New IT for A&E

The introduction of a new computer system for use in hospital accident and emergency departments (A&E) in England is to be cautiously welcomed. http://www.bbc.co.uk/news/uk-20846317

I have previously suggested that such a system – which provides access to information about whether a child is subject to a child protection plan - might be a worthy successor to ContactPoint, which I believe was wholly misconceived. http://chrismillsblog.blogspot.co.uk/2010/06/after-contactpoint.html

But those responsible for the new database must not claim too much for it and they must resist the temptation to elaborate it. Keeping it simple is essential. And it should be UK wide, not simply confined to England.

Why do I support this system when I was very opposed to ContactPoint? This system deals with simple factual information – whether a child has been made the subject of a child protection plan, whether a child is in care – and should contain only details of children who meet these criteria. ContactPoint concerned all children and it was spuriously claimed that being able to see patterns in child/agency involvement was an indicator of risk.

Lisa Harker of the NSPCC is spot on when she says that it is people who protect children, not IT systems. An IT system can support professional practice if its objectives are simple and clear, but don’t ever fall into the trap of thinking that it can take decisions or even suggest courses of action.

Privacy not Publicity

There are no links in this post. I do NOT want you to read the articles I am referring to. I want you to ignore them.

How, I wonder, have we arrived at a situation in which national broadcasters and newspapers feel able to name very young children who are the subject of civil court action or even, in one case, a child of FIVE, who is subject to disciplinary action by his infant school? His name and photographs are plastered all over the pages of a leading tabloid.

In another case a national broadcaster seems quite relaxed about naming a seven year-old child whose medical care is the subject of a High Court action. All the medical details are being aired in public.

I don’t care whether the parents of these children or the courts or whoever has given permission for the children to be named. The private business of young children should never be aired in public in such a way that the child can be identified. How is a five year-old or a seven year-old going to feel looking at the ‘press cuttings’ in 20 years time? And who might be keeping those press cuttings for future reference – neighbours, schools, police, future employers? The list is endless!

We need to reassert the sensible and humane rule that always seemed to apply in the past. Children whose cases may be of public interest should never be named or otherwise identified.

A Culture of Overwork and Fear

MPs are holding an inquiry into the state of social work.

Karen Goodman, an independent social worker currently employed as an interim manager in child protection, is quoted by the British Association of Social Workers as telling the MPs social work has never been “… as stressed, fraught and overwrought “.

http://www.basw.co.uk/news/article/?id=273

She recounted how dedicated members of staff typically stay at work until 8pm on Fridays and still have to take work home with them. She said “… there’s just not the capacity in the system and I’ve never known it like it is now – just impossible."

Even more worryingly Karen recounted a culture of fear. “There is an ongoing culture of fear amongst my staff – they do fear telling the truth and losing their jobs. They don’t feel whistleblowing works.”

Karen is to be congratulated on telling it like it is. I hope that the MPs take note!

Children in care and in trouble

There were few surprises for me in the report [1] of the thematic inspection into looked after children subject to supervision by Youth Offending Teams and placed away from home. This is a small group of very vulnerable children and young people who have come into care, probably as a result of abuse and neglect, and who have also been convicted of criminal offences.

The inspection found that the outcomes for these children and young people were generally poor. They were not always protected from further abuse and neglect. Some had been assaulted or sexually exploited while in care. Some were involved in assaults of other children and young people. Several had gone missing.Their education had suffered. Few were well prepared for the transition to adulthood.

This is not a happy picture. While many children who are abused and neglected are able to recover from early adverse experiences, some children are not able to recover satisfactorily without special help.

Some years ago I wrote a research review for the NSPCC on the impact of child abuse and neglect on children’s performance at school [2]. Research shows without doubt that abuse and neglect make more likely a whole range of undesirable outcomes for the victims, including being at greater risk of poor educational performance, mental health problems, behavioural difficulties and involvement in the criminal justice system.

That is not surprising. Some children suffer long-term effects similar to those experienced by military personnel who have been exposed to combat. So they can need expert help and, where appropriate, post-traumatic stress disorder needs to be treated by skilled professionals.

The inspectors’ report did not say as much as I would have liked about the therapeutic services these children were receiving, or not, as the case may be. The impression gained was that the services were sparse and of variable quality, because the inspectors call on local authorities to: “… satisfy themselves that specialist therapeutic interventions provided by residential placements are of good quality and suitable for the needs of children and young people.”

I would go further than that. I believe we need a thoroughgoing review of therapeutic services for abused and neglected children and young people with a view to providing a comprehensive audit of what I believe to be manifest shortfalls.

[1] Looked After Children: An inspection of the work of Youth Offending Teams with children and young people who are looked after and placed away from home. A Joint Inspection by HMI Probation, Ofsted and Estyn ISBN: 978-1-84099-584-8 December 2012

[2] Mills, C (2004) Problems at Home, Problems at School London: NSPCC - http://217.35.77.12/archive/England/papers/welfare/pdfs/ProblemsAtHome.pdf

Getting it wrong – in Hampshire?

Wrongly taking children, who are not being abused or neglected, into care is as bad as wrongly failing to take children into care when they are being maltreated. The one type of error is the mirror image of the other.

I don’t know how accurate the Daily Mail’s recent story is. It concerns events in Hampshire, in which three children were taken from their mother in a 6 am police raid. If it is true it is utterly shocking - http://www.dailymail.co.uk/news/article-2248370/Social-workers-tore-babies-year-Nightmare-innocent-mother-accused-harming-son.html

The questions the article doesn’t answer are:

·       What medical opinion was sought and obtained?

·       Why has it taken so long for the children to be returned if, as the judge is reported as saying: ‘What happened here is that a picture was painted before the facts were properly analysed, indeed before many of the facts were actually known, and then the facts were made to fit the picture’?

·       Why were the children taken in an apparently heavy-handed dawn raid with the deployment of fourteen police officers?

My view is that John Coughlan, Hampshire County Council’s director of children’s services, and the police, have some important questions to answer.

It is not good enough just to say that the council acted with the ‘best motives’, or that it was acting out of a duty ‘to secure the wellbeing of children.’ The Council and Hampshire Police need either to refute the claims made in the article or to offer to explore what went wrong with a view to understanding the causes of what seems to have been a catastrophic error.

It has always seemed odd to me that we do not usually hold Serious Case Reviews in circumstances like this. The damage done if children are wrongly taken into care can be very great. Professionals need to know what went wrong and why it went wrong. The public need to be assured that someone somewhere is learning the lessons that make a repeat less likely.

  

Child Sexual Abuse - Surges in Demand for Protection Services

The Child Exploitation and Online Protection Centre (Ceop) says there had been a 30% rise in reports of abuse as a result of the "Savile effect". http://www.bbc.co.uk/news/uk-20716300

Back in November the Guardian reported that the NSPCC had experienced a 200% increase in calls about sexual abuse. http://www.guardian.co.uk/uk/2012/nov/15/jimmy-savile-police-arrest-fourth-suspect

More generally, the BBC article also reports that the Metropolitan Police has experienced a four-fold increase in complaints of sexual assault, in the wake of the Savile allegations.

It quotes the director of the NSPCC helpline as saying that by speaking out Savile's victims have raised awareness of child sex abuse so emboldening others to do the same.

We do not know how reports of abuse map to actual incidence and prevalence. Clearly there is a big ‘iceberg effect’ with much abuse going unreported.

But more reports of abuse mean more work for agencies and professionals, stretching already under-funded services. The Savile affair demonstrates the need for child protection services which are flexible and which are capable of rapid expansion to take account of surges in demand.