Disquieting responses.
Bullock, Roger
The death of Baby Peter, the infant who died from appalling abuse
despite having his name on the child protection register and being seen
by numerous professionals, has caused an outcry in Britain. But the
responses have been equally worrying and, as they have implications for
adoption and fostering, merit attention.
I have no special knowledge of what happened but I found the
ill-considered and contradictory nature of the accompanying discussion
alarming: a grotesque mixture of the probable, possible and improbable,
and an indictment of the inadequate appreciation of the complexity of
social problems.
Initially, the Government seemed taken by surprise, despite
knowledge of the impending scandal, but acted swiftly both locally and
nationally. This uncertainty was manifest in the varied estimates of the
number of similar cases occurring annually. The first figures were based
on the 100 or so serious case reviews conducted each year, although a
quarter of these reports concern serious injury and not death. OFSTED
then came up with a higher figure, nearer 150, with the NSPCC trumping
that with something even higher. Eventually, Lord Laming, in presenting
his report, reduced it to 55. If it did not have such a deleterious
effect on children's well-being, not least by chasing able
practitioners into more respected and comfortable lines of work, one
could marvel at the irony of this situation. We had one group of
professionals--mostly employed by central government--with wildly
varying judgements criticising the lack of perspicacity of another
group--mostly employed by local government.
Others were quick to join in, many using the tragedy to bolster
their particular cause. 'It reflects our broken society', said
one politician. 'Nay, but broken families perhaps', retorted
another. 'Baby Peter would have become an offender', foretold
one charity manager. 'Policies are too pro-family', opined
another. 'More children should be in care', concluded a
Parliamentary Committee, unexpectedly supporting the use of more
residential care. 'Nonsense', said a broadsheet newspaper,
'Care is a fate worse than death.' Meanwhile, the popular
press demanded the blood of the professionals involved, despite having
been recently duped itself by someone seeking financial gain from a
fabricated abduction.
The problem is that the evidence does not fit with the easy answers
that discussants were seeking. The three major studies of serious case
reviews in England show that the situations surrounding dangerous harm
to children are much more varied than those affecting Baby Peter. (1)
Altogether, they scrutinised 246 cases and found many quite different
circumstances: for instance, 52% of children were over the age of one,
52% were not violently killed and 86% were not registered at the time of
the incident. In fact, a recommendation in one of the reports was to pay
more attention to vulnerable adolescents.
Lord Laming subsequently recommended practical reforms, all of
which the Government says it will implement. But while these will
undoubtedly help, the problem is also a clinical one--trying to predict
which children at risk of harm will be abused, and which of those will
be murdered. This is immensely difficult because of the weak predictive
power of the risk factors associated with abuse and the large number of
'false positives' they produce when applied prospectively.
Neither of these points, along with discussions of the necessary
research to remedy them, was mentioned in any of the discussions I
heard. So, while Lord Laming was right to recommend strengthened
process, he was unduly optimistic in telling people to 'Go out and
do it'. Likewise, the Government's announcement that millions
of pounds are now to be made available to recruit and retain social
workers will not necessarily resolve the perplexing problems surrounding
the identification and their decisions about potential child abuse. As
the Brandon et al. research study concludes, 'Most serious child
abuse is essentially unpredictable' (p 98). This does not mean that
we can do nothing, but questions false optimism. To illustrate this:
take a group you once knew--students or work colleagues--and review your
predictions about the success of their partnerships.
All of this confusion is harmful for children's services
generally and substitute care specifically. The media rush to report
poor practice is not balanced with information on social work success in
protecting and caring for children, frequently confusing that with
'difficult' practice. In part, the absence of such a
counter-balance reflects the lack of reliable evidence about the effects
of child protection, foster and residential care and, to a lesser
extent, adoption on children's health and development. But worse
still, we seem incapable of answering simple epidemiological questions,
such as how many children die or are seriously injured each year at the
hands of their parents. No wonder the media run roughshod across the
profession, and governments panic in response.
This absence of outcome data also fuels commentators' widely
contradictory calls, which further undermines the work of this
journal's readers. So, should there be more children in care, or
fewer? We simply don't know. But one thing is clear, we cannot have
a situation where the size of the looked after population and the number
of adoptions are set by the whims of interest groups. As a recent review
of family courts in the UK concluded, 'Since the abolition of
capital punishment, taking a child away from its parents is considered
by many judges the heaviest responsibility left in their hands.'
(2) Until we have robust evidence to indicate how many children need to
be looked after or adopted, the best ways of doing this and the likely
outcomes, a lack of knowledge is unlikely to impede those not having to
do it from demanding action of one kind or another.
(1) Sinclair R and Bullock R, Learning from Past Experience,
London: Department of Health, 2002; Rose W and Barnes J, Improving
Safeguarding Practice, London: DCSF, 2008; Brandon M, Belderson P,
Warren C, Howe D, Gardner R, Dodsworth J and Black J, Analysing Child
Deaths and Serious Injury through Abuse and Neglect: What can we learn?,
London: DCSF, 2008
(2) The Week, 717, 30 May 2009, p 13
Roger Bullock is Commissioning Editor of Adoption & Fostering
and a Fellow, Centre for Social Policy, Warren House Group at Dartington
