UK
To coincide today with the opening of the annual
social services and education conference, the Guardian has published an
important survey of 400 professionals on how far they believe children's
services are more integrated
How to better protect vulnerable
children
Once upon a time a fresh new government arrived in
Whitehall pledging to concentrate on "standards not structures".
Standards take time, investment, long-term commitment, while new
structures inevitably divert management time away from service
improvement to the restructuring itself. Yet slowly but inexorably,
restructuring has come to dominate.
To coincide today with the opening of the annual
social services and education conference, we publish an important survey
of 400 professionals on how far they believe children's services are
more integrated. Eighteen months ago, ministers produced the children
bill - now law - promising that their 10-year plan would produce the
biggest change in children's services for 30 years.
This was a response not just to the failure of
agencies - social services, health, education, police, NSPCC - to
protect Victoria Climbié, the eight-year-old brutally killed by her
carers, but also to the 2001 Kennedy report, which documented the causes
of a succession of unnecessary deaths of children undergoing heart
surgery at Bristol Royal infirmary.
Our survey shows that support for the vision, set out
in the government's white paper Every Child Matters, remains strong.
Remember, almost all parties signed up to this vision following
publication of Lord Laming on Climbié and Kennedy on Bristol. Their
catalogues of shortcomings included: fragmented responsibility; and a
lack of effective planning and leadership.
On one reform all people polled agreed - better
integration and co-ordination of services. This is an aspiration with a
long history that now generates more hope. Asked whether they agreed
"the integrated agenda will lead to more coherent purchasing of
children's services", 57% agreed and 24% disagreed.
But the survey underlines just how far we have to
travel. Two-thirds believed frontline staff did not fully understand
what integrated services would mean to them. The caseloads they carry
leave them little time for looking at the bigger picture. Moreover,
reorganisations generate anxieties, which in turn leads frontline staff
to keep their heads down.
There were graver doubts about how far the new
supporting services believed in integrated care, with just 20% believing
it was understood in health and only 16% in education. You cannot change
cultures overnight. Health is notorious for regarding children as an
"add on" service. This was one reason why only 10% of young people were
cared for in appropriate facilities and why there was only one full-time
physician trained in the medical needs of adolescents.
Education is driven by tough academic targets, by
which headteachers and schools are judged, not by their approach to
caring. Indeed children in high need of help - the alienated, excluded
and truants - and their parents have the weakest links with schools.
A clear majority rightly believes that because the
integrated agenda is too ambitious - and the commissioning framework too
unclear - vulnerable children may not receive the protection they
require. Here is the biggest paradox. A reform prompted by the failure
of agencies to pick up the abuse that Victoria was suffering, could end
up with vulnerable children being given poorer protection for two
reasons. First, because the reformers' remit was widened to safeguard
all children; second, because in the restructuring, there will not be
the same experience of child protection at the top. Most children's
services will be run by former education, not social service, directors.
Ministers deserve praise for not being prescriptive
about the new structures. This will allow local variations to emerge, as
our case studies show. But chief officers must involve their frontline
staff - and middle managers - in drawing up their plans. Without this
involvement, integration will never lift off.
Malcolm Dean
October 19, 2005
http://society.guardian.co.uk/comment/story/0,7884,1594967,00.html
