Putting the child first: the case for care for neglected children.

In social worker and academic circles my name is most frequently associated with adoption, my appointment as the so-called Adoption Czar having driven – I am proud to say – a significant recovery in the number of adoptions in 2013.

But my interest in adoption has always been part of a much wider interest in inequality, disadvantage and neglect and the long-term consequences of that. One can’t work for twenty three years with offenders, as I did, without drawing conclusions from the reality that the proportion of those we incarcerate who enjoyed a stable and economically secure start in life is a very small one.

Before beginning to advise the Government on adoption I ran Barnardo’s for six years from 2005. My arrival there was still in the period of great optimism about early intervention with families, offering support to keep them together, based very much on the proposition that children should not – save in the most extreme circumstances – be separated from their families.

I embraced that philosophy and prioritised in the charity our contributing to early intervention work that included a very large expansion in the number of Sure Start Centres that we began to manage. But as I spent more time with my staff, as I met more Mums, and it was always Mums (I found the lame denial in recent weeks of the Centre For Social Justice proposition that we have a significant problem with absent fathers depressing) and looked at cases where children were on the verge of being returned to their birth families from care I began to be concerned. It seemed to me that – as a society - we were hesitating too long before intervening to take a child into care and then, when finally that brave intervention was made, were seeing success, too often, only in terms of reunification between child and birth family.

In 2009 I wrote something to that effect for IPPR (1) arguing that we might need more, not fewer, children in care. That drew a predictably outraged response from politicians from all sides, Ed Balls, then Secretary of State for Education going on TV to criticise what I had to say, Tim Loughton, Shadow Children’s Minister describing what I had written as “shock tactics” and saying that “parents always knew best” and the National Children’s Bureau, unusually for one charity speaking of another, saying my arguments were misconceived.

When I researched adoption for The Times (2) I looked more closely at social worker hesitancy in taking children into care. I concluded that there were three main reasons for such caution. The first was generally prompted by misconceived interpretations of attachment theory that encouraged a view that, at almost any cost, the relationship between birth mother and child must be maintained. Those holding this view were often quick to quote Bowlby and the stress he put on a warm and continuous relationship between infant and mother. I don’t believe Bowlby was necessarily suggesting that an attachment always had to be with the birth mother. But certainly by 1972, Rutter had demonstrated that the main attachment between a baby and carer was not always with the mother (in a third of cases it was with the father) and a warm bond with a mother substitute could succeed (3). So, while attachment theory certainly points to the need for a loving bond with one individual to be allowed to flower before a child reaches his or her first birthday it does not support notions – held by many practitioners - that such a bond can only be achieved between the child and his or her natural mother. What is important is that a child develops a stable attachment. As the Royal College of Paediatrics explain (4)

Babies and children raised in loving homes with at least one responsive parent are likely to be securely attached. They are more likely to be resilient to the ups and downs of life, be psychologically and physically healthy, do better at school, make and sustain mutually-satisfying relationships, make a positive contribution to society and be good parents themselves.

Insecurely attached children may achieve such good outcomes but life may be much more of a struggle.

Those with disorganised attachments are most at risk and are more likely to have mental health problems, misuse drugs and alcohol, become teenage parents and be involved in anti-social behaviour and criminal activity.

I found the second main reason for social worker hesitation about care to be based on the passionately held belief on the part of some practitioners, and a number of academics involved in social worker education, that in considering whether a child should be taken into care, there was a need to balance the interests of the child with those of its parents. When my IPPR piece was published, one academic wrote to me in angry terms and, quoting Article 8 of the Human Rights Act, insisted that the interests of parents had to be balanced alongside the interests of the child in any decision about care. This is, of course, not so. The paramountcy principle in the 1989 Children’s Act makes it clear that the child’s welfare is the paramount consideration. Liberty accepted that interpretation, acknowledging on their website:

Separation of family members will normally constitute an interference with the right to respect for family life, although such interference may be justified, for example where a child is taken into care for his or her own protection.

Paramountcy has not been challenged either by the European Court of Human Rights or by the UK Courts and the House of Lords has found that the paramountcy principle and Article 8 are consistent.

But perhaps the most important reason for social worker and local authority unwillingness to intervene, sometimes until neglect had turned into abuse was the still widely held view not just on the part of practitioners but also, and crucially on the part of politicians and the media, that managed neglect was preferable to care and however bad things were at home, local authority care would make things worse.

It was hardly surprising that this view prevailed (and still prevails in some quarters) since it received public support from a number of key commentators. Barry Sheerman, then Chair of the Select Committee on Children Schools and Families told his Committee in 2009 that there was a continuing:

perception that entering the care system is catastrophic for a child’s future prospects (5).

The then newly appointed President of The Family Division, the most senior Family Law Judge in England, the much respected Lord Justice Wall said shortly after his appointment:

What social workers do not appear to understand is that the public perception of their role in care proceedings is not a happy one. They are perceived by many as arrogant and enthusiastic removers of children from their parents into an unsatisfactory care system

While still at Barnardo’s in 2010 and in an effort to address this prejudice against care which I knew was not supported by the research, I commissioned DEMOS (6) to review the evidence for and against care. They concluded that:

Stigmatisation of the care system, combined with concern about the upfront costs to the state, means that some children who might benefit from the care system do not do so.

When the care system is used effectively in this way it can be a powerful tool for improving the lives of vulnerable children and young people.

The mistaken belief that care consigns all looked-after children to a lifetime of underachievement and poor outcomes, creates a culture of uncertainty, increasing delay and leading to instability later on.

There is now a substantial body of academic evidence that provides a longer-term and more nuanced perspective on looked- after children’s lives, taking into account the nature of their pre- care experiences and comparing them with more appropriate control groups. This evidence shows that care can be a positive intervention for many groups of children.

Some groups of children whose entry to care is delayed by indecision or drift are at risk of experiencing a longer exposure to pre-care adversity; higher emotional and behavioural problems; placement disruption and instability.

Because of my view that we have tolerated neglect for too long it is sometimes suggested that I believe that we should not try to support families, not try to effect positive change and make a neglected child’s parenting acceptable so that they can stay at home. That’s nonsense. I believe that families can and do change, particularly when support is accompanied by rigorous challenge and timescales for the care of children to improve. Making the birth family successful should certainly be our first option, and I am not arguing that mothers should not be given a second or even a third chance, just not a fourth, fifth and sixth.

The unjustified optimism in the capacity of deeply inadequate and sometimes uncaring parents to change may have abated somewhat. But I would argue that there is more to do yet to tackle the naïve optimism that so often condemns children to a miserable and damaging start in life. And there is more to be done yet in terms of realism about re-unification from care. We have to stop letting children down by returning them to parents only for them to be neglected once again. Professor Elaine Farmer’s 2010 study of 138 children returned from care to their parents (7) and which found that three in five suffered further abuse or neglect should horrify those who still see success in neglect cases as inevitably achieving reunification. Families should be supported, but only for so long and we need to be realistic about those families whose capacity to recover is patently limited. Recent initiatives by at least one large local authority, financially to incentivise reductions in the number of children in care, are at best misguided and at worst dangerous.

There is no over reaction to neglect or abuse in England indicated by the relatively modest increases in the care population since the death of Peter Connolly. The current population of 67,000, a little high by the standards of the last decade, but would have to grow by almost 40% to match the size of the care population in 1981. What,

apparently, has happened since 1981, to make parenting so much better?

There can be no target for the number of children in care. There can be no right number. We simply have to do what is best for the child in each and every case of neglect. Sometimes that might lead to leaving the child at home. But we cannot gamble with children’s life chances in the misguided belief - as a social worker once pleaded with me – that blood is thicker than water.

(1): http://www.ippr.org.uk/publicationsandreports/publication.asp?id=703(2): http://www.mnarey.co.uk/publications.php(3): Rutter, M (1981) Maternal Deprivation Reassessed(4): Royal College of Paediatrics and Child Health Teaching materials (2011)(5): Children, Schools and Families Committee - Third Report Looked-after Children(6): http://www.demos.co.uk/publications/inlocoparentis(7): Farmer E (2010): Case management and outcomes for neglected children returned to their parents: a five year follow-up study.