Time to crucify the social workers
It’s time, once again, to vent our collective spleens.
It’s time, once again, for those on the moral high ground to stand up and be counted.
It’s time, once again, to crucify a social worker.
Haringey Council has done it again. Eight years on from the Victoria Climbie scandal, their social service department has allowed another defenceless child to be horrifically murdered. Frankly, we find the details of Baby P's case too distressing to read, and it seems nobody comes out of it well. But it beggars belief that Haringey Social Services decided to leave the child with his drug addict "slob" mother, even though he was on the "at-risk" register, and even after the police had advised he should be removed.You cannot legislate to eradicate evil. There is no system on earth that will protect us against Harold Shipman, Fred West, Peter Sutcliffe and all the rest of them. You do the best you can, in difficult circumstances. Some times you get it wrong. Haringay Council got it wrong this time. God, did they get it wrong and, yes, once again we need to examine procedures and see if we can get it any better.
(Three star disgrace)
But, once again, the whole emphasis of the story is on social services rather than on the evil thugs that committed the offence. It was the same with Victoria Climbie:
Haringey social services were branded as incompetent by Nigel Rumfitt QC in the trial over the murder of Anna Climbie. "If you came across a child in need in Haringey, it would be better to call out the RAC than social services," he said.A headline grabbing remark by prosecuting counsel? No. Nigel Rumfitt was defending one of the murderers and trying to shift emphasis away from his client and onto social services.
Which reminds me. What’s the difference between a Rottweiler and a social worker? The Rottweiler only takes your children away one at a time. Ha! Ha! Did that make you all laugh? That’s how we approach social workers, isn’t it?
A social conscience and a geography degree are no preparation for the realities of life. And we all know what [social workers] are like, don’t we? A load of tree-hugging, anorak wearing, yaks-milk drinking do-gooders. However did we allow them into positions of responsibility?When did you last read an article in a newspaper saying that social workers did a brilliant job, saving the lives of countless at risk children? That article does not exist. When did you last read an article in a newspaper about social workers removing an “at risk” child and then being over-ruled by a court? It happens all the time.
Recognise the picture?
We all do, don’t we? And it is that gleeful recognition that characterises the real problem.
Which is the greater of two evils? A child at risk of abuse not being removed from the family environment and being damaged; or a child not in danger being mistakenly removed from innocent parents? Society - that’s a pompous word for you and me - is hypocritical. It offers no answer to the problem and, with a sigh of relief, leaves it to the social workers. When they get it right, which is most of the time, Society’s conscience is untroubled. We do not worry about social problems provided we do not hear about them. But let there be one mistake and the social workers are pilloried.
Social workers are professional “do-gooders”. What is wrong with that? Some of them are vegetarians and I dare say that some of them have geography degrees. A few may even, Heaven forefend, read the Guardian. So what? They also happen to be a group of highly trained, intelligent, caring professionals.
One thing is certain; they are not in it for the money.
Sorting our social workers
It is the same with the Jean Charles de Menezes tragedy. Bush, Blair and Rumsfeld would have talked cynically of “collateral” damage. In fact, his death was a tragic accident. He was an innocent victim of terrorism, an innocent bystander. Now we are going to crucify some police officers. I have not the slightest doubt that the officers opened sustained fire on this poor innocent man without giving warning of any sort. I also have not the slightest doubt that, had he been a terrorist bomber, and had the police not taken him out at the first opportunity, many innocent lives would have been lost. Thus, the police cannot win.
On the front line of the fight against fanatical terrorists there is no time to say, “Excuse me, old chap, would you mind putting your hands in the air”. It is different on the front line of the fight against child abuse. There is a little more time. The social workers do not “fire” without first asking questions.
I think of the knocks and bangs my four children have had over the years; the bruises, the grazes, the broken tooth, the cut lip, the sprained ankle, and the broken arm. Do I want a medico-legal cross-examination every time I go to the Accident and Emergency department? When my daughter tripped and broke her arm, we did not take her to hospital the same night. We waited until the next morning. Should social services have taken her into care for two or three days whilst “appropriate” enquires were made”?
Where are you going to draw the line? If you want to prevent all parental child abuse then you will have to move all our children away from their parents and into institutionalised care to be supervised by the church, the children’s homes and the boy-scout movement.
Hmmm. Suddenly, the status quo seems quite appealing.
Labels: blame, Climbie, Hypocrisy, social workers
49 Comments:
Social workers in child protection, like a lot of the NHS, have to try to do a near-impossible job with limited resources and a whole slew of bureaucratic constraints. It's not that they're incompetent (some are, but no more so than in any other profession), more that they're pissing in the wind.
A section of the Victoria Climbie Report that always appals me:
It is not to the handful of hapless, if sometimes inexperienced, front-line staff that I direct most criticism for the events leading up to Victoria's death. While the standard of work done by those with direct contact with her was generally of very poor quality, the greatest failure rests with the managers and senior members of the authorities whose task it was to ensure that services for children, like Victoria, were properly financed, staffed, and able to deliver good quality support to children and families. It is significant that while a number of junior staff in Haringey Social Services were suspended and faced disciplinary action after Victoria's death, some of their most senior officers were being appointed to other, presumably better paid, jobs. This is not an example of managerial accountability that impresses me much.
Newly-qualified staff juggling impossible caseloads with zero management support got absolutely crucified. The senior managers who presided over the whole mess swanned off to better jobs. Always the way, sadly.
I am beginning to meet parents who are *not* taking their children to A&E with injuries because they are worried that SS will be called. Child abuse is often given at the top of a differential of a symptoms when a child presents. I often feel the need to remind training doctors that the vast majority of parents do *not* abuse their children.
FYI - a related report released yesterday by the SCLD ( Scottish consortium for learning disabilities ) showing the unfair treatment ( often by social work services ) of families where mum, dad or both has a learning disability.
http://www.scld.org.uk/data/asset/file_669_Fair_Deal_for_Families_.pdf
I am beginning to meet parents who are *not* taking their children to A&E with injuries because they are worried that SS will be called.
But how realistic a fear is that?
I've made loads of child protection referrals. The majority of them come back stamped "no further action". They simply don't have the resources to investigate every child with a bump or a bruise.
In my experience the myth of social workers abseiling in SAS-like and snatching kids away is mostly just that - a myth. They're so overstretched that the bar has to be pretty high for them to get involved in the first place. And when they do the emphasis is usually on supporting families to stay togethe rather than on breaking them apart. Things have to be deeply serious before they'll actually start removing kids from the family home.
A very instructive and interesting picture-poster, Dr Crippen.
Note that the Sri Lankan authorities have no fear in using such a device to promulgate the view of what is acceptable and what is not. It is very clearly spelled out that certain forms of behaviour towards children - whatever the audience's 'culture' might be (cf. Haringey & Victoria Climbie) - are wrong.
In the same vein, here in Mexico, certain social health provisions are denied to unmarried, non-working mothers where their conjugal partner is employed.
Can't see the NHS applying consistent, morality based standards anymore, can you?
Whilst I quite agree that this is a problem society needs to confront rather than making any profession or the state responsible, social workers do rather bring this upon themselves. I have personally experienced the best and worse of doctors, nurses, those working within the benefits system etc as anyone with chronic health issues tends to do.
Unfortunately with social workers I can only say if there is a best of the profession I'll change my mind when I come across it but, sadly, I don't expect to ever have that change of opinion.
The problems amongst social workers are not the same as the problems society might like to make them responsible for, but until both those factors change social workers deserve all the criticism they get and then some.
Bendy Girl
Just something that's been bugging me about that Sri Lankan child abuse poster.
How come the parents are Asian and the abused child is white?
@Eddie Willers
It is very clearly spelled out that certain forms of behaviour towards children - whatever the audience's 'culture' might be (cf. Haringey & Victoria Climbie) - are wrong
For all the (many) failures identified in the Victoria Climbie inquiry, being too "culturally sensitive" was simply not one of them. Sorry if that deflates your righteous indignation.
I'm in complete agreement with Zarathrustra. I have a lot of contact with social services in this context and I think they do a pretty good job. Yes, these days, like everyone else, they are becoming too protocol driven - people incorrectly think that rigid adherence to a protocol is a complete defence if medico-legal problems arise - but I hate this perpetual assumption that all social workers are bearded tossers who don't know what they are doing.
Mostly they are doing an excellent job making daily decisions that would tax Solomon. Yes, I have been involved in cases when children are taken into care, and those who have not been involved would not understand or appreciate the agonising that goes on before such a decision is made.
We need to support our social workers, not slag them off every time there is a mistake.
John
See, folks? Dr Crippen and I do agree sometimes. ;)
Z: Just something that's been bugging me about that Sri Lankan child abuse poster.
How come the parents are Asian and the abused child is white?
Climate change, mate.
Child welfare is as popular as mental health. It's a social burden that is serviced more in rhetoric than in any substantially meaningful terms.
It is another social disease where those socio-economically deprived are more readily targetted - rather than 'helped'. And those of higher socio-economic class are much less of an eyesore on the social landscape and left alone.
Child protection and mental health - two services that appear we care - but only enough to stop it bothering our conscience.
But what, Dr C, do you make of the medical professionals who were involved?
What of the paediatrician at GOS who may now be referred to the GMC for sending home Baby P with antibiotics two days before his death - 8 broken ribs, tip of finger missing, broken spine, bruising. We're not talking about an understaffed, overworked District Gen Hospital situation here, we're talking about one of the top Children's Hospitals in the world.
In the case of the 13yr old girl with leukamia who has refused a heart transplant, a locum doctor was able to invoke the High Court and a threat to remove the patient from her parents' home; yet ironically, it appears that Baby P was let down by the police and the medical profession perhaps even more than by hard-pressed social workers.
Sorry, 'leukaemia'.
Hi Roman
On the facts as you give them (and I don't doubt them) I feel exactly the same as you do about the apparent lack of medical judgement.
In a way, that tends to exonerate the social workers - they would be perfectly entitled to take the view that as an experienced paediatrician did not see the need to admit the child to hospital, there was not a high level of concern.
So why does the meja always direct its heavy guns against the social workers?
John
FAO Zarathustra
RE: Climbie case & 'Culture'
Forgive me, my 'righteous indignation' (whatever that might be) was largely based on such sources as this:
http://news.bbc.co.uk/2/hi/uk_news/england/1672265.stm
Clearly, a public sector worker did not act out of fear of upsetting a percieved cultural sensitivity.
dr c
i have not read your comments
i gave up at the 1st line
social worker management in this country is CRAP it is a perfect example of how the public sector fucks up everything it touches
to try and defend such ass holes is beyound belief
and yes many of the individual social workers are crap too, its light bulb attracting the moths of leftie politically correct skivers up and down the land
what bollocks
No one, Everyone is stating that social services higher management is crap. social workers sometimes have 70+ families on their caseloads this is unmanageable.
What is also being pointed out is that lots of other professionals saw this child too and did nothing. A bit of communication could have worked wonders.
please don't expect no one to read anything sensible and understand intelligent comments - xxx is crap is all you will get...
Dr Crippen
You write, 'the whole emphasis of the story is on social services rather than on the evil thugs that committed the offence'.
This is easily explained. In fact, you do it yourself earlier in the article: 'You cannot legislate to eradicate evil.'
We know evil people exist. That's why we hope social workers, doctors, police etc get between them and their victims. They are trained to do so.
I don't doubt for a moment that most social workers are good and conscientious. It must be an appallingly difficult job. But to read the details of this case and not feel like blaming the people who should have stopped it is very difficult.
A bit of communication could have worked wonders
I despair I really do. Of course some communication could have worked wonders in this case, but that was the principle conclusion of the enquiry into the Climbie murder. These conclusions were meant to be implemented across the social services community, after all it wasn't the first time there had been a communications cock-up. You would have thought that some far distant social services departments might not yet have got around to it, but not in Haringay! God Almighty this was where it went disastrously wrong last time. Heads in Haringay should roll, not necessarily the social worker on the ground but higher up the organisation.
And pace Dr Crippen, this is not just a knee jerk reaction to blame the social worker, in some cases people should be blamed and suffer penalties for dereliction of duty.
The public sector, and I include the NHS and the GP service, is far too complacent, too often a 'system failure' is used as an excuse for personal failure.
The problem that I have with trying to defend the social workers in this case is the extent of Baby P's injuries. As already highlighted by 'Roman', when discussing the failings of the paediatrician, there were multiple, obvious injuries. In an interview which I heard the social worker involved had accepted the Mother's explanations for the injuries 4 days before the baby died, ripped out finger nails?? that would take some explaining.
It may well be that when your daughter broke her arm you didn't attend A&E until the next morning. I assume though that her fracture was the only recent injury, you did not present with a toddler who had -
Severe cuts + bites to
head
Multiple facial bruises
Missing finger tip + nails
8 broken ribs
Skin torn and missing from mouth, gums and lips
Tooth knocked out
Multiple bruises to rest of body
Healed leg fractureand a recently fractured spine -
if she had attended with these injuries I would hope that you would be referred to SS.
Sorry, emotive stuff but that's how I feel. A baby has died and just imagine what he endured beforehand.
It's part of your job spec on this blog to worry about docs. Social workers are peripheral.
The doc in this case, a locum pediatrician from Saudi Arabia, has had her contract with the hospital terminated.
If reports are to be believed - and I don't believe them - she missed the kid's back being broken.
Could you miss that?
That aside, the docs got shot while the social workers have been cleared.
Something about equivalance and proportionality, I believe.
Dr Crippen - your reticence concerning the performance of the consultant paediatrician surprises me.
I can't imagine you overlooking so many serious injuries because the child was "cranky".
Maybe she was a very good doctor who took her eyes of the ball for a moment, or was it case of colleagues nudging each other after the event saying "I told you so" ?
The NHS has ALWAYS been very poor at performance managing problematic staff.
We have had crap nurses in A&E and x2 iron laws seem to apply.
[1] such staff rarely improve very much [two steps forward three steps back syndrome] despite lots of hand holding, reassurance, supernumerary status, etc.
[2] they suck the life blood out of the 'doers' [i.e. those nurses who are already knackered yet have the unenviable task of mopping up].
If all else fails simply cry 'racist' and watch even senior colleagues scuttle for cover [after all who wants to be tarred by the racist brush].
It's virtually impossible to [easily] get rid of underperforming colleagues, and even if we could it would only be an advantage to patients if a more able candidate was waiting in the wings - unfortunately, there often isn't' [at least in London] were most hospitals run on 10% and sometimes 20+% agency staff.
My best mate just happens to be a very senior social worker - he warned me about Baby P long before the story broke in the media.
Haringey is still a mess I'm afraid, poor leadership and limited talent [amongst the social workers at the coal face], at least that's his opinion, and after the official statement put out by the big boss at Haringey I tend to agree with his comments.
I had a look at Haringey borough website last night - do you know what their top priority apparently is ??
"To create a greener borough" - it beggars belief. One of the most deprived shitholes in Europe and their priority is recycling ??? Says it all really.
They were the first council to ban smokers from their workforce back in the 90s. They are the embodiment of everything that's wrong with the left wing, ideology driven, politically correct thought police that local councils have become. Be a drug addict, be a violent thug, be a baby killer, be illiterate, be a slob, be what you like, as long as it's not white, christian, islamophobic, racist, middle class or a smoker. Despite the fact that social workers do not fit the criteria for professionals (they are glorified town hall bureacrats) I heard some silly cow on the radio this morning declaring that social workers must be allowed their "professional practice"
(er 60 visits, no intervention and a death is "professional")
Wankers indeed.
Dr Crippen - your reticence concerning the performance of the consultant paediatrician surprises me.
I can't imagine you overlooking so many serious injuries because the child was "cranky".
++++++
Gawd, no, I am not reticent; sounds like a right royal cock up. Problem is, we do not know exactly what the clinical picture was on the day but I agree - strongly - that on the facts as above it was an appalling case of mismanagement. The paediatrician was also of foreign origin and training and it maybe that there was a culturally different approach. But it is appalling.
Yes, we all have bad days, and take our eyes of the ball, but this sounds like culpable negligence to me - and, as I say, tends to mitigate the social workers failure to act.
Seems there are management problems. The rot usually does start at the top and filter down. I suspect Ms Shoesmith has been promoted above her genetically determined paygrade.
I still hate the knee jerk condemnation of all social workers. It's too pat. Too easy. And mostly unfair.
John
“It is the same with the Jean Charles de Menezes tragedy. ……In fact, his death was a tragic accident….Now we are going to crucify some police officers. I have not the slightest doubt that the officers opened sustained fire on this poor innocent man without giving warning of any sort”
Not entirely guiltless then. Shouting a warning is a pretty crucial part of the process if you are an armed officer arresting a suspect and not to do so would have been negligent on the part of the officers involved. Similarly with respect to the Victoria Climbie case with which the most recent case of Baby P is being compared, the standard of the work carried out by the front line staff was described by Lord Laming’s report as being of very poor quality and the staff themselves as being inexperienced and hapless.
"An initial investigation has already found evidence of "poor quality practice, management and supervision of staff" in Haringey. Baby P had suffered 50 separate injuries before his death despite being visited 60 times over eight months by social workers, police and health professionals. The child's mother had also been arrested twice for suspected child cruelty but the day before her son died had been told by police she would not be prosecuted. The mother was said to have manipulated the agencies involved in her son's welfare, on one occasion concealing bruises by smearing them with chocolate.
The mother was described by an officer in the case as a "slob, and completely divorced from reality" spending hours in internet chat rooms or watching television. While her boyfriend kept knives and Nazi memorabilia in the house and was described as "sadistic” and fascinated with pain".
It is difficult to read the above without concluding that a social worker or policeman somewhere during one of those 60 visits, knowing what they did about the mother and her boyfriend did not suspect something. Not to have examined a child who was on the at risk register without chocolate smeared over it’s face was I think negligent. I would not want to see front line workers be they social workers, policemen or doctors hung out to dry but poor practice is poor practice whoever it is carried out by and everyone should carry responsibility for their actions be they manager or front line worker.
JC: Problem is, we do not know exactly what the clinical picture was on the day
Lack of knowledge has never precluded you from spurious accusation before John. Why now?
But I agree - it is not a time to isolate and castigate clinical individuals or their sect. The atrocities are systemic.
JC
As you are aware, there is a concerted campaign against Child Protection Professionals. This emergency situation has been predicted for the last 10 years. Indeed, it was predicted by David Southall in his talk to the Royal College of Paediatricians some years ago in 2004. He stated that there is nothing to prevent another Victoria Climbie.
Anyway, the reluctance to take action by child protection workers is a result of mass publicity against child protection workers for potentially "Getting it wrong". The media misses this aspect out.
All this year, we have featured all issues related to the current risk to children. This can be read on our website.
I think people have to understand that you cant have it both ways - attack the doctors for raising concerns and attack the doctors when child protection fails.
Sally Clark's children have some interesting pathology reports. Does anyone pay much attention to this - no. They pay more attention to her.
Anyway, there will be another Child P - there are already many Child P. This is what happens when the media vilify child protection professionals for doing their job.
The staff aren't to blame and neither should they be scapegoated in Child P. The people who should be accountable are Beverley Hughes [ who by the way has assisted a concerted campaign against child protection professionals through her association with Penny Mellor] and the media who have vilified doctors who have tried to do their job to protect children.
One lesson to learn is this - had it been David Southall on the shop floor - Child P would be alive. Let the media think about that in depth.
Regards
Rita Pal
NHS Exposed
NHS Exposed Blog
Ward87
Concerning the pediatrician.
The essential question to be asked is whether it was within her sphere of competence to determine that the child's back was brokern (notwithstanding concerns about the reporting of the facts of the case).
I would submit that it was clearly a prima facie part of her professional skill level. Without any medical knowledge myself, I would assume from this blog that it would also be well within the capabilities of Dr Crippen.
I can then only assume that the pediatrician was grossly negligent.
Out of pure lay speculation, in IMO it beggars belief that this individual was allowed to practise.
With great respect to the poster above, Rita Pal, and her invocation of that all-purpose term "child care professionals".
I seem to remember that it was these CCPs who were examining the bums of kids and deciding the parents were complicit in withcraft.
I suggest Ms Pal makes a sharp exit before some common-sense professsional takes a close interest in her beliefs.
Arthur Miller, a reliable csp, would no doubt wish to expunge the fantasies of Ms Pal by methods other than fire.
Of course, the difference here is that I have studied the issues involving child protection for the last year or so.
The public are so keen to scapegoat the paediatrician aren't they. An asian one at that. I for one would never assume anything because we don't have the child's medical notes in front of us. In any case, even if we had, would you be able to understand them [ being lay]? :). Or do all lay people think they know who to witch hunt?
The point I am making is this - University of Anglia did some substantive research a number of months ago and warned this would happen. David Southall has been talking about the risks for years and years. Let us note that David Southall is not at the GMC for failing to protect children is he? He has though had more publicity thrown at him than any dead child in the UK.
Perhaps if the media concentrated on protecting children instead of witch hunting doctors then they may well get somewhere.
Of course, mine aren't "Beliefs". I am not a christian or any religion that believes things for the sake of it. I am merely stating factual evidence. I am not the sort of person that judges people because the media - the governments lapdog presents material in my direction.
The basic issue is this - the risks were known to the government, child protection professionals all warned the government that this would happen. Now it has happened.
It is convenient to blame the social worker and the doctors because that is the way the government spins it. What we really should consider is the government's negligence in failing to protect children.
The risks were known to the government, it was debated in the House of Lords.
Again, few people can disagree that had it been David Southall treating Child P - the child would have survived, the parents may have complained to the GMC about his actions because that is what personality disordered, manipulative criminals do.
Child P is dead. Someone will be scapegoated - last time it was Lisa Arthworrey - a admirable lady who was blamed for government failures.
Of course, not everyone let off by the courts are innocent.
I would suggest that the above poster practise the art of reading. The rest of us do. Perhaps then he won't pretend to be a doctor - because lets face it, it takes years of training. I am certainly not going to lay blame on the paediatrician because we don't have an independent set of facts. We have a government spun media frenzy.
Let the government tell us how many children have died so far because they provided and supported the antics of the dysfunctional parents accused of msbp. You just have to count the media articles on this issue.
Regards
Dr Rita Pal
NHS Exposed
NHS Exposed Blog
Ward87
Shall we try this - rest on
http://www.nhsexposed.com/patients/msbp-penny-mellor/child-protection-emergency.shtml
Harassment of Professionals Undertaking Child Protection
David Southall OBE MD FRCP FRCPCH
Professor of Paediatrics
Martin Samuels MD FRCP FRCPCH
Senior Lecturer in Paediatrics
University Hospital of North Staffordshire
Stoke on Trent
Staffs
ST4 6QG
Correspondence to:
Professor Southall
Academic Department of Paediatrics
University Hospital of North Staffordshire
Stoke on Trent
Staffs
ST4 6QG
Tel 01782 552575
Fax 01782 713946
Introduction
Parents or carers who abuse their children may not respect the rights of persons seeking to protect their child. The following are hazards for professionals who recognise and contribute to the management of child protection cases: emotional distress, threats to self or to family, physical attacks, complaints to employers and professional registration bodies, and adverse coverage by the media. Of far more concern are the dangers for children, in particular, the trend for professionals to under report child abuse.
All professionals in contact with children have to decide whether or not a presenting symptom or clinical sign is due to a natural disease, to accident or to abuse. This task currently depends not only on the knowledge of the professional, but perhaps as importantly on their willingness to highlight the possibility of abuse, knowing that one consequence may be adverse family responses and effects on their livelihood (Table 1). The issue is complicated when the professional is a paediatrician who may have been unwittingly contributing to the abuse, as in factitious or induced illness syndrome, by inappropriate or invasive investigations or treatments.
After the death of Victoria Climbie aged 8 years in February 2000 and the conviction of her aunt and partner for her murder in January 2001, Ainlee Labonte (figure 1) was starved and tortured to death in 2002 [1]. Both parents were imprisoned for manslaughter after deliberately punching, scalding and burning her. She died with 64 scars and bruises on her emaciated body. A subsequent inquiry found that health and social workers had failed to protect her partly because they were paralysed with fear of her parents and partly through poor communication. A social services department file was closed on the family because parents refused to co-operate. The family had been removed from two GPs registers; two GP home visits were undertaken under police escort. Health visitors stopped going to the family’s flat after one was seriously assaulted. Professionals were confronted by the parents about their contributions to case conferences. There were multiple threats of violence to medical staff. The mother called the police 53 times in two years because of the father’s violence. Health and social workers were said to be’ paralysed by fear’.
In his final report into the circumstances surrounding the death of Victoria Climbie, Lord Laming wrote, "staff who undertake the work of protecting children and supporting families on behalf of us all deserve both our understanding and our support" [2]. However, this needs to be evident. Lord Laming’s inquiry team replied to one of us and to a human rights worker that it was outside their terms of reference to consider the issues regarding the harassment of child protection workers (personal communications-available on request). Thus Lord Laming's subsequent report did not address the way in which abusers are increasingly adept at using complaints procedures and the media to attack professionals. While the report recognises that "staff doing this work need . . . persistence and courage”, some senior managers and civil servants have failed to protect professionals [3].
Making It Safe to Protect Children
Survey by the British Association for the Study and Prevention of Child Abuse and Neglect (BASPCAN)
A questionnaire was sent in 2000 to all members of BASPCAN and to all participants at the BASPCAN 2000 Congress, a total of approximately 1900 professionals (personal communication, Dr Lorna Bell). There were responses from 295 professionals involved in child protection work: 31% were social workers, 25% paediatricians, 13% health visitors, 4% either police or psychologists, 2% psychiatrists and 1% nurses. Of respondents, 31% reported actual violence, 67% were threatened, 35% were formally reported for potential disciplinary action and 33% informally reported. Some examples of the specific responses are shown in Table 2. This survey also revealed that ill treatment by colleagues was a major problem: as if the nature of the work somehow leads some of those involved themselves to become abusive of colleagues (Table 3).
The authors of an unpublished report on these data entitled “Making it safe to protect children” (Lorna Bell and Jonathan Picken) stated that many professionals “expressed a sense of injustice and powerlessness, since the systems in place appeared to make it relatively easy for aggrieved parents to threaten professionals and make malicious complaints against them, but much more difficult for professionals to make complaints against violent parents or defend themselves against false accusations”.
Unsurprisingly, perhaps, a number of respondents acknowledged that the experiences that they had faced were leading them, somewhat reluctantly, to consider leaving the field of child protection altogether. For example, one respondent stated ”This last 12 months have made me feel awful and I wonder for how much longer I am willing to stand up in Court to defend children given the violence, threats and intimidation I have received”. Another stated: “This will be the last generation of doctors prepared to do child protection work. All the specialist registrars I have met have no intention of following us down this painful road”.
The authors concluded: "there is a real danger that it may be difficult to recruit new professionals into working with abused and neglected children and to retain those professionals already engaged in such work. Who then will protect vulnerable children?”
Survey by the Royal College of Paediatrics and Child Health [4]
A written questionnaire was sent to all 6072 members, of which 4776 (78.7%) responded. There were 536 respondents (13.8%) who had been subject to one or more formal complaints and these had increased in frequency from less than 20 in 1995 to over 100 in 2003. Eighty-seven complaints were made to the General Medical Council about 71 paediatricians: 41% of cases were dropped, 59% found unproven and none were upheld. Fifteen of these complaints involved one of the authors (DS). Twenty nine percent of paediatricians complained about said they were affected in terms of their willingness to become involved in child protection cases subsequently.
The time taken by the General Medical Council to deal with these complaints, often many years, can mean that referred doctors are disempowered from undertaking child protection whist the complaints are processed [5]. This is similar to the protracted investigations that were undertaken between 1999 and 2001 in response to contemptible allegations about the authors’ child protection work which were not based on any evidence produced by campaigning advocates [6]. The current high level of complaints to employers and the General medical Council, and how they have been handled, may partly explain why nationally one third of posts for designated doctors in child protection are currently unfilled [7]. In our view, employers or registration bodies should address complaints about professionals involved in child protection only if they come from the Courts or statutory agencies for child protection.
We do not know the exact combination of factors that is leading to falls in the numbers of child protection case conferences and children on ‘at risk’ registers, but the willingness of professionals to consider and be involved in child protection cases may be one such factor (figure 2).
Lack of Support by Managers for Professionals Undertaking Child Protection Work
Appropriately, actions are now usually taken seriously when an inebriated patient assaults a health worker in the emergency room, and management may be asked how they had minimised that risk. However, some health and social services departments do not appear to appreciate that professionals in their employ doing child abuse work face risks that are just as dangerous, equally as predictable, but somewhat less immediately visible. Furthermore, some employers have made matters worse by the way they have mishandled the complaints about and harassment of their employees [6]. It is patently evident that professionals may be less inclined to take on work that risks a major impact on their own families, to which they have a clear duty, when society seems to fail to support them.
Professionals Who Do Not Accept The Existence or Severity Of Child Abuse
Unfortunately, a small group of professionals, including some paediatricians, do not understand child abuse. Some become experts in both family and criminal courts, working largely on behalf of accused parents. Because they become known as professionals who tend to minimise or reject abuse, they are widely sought by lawyers acting for accused parents.
This had perhaps its most serious consequences for children in a case recently before the General Medical Council [8]: “For courts to be asked to believe that bone fractures in early infancy can be caused by what a single defence expert has called "temporary brittle bone disease" risked exposing children to further injury and possible death”. Subsequently this expert was found guilty of serious professional misconduct and his name was removed from the medical register [8,9], but the media showed minimal attention to this situation in which it is likely that many children had been returned to abusing parents. False positive diagnoses are inevitable and are always to be regretted. However, although the media understandably express outrage when one of these (possible) false positive cases does not get recognised for what it is when before the courts, they show absolutely no interest in the false negative cases. The voice of the alleged adult abuser is well heard, but the child remains mute and invisible if the professional does not speak on his/her behalf.
Orchestrated Campaigns
There is increasing evidence not only of the presence of these, but also of their effectiveness [10]. One of the authors (DS) reported in 1999 details of an orchestrated campaign against his child protection work [11]. This campaign entrained his clinical research work and subsequently led to his suspension for 2.5 years. Orchestrated campaigns use a variety of techniques to achieve maximum disruption to the professional’s work (Table 4).
The following is a quote from a letter published in the BMJ in 2001 following a number of highly successful campaigns by those accused of abuse and their advocates [12]: “According to a widely accessed website (MAMA (Mothers against Munchausen syndrome by proxy allegations) www.msbp.com), the 18 authors of this letter have all been reported by the same small group of people, although attempts to clarify the situation with the GMC have been unsuccessful. One formal letter from a defence society merely generated (after five months' delay) a reply that the person in question was not "currently" under investigation. One of us used the Data Protection Act to obtain material held on file about him by the council and was disturbed to find that members of the council's staff and a regular complainant were on first name terms”
The Role Of The Media In Making Child Protection More Difficult
One effective way in which campaigners have achieved denigration of child protection professionals has been by arranging for a parent to complain to either the police or to a professional’s registration board and then contacting the local or national media to inform them that the professional is, as a natural consequence, under investigation. A good example of this occurred in the weekly newspaper “Wales on Sunday” which on January 25th 2004 carried the following headline: “Welsh doctors in cot death probe” and then these quotations: “TWO of the most senior doctors in Wales are being investigated in connection with the Roy Meadow babies in care scandal. National campaigner Penny Mellor, who has claimed for many years that many accusations of MSBP are unfounded, says she is aware of a number of complaints which have been made to the GMC about the two doctors….. She even served a jail sentence for helping a family prevent social workers take away a child on grounds of MSBP. The GMC last night confirmed it was investigating. A spokeswoman said: "We can confirm the GMC has received information on these two doctors and we will be looking at it." Penny Mellor also initiated the procedures which lead to the suspension of the authors with extremely serious allegations, but without evidence for them. Subsequently, Mrs Mellor was sent to prison for “conspiracy to abduct a child”. In his summing up at her trial, Judge Whitburn stated “what you are guilty of is orchestrating the abduction of a child for your own propaganda purposes”.
The medical media have also given voice to campaigners. From 2000-2004, 5 persons contributed 455 rapid email responses to articles in the BMJ written by targeted doctors [13]. Many responded to articles that were not concerned with child protection; for example papers on humanitarian aid for poorly resourced countries. Nearly all the letters were “critical of the role of paediatricians in child protection; the language often vitriolic, abusive and speaking of a thirst for revenge”. The author wrote ironically; “there is of course no evidence that these responses are in any way coordinated” [13].
Newspaper headlines such as the following need to be strongly rebutted by the employers or insurance organisations of professionals: “Mother breaks her baby’s arm in child abuse experiment” which was referring to abuse seen during covert video surveillance undertaken for probable attempted suffocation; and “Scandal of ‘smothered’ babies in cot death test”, referring to a project involving standard lung function tests. The medical defence organisations need to re-examine their current inactive policies over libel actions.
Confirmation Of The Legal Protection For Professionals Involved In Child Protection
Parents frequently give their side of the story (sometimes regardless of contempt laws surrounding Family court actions), but professionals cannot respond because of their duty of confidentiality to the child or because they are under legal command following earlier referral to their registration bodies, or employers or both. A complaint to the Broadcasting Standards Commission after the BBC read and acted out confidential proceedings of the Family Court (namely sections of an expert witness report and statements in court respectively) was turned down. However, the BBC and others will need to be more careful about what they report in future in the light of the judgment discussed below.
In the Royal Courts of Justice, London on 19/3/2004, Mr. Justice Munby firmly addressed the confidentiality of Family Court proceedings: “A mother who claims to be the victim of a miscarriage of justice in care proceedings brought by a local authority seeks to debate her case in public. The question is whether the law permits her to do so. The issue is one of great importance, which is why I am giving this judgment in public” [14]. He summarized the relevant legal issues surrounding confidentiality and reported in Section 87 of the Judgement as follows:”Finally, there is a public interest in preserving faith with those who have given evidence to the family court in the belief that it would remain confidential”. He made powerful orders concerning confidentiality, which should inhibit further breeches of this by the media.
The Actions Of Some Politicians
In the House of Commons on 24th February 2004, Mr George Osborne (Tatton, Conservative party) stated: “I am neither a doctor nor a lawyer, but all too often our legal and medical establishment gets swept along by new-fangled theories and fads…………..Munchausen syndrome by proxy is the latest in a long line of theories that has now been discredited.” (Hansard 24 February 2004).
Last year, Lord Howe, shadow spokesperson for Health in the House of Lords called Munchausen syndrome by proxy (MSBP) or factitious or induced illness syndrome (FII) “one of the most pernicious and ill-founded theories to have gained currency in childcare and social services over the past 10 to 15 years. It is a theory without science. There is no body of peer-reviewed research to underpin MSBP or FII. It rests instead on the assertions of its inventor and on a handful of case histories..” (Hansard 5 February 2003).
In the House of Commons 24th February 2004 Vera Baird (Redcar, Labour) stated: “It is not unkind to say that he [Sir Roy Meadow] invented Munchausen syndrome by proxy, and I do not use that word in a pejorative sense. He created it and has lived on it ever since. He was a permanent professional witness in cases where he felt that the syndrome—now highly questionable—existed, which is a difficult model. …. We have stretched things so far that Professor Meadow, a paediatrician, is talking about statistics in front of a court that does not question his ability to do so for one moment. It is not his field at all. The Royal Statistical Society referred to his one in 73 million figure, which has already been mentioned, as a complete error, but he was allowed to give such evidence despite the fact that he was a paediatrician and not a statistician” (Hansard 24 February 2004).
Professor Meadow attempted to correct the issue of his use of statistics in an article in the BMJ [15]. This statistic was actually taken directly from a government publication: “For a family with none of these three factors [that is, no smoking in the house, mother >26 years or parity =1, waged income], the risk of two infants dying as SIDS by chance alone will thus be one in (8,543 x 8,543) ie approximately one in 73 million. For a family with all three factors, the risk will be one in (214 x 214), ie approximately one in 46,000. Thus, for families with several known risk factors for SIDS, a second SIDS death, whilst uncommon, is 1,600 times more likely than for families with no such factors. Where additional adverse factors are present, the recurrence risk would correspondingly be greater still” [16].
A second criticism used to denigrate Professor Meadow was the so-called “Meadow’s Law”. This was not created by Roy Meadow, but by Professor Di Maio, who made the following quote in 1989: “It is the general policy of the authors to ascribe the first death in a family presenting as SIDS to SIDS. The second death by the same mother is labelled as undetermined and a more intensive investigation of the circumstances surrounding the death are conducted. The police are usually asked to interview the family, though in a discrete fashion. A third such death in the family is felt by the authors to be homicide until proven otherwise. It is the authors' opinion that while a second SIDS death from a mother is improbable, it is possible and she should be given the benefit of the doubt. A third case, in our opinion, is not possible and is a case of homicide. The second case is labelled "undetermined" rather than SIDS to flag the case, that is, to make it stand out for future reference” [17].
Further condemnation has come from inadequate evidence base for the Appeal court judgement on Angela Cannings [18]. The Court failed to mention one of the world’s leading textbooks on child protection [19], in which the following was written: “If a previous unexplained infant death, including SIDS, has occurred in a family and no further evidence of metabolic disorder is forthcoming, the unexplained death of a second infant should be classified as undetermined, as suggested by DiMaio. Should a third infant death without an obvious natural disease process occur in the same family, the cause of death should be identified as asphyxiation, and the manner of death classified as homicide”. Following this judgment, a peak time television news program purporting to quote from the Appeal Court Judgement stated: “Six weeks ago in the court of appeal, Angela Cannings was finally freed by 3 judges who told her that it was clear there was no case against her. Sir Roy Meadow’s evidence was described as a travesty of the truth”. In fact the judgement stated: “The study itself refers to three families which had experienced three infant deaths, without any detailed analysis. We do not know whether Professor Meadow had the advantage of reading Professor Emery’s notes about these three cases. If he did, his evidence on this point was indeed a travesty: if not, it would be unfair to criticise him for knowing less about the three families than we have discovered from Professor Carpenter’s analysis of the notes themselves.” [18]
Problems With Undertaking Research Into Child Abuse
The only hope for improving precision in the difficult diagnosis of abuse is to find by research better factual data that can help construct the jigsaw puzzle that so often relies on pieces of circumstantial evidence. In our attempts to report on 25 cases of abused children where bleeding from the nose and or mouth during apparent life threatening events appeared to be a marker for intentional suffocation, we asked the permission of the Chair of our local research ethics committee if we could publish an anonymised series of case reports without the individual permission of each of the parents. The reply was that "as data was being used for new purposes an application was needed." and they suggested an approach be made to the research and development consortium for assistance “as any project will also need to be approved by the Trust”. In our view much of this defensive attitude has followed the Griffiths report on research governance [3], which has made clinical research in this country so much more difficult.
Making Child Protection More Effective - Protecting Professionals
Perhaps, as in the USA, reporting of suspected child abuse should be legally compulsory. Certainly professionals in the UK could learn from the experiences of other countries practising child protection and could be more proactive about seeking their support and suggestions.
Clearly as the above surveys have shown, managers in hospitals, social services and education departments as well as the Department of Health should provide more support to professionals practising child protection. Area Child Protection Committees and Hospital Trusts should understand the vulnerability of child protection staff to violence, threats and intimidation and develop strategies to ensure that professionals engaged in child protection work are not bullied by families and do not bully and intimidate each other. ‘Dangerous situations’ should be identified, monitored and reviewed.
Complaints from parents suspected of abuse or their advocates must be investigated in a way which includes major support for the professional involved. Extreme care must be taken over the veracity of allegations. Complaints suspected to be part of an orchestrated campaign could be referred to the police for investigation regarding possible harassment charges.
Advice from the police and legal departments may help determine whether legal action could be taken against harassment. Where libel has occurred that has denigrated the professional’s standing, professional and defense organizations should consider legal action; this would help to act as a deterrent to what can be an unremitting pursuit of professionals involved in this work. Ultimately, professionals should be aware of their own vulnerability and the effect that this can have on their ability to protect children.
Certainly all experts giving advice to the court on matters concerning child protection should know the evidence base for the statements they are giving. Probably they should also be actively involved in the practice of child protection so that they understand the complex clinical issues involved. There is a need for professionals to support each other, ideally working in teams rather than individually, and at the least obtaining second opinions, whenever a serious form of abuse is suspected.
The adversarial component of court proceedings should be removed and instead proceedings based on the working together of experts to reach a consensus on areas of agreement and disagreement and what is in the best interests of the child and other children in the family. The accumulated opinion could then be presented to either the jury or to a family judge. Family courts have already moved partway towards this approach.
The results of the ongoing review of both criminal and family court cases in the Appeal Court is important and will hopefully soon be available. Meanwhile there are encouraging signs in that within the Family Court two family’s claims that their children had been taken into care following false accusations of abuse have been rejected [20]. Moreover, only 5 of the first 97 cases in the criminal court in which there had been expert medical evidence by Professor Meadow have been referred for further investigation and appeal [21]. However, the Attorney General warned that the move does not mean that these people were wrongly convicted. "The fact that a case has been referred to legal representatives of the convicted person does not amount to a positive determination that their conviction is unsafe” [22]
In another important appeal court judgment (Royal Courts of Justice London 31st July 2003) Lord
Phillips, Lady Justice Hale and Lord Justice Latham rejected an appeal by parents claiming damages for psychiatric harm said to have been caused to them by the consequences of false allegations [23]. This judgment is now before the House of Lords. It means that parents who have been wrongly accused of abusing their children cannot sue health authorities, but children can take action if they are victims of negligence over investigation of abuse or in care proceedings. Lord Phillips said the court had reached the conclusion that it was no longer legitimate to rule there was no duty of care owed to a child over child abuse investigations or care proceedings. But he said the position of the parents was "very different." "We consider that there are cogent reasons of public policy for concluding that, where child care decisions are being taken, no common law duty of care should be owed to the parents." Sadly, in the worst cases (like Victoria Climbie and Ainlee Labonte) the wronged party is no longer alive and able to sue those whose negligence contributed to the death.
As conflict and denouncing professional authority drives the media, measures are needed to deal with inappropriate press coverage. We suggest courts seek orders for contempt if quotes are made from family court proceedings that expose either families or the involved professionals. In addition, organisations defending and protecting doctors should now consider libel actions against sections of the media who defame doctors involved in child protection.
In parallel we should invite the editors of the major newspapers and broadcasting networks as well as the politicians to examine the facts and myths surrounding child abuse. One potentially effective way of making the community become more aware of the nature of abuse would be to show the covert video recordings showing suffocation, fracturing of limbs and emotional abuse that make up the spectrum of ill treatment practiced daily on children [24]. The fact that consent for showing such images is bound to be withheld should not be a bar to this as long as anonymity is ensured. We need to change the current mindset that child abuse is a ‘stranger induced’ rather than ‘family based’ problem.
Finally, as previously discussed in our earlier publications [25, 26], there should be greater and earlier involvement of the police child protection team in cases where there is physical danger from possible abusers. “Addressing the criminal abuse of children must be a priority, not only in England, but in the majority of countries that do not have any child protection systems and where many thousands of children like Victoria are cruelly enslaved and exploited every day. There is nothing worse for a child. We need an international response to criminal abuse namely, an effective, police led protection force”.
Acknowledgments
We thank Dr Lorna Bell and Jonathan Picken for their permission to include data from the BASPCAN study. We are also indebted to Dr Edmund Hey for his invaluable comments on this paper and for his compassionate and unforgettable personal support.
Conflict of interest.
The authors have provided expert opinions to the civil and criminal courts in cases of child abuse.
References
1. Newham Area Child Protection Committee. Ainlee. Born 24.6.1999. Died 7.1.2002. Chapter 8 Review. December 2002. (Link accesed 9 June 2004).
2. Lord Laming. Inquiry into the death of Victoria Climbié. London: Stationery Office, 2003.(Link accessed 9 June 2004).
3. NHS Executive West Midlands Regional Office. Report of a review of the research framework in North Staffordshire Hospital NHS Trust. (Griffiths Inquiry). Leeds: NHS Executive, 2000. Issued 8th May 2000. (Link accessed 9 June 2004).
4. The RCPCH Child Protection Survey, 8 March 2004. (Link accessed 9 June 2004).
5. Marcovitch et al. GMC must recognise and deal with vexatious complaints fast. BMJ 2002;324:167.
6. Hey E, Fleming P, Sibert J. Learning from the sad, sorry saga at Stoke. Arch Dis Child 2002;86:1–3.
7. Dyer O. Doctors reluctant to work on child protection committees survey shows. BMJ 2004;328:307.
8. Hey E. Editorial. Suspected child abuse: the potential for justice to miscarry. Poor process causes more injustice than poor professional practice BMJ 2003;327:299-300.
9. Professional Conduct Committee Proceedings for Colin Paterson. (Link - GMC).
10. Marcovitch H. Diagnose and be damned. BMJ 1999; 319: 376.
11. BMA Press Release Archive. Leading paediatrician hits back at orchestrated campaign to obstruct child protection work issued by - BMA London Office - Monday 11 Oct 1999. (Link accessed 9 June 2004).
12. Marcovitch, H et al. GMC must recognise and deal with vexatious complaints fast BMJ 2002;324:167.
13. Stevens, D. Reluctance to work in child protection. BMJ 2004:328 Rapid Responses (Link accessed 9 June 2004).
14. The Court Service - KCC v B (Link accessed 9 June 2004).
15. Meadow R. Personal paper: A case of murder and the BMJ. BMJ 2002;324:41 - 43.
16. Sudden Unexpected Deaths In Infancy. The CESDI SUDI Studies 1993 – 1996 London: The Stationery Office.
17. Di Maio VJ, Di Maio D. Forensic Pathology, 2nd Edition. CRC Press, Florida, USA. 2001, p327.
18 The Court Service - Regina v Cannings (Link accessed 9 June 2004).
19. Kirschner RH. The pathology of child abuse. In: The Battered Child. Ed: Helfer ME, Kempe RS, Krugman RD, 5th Edition, University of Chicago Press, London and Chicago, 1997, p279.
20. Dyer C. Court dismisses appeals of two mothers. BMJ 2004;328:1219.
21. Dyer O. Five cases of child murder to be reopened. BMJ 2004;328:1154.
22. BBC News - Health (Link accessed 9 June 2004).
23. The Court Service - DKK v East Berksire and Ors (Link accessed 9 June 2004).
24. Southall DP, Plunkett MCB, Banks MW, Falkov AF, Samuels MP. Covert video recordings of life-threatening child abuse: lessons for child protection. Pediatrics 1997;100:735-760.
25. Southall DP, Samuels MP, Golden MH. Classification of child abuse by motive and degree rather than type of injury. Arch Dis Child 2003;88:101-104.
26. Southall D, Samuels M, Bridson J. The police should take the lead on protecting children from criminal abuse. BMJ 2003;326:343.
Lets ask the government what they did. Here is the study. There were many articles before this.
Learning the lessons of child abuse and neglect
Thu, 31 Jan 2008
A new report by the University of East Anglia shows that during the period 2003 to 2005, agencies were struggling to prevent serious injury and death among abused and neglected children.
Commissioned by the UK Government, the in-depth findings will be published by the Department for Children, Schools and Families (DCSF) on Thursday January 31.
The UEA researchers studied 161 serious case reviews (SCRs) in England between April 2003 and March 2005. Of these, two thirds of the children died and the rest were seriously injured. Almost half of the children were under 12-months-old.
The report found:
· 55 per cent of the children were known to children’s social care at the time of the incident and 12 per cent were named on the child protection register
· 83 per cent of the families involved had been previously known to children’s social care
· Some cases were ‘closed’ just days or weeks before the incident
· All agencies were preoccupied with eligibility for services rather than having a primary concern for the child
· Agencies neglected ‘hard to help’ older children (over the age of 13), wasting time arguing about which agency was responsible
· Poor communication between agencies was common
· In families where children suffered long-term neglect, children’s social care often failed to take account of past history
“Our report makes powerful reading. Though the majority of these cases were essentially unpredictable, our findings suggest that risk could be minimised if practitioners were more curious and thought more critically and more systematically. But in order to practise in this way, workers need to be well supported, by their managers and senior managers. Many practitioners lacked support and were in teams depleted by staff absence and long term sickness,” said lead author Marian Brandon, a child care specialist at the University of East Anglia.
“In many cases families were known to adult services and not just to children’s services. There needs to be a shift so that children and whole families are a priority for all agencies not just those directed at children. We need better join up between agencies and more creative, more responsive services that have the interests of children at their core.”
SCRs are carried out when a child dies or is seriously injured due to abuse or neglect and there are lessons to be learnt about inter-agency working. Every two years, an analysis is made of all such cases in England to establish trends and inform policy and practice. The UEA report covers reviews which took place between April 2003 to March 2005 and is the third such analysis.
‘Analysing Child Deaths and Serious Injury through Abuse and Neglect: What can we Learn?’ is published on Thursday January 31. The authors are Marian Brandon, Pippa Belderson, Jane Dodsworth, Ruth Gardner, David Howe, Catherine Warren and Jane Black. All except Jane Black are members of the Centre for Research on the Child and Family in the School of Social Work and Psychosocial Sciences at the University of East Anglia. Ruth Gardner is also employed by the NSPCC. Jane Black is a Designated Nurse at Norwich PCT.
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University of East Anglia - Communications Office
Tel: (+44) (0) 1603 592203 Fax: (+44) (0) 1603 259883
Email: press@uea.ac.uk
Refence to Dr Rita Pal.
The Medical Register records an individual with your name as having obtained a medical qualification in 1998.
However, the record records that you are "not in the specialist register".
The record also shows you are not in the GP register.
In what capacity are you making the comments you are making on this website?
oh dear. It's a little late in November for fireworks... but oddly I feel some coming....
Anon - I'd suggest you just go follow Rita's links and "know thine enemy" :o)
Actually I am not on the GMC Register either. I do though happen to have a medical degree. That doesn't make me better than the average bear but it does make me want to analyse the information given to us by our government.
I happen to also be one of the editors of http://www.nhsexposed.com.
Finally, no amount of attempts to discredit me :) will take away the fact that
1. Child Protection was at risk for 10 years. Nothing was done by the government.
2. Warnings happened through various studies and various professionals. The government did not heed it.
3. Now a whistleblower at Harringey tell us how she informed ministers who ignored her.
I don't require a GMC registration to make those statements :).
Dr Rita Pal
Ian
Leave him be - it is good for people to argue their frustrations online when they have nothing more interesting or analytical to say :). No one needs a medical degree or a GMC Registration to be analytical. They just need brain. Anon's brain reminds me of Homer Simpson - all the right neurones but not quite in the right order.
RP
NHS Exposed
NHS Exposed Blog
Ward87
The moral outrage from the rest of us in cases like this is driven by frutration.
Frustration at our inability to protect children, despite the huge amount of tax payers money devoted to social services. Maybe not enough for those spending it, but it seems like a a hell of a lot to those of us paying it.
Frustration at the lack of mea culpa. Nobody seems to have ownership in cases like this. I don't believe that someone should necessarily be fired every time something goes wrong when events like these occur. However the lack of ownership by one person is probably the biggest factor whenever something so catastrophic and tragic happens in any walk of live. How can we learn if nobody has ownership?
Frustration at the iablity professionals to learn by past mistakes. Professionals are supposed to be experts in their field yet we hear cries for more supervision. Either they are drones who need supervision or they are professionals who can be trusted to call for help when they need it.
Frustration that, despite very good wages, managers lack the ability to manage. They can't see when something is going wrong and fix it before the problem gets so far out of hand. Thats what managers should be doing, not constantly supervising individual professionals but taking a wider view ensuring that systems and procedures are in place to catch the exceptions that lead to these hoorendous deaths.
Frustration to learn that yet again its a lack of communication that is the root cause, despite the £millions spent on IT and telecoms, hours spent in cross departmental meetings and the appointment of evermore coordinators.
Frustration that the "system" seems hell bent in keeping children in care rather than risk them going to live with people prepared to offer them a home, time, love and dedication because they might smoke. Frustration that we know that this will extend from one borough to the rest of the country and more children will suffer at the hands of self righteous indignation that people smoke.
Frustration that the standard response is yet more enquiries and reviews, which only seem to give those involved a chance to take one pace back with a "not my fault guv" shrug of their shoulders.
Frustration that despite all these enquiries we find that recommendations of the learned people who chair them are ignored by the Government and professionals, only for the same mistakes to be made again.
Frustration that whenever we raise our concerns we are told that we don't understand and should leave it to the professionals, only to see another child die in such distressing circumstances. Yet at the same time those same professionals are drawing up plans to give themselves power to remove overweight children from their parents and place them into a system that can be so broken that this child died.
So, Dr C, by all means point out that some of the moral outrage may be misplaced, but don't think for one minute that it isn't real or unwaranted.
And yes, if we never heard of another death we would ignore social service, but thats the point isn't it? Professionals want to be left alone to get on with their jobs while the rest of us go out and generate the wealth to pay for them?
Ok, so that's the general outrage dealt with and now this:
[my emphasis]
"You cannot legislate to eradicate evil. There is no system on earth that will protect us against Harold Shipman, Fred West, Peter Sutcliffe and all the rest of them. You do the best you can, in difficult circumstances. Some times you get it wrong. Haringay Council got it wrong this time. God, did they get it wrong and, yes, once again we need to examine procedures and see if we can get it any better.
But, once again, the whole emphasis of the story is on social services rather than on the evil thugs that committed the offence. It was the same with Victoria Climbie:"
Yes there are evil people but we know that, that's why we have set up social services and other specialists, to protect the vulnerable. That's why we give them special powers, so they can act to protect the vulnerable.
I agree that there will always be hard cases like Shipman and most people accepted that fact and looked to the subsequent enquiry to provide the recommendations that protect us from from future Shipmans. But if it happens again the moral outrage will be deafening, because yet again we will have found that professionals have becaome self righteous and compacent and unable to learn from past mistakes.
And that's the point with this moral outrage, as I said in my first comment, we've seen it all before.
Mr Simpleton
I too have seen the moral outrage before too - and to be honest - it pisses me off.
Your frustration posting smacks of the typical "out of sight - out of mind" mentality that feels offended when your media should bring this matter to your attention and dare interrupt your boiled eggs and tea for breakfast.
These guys do a hard job and put their own safety on the line many times in the course of their professional work.
Society treats all it's social ills the same - we'll pay someone to take it away and hide it from us.
As a social worker and resident of Haringey (but thankfully not a combination of the two), I think that as is written, it very easy scapegoating process. The last thing I would ever want to do is to defend poor practice or mistakes in any respect, I think that it is far too easy to make fun of 'cabbage munching do-gooder social workers' and ridicule the profession.
This only really serves to further alienate those who do battle through and sometimes against the systems and deter people from a profession which is necessary - however much people wish that it wasn't.
The last thing I want to do is defend Haringey, but since I qualified in 2000, it has been whispered and sometimes shouted that it is one of the 'worst' boroughs to work for in London. With a reputation like that, that was already very evident when I was studying, it is hardly likely to attract the best applicants - but that's something the profession needs to look at more widely.
Also it is most commonly the newly qualified social workers who go into Child Protection - those with a few years experience move to something a like fostering/adoption/leaving care with as much haste as they can. The frontline child protection teams are often the ones with the staff who are least experienced. Of course, you can't force people to do jobs they don't want to do (I don't work in Children's Services and never have - it was a conscious decision I made)this also needs to be addressed.
As for me, I'd say that a strong and effective workforce is needed (unsurprisingly, perhaps) and it will happen with management that works and is able to provide supervision and training on an ongoing basis and although there is nothing that will solve the issue of understaffing and overwork on a short term basis, there is no room at all for complacency.
Mr Ian,
I don't doubt that social workers are hard working, dedicated or conscience and don't think I even implied they weren't. As I said "I don't believe that someone should necessarily be fired every time something goes wrong when events like these occur."
Yes there is an "out of sight, out of mind" element to this. Partly because so much is deliberately hidden in the interests of protecting children. Partly, I suspect, because social workers dodn't want to spend their time in the public eye as it will amke their life harder and partly because we are also busy working hard and don't have the time to get close, even if we wanted to.
All of that doesn't negate the criticisms and moral outrage, just explains why, when these episodes occur, it is so loud.
The world is shades of grey.
There is certainly no justification for saying that every time social services makes a mistake, everyone involved in the mistake should be fired. There is an (apocryphal no doubt) story that a senior IBM executive having made a 20 million dollar mistake was called into his boss's office saying "I assume you have called me in here to fire me?", "Fire you? I've just spent 20 million dollars training you".
Bearing that in mind, should it then be the logical position that anyone making a mistake should be "let off" because they'll have learned their lesson? It doesn't make sense. Let's say I'm a surgeon who is losing his eyesight and don't tell anyone -- I make ever increasing, preventable by another, mistakes -- should I be forgiven or fired?
The negligence/incompetence in this case, if we believe the reports, is so extreme, that it is not unreasonable to suggest someone should be fired.
Given the choice between positions of responsibility filled with competent people instead of incompetent people, it's not rocket science to strive for the former. If it were not the case, we shouldn't bother with exams, qualifications, CVs, interviews or salaries.
I'm not sure that you can compare the cases of baby P and Jean Charles de Menezes, they are totally different.
With baby P we are talking about a 17 month old baby, who over several months had suffered terrible injuries. He was seen by social workers and health care professionals 60 times, we are told.
The fact that none of them appeared to see (or if they did see they were not worried) the injuries should be of concern.
It is also worrying to hear Ms Shoesmith reading out a statement, part of which stated, "most of our child protection policies worked well". Thats OK then eh?
As a psychiatric nurse, and having worked on acute admission wards and latterly with people suffering from Alzheimers disease, I have met many social workers. I have to say that the good ones are few and far between, mediocre and poor are the most frequent terms I have used to describe them.
This is a complex issue that I don't want to go into much detail on a blog comment, but quoting from the blog:
>When did you last read an article
>in a newspaper about social
>workers removing an “at risk”
>child and then being over-ruled
>by a court? It happens all the
>time.
Please cite 3 cases. I know of one case that was reported int he mainstream media in 2008. (Nottingham Baby G)
I do know of other cases that were not reported. However, the main problem here is the failure of the decisionmaking process resting particularly within the way in which the courts work and particularly the absence of second opinions.
Dr. Crippen,
I am in complete agreement that the vast majority of social workers are in fact hard working individuals much like elsewhere in the public health "spectrum".
The problem is that they tend not to be in positions of authority; that eschelon is reserved for the righteous, the ideologue, the bootlick and the party-cretin.
Don't believe me? I have a relative in the social service who conveyed to me the following story: her once-upon-a-time supervisor at a social housing centre for "damaged" kids was eventually fired after a string of charges were allayed including fraud, assault, nepotism (they hired a relative negating the interview process who was then squirrelled away after assaulting one of the children in their care) and abuse of power. This took several years to bring about and despite being rated a rank incompetent was immeadiately "shunted" into another role elsewhere. A large element that weighed in this supervisors favour, despite several anonymous, unrelated calls by several concerned members of staff, was that they were black and therefore played the race card and eventually, up to their dismissal, the whole deck.
As a youth group leader working with kids from one of the worst run down estates in Leeds I get to handle all the children left behind whilst the social services are on lunch or attending an equality training session run by a guardianista; one child has to live with their father who does not allow them to return home until his "business" (drug-dealing) has been concluded for the day (usually around 11pm every night). Another child was recently thrown out by their parents after being abused by one of their parents friends; they sided with the friend, our more dedicated youth group leaders sided with them (they are now living with these people).
What I am trying to say is that the reality is vastly different to either myth of "good" or "bad". It tends to be the worst of both worlds; either family units are disrupted for petty indiscretions or children are left in the clutches of truly evil people.
The problem is accountability and where that lies; when you have the wooden tops in charge being accountable to Whitehall first, the citizens second you will get skewed results. Always. The reason is that Gordo and Co cannot move past the legislative stage, EVER, nor would we want them to; their job, if thats what you can really call it, should be to manage and streamline existing laws and negotiate the defense of the countries constitution (if we had one) and its borders; the job of policing our laws should be the job of the councils themselves (because they can be changed a lot more readily and thus held more accountable).
Dr. North over at EU Referrendum has succinctly explained this (in another context, but equally applicable here) as a move from a results based philosophy to a rules based one.
Anyone can have rules.
But rules can be broken (ask Gordo how his golden economic rules are doing).
Anyone can have a constitution.
But ask the US how George Bush has steamrollered over it with the patriot act or any number of invasive horlocks.
What everyone can do is ask, and answer, the difficult questions:
How do we create a civil service that both protects the weakest in our society and is not prone to miscarriages of justice?
If you ask most people the answer will change, if you ask enough and then give them control over the answer...you change a nation.
My view, as a semi-professional, has always been that making an honest mistake may be excusable, but if someone says "you need to watch out for X" and then X happens, you are on very dodgy ground.
So for me, the issue is the allegations made by the social worker Nevres Kemal, and how these were treated.
well some of these societies got a near impossible jobs.
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