Where do we go from here?

Bullock, Roger

Two important books are reviewed in this edition. (1) The first assembles virtually everything known about care placements and the other comprehensively reviews the permanency concept. Both offer a compendium of current knowledge and will undoubtedly inform policy and practice in coming years.

But looking further ahead, how should these books be viewed? Are they final statements that exude confidence or are they an introit to more searching questions? What is their historical equivalent--an Edwardian tea party, complacent and oblivious to forthcoming turmoil, or a penicillin moment that makes existing practice old fashioned? Perhaps a bit of both. But, in Roy Parker's endorsement that 'there is a need for studies like this; they offer a kind of stocktaking', there is implicit caution. This is because despite all this knowledge, and indeed certainty in some areas, most of our actions with vulnerable children and their families struggle to rise above practice wisdom and so are easily challenged by critical observers. Hence, while welcoming these books, we have to ask what comes next.

Previous editorials have argued for a different approach to research and its implementation if children's services are to move forward and explain processes--rather than describe them--and answer fundamental questions about substitute care. This is especially urgent at the present time as welfare is likely to be an early casualty of the economic downturn and protection issues, including the right of children to sue agencies failing this task, have again become pressing.

It is not surprising, therefore, that frustrated commentators often ask me, 'OK, Solomon, what would you do?', a perfectly reasonable question given the situation but one that is difficult to answer. As the US commentator HL Mencken said, 'There is always a well-known solution to every human problem --neat, plausible and wrong.' But to avoid the question or adorn it with academic frippery isn't helpful either.

One observation in the media discussions following the death of Baby P is that 'the training of social workers is too theoretical. There isn't enough on-the-job training.' (2) This desire to be more 'practical' is fine if it means social workers giving more help to children and families; but if it means eschewing theory, the suggestion is potentially dangerous. George Formby used to perform a song called Auntie Maggie's Home-made Remedy, which was 'guaranteed never to fail'. Although the form of this medication was unspecified, it allegedly cured everything--'lumbago, rheumatics or gout'--and, as suggested by the typically naughty lyric, problems of a more personal nature. Such a nostrum might indeed exist (3) but in the absence of any underpinning theory, we cannot know. A foreman once told my relative that it was 'practical' to cut asbestos sheeting with a circular saw but was not around to hear his last gasps because mesothelioma had polished him off too.

It is self-evident that in fraught circumstances, some decisions have to be made quickly. But in saying this, immediate 'practical' action concerned with such things as safety, comfort and communication often get confused with good practice in acute situations. Much of the first may be common sense, but the latter needs just as much sophistication as any other form of welfare work. So, when asked what to do when attacked by someone wielding a knife, I have no more idea than anyone else, and any 'professional' expertise might be restricted to techniques of physical disarmament. But taking a wider view, training might help prevent and divert the build-up to such an event, as well as indicate what best to do once the threat has subsided. The practical cannot be viewed in isolation from the context.

So to answer those who want specification of what a children's service would look like if it is to achieve optimal outcomes for children and ensure consistency of services and equality of provision, I will stick my neck out and suggest the following four developmental stages. First, everything possible would have been wrought from traditional solutions to problems, ie increased resources, organisational change, attention to human rights, user participation, better management information and compatibility between central and local control. Second, I would expect old issues to have been long resolved--foster care replacing much residential care, more children supported at home, sensible use of adoption, children's protection concerns considered alongside their other needs, and the use of robust family services to protect many of those at risk of harm.

Third, I would envisage the following to be nearly sorted: the development of needs-led, as opposed to service-led, strategies; practical support to complement process and procedures; greater use of national and local evidence bases; and services designed with users rather than for them. Fourth, I would assume policies to be underway to provide services for all children in need, not just the poor; a better balance between prevention, early intervention, treatment and social prevention, in contrast to an emphasis on the last two; and interventions that demonstrably improve the quality of life and prevent impairment and social exclusion rather than rely on process and outputs. All of this would be pursued to produce a needs-led, evidence-based, outcomes-focused approach with clear thresholds for receiving services. This would be based on a single process leading to a continuum of interventions and would support an integrated team approach.

Many will think this framework misguided, so please prove it wrong. Sadly, it will not eliminate social problems and care tragedies although, if adopted, should help reduce their incidence and severity. Nevertheless, I believe that it would provide a robust basis for planning, boost the authority of practice wisdom and offer a way of taking forward the knowledge amassed in the books reviewed. Who knows, it might even ensure a positive role for Auntie Maggie's Remedy.

Editors' note

Owing to the increased duplication of information on the internet, Newspoints and the Diary of BAAF events are no longer listed in the journal. News and information on new legislation, policies, consultations, research, statistics and websites, plus details of journals added to the BAAF library in recent weeks, are available in regular e-bulletins--free to all BAAF members. For access please contact katrina.wilson@baaf.org.uk. Full details of all BAAF events and training are listed at www.baaf.org.uk/ res/training/index.ahtml.

(1) Schofield G and Simmonds J (eds), The Child Placement Handbook: Research, policy and practice, London: BAAF, 2009; Sinclair I, Baker C, Lee J and Gibbs I, The Pursuit of Permanence: A study of the English child care system, London: Jessica Kingsley Publishers, 2007

(2) BBC, The Politics Show, 7 December 2008

(3) Several such remedies were widely available in the 19th Century. One was Dr James's Fever Powder which contained toxic metals. Another was Godfrey's Cordial, comprising opium, alcohol, treacle, water and spices. It cost one penny and was used to 'quieten' infants. Wohl (Endangered Life in Victorian Britain, Cambridge, MA: Harvard University Press, 1983) argues that it killed many children through starvation (it depressed appetite) as well as overdose. Its use was unregulated until the 1890s, with final proscription in the 1920s.

Roger Bullock is Commissioning Editor of Adoption & Fostering and a Fellow, Centre for Social Policy, Warren House Group at Dartington