Thousands of children without under-six health checks face increased risk, watchdog finds

The State has failed to ensure effective delivery of universal public health development checks for all children under the age of six, an investigation by the children’s rights watchdog has found.

The Ombudsman for Children’s Office on Tuesday published an investigation highlighting concerns that changes made to the Health Service Executive system for public health development checks in 2022 have led to some children missing out on these vital assessments by public health nurses.

This situation has “increased the risk that developmental, behavioural, emotional and health needs may not be identified and addressed in a timely manner”.

The 2022 changes replaced universal access to developmental checks with a prioritisation system and are in operation in varying degrees across five of the country’s six health regions.

The ombudsman said there is a lack of complete and available data on how many children have missed their checks, making it difficult to get a national picture of the scale of the issue.

The Ombudsman for Children’s Office said it has been contacted by families over the years, worried about the impact on their children of missing their checks and the long-term consequences on their development and potential access to services and supports.

“We believe this has significant implications for children’s rights,” noted the report.

“We are also concerned that children living in emergency accommodation and in the International Protection system are at particular risk due to the transience of their living arrangements.”

Ombudsman for Children Niall Muldoon said the first years of a child’s life are “essential for their development and ... The universal child developmental health checks carried out by public health nurses in Ireland are a critical part of those early years.”

Muldoon cited figures from Minister for Health Jennifer Carroll McNeill in response to a parliamentary question in January 2026, which suggested that about 14.2 per cent of children did not receive the nine- to 11-month developmental assessment within the recommended timeframe the previous year.

“With around 54,000 births registered in 2025, this equates to around 7,700 babies. The situation is worse in different parts of the country, with blackspots identified in different areas,” he said.

Muldoon made four recommendations to the Health Service Executive to improve access to developmental checks.

These include: putting a plan in place under the National Healthy Childhood Programme to ensure all children receive their checks; making special arrangements for children in temporary accommodation to access public health nurses (PHNs); strengthening the child protection and safeguarding role of the PHN; and developing a national system for collecting data and monitoring public health nurse child health services.

The HSE has accepted the findings and has committed to setting up a national oversight group to implement the recommendations.