Tuesday, 27 November 2012

Should more children be taken into care?

In this post I want to look at some more of the failings identified by Michael Gove.

I had planned to tackle ‘Failing No 1’ next, because it seems to me that the issue of too many local authorities not meeting acceptable standards for child safeguarding is very fundamental.

However, because of recent letters published in the press, which will be discussed below, I think I had better say something first about Failings 2, 4 and 5.

2.    Too many children are left too long in homes where they are exposed to neglect and      abuse

4.     Intervention is often too late

5.     Children are often returned prematurely to abusive homes

Let’s begin by discussing the last of these, Failing No. 5.

The available empirical evidence strongly supports the claim that in Britain children are often returned prematurely to abusive homes or left in them following some intervention. Brandon and Thoburn [1] found that 57% of the children that they studied, who were subject to a child protection intervention, experienced re-abuse. Farmer [2] reports that in almost half the cases she studied, where children returned home from care, they were neglected or abused during the return.

These are grim and disturbing findings.

Reducing the likelihood of re-abuse following intervention should be a major aim of child protection policy and practice. The very last outcome for which any of us would wish is for a child to be left in, or returned to, a home where abuse will continue to occur. But it is amazing that in all the mire of UK child abuse statistics there appears to be no routine collection of data directly relevant to the issue of re-abuse. This needs to be urgently addressed.

Nor does there seem to be a sufficiently high level of organisational awareness about the frequency and nature of re-abuse following intervention. At the very least I would hope that all cases of re-abuse should be treated as critical incidents. They need to be examined and investigated and any factors that might have been predictive of re-abuse identified. The characteristics of the child, the family and the case need to be scrutinised and careful aggregation of data needs to take place to build-up an ever improving picture of the circumstances – both familial and organisational - in which re-abuse occurs. This corporate learning should form the basis of service improvements designed to reduce the incidence of re-abuse. Such high levels are unlikely to reduce rapidly, so this is a long-term strategy and an ongoing piece of work.

Michael Gove asserts (Failing No. 2) that too many children are left too long in homes where they are exposed to neglect and abuse. The very high rates of re-abuse identified in the UK literature support a conclusion that at least some of the re-abused children should have been placed or remained in care. But - and this is the important point - it does not automatically imply that more children per se should be in care, only that more of the right children should be in care.

Martin Narey (the former head of children’s charity Barnardos and Government ‘adoption tsar’), who has clearly influenced Gove, is famously quoted as saying: “We just need to take more children into care if we really want to put the interests of the child first”. [3]

But I think this oversimplifies the issue greatly. It’s not a matter of more children across the board being taken into care, but more – the right more – being taken into care early on.

So I agree with Gove that intervention is often too late (Failing No. 3) and I would argue that any discussion of numbers of children coming into care has to take place in the context of a discussion of when they come into care.

A child who is removed from an abusive or neglectful home at a very early age suffers less long-term damage than a child who is allowed to spend her or his toddler years being abused and neglected. Indeed arguably many of the whole life ‘sequellae’ of child abuse and neglect, such as mental illness and educational underperformance, would be reduced in severity or avoided completely. Not only that, but a child who is removed early can often be more easily adopted and so the costs of care are usually substantially less. Plus there is a reduction in overall intervention costs, such as those of family support. The child benefits from a loving and a safe home at the earliest opportunity. And, of course, a child who has been made the subject of a care order early in life does not become a new care case later in childhood.

So the issue is the right number of children at the right time – not simply an issue of numbers more or less. It is a question of 'doing it right first time' which not only results in higher quality (better outcomes for children) but also lower costs [4].

My view is that a central question in child protection, with which we should all be preoccupied, is how we can shift the age of intervention earlier and earlier while at the same time making more and more accurate decisions about which children require care. ‘Early intervention’ is a phrase that is often used to describe preventative work; something I think is very important, but which is quite different. I am talking about ‘early intervention’ in the sense of interrupting abuse and neglect at an earlier stage in a child’s life.

Of course our knowledge of how to succeed with this sort of early intervention is very partial. It will certainly help greatly if academic research, in future, is much more focused on this area; and children’s social care information systems should be adapted to produce much more relevant improvement information. A key focus of study should be the characteristics and circumstances of those children who were considered marginal for care proceedings at a very young age, but who were, in the event, left at home with support until subsequently care proceedings became inevitable. Research here also needs to address the legal, business and professional processes that resulted in these cases being dealt with in this way. At present we know very little but that should not deter us from trying to learn more. “A journey of a thousand miles starts with a single step”, as the Chinese philosopher Lao Tzu said long ago.

You will probably not be surprised to hear that I find it a bit sad that this debate about care and numbers already seems to be polarising around the ‘mores’ (like Martin Narey and Michael Gove) and the ‘fewers’, such as a plethora of social work (and social policy) professors who wrote to the Guardian newspaper the other day [5].

I take no issue with the professors’ concerns that Government welfare benefit policies are likely to have a negative impact on the lives of many families with children at risk, increasing the number of ‘stressors’ which disadvantaged families face. That is not right and in my view not sensible. But it is difficult to see welfare benefits as a direct alternative to care. That is a bit like arguing that resources should be diverted from the ambulance service to road safety campaigns, rather than arguing that ambulance service costs will fall if road safety campaigns succeed in reducing accidents! Indeed the more the preventative service fails the more the emergency response is required.

And the professors seem willing to concede that  ‘… research … reveals a pattern of "too little for too long and too much too late" ‘ (letter from Brid Featherstone et al) and “… that abused and neglected children tend to do better if they remain looked after by the local authority than if they return home” (letter from Harriet Ward). So there may be more common ground than the tone of the letters implies.

My advice to Michael Gove would be to engage with the research community, including the professors who have signed these letters, and to make some resources available for research into the issue of how care can become an early option rather than a backstop. I would also advise him to take note of their concerns about the impact of the so-called ‘welfare reforms’.

And my advice to the professors would be to try to separate, rather than conflate, the issue of the early use of care and issues of welfare benefits policy. Attention to this problem should not be neglected simply because it comes from a government which pursues welfare benefits policies which are wrong-headed. Rather academics need to devise some creative, novel and helpful research to inform how we can get more of the right children into care at the earliest possible moment.

[1] Brandon, M. and Thoburn, J. (2008) “Safeguarding children in the UK: a longitudinal study of services to children suffering or likely to suffer significant harm” Child and Family Social Work 2008, 13, pp 365–377

[2] Farmer, E R G (2009). "Reunification with birth families", in Schofield, G and Simmonds, J (Eds.) The child placement handbook. London, BAAF.

[3] See

[4] The phrase 'doing it right first time' is associated with Philip Crosby - see his book  Quality is Free. New York: McGraw-Hill (1979).