidy. In the 2024 budget, the hourly subsidy increased from €1.40 to €2.14, but this will not come into effect until September 2024. The NCS aims to: i) improve outcomes for children and support lifelong learning; ii) reduce poverty; iii) facilitate labour market activation, and iv) tangibly reduce the cost of early learning care (ELC) and school-age childcare (Pobal, 2022). In a review of the first year of the NCS, Paull (2021) estimated that, as a proportion of the population, approximately 9% of children up to age 15 had made an application to the NCS and around 5% had a claim. The review found that the scheme successfully targets higher payments at more disadvantaged areas. Almost a quarter of applicants (23%) were from disadvantaged areas, with two-thirds from areas of average disadvantage. Among claimants of the NCS income-assessed subsidy, about a third were single parents, and around a third were households with just one child (Paull, 2021). Importantly, Paull (2021) notes that COVID-19 had a significant impact on the use and development of the NCS[ii].

For pre-school settings, Ireland has a universal two-year Early Childhood Care and Education (ECCE) programme which provides free pre-school to children over 3 years’ old. However, the scheme only provides 15 hours of free schooling a week in term time, so three hours of pre-school a day for five days a week, with charges applied for any additional hours. The scheme is available to all children who have turned 2 years and 8 months of age before 1 September of the relevant year. Participating playschools and day-care services are paid a set amount per child by the state to offer the ECCE service.

The provision of childcare in Ireland primarily relies on the private sector which contributes to the high and variable cost of non-parent childcare (Curristan et al., 2023). Furthermore, staffing issues continue to affect the accessibility and affordability of Ireland’s early childcare system. There are issues relating to recruiting and retaining sufficient staff, primarily due to the low rates of pay in the childcare sector. There are large waiting lists for children to access childcare and, according to the Federation of Early Childhood Providers (FECP), there are a number of service providers who are considering closing their operations due to staffing issues and profitability concerns, with a reported 97 childcare providers having closed between March and August 2023 (Johns, 2023).

There are also several non-financial barriers that impact access to early childcare in Ireland.  An OECD (2022) report found that the NCS was viewed as complex by stakeholders, particularly those who had low digital and literacy competencies. Furthermore, many childcare providers are unable to avail of the NCS as, currently, only providers who are registered with Tusla, the Child and Family Agency, can participate in the scheme. However, legislative and regulatory barriers remain that prevent many childcare providers from being able to register with Tusla. For vulnerable households, who are on low incomes, they often lack digital capabilities, or do not have ready access to IT to make online applications. Furthermore, many Traveller households remain unaware of the financial childcare subsidies available and can lack the literacy skills or the digital infrastructure to complete their applications (Children’s Rights Alliance, 2022). Similarly, as language barriers are an issue for some migrant households when trying to access information in Ireland (see e.g. Norris et al., 2022), this may impact their ability to navigate the application process.

Education and School-Based Activities

School-related activities in public primary and secondary schools is not free for the majority of children in Ireland. A 2022 survey by Barnardos (2022) estimated that the full costs to parents of sending a child to primary school were €424 per annum, whereas secondary school costs range between €772 and €814. However, these estimates did not consider costs for transport, sport or music equipment, or extracurricular activities, although they did include voluntary contributions (often requested by schools), and the costs of classroom resources (e.g. stationery).

From September 2023 onwards, all public primary children in Ireland were provided with free books, and Budget 2024 announced that this scheme would be extended to second-level pupils up to the Junior Cycle, commencing in the 2024/2025 school year, which will benefit 212,000 students (Department of the Taoiseach, 2023; 12). With regards to the cost of examinations, secondary school pupils whose parent or guardian has a medical card do not have to pay for State examinations at the junior and leaving certificate levels. In Budget 2024, it was announced that fees for State examinations will be waived for all pupils sitting exams in 2024. Additionally, cash benefits for school uniforms and footwear are available for children from low-income households via the back-to-school clothing and footwear allowance.

There are no comprehensive data on the barriers to effective and free access to school-based activities for low-income children, but an annual survey conducted by the Irish League of Credit Unions (2022) showed that 67% of respondents could not facilitate their children in the pursuit of extracurricular activities due to financial barriers. Barnardos (2022) observed that, due to the increased cost of living, the low-income families that they support are using all disposable income towards bills, energy, food, and travel, with no surplus income for school activities or trips. Thus, financial barriers remain an issue for accessing education and school-based activities.

Free Meals at School

In Ireland, free and healthy school meals are not accessible for all children in low-income households. Firstly, for pre-school aged children, full-time participants in pre-schooling and day-care of more than five hours are provided with two free meals each day, one of which must be a hot meal, and two snacks. Children in pre-school and day-care for up to a maximum of five hours can receive at least two meals and one snack, though it is not necessary to provide a hot meal. For children in pre-schooling and day-care for up to 3.5 hours, one meal and one snack is offered, but it does not have to be a hot meal (Tusla, 2018) However, low-income children are less likely to participate in full-time care and thus will be less-likely to access the additional free hot meal and snack. In November 2022, the Irish government announced funding for a scheme piloting the provision of meals for children in ECEC settings in disadvantaged areas, and particularly for those children who use childcare services for shorter periods.

For school-aged children, there is a targeted publicly funded schools meals scheme – the School Meals Programme – for schools in disadvantaged areas (those that are included in the DEIS – Delivering Equality of opportunity In Schools – programme). An evaluation of this programme found strong evidence that the provision of school meals resulted in improvements in attendance at school (RSM, 2022). However, there are ongoing concerns around eligibility as, to access the scheme, children from low-income households need to be enrolled in the chosen schools. Therefore, those who attend different schools or who do not live in more densely populated disadvantaged areas, are unable to access this scheme. In March 2023, the government announced the extension of the free hot meals element of the School Meals Programme to primary schools in disadvantaged neighbourhoods from the 2023/24 school year, with a phased approach to extend this initiative to all other primary schools from 2024, resulting in universal hot meals by 2030 (Department of Social Protection, 2023).

Healthcare

Children from low-income households can access effective and free healthcare in Ireland. Free GP care is provided to holders of medical or general practitioner (GP) visit cards. Since July 2015, all children under 6 are eligible for free GP visits which includes preventative assessments and care management for children with chronic health conditions such as asthma[iii]. This was extended to children aged 6 and 7 in August 2023 (Department of Health, 2023)[iv]. For older children, eligibility for the GP visit card is dependent upon household income. Free GP visits are also covered for households who qualify for a means-tested medical card, which covers free GP visits, most medicines (with prescription charges), eye and ear tests, and dental checks.

There is a national strategy to protect children from infectious diseases through vaccinations via the primary childhood vaccination programme and the school immunisations programme. Through these programmes, most vaccines are free to all children. Specialist healthcare is also free for all children, and this includes mental health services and rehabilitation services. Furthermore, every child up to age 5 has access to free health and development checks including hearing, eyesight, speech development and physical development. This is provided by public health nurses (as well as other health professionals). However, it is important to note that the redeployment of public health nursing during the COVID-19 pandemic has acted as a barrier to developmental checks for children born during that period (Irish Times, 2022).

The Department of Health (2019) underlined that children from poorer socio-economic backgrounds are at high risk of dental disease. The Health Service Executive (HSE) operates a children’s dental service that provides dental care to all children up to age 16 in dental clinics across Ireland. It is a free service for children under 6, children attending primary and secondary school. Children who have left school, are under 16, and dependants of medical card holders, are also eligible for free dental care. Additionally, children are also offered dental treatment in HSE dental clinics for emergency treatment.

However, there are non-financial barriers to effective and free access to healthcare in Ireland. Firstly, vaccine hesitancy has been identified as barriers to vaccination (see Whelan et al., 2021). Secondly, there is no automatic enrolment system for medical cards, applicants need to opt in. However, opting in can require knowledge of the social security system and there can be confusion about entitlement. Additionally, recent research found that a lack of take-up of medical cards in Ireland among those who meet the eligibility criteria indicates a social stigma caused by basing eligibility on income (Keane et al., 2021). In contrast, there is a near 100% take-up of GP visit cards provided to all children under 6, and those over 70 (Keane et al., 2021).

Furthermore, the accessibility of healthcare and dental care in Ireland is under severe strain. There are long waiting times to access many forms of healthcare in Ireland due to near-complete capacity at public hospitals and critical staffing issues. This hinders effective and free access for low-income children. Geographical disparities are also a problem for those with medical cards as workforce issues have resulted in a lack of availability of GPs in many counties in Ireland. Thus, distance to service providers and a lack of effective transport options also contribute to limited accessibility.

Healthy Nutrition

Financial constraints are a key barrier to lower-income households accessing healthy nutrition in Ireland (Children’s Rights Alliance, 2022). A 2021 report found that the cost of a healthy diet would account for 12-35% of the weekly take-home income of low-income families, depending on the household composition and location (Safefood, 2021). Increases in the cost of living is also impacting healthy nutrition. Barnardos and Aldi (2022) conducted a study on families with children in which 25% of respondents stated that, in October 2022, they could not provide their children with sufficiently nutritious food, up from 17% in January 2022. In addition, 64% of parents said that they have cut down on other essential items to afford food costs. In the same study, parents (including low-income parents) reported other barriers to healthy nutrition including a lack of time to cook, a lack of knowledge about fresh food and cooking needed to confidently cook nutritious meals, and a dearth of cooking facilities (ibid).

The government promotes a variety of healthy food schemes within schools, and outside of schools, with the aim of reducing health inequalities. The promotion of healthy eating is done largely through educational campaigns (such as the START campaign). The focus on healthy nutrition for children has been to support all parents to take responsibility for improving their children’s nutrition. However, there are no government-funded programmes that provide healthy food subsidies or food vouchers for low-income families to buy healthy food. Therefore, while awareness of healthy food may have increased, lower-income households may still struggle to afford some healthier food options.

It is also important to note that while the publicly provided school meals meet basic nutritional standards, they are produced on a large-scale, they are pre-packed, and are generally heavily processed. In addition, most Irish schools do not have infrastructure such as canteens or cooking facilities, which makes the school meals programme heavily reliant on the ability of schools to secure deliveries of hot food from external suppliers. For the 2021/2022 school year, 31 DEIS Schools who were eligible to participate in the School Meals programme could not do so, mainly due to their geographical location and a lack of availability of suppliers in their area (RSM, 2022).

Adequate Housing

Ireland provides a system of housing allowances for the private sector, and social rented housing. Access to both is means-tested, and the test takes account of the number of children in the household. There is a comprehensive system of housing allowances to enable low-income households, both with or without children, to pay their rents. However, in contrast to other EU Member States, in Ireland these allowances are only available to tenants renting accommodation in the private (for profit) sector. They are not available to social housing tenants or homebuyers. There are two housing allowance schemes that are currently in operation: Housing Assistance Payment (HAP) and rent supplement. Rent supplement is designed to provide short-term housing support for households during periods of unemployment of while awaiting the allocation of a social housing tenancy. Unlike rent supplement, HAP is available to both social security benefit claimants and those in low-paid employment. HAPs play a key role in preventing homelessness among families with children and enabling them to exit homelessness. In 2019, 42.79% of first-time claimants of HAPs were single parents with children and a further 24.2% were couples with children (CSO, 2019). However, there is significant evidence indicating that HAP rates are no longer sufficient to meet housing need effectively for many low-income families with children. The maximum rents eligible for HAP subsidies have not been increased since 2016, despite very significant private rent inflation and a declining number of available dwellings for rent since then (see e.g. Simon Communities of Ireland, 2022).

Social rented housing in Ireland is provided by local government and non-profit sector housing associations. Almost 10% of Irish households were accommodated in social housing in 2016, some 89.5% of whom lived in dwellings rented from local authorities (CSO, 2016). Social housing is allocated based on an income qualification and assessment of housing need. The income limit for access to social housing is higher for households with children than for single-person or two-adult households. In 2021, 59,247 households were on the waiting lists for access to social housing (the latest year for which data are available). One fifth of these were single-parent households and some 8.6% were couples with children (Housing Agency, various years).

It is important to note that income limits for access to social housing and housing allowances have not kept pace with increases in incomes and increases in private rents over the last decade. However, in an effort to address this problem, incomes limits and housing allowances were increased in 2022. Additionally, a key barrier to accessing adequate housing is a lack of suitable supply. There is a very acute shortage of private rented housing for all categories of HAP claimants, including households with children. While output of social housing has increased in recent years, there remains a significant shortage, especially in Ireland’s cities. Therefore, households with children living in these areas are likely to wait significantly longer for a social housing tenancy. Homelessness, of all types, including child homelessness, is much higher in cities. In November 2023, 4,105 children were members of homeless households, 3,116 of whom lived in Dublin (Department of Housing, Local Government and Heritage, 2023). Furthermore, as most local authority housing stock consists of three-bedroom dwellings, small families and large households are likely to wait longer to be allocated a social housing tenancy (see e.g. National Oversight and Audit Commission, 2017).

Concluding Remarks

This review underlines that Ireland is not meeting all its targets relating to the European Child Guarantee. There are barriers to accessing early childhood education with childcare costs in Ireland among the highest in the OECD. While the NCS helps to partially cover early childcare costs, other barriers remain. This includes issues with early childcare providers retaining staff, and issues with digital capabilities, literacy skills, and access to IT impeding applications for financial subsidies. More awareness-raising is needed around the financial childcare subsidies available, and there is a need to provide practical assistance with applications. Additionally, financial constraints remain a barrier for children from low-income households to access some school-based activities.

Financial constraints also remain a key barrier to accessing healthy nutrition in Ireland. Furthermore, all children in low-income households in Ireland are not able to access free meals at school as these children are less likely to participate in full-time pre-schooling where meals are provided. However, for school-aged children, the gradual extension of the School Meals programme to all primary schools by 2030 is a welcome development as, previously, some children in low-income households were excluded by way of not living in the correct catchment areas.

Children from low-income households can access effective and free healthcare in Ireland. However, non-financial barriers remain an issue, such as parents and guardians lacking knowledge of the social security system and being unaware of the need to apply for a medical card. Furthermore, as Ireland’s health and dental care systems are under severe strain, this impacts accessibility.

Finally, while Ireland has a comprehensive system of housing allowances to enable low-income households, both with and without children, to pay their rents, barriers to adequate housing remain. This is mainly due to lack of housing supply, especially in Ireland’s cities.

References

Barnardos and ALDI. 2022. Food Insecurity in Ireland: Impact on Children and their Parents. Available to download: https://knowledge.barnardos.ie/items/0f7e5427-effd-4aaa-9ac9-546a87f0e2c5

Barnardos. 2022. Back to School Survey 2022. https://www.barnardos.ie/policy/the-issues/education/back-to-school-2022-2/

Central Statistics Office (CSO). 2016. Census of Population: Housing Report.

Central Statistics Office (CSO). 2019. Social Housing in Ireland 2019 – Analysis of Housing Assistance Payment (HAP) Scheme. CSO, Cork. Available at: https://www.cso.ie/en/releasesandpublications/ep/p-hhwl/socialhousinginireland2019-analysisofhousingassistancepaymenthapscheme/householdscomingintohap/

Central Statistics Office (CSO). 2023. Press Statement: Census 2022 Profile 3 – Households, Families and Childcare.  https://www.cso.ie/en/csolatestnews/pressreleases/2023pressreleases/pressstatementcensus2022resultsprofile3-householdsfamiliesandchildcare/

Children’s Rights Alliance. 2022. Child Poverty Monitor. https://www.childrensrights.ie/resources/child-poverty-monitor

Curristan, S., McGinnity, F., Russell, H., and Smyth, E. 2023. Early Childhood Education and Care in Ireland and Northern Ireland. ESRI Research Series, No. 157. https://www.esri.ie/publications/early-childhood-education-and-care-in-ireland-and-northern-ireland

Department of Health. 2019. Smile agus Sláinte – National Oral Health Policy. https://www.gov.ie/en/publication/90687b-smile-agus-slainte-national-oral-health-policy/

Department of Health. 2023. Minister for Health encourages families to register for free GP care for children aged 6 and 7. Press Release, 11 August. https://www.gov.ie/en/press-release/1b13e-minister-for-health-encourages-families-to-register-for-free-gp-care-for-children-aged-6-and-7/

Department of Housing, Local Government and Heritage. 2023. Monthly Homelessness Report for November 2023. DHLGH, Dublin. https://www.gov.ie/pdf/?file=https://assets.gov.ie/280339/c5e40a9a-8481-49a9-9093-7b40254f168f.pdf#page=null

Department of Social Protection. 2023. Minister Humphreys announces plans for roll-out of Hot School Meals to all Primary Schools. Press Release, 30 March. https://www.gov.ie/en/press-release/3d5f9-minister-humphreys-announces-plans-for-roll-out-of-hot-school-meals-to-all-primary-schools/

Department of the Taoiseach. 2023. Breaking the Cycle: New Measures in Budget 2024 to Reduce Child Poverty and Promote Well-being. 14 November 2023.

Irish League of Credit Unions. 2022. ICLU annual survey finds rising costs of living impacting heavily on funding back to school costs. 6 July. https://www.creditunion.ie/news/latest-news/irish-league-of-credit-unions%E2%80%99-annual-survey-finds/

Irish Times. 2022. Withdrawal of baby developmental checks “hugely concerning” psychologists say. Irish Times, 12 August. https://www.irishtimes.com/health/2022/08/12/withdrawal-of-baby-developmental-checks-hugely-concerning-psychologists-say/

Johns. N. 2023. Childcare providers warn increase in closures could threaten capacity to meet demand. Irish Times, 31 August. https://www.irishtimes.com/ireland/social-affairs/2023/08/31/childcare-providers-warn-increase-in-closures-could-threaten-capacity-to-meet-demand/

Keane, C., Regan, M., and Walsh. B. 2021. Failure to take-up public healthcare entitlements: Evidence from the Medical Card system in Ireland. Social Science & Medicine, 281(114069). Available at: https://doi.org/10.1016/j.socscimed.2021.114069

Laurence, J., Russell, H., and Smyth, E. 2023. Housing adequacy and child outcomes in early and middle childhood. The Economic and Social Research Council Research Series, 20 February. https://www.esri.ie/publications/housing-adequacy-and-child-outcomes-in-early-and-middle-childhood

McDonnell, T., and McAuliffe, E. 2022. Assessing how the policy of free GP care for children aged under 6 has impacted unscheduled paediatric healthcare in Ireland. PublicPolicy.ie 29 April: https://publicpolicy.ie/health/assessing-how-the-policy-of-free-gp-care-for-children-aged-under-6-has-impacted-unscheduled-paediatric-healthcare-in-ireland/

National Oversight and Audit Commission. 2017. A Review of the Management and Maintenance of Local Authority Housing.

National Oversight and Audit Commission. 2017. A Review of the Management and Maintenance of Local Authority Housing. https://www.housingagency.ie/publications/review-management-and-maintenance-local-authority-housing

Norris, M., Szelewa, D., Kelleher, J., Bwalya, J. 2022. Meeting the Information Needs of Migrants in Vulnerable Situations: A Citizens Information Perspective. https://www.citizensinformationboard.ie/downloads/social_policy/socialpolicy-information-needs-migrants-june2022.pdf

OECD. 2020. Is Childcare Affordable? Policy Brief on Employment, Labour and Social. OECD, Paris.  https://www.oecd.org/els/family/OECD-Is-Childcare-Affordable.pdf

OECD. 2022. Education at a Glance 2022. OECD Indicators. OECD, Paris. https://www.oecd-ilibrary.org/education/education-at-a-glance-2022_3197152b-en

Paull, G. 2021. 12 Month-Review of the National Childcare Scheme: A Report prepared for the Department of Children, Equality, Disability, Integration and Youth (Ireland). Frontiers Economics, Dublin. Available to download: https://assets.gov.ie/205797/f6c41d8e-a71c-488e-b8e8-590cdbd4a69c.pdf

Pobal. 2022. Annual Early Years Sector Profile Report 2020/2021. https://www.pobal.ie/app/uploads/2022/05/Pobal_22_EY_20-21-Report_final_2.pdf

RSM. 2022. Department of Social Protection: Evaluation of the School Meals Programme. Available at: https://www.gov.ie/en/publication/473a6-evaluation-of-the-school-meals-programme-december-2022/

Safefood. 2021. What is the cost of a healthy food basked in Ireland in 2020? Available at: https://www.safefood.net/getattachment/3bce7bc6-86db-4480-8c2a-719fb223dc5b/safefood-Cost-of-a-healthy-food-basket-2020-Report-ROI.pdf?lang=en-IE

Simon Communities of Ireland. 2022. Locked Out of the Market Study in June 2022: The Gap Between HAP Limits and Market Rents. Snapshot Study. June 2022. https://www.simon.ie/wp-content/uploads/2022/07/Locked-Out-of-the-Market-June-2022_final.pdf

Tusla. 2018. Quality and Regulatory Framework: Full Day Care Service and Part-Time Day Care Service. Early Years Inspectorate, Tusla, Dublin. https://www.tusla.ie/uploads/content/4566-TUSLA_QRF_DAY_CARE_LR.pdf

Whelan S.O., Moriarty, F., Lawlor, L., Gorman, K.M., Beamish, J. 2021. Vaccine hesitancy and reported non-vaccination in an Irish pediatric outpatient population. Eur J Pediatr, 180(9): 2839-2847. doi: 10.1007/s00431-021-04039-6. 


[i] As this was the first time in the census that households were asked about childcare so we cannot compare with previous years.

[ii] The NCS was launched in November 2019 and, five months later, all childcare services closed between 12 March 2020 and 29 June 2020, due to COVID-19 restrictions, which may have severely impacted the scheme’s development in the first year.

[iii] See McDonnell and McAuliffe (2022) for an assessment of how the policy of free GP care for children aged under 6 has impacted unscheduled paediatric healthcare in Ireland.

[iv] The government aims to provide a phased expansion of these arrangements to all children aged 12 and under, over time.