The number of children and young people in Queensland's residential care more than tripled in a decade, the Child Safety Commission of Inquiry final report revealed.
"Our child safety system is meant to protect vulnerable kids, but during a decade of decline, the child safety system was neglected," Premier David Crisafulli told parliament before the more than 1300-page document was tabled on Wednesday.
"The evidence has been shocking, and it's been deeply concerning."
"Frontline staff didn't get the support or the resources they need, and vulnerable kids with complex needs and traumatic experiences were not properly cared for."
The report also found Queensland had almost as many children in residential care as every other state and territory combined.
The state's Liberal National government, which was elected in October 2024, pinned most of the blame on the former Labor government.
Child Safety Minister Amanda Camm said it left behind a broken system.
"This report should keep Queenslanders awake at night," she told reporters.
"The findings lay bare the scale of the crisis we inherited, with vulnerable children failed by a system that became increasingly reliant on residential care instead of supporting families and carers."
The state's residential care population surged by 229 per cent from March 2015 to March 2025, the commission found.
The annual cost of residential care in Queensland increased from about $300,000 per child in 2019-20 to approximately $500,000 per child in 2024-25.
Attorney-General Deb Frecklington said the report exposed the shocking consequences of a decade of neglect and failure under the former government.
"Queensland's child safety system was failing the very children it was supposed to protect," she said.
"The commission's findings are deeply concerning, particularly the evidence that a significant proportion of reported sexual abuse incidents in care involved children placed in residential care."
The inquiry - the third of its kind since 2003 - heard harrowing testimony from witnesses who suffered abuse in state care as children.
It also chronicled "rapacious" growth in spending, and substantial growth in children in out-of-home care and the residential care sector, and the intersection between the child safety and justice systems.
The number of children in out-of-home care increased from 7999 in 2011/12 to 10,092 in 2023/24, while the number in residential care rose from 653 to 1994 over the same period, the inquiry found.
Spending on child safety services increased from $753 million to $2.36 billion in that time.
Data also showed 72.9 per cent of children under youth justice supervision in 2022/23 had interacted with the child safety system in the preceding 10 years.
The commission made 52 recommendations, which the government said it would carefully consider.
A cabinet sub-committee has been set up to consider and implement the report's recommendations and to prepare the government's response. Together Union said the findings confirmed what frontline workers had been warning of for years.
It called on the government to take urgent action and invest in early intervention and trauma and family support, and boost workforce capacity.
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