Children in residential care whose parents refuse to allow their fostering should be given the opportunity to live in a family environment even if it means waiving parental rights.

There is a pressing need to set up a system that allows such children to be fostered, irrespective of their parents' wishes, if fostering is deemed to be in the child's best interest by social workers, according to recommendations made in the Commissioner for Children's annual report.

As things stand, social work practice requires parental consent for children living in residential homes to be fostered. However, international research has shown that fostering is the better option for these children, especially those under five years, as it allows them to live in a family environment.

Unfortunately, the report pointed out, a number of parents still preferred that their children remained in residential homes and most children in out-of-home care lived in institutions.

Last year, for example, about 400 children lived outside their homes but only 190 were in foster care. Another 60 children were in homes waiting to be fostered. This spurred the government to launch a campaign to entice more families to foster children and, so far, 29 new foster carers have been recruited.

On presenting the annual report to President George Abela, Children's Commissioner Carmen Zammit pointed out the lack of a national policy on looked-after children that would ensure the best interests of children in care. The policy would also regulate the placement of all children in care, including hospital care, according to a personalised plan.

The annual report highlighted the urgent need for investment in alternative accommodation for children placed under a care order so that they were not left to live in an institution as there were no other alternatives.

The report stressed on the need to have a Children's Act that would collect all relevant children's legislation now fragmented across different laws.

All placements of children into care, whether by the parents or on the strength of a care order by the government, should be regulated to ensure more uniformity, the report said.

The law should also be reviewed to lower the age of medical counselling and treatment without parental consent, which stands at 18. This posed obstacles for those children who wanted to access healthcare, especially in cases of abuse.

The report suggested increasing the age of criminal responsibility from nine to 14 years as recommended by the UN.

Turning to the imprisonment of children, the report called for alternative methods of detention. Children should not be detained at Corradino Correctional Facility but should be kept in a special therapeutic setting.

Ms Zammit said it was important to establish measures so that minors co-accused with an adult had their case heard by the Juvenile Court. As things stood, such minors ended up at the law courts in a joint court case.

The report also pointed out the need to address court delays; change body-piercing legislation to ban it on minors or require parental consent; implement the long-awaited sexual health policy and put in place a sex offenders list that would ensure that those convicted of sexual crimes against children were not allowed to return to an environment where there were children.

Dr Abela pointed out that Ms Zammit's three-year term as Children's Commissioner had expired but the law provided for her to remain in office until her successor was appointed. He said the time was ripe for legislators to consider extending the commissioner's term to five years.

The situation in numbers

• 21 girls and 15 boys lived with their families despite being issued with a care order last year. This highlighted the need for investment in adequate government accommodation.

• Some 122 children are using the supervised access visit service, offered by Appoġġ Agency, to spend time with one of their parents.

• Last year, five boys and two girls, aged between 15 and 17, were detained at Corradino Correctional Facility. Four were awaiting trial and the others were serving time.

• 89 children were injured in traffic accidents in 2009, suggesting a need to promote better road safety.

• Appoġġ Agency saw to an average of 30 cases a week and child protection services investigated 1,022 cases, while 37 care orders were issued.