Numbers in care and neglect (from Times Report on Adoption
Numbers in care and neglectAfter the Second World War the number of children in care fell steadily,dropping to a little over 50,000 in the mid fifties and stayed at a relatively lowfigure into the sixties. But, in the seventies, the numbers began to climb steadilyas the reality of child neglect and abuse began to take hold in the UK. By 1981there were 92,000 children in care in England an increase of almost 50% or 30,000children on the figure just twenty-five years previously. Of this 92,000, almosttwo thirds, about 58,000, lived in residential homes.So there were almost as many children in children’s homes in 1981 as there are inall forms of care now (that needs to be remembered when it is argued that thecurrent care population is too large). Inevitably, the costs of almost 60,000children in residential care were seen as unsustainable and in any case, a numberof high-profile abuse scandals brought the residential sector into disrepute. Thelarge institutions began to close as the voluntary sector rapidly abandoned itsorphanages.In the working group I led for Alan Johnson, Secretary of State for Education, Iwas keen to help further drive down the numbers in care seeing that reduction,incontrovertibly, as a good thing. No one suggested otherwise, at least notpublicly. But, sometimes, in the margins of consultation events or at conferences,front line social workers would sidle up to me to whisper their anxiety that thedirection of travel was not as clear as I thought. The whispers grew, I becamenervous about my initial certainty, and eventually my working group concluded,almost certainly to Ministerial disappointment, that we should not have targetsfor further reducing the numbers in care.At about this time I started to see a little more of Barnardo’s own work in thisarea. I recall a particularly fascinating day in one of our services talking toparents – or more specifically mothers – who were seeking the return of theirchildren from care. Our job was to assess their readiness to re-assume theirparenting responsibilities. What I saw made me uneasy.My practice whenever I visited a Barnardo’s service was to reflect for a day ortwo on what I had seen and then to share my thoughts with senior colleaguesand Trustees. After this visit I wrote:[I was worried that staff] seemed to be working in a context which required them not todo what was unequivocally the best for the child, but instead one which tasked them,whenever possible, with keeping children with their mothers. One family was described tome as being guilty of the most abject neglect of their children who were filthy, sufferedexceptionally serious dental decay and were not attending school. Now fostered, the
children, 10 and 14, were doing reasonably well and were both at school. Meanwhile weseemed to see success in this case as eventually returning the children to a mother who, Iwas told, had very limited awareness of the inadequacy of her care for her children. Iwondered why on earth we would contemplate taking such a risk and the answer that“blood was thicker than water” certainly did not convince me.I went on to observe:Part of the problem is, I fear, that these seem such illiberal things to think, much lesswrite. But I left this visit seriously perturbed that staff were working in a context, overlyinfluenced by considerations of what a Court might opine, in which the interests of thechild were not the overwhelming consideration they should be.As I began – tentatively at first – to utter publicly the view that we might have tothink about taking more, not fewer children into care, my motives were attacked.Some correspondents said I was drumming up trade for Barnardo’s Children’sHomes (ignoring the fact that the last one had been shut two decades earlier).John Hemming MP dismissed my view without debate blogging, simply, ‘MartinNarey is wrong’ and there was a great deal ofoffensive comment on the internet.Meanwhile, at successive presentations to staff from Children’s ServicesDepartments in two northern counties, each host Director referred to my views,respectively as unorthodox and challenging.But amongst the abuse, letters I received convinced me that this was a debateworth having. Meg, a Social Worker with decades of experience wrote to say:I am 57 and started my career as a child care social worker but I found myself unable totolerate the incredibly low standards that were tolerable within the childcareservices...Thank Goodness someone is speaking up for all those children whose lives arewitnessed and about whom nothing is done.I did not know it at the time but there was no shortage of very sound research toback up my anxieties about the children we leave in neglectful and abusivehomes.The reality is that care can be much improved and the current Children’sMinister is right to be impatient about achieving such improvements. But, evenas it is, care is much to be preferred to leaving a child in neglect. As ProfessorMike Stein from the University of York has said:The simplistic view of care as failing 60,000 young people should be confined to thedustbin.
Extensive research, much of it commissioned by the Department for Educationconfirm the Stein view. Very recently, in 2010, DEMOS were commissioned byBarnardo’s to take a comprehensive look at the evidence. DEMOS confirmedthat:• Stigmatisation of the care system, combined with concern about the upfront coststo the state, means that some children who might benefit from the care system donot do so.• When the care system is used effectively in this way it can be a powerful tool forimproving the lives of vulnerable children and young people.• The mistaken belief that care consigns all looked-after children to a lifetime ofunderachievement and poor outcomes, creates a culture of uncertainty, increasingdelay and leading to instability later on.• There is now a substantial body of academic evidence that provides a longer-termand more nuanced perspective on looked- after children’s lives, taking intoaccount the nature of their pre- care experiences and comparing them with moreappropriate control groups. This evidence shows that care can be a positiveintervention for many groups of children.• Some groups of children whose entry to care is delayed by indecision or drift areat risk of experiencing a longer exposure to pre-care adversity; higher emotionaland behavioural problems; placement disruption and instability More recently, and more vividly, Becky Hope’s All In A Day’s Work,published in April of this year offers a frequently moving record of theexperiences of a social worker who has spent twenty years working in childprotection. Her preface could not be more stark when she says: Children whose basic needs for responsive loving care are not met, and who are left toflounder, have been found to suffer clear detrimental effects to their braindevelopment long before they reach anywhere near their first birthday. It has alsobeen found that children who have experienced severe neglect as tiny babies, but areplaced in long term adoptive homes before the age of six months are able to make fargreater progress overall than a child placed after that age. [But} at present thisresearch is not infiltrating social work practice in a way that best supports thechildren who depend on us. To allow these research findings to change our practicewill require a change in the mind-set of all involved in the process of child protection.She captures the sad reality that too often we wait too long before removing achild from parental neglect, sometimes because of an unjustified optimism aboutthe capacity of parents to improve. As Jonathan Ewen the Director who leads foradoption for Barnardo’s told me:Speeding up the decision making after a child first comes to the attention of theauthorities is key; research shows that most parents who are going to significantlyimprove their ability to look after their child do so in the first six months of the child’s
life. If that doesn’t happen, then we need to be bolder – and quicker - in making thedecision to remove that child permanently.It needs to be stressed here that I am not talking about cases where there is roomfor doubt over whether or not a child has been neglected or the capacity of themother to become an adequate parent. This is not to deny that mistakes are notsometimes made and that, however occasionally, decent and loving parentssuffer the horror of having their children taken from them without justification.But front line practitioners know that those cases, however regrettable, areovershadowed by a much larger number of cases where we leave children toolong and until neglect turns into abuse. I believe that most lay people, mostparents, would be deeply shocked both at the conditions in which we routinelyleave children and at our continued consideration of returning a neglected childto the circumstances which led to his or her abuse.In All In A Day’s Work, Hope describes her experience with a typical case where achild had been physically abused, was in care, but seeing her mother regularly(known as contact) with the possibility of a future reunion. The child is Sarahand the mother, Julia:Over the weeks since Sarah had been taken into care, Julia was often very late for contactmeetings and a couple of times she forgot to come altogether. Sometimes it was suspectedthat she was high on something, at other times there was asuspicious smell of alcoholabout her person. It was a frequent event for it to be reported that she had spent her timereading a women’s magazine at contact and often had very little time for Sarah at all,just making the very barest attempts to interact. Sarah said little after these contactsessions but reacted silently with the inevitable wet beds, disturbed sleep and verydifficult behaviour at school.Before her birthday Sarah was getting very excited about the prospect of a party andpresents and, during contact the week before, her mother had made repeated promises interms of presents, building up Sarah’s hopes. Sadly, when the pre- birthday meeting withthe mother took place, nothing appeared, her mother arrived both an hour late and empty-handed. The long promised bike, the puzzle and the skipping rope – all evaporated invague excuses. Not even a card. Sarah’s behaviour at the remainder of this contactsession was of hesitation and confused silence, but later her hurt came out intremendously angry outbursts and terrifying nightmares, plus some fights at school. Thiswas the culmination of months of disappointment with her mother’s disinterestedbehaviour.Why do we allow children to be damaged in this way? Sometimes it is becausesustained changes in parenting capacity can be and are achieved. But the currentsystem is gripped by an unrealistic optimism about the capacity of deeplyinadequate parents to change. Making the birth family successful should be ourfirst option, and I am not arguing that mothers should not be given a second oreven a third chance, just not a fourth, fifth and sixth.
This unjustified optimism in the capacity of deeply inadequate and sometimesuncaring parents to change condemns children to a childhood of neglect andsometimes abuse and damages their chances of leading a successful life inadulthood. We should and do help parents to change and when that is successfulthat is a great achievement. But we have to tackle the naïve optimism thatparalyses the system. And we have to stop letting children down by returningthem to parents only for them to be neglected once again. This is not simply myview. Research supports it. In Casemanagement and outcomes for neglected childrenreturned to their parents: a five year follow-up study (2010), Professor Elaine Farmerfollowed the fortunes of 138 children who had been taken into care and thenreturned to their parents. She discovered that:• [There was] a tendency over time for abuse and neglect to be minimised so thatreferrals about harm to children [did] not lead to sufficient action to protect them.• Plans made during care proceedings did not work out in three fifths of cases, oftenwhen children were returned to parents because of an over- optimistic view of thepossibility of parental change by guardians and expert assessors, in the face oflong histories suggesting the contrary. And, most troublingly, she found that two years after those children had beenreturned to their parents three in every five (59%) had been abused or neglectedonce again. We cannot let children down in this way. Findings from aUniversity of York study (Jim Wade, Nina Biehal, Nicola Farrelly and IanSinclair) also published last year echo Professor Farmer’s findings. This studycompared the progress and outcomes of a sample of maltreated children some ofwhom were returned home from care with those who remained in care. It wasfound that outcomes for the children who remained looked after were better thanfor those who went home with respect both to stability and well-being.