Thirty five children and teenagers known to the Health Service Executive (HSE) have died since March of last year, it was revealed yesterday.

It was also revealed that were 16 serious incidents involving children or adolescents known to the HSE over the same time period.

Of those 35 deaths, most were due to natural causes, or accidents, but causes also included drug overdose, suicide and even homicide, according to RTE news.

The 16 cases described as serious incidents included accidents, parental abuse or neglect, or alleged sexual abuse.

The National Review Panel, a group established by the HSE to investigate all deaths and serious incidents of children in care – has found that the inaction of the HSE was not directly linked to any deaths.

However, the independent chair of the group, Dr Helen Buckley of Trinity College Dublin, criticised the HSE for numerous failures which led to sub-standard care in some cases.

The panel that the HSE’s failure to implement a standard method for assessing the needs of children was a considerable failing.

Professor Buckley said there were deficits in services and poor inter-agency communication at times.

The panel published reports on six of the cases yesterday.

In one case, the death of a four-month-old baby from natural causes in July 2010, the report criticises the time lapse between December 2006, when An Garda Síochána notified the HSE of concerns, and October 2008 when the HSE met the family.

In another case, the report said that the Executive should have had a screening tool in place to highlight chronic illness in a child.The child had died of complications associated with diabetes and there were ‘communication’ gaps which had implications for this well-being.

HSE National Childcare Specialist Paul Harrison said he believed the HSE had an effective and robust system, but he accepted the criticism that assessments are not always uniform around the country.

In March 2010, the Health Information and Quality Authority issued directions to the HSE to review all serious incidents including deaths in care and detention.

A national review team was set-up and since then the HSE must notify HIQA of all deaths and serious incidents within 48 hours.

Concern over deaths in HSE care arose last year, when it emerged that some 200 minors had died in HSE care, or in contact with HSE care services in the past decade..

Last year, a spokesperson for a leading children’s charity said that the HSE’s child protection system was “not fit for purpose”.

Norah Gibbons, head of advocacy at children’s charity Barnardos told the McGill Summer School that the HSE showed “a lack of leadership, a lack of clear national standards, a lack of a clear assessment model and no national agreement on the threshold we as a nation want to set in respect of protecting our children.”

A recent report by the Health Information and Quality Authority (HIQA) showed that some children were being placed by the HSE with foster parents who were not properly vetted.

The report into the HSE in Dublin found “significant deficiencies in the vetting, assessment and approval of carers, particularly relative carers” and “serious concerns in relation to child protection practices and the assessment of child protection concerns”.

A report in the Irish Times in August showed that fewer than 15 per cent of the convicted sex offenders on the sex offenders register are being properly monitored.

Last year 158 convicted sex offenders, out of 1,100, were supervised by the Probation and Welfare Service, according to figures obtained by the paper.