Is Child Protection a public health issue?
Views from Australia
and the UK
Thursday 6 April 2006
Jointly presented by
UNIFEM Australia and The Bob Hawke Prime Ministerial Centre at UniSA
Government/Inter-sectoral Approaches to Child Protection in the UK
University of Dundee
The child protection systems in the UK are primarily based upon a forensic and investigative model within the context of provision of welfare on a residual basis. There is a heavy reliance upon central guidance that is developed in the form of detailed local procedures for individual agency practice and inter-agency practice. Mandatory reporting has not been instigated in Britain, although the possibility has been debated. However, although reporting is not mandatory, the professional bodies provide clear guidance about the duties of practitioners to be alert to, and act upon, signs of abuse and neglect.
The Scottish system is an interesting hybrid of civil procedures like those England and the Children’s Hearing System. The Hearing system, unique to Scotland, considers all children at risk, whether they are in need of care and protection or are offending. Referrals are made to the Reporter to the Children’s Hearing on the basis of a number of grounds for referral. The Children’s Hearing is a tribunal made up of three lay members. The children’s circumstances are only considered by the Sheriff in court if grounds of referral are disputed or not understood.
Child care and protection practice across the UK has entered a time of unprecedented change in response to a range of pressures including:
- inquiries into child deaths
- audit and inspections of practice
- shifts in expectations of public services
- increased emphasis on support for parents
- resource constraints
- public concerns about perceived dangers to children
- theoretical discussions about the nature of child abuse.
For a number of years there have been calls for the system to be re-focused to shift the emphasis towards earlier prevention and the provision of family support. Policy initiatives are being shaped with a view to a re-focus. This re-focusing is being underpinned by an increased emphasis upon the responsibility of the universal services for the welfare of children.
Axford and Little (2004) have described the shift in emphasis as involving refocusing from:
- residential care to family based foster care
- supporting children away from home to supporting children in their Home environment
- separate services for children at risk of social, health and psychological problems to mainstreaming services so that they can support all children, including those at risk
- separate processes for child protection and family support to using family support as a primary mechanism to protect children from harm.
The underlying principles for change are similar across the UK, but have been driven by different reports and are manifested in different reform programmes. In England and Wales Keeping Children Safe the Government’s response to The Victoria Climbié Inquiry Report (Department of Health, 2003) and the Joint Chief Inspectors’ Report Safeguarding Children (Department of Health, 2002) lead to the publication of Every Child Matters: Change for Children (Dfes, 2004) which sets out a raft of reforms. In Scotland the publication of ‘It’s everyone’s job to make sure I’m alright’ the Report of the Child Protection Audit and Review (2002), amongst a number of other key policy documents has lead to the publication of Getting it Right For Every Child (Scottish Executive, 2005).
In both jurisdictions the governments have set out a number of outcomes that they expect for all children and which underpin all policy initiatives. In England and Wales the expected outcomes are an emphasis on:
- being healthy
- staying safe
- enjoying and achieving
- making a positive contribution
- achieving economic well-being.
In Scotland they are for children to be:
- respected and responsible
It is interesting that, although the UK is relatively small, the differences between the jurisdictions can be expressed in subtle differences such as these. Rose et. al (2006) suggest that there had been a time when the focus was more on longer term outcomes and ‘ensuring that children grew up to fulfil their potential as citizens’. They assert that there is now a recognition that ‘well-being’ is as important as ‘well-becoming’.
In England and Wales Every Child Matters: Change for Children is aimed at:
- increasing the focus on supporting families and carers
- ensuring necessary intervention takes place before children reach crisis point and protect children from falling through the net
- addressing weak accountability and poor integration
- ensuring that people working with children are valued, rewarded and trained.
There are a large number of activities that are tied into, and
underpinned by this programme of reform including the expectation of the
development of Children’s Trusts by which local agencies will be expected to
cooperate and pool budgets. No one specific structure has been prescribed
for children’s trusts so that structures can be developed to suit local
need. The aim of Children’s Trusts is to ‘address the fragmentation of
responsibilities for children’s services. Children’s Trusts bring together
all services for children and young people in an area to cooperate and focus
on improving outcomes. People will work in effective multi-disciplinary
teams, be trained jointly to tackle cultural and professional divides, use a
lead professional model where many disciplines are involved and be
co-located often in schools or children’s centres. They will be supported by
integrated processes such as the Common Assessment Framework.’
The National Service Framework for Children, Young People and Maternity Services (DoH, 2004) is a 10 year programme intended to stimulate long-term and sustained improvement in children’s health. It aims to ensure fair, high quality and integrated health and social care from pregnancy to adulthood. The Framework is intended to lead to a cultural shift, resulting in services which are designed and delivered around the needs of children and families using those services, not around the needs of organisations. The Children’s National Service Framework is aimed at everyone who comes into contact with, or delivers services to children and young people.
There is also new guidance on children missing education; a new information sharing index and an integrated assessment system known as the Integrated Children’s System. All of this builds on the existing framework for assessment for children in need and their families (DoH, 2000).
In Scotland Getting it Right for Every Child has four strands of activity:
- improving delivery
- quality improvement framework
- assessment and information sharing
- children’s services workforce.
The programme of reform has been built around a Children’s Charter that was developed after extensive consultation with young people. The Charter sets out children’s expectations of agencies and professionals and is written from the perspective of children and young people. A framework for the multi-disciplinary inspection of services has been designed around each of the statements in the charter:
- Get to know us
- Speak with us
- Listen to us
- Take us seriously
- Involve us
- Respect our privacy
- Be responsible to us
- Think about our lives as a whole
- Think carefully about how you use information about us
- Put us in touch with the right people
- Use your power to help
- Make things happen when they should
- Help us be safe.
In Scotland there is less appetite than in England to re-organise
services or to bring in extensive legislation. However, the Scottish
Executive is considering imposing new statutory duties on agencies to
identify children who are in need; seek and record a child’s view; cooperate
so that agreed action happens; appoint a lead professional to plan and
coordinate activity where a child requires a multi-agency input; and to be
accountable for their actions.
There are plans to reform the Hearing system by greatly simplifying the grounds of referral so that they focus on significant need and to ensure that referrals are based upon the need for compulsion rather the hearings system being seen as a route to services. Agencies will be required to deliver on Hearing decisions because currently it is possible for a child on supervision to receive a patchy service from a local authority.
A significant element in the Scottish reform programme is the expectation that the first agency to identify that a child needs help will be expected to act and to provide as much assistance as they can. They are also expected to consider whether they need the help of other agencies but that:
‘Before referral to another service, agencies should take responsibility and do all they can, with the help of others, to support the child. The child should not automatically be passed to another agency.’
This recommendation arises out of the recognition that children were being subject to a ‘round of referrals’ that did not necessarily result in a service and that assessments often service to screen children out of, rather than into, services. Precisely how this will be carried out in practice is the subject of considerable discussion in Scotland and some anxiety about the limits and extents of professional responsibilities.
The Integrated Assessment Framework in Scotland is, like the Children’s Charter, written from the child’s perspective. This will link with another significant piece of legislation The Education (Additional Support for Learning) Act 2004 which enables parents to trigger a comprehensive assessment of need for additional support. All schools are to become Health Promoting Schools by 2007, an initiative supported by A Scottish Framework for Nursing in Schools.
In summary, the vision for UK children’s services is for an integrated approach that is responsive to children’s needs. The aim is for services that are proportionate to need and are offered on a continuum from:
- support for all parents and children
- targeted support for those at risk of not achieving their potential
- authoritative intervention on behalf of children.
However there are some gaps in evidence and guidance on precisely best to develop an integrated protective network that enables each agency to effectively deliver its own core skills in cooperation with others. There is now ample research information about children’s developmental needs and attachment theory offers a helpful organising concept as to how those needs can best be met. There is also a considerable amount of information about factors that support or impede parental capacity to meet children’s developmental needs. The key issue for public services is how they can best ensure that children’s developmental needs are met whatever the level of parental capacity. It is here that the gaps in evidence are apparent:
- All services strive to offer parenting support which can range from universal support for all parents through to very comprehensive packages of support for struggling parents. But there is a gap in knowledge about how to ensure that support for parents converts into an improvement in children’s lives.
- Aspects of children’s developmental needs, including those for health and education, depend upon children having access to universal services and such access is usually facilitated by parents. When parental facilitation fails for whatever reason there is a lack of clarity about how best to ensure that children’s access to universal services is facilitated in other ways.
- On some occasions children’s needs are not met by parents or their development is actively impeded by the action of parents or others. There is a gap in knowledge about how best to ensure that all services work together to ensure that children’s developmental needs are met in a way that is congruent with attachment theory.
The reforms across the UK are driven by similar underlying principles
although they build on different cultural and legislative backdrops. There
is a strong emphasis upon the important role of universal services in
meeting children’s needs and upon prevention and early intervention. There
is also a stated aim to reduce bureaucracy. Within the field there is,
however, some scepticism about this policy discourse because of the
perception of a culture of blame that is associated with ‘cover you back’
practice and retreat to procedures as a safe haven. Ironically the reforms
are being introduced amidst a welter of centrally driven guidance, intensive
inspection regimes and further legislation.
It is early days in the reform programmes and too soon to tell whether children’s lives will improve as a result of all the changes. If the aims are to be attained practitioners must be released from current bureaucratic constraints, be provided with a policy and legislative framework that genuinely supports non-stigmatizing early intervention and be supported to work creatively with, and on behalf of children and families.
Axford, N. and M. Little (2004). Refocusing Children's Services Towards
Prevention: Lessons from the Literature Research Report RR 510. Dartington,
Darlington Social Research Unit.
DFES (2004). Every Child Matters: Change for Children. London, The Stationery Office.
DFES (2006) Children’s Trusts FAQ http://www.everychildmatters.gov.uk/aims/childrenstrusts/faq/
Department of Health (2000). Framework for the Assessment of Children in Need and their Families. London, The Stationery Office.
Department of Health (2002). Safeguarding Children: A Joint Chief Inspectors' Report on Arrangements to Safeguard Children. London, Department of Health.
Department of Health, Home Office, et al. (2003). Keeping Children Safe: the Government's Response to the Victoria Climbie Report and Joint Chief Inspectors Report Safeguarding Children. London, The Stationery Office.
Department of Health (2004). National Service Framework for Children, Young People and Maternity Services. London, Department of Health.
Scottish Executive (2005). Getting it Right for Every Child: Proposals for Action. Edinburgh, Scottish Executive.
Rose, W., J. Gray, et al. (2006). Child welfare in the UK. Enhancing the Well-being of Children and Families through Effective Interventions
International Evidence for Practice. C. McAuley, P. J. Pecora and W. Rose. London, Jessica Kingsley Publishers.