You judge a society by how it treats its most vulnerable citizens, and once again it seems we are failing.

We’re one of the richest, happiest and most advanced countries in the world but we can not get care – of our children, our elderly, our sick or our people with disabilities – right.

We leave it up to the market to decide how we look after our vulnerable. A mix ‘em gather ‘em of charities, religious organisations, community groups, businesses and the odd public body look after the people who are most open to exploitation, abuse and mistreatment.

Many of them are excellent, full of committed, knowledgeable, kind staff with their charges’ best interests at heart. Childcare is a vocation and it takes a very particular personality type to maintain interest, kindness and enthusiasm when looking after small children for long days at very low pay.

Studies show that a good creche environment that follows best practice is no better or worse for small children than a home environment, after the age of one. And we rely on that being the case for our chosen provider, trusting them to be a home from home and to nurture, educate and look after our children as well as possible.

But most creches, like most nursing homes, are businesses run for profit, and profit is the main aim, no matter what the mission statement on the wall says about cherishing your little cherubs.

Maximising profit, according to Wednesday’s Prime Time Investigates, means watering down milk, serving instant noodles instead of the advertised stirfry, and cutting corners generally. Clearly, either the regulations are not onerous enough or the regulator – as so often happens in Ireland – is asleep at the wheel.

The programme, which exposed poor safety standards and unkind, rough treatment of children at the Hyde and Seek creche chain, was a harrowing watch.

Watching tiny kids being shouted at, roughly treated, physically forced down to sleep, unsafely, on their tummies without a word of comfort or the cuddle they should be expecting realises every parent’s fears about the choices we have made for these tiny, vulnerable people who rely on us for everything.

Parenting comes with guilt built in. Every decision is fraught. What we do in pregnancy, how we feed the baby, where they sleep, how we choose to wean them, but most of all how we decide they will be looked after. We do our research, but at the end of the day our choices are limited by the world around us.

In an ideal world we would still live in multi generational households in a village, where people we know and trust care for each other. It wasn’t perfect (Ireland is well populated with stories of in laws who didn’t speak for 30 years while living in the same house), but it’s how things have worked throughout history.

But with increasing urbanisation, nuclear families living far from grandparents and extended families, with both parents working full time to keep afloat financially and a lack of flexibility among employers, this isn’t practical for most of us.

And unlike in other European countries, where childcare is provided by the state in highly regulated, relatively low cost environments with well trained staff, we have left childcare as a hodge-podge of private industry, community facilities, unregulated private childminders and family help.

This ad hoc set up appears to offer some options for you to choose from, but in reality it’s no choice at all, because it comes down to take what you can get, and pay a second mortgage for it.

Almost everywhere in the country there is a shortage of creche places. We put our baby on the waiting list at 3 months’ gestation, and he got the last place available for the following year. Some people must be registering them the moment they conceive.

Personal research, judgment and choice can only go so far.

We need the system to kick in. Local authorities, community development associations and education and training boards (ETBs) all run some childcare facilities throughout the country. These not-for-profit centres, where staff have better job security, giving them more power to speak up if things aren’t right, and they are more likely to unionise, should be the model.

Government needs a more active role in this sector, perhaps through a patronage model via the department of education or local ETBs, or through expanding the provision of public sector creches and establishing much stricter oversight over private enterprises.

The regulatory framework needs to be strengthened to allow Tusla to immediately take action when there are breaches to shut an unsafe creche down, and to ban repeat offenders from running creches.

Professionalising the sector is happening, slowly, but a professional body, like the Medical Council needs to be set up which can strike off childcare professionals who have seriously breached guidelines. Only with more safeguards in place will horrified parents who have watched Prime Time with a guilty mind be able to rest easy.