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Committee for Health,
Inquiry into Child Protection Services in
Ordered by the Committee for Health, Social
Services and Public Safety
POWERS AND MEMBERSHIP
The Committee for Health, Social Services and Public Safety is a Statutory Departmental Committee established in accordance with paragraphs 8 and 9 of Strand One of the Belfast Agreement and under Standing Order No. 46 of the Northern Ireland Assembly. The Committee has a scrutiny, policy development and consultation role with respect to the Department of Health, Social Services and Public Safety, and has a role in the initiation of legislation.
The Committee has the power to:
The Committee was established on 29 November 1999 with eleven members, including a Chairman and Deputy Chairman, and a quorum of five.
The membership of the Committee is as follows:
On 14 May 2002 the Health, Social Services and Public Safety Committee launched an inquiry into the arrangements in Northern Ireland to protect infants and children from physical, sexual and mental abuse. This followed on from a number of recent cases that highlighted the dangers faced by children, both inside the family home and at the hands of those entrusted with their care and protection.
The aim of the inquiry was to determine whether the current arrangements were meeting the welfare needs of children and protecting them from significant harm. Particular regard was paid to the role and responsibilities of the Department, statutory and voluntary agencies, including Child Protection Committees and Panels; the role of the Commissioner for Children; the role and usage of the child protection register; the legislative context within which the child protection services operate; resources available for those services; and current guidance.
The Committee consulted with a wide range of experts in the field of child protection, and received 53 substantive written submissions. It also held 14 oral evidence sessions and two informal meetings. The Committee agreed on 09 October 2002 to publish the oral and written evidence prior to completion of the Inquiry and publication of the final report, in order to help inform the public. As the Northern Ireland Assembly went into suspension from 14 October 2002, it has not been possible to make further corrections to transcripts of oral evidence outstanding at that date. The publication is annotated accordingly to indicate where evidence has not been examined. The Committee would like to thank all those organizations that responded for their valued submissions.
TABLE OF CONTENTS
Minutes of Proceedings
Minutes of Evidence
List of Witnesses that gave Oral Evidence
Volume 2 - Written Submissions Part I
Archbishop of Armagh
Volume 3 - Written Submissions Part II
Northern Ireland Office
MINUTES OF PROCEEDINGS
TUESDAY, 14 MAY 2002
Present: Dr J Hendron (Chairman)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Committee Work Programme
The Clerk outlined the Committee's forward work schedule, which will include the Committee Stage of three Bills, and the provisional timetable for any inquiry to be completed before the Assembly's dissolution in spring 2003.
The Committee deliberated on a number of options for an inquiry.
Agreed: The Committee selected the area of child protection for its next inquiry. The Clerk will draft focused terms of reference for consideration at next week's meeting, as the Committee's aim is to report to the Assembly in early 2003. The Clerk will draft a press release, for the Chairman's approval, announcing the launch of the inquiry.
DR J HENDRON
WEDNESDAY, 22 MAY 2002
Present: Dr J Hendron (Chairman)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Protection of Children -Terms of Reference
Agreed: The Committee considered and agreed the following terms of reference for its inquiry into the protection of children:
"To inquire into the arrangements in place in Northern Ireland to protect infants, children and young people under the age of 18 from physical, emotional and sexual abuse and neglect; and to determine if child protection services are meeting the welfare needs of children and protecting them from significant harm.
Regard will be paid to the:
The Clerk advised that the Committee could consider appointing a special adviser to provide expert, independent advice to the inquiry. In such an event, the procedure would be for the Committee to short-list and interview from a list of experts drawn up by Assembly Research Services. Committee member can also suggest additions to the list.
DR J HENDRON
WEDNESDAY, 29 MAY 2002
Present: Dr J Hendron (Chairman)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Protection of Children Services in Northern Ireland
Assembly researcher Dr Janice Thompson briefed members on a list of experts on child welfare and protection that she had drawn up as potential special advisers to the above inquiry. The Clerk explained the selection process and sought the Committee's approval to approach the experts listed.
Agreed: The Assembly Research Services will write to the experts listed seeking expressions of interest in acting as a specialist adviser to the inquiry. The Clerk will issue a press statement outlining the terms of reference for the inquiry.
DR J HENDRON
WEDNESDAY, 19 JUNE 2002
Present: Dr J Hendron (Chairman)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Child Protection Inquiry
The Clerk updated the Committee on progress on the appointment of a specialist adviser and arrangements for evidence. Members noted a paper from Research Services on potential specialist advisers, of whom nine have expressed an interest in the position. A short-list will be drawn up by Research Services, based on the agreed criteria for selection. Oral evidence sessions will be provisionally scheduled for mid- to late-September 2002. A draft report should be completed by early January 2003, with the final report being debated in the Assembly later in the month.
Agreed: The Clerk will arrange a Committee interview panel, representative of the parties, for week commencing 01 July 2002, to make the final selection. The draft consultation letter for the inquiry, based on the terms of reference, and requesting replies by 16 August 2002, was agreed.
DR J HENDRON
WEDNESDAY, 11 SEPTEMBER 2002
Present: Dr J Hendron (Chairman)
Apologies: Rev R Coulter
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Child Protection Services - Briefing by Specialist Adviser
The Chairman welcomed Mr David Spicer, Specialist Adviser to the Committee's Inquiry into Child Protection Services in Northern Ireland, and wished him well in his work with the Committee. Mr Spicer briefed members on the main themes arising from the 50-odd written submissions received to date and his own observations as an expert in the study of child abuse. These are summarised as follows:
DR J HENDRON
TUESDAY, 24 SEPTEMBER 2002
Present: Dr J Hendron (Chairman)
Apologies: Mr T Gallagher (Deputy Chairman)
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Child Protection Services in Northern Ireland: Oral Evidence
NI Guardian Ad Litem Agency
Witnesses: Mr Ronnie Williamson
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 12.30pm.
Ms Ramsey left the meeting at 12.23pm and returned at 2.35pm.
Mr Kelly joined the meeting at 12.23pm.
Inner City South Belfast Sure Start
Witnesses: Ms Joy Poots
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 1.00pm.
Rev R Coulter left the meeting at 12.32pm and returned at 2.35pm.
Mrs Courtney joined the meeting at 12.32pm.
Mr Berry sought leave to attend urgent business elsewhere. In the absence of a quorum the meeting was not properly constituted and the Committee could not transact formal Committee business. The Chairman sought the views of members. Members were content to continue in informal session in order to receive a presentation from Barnardo's.
Mr Berry left the meeting at 1.00pm.
Witnesses: Mr Maurice Leeson
The Chairman welcomed the panel and invited them to make a presentation.
Ms McWilliams joined the meeting at 1.20pm. There being five members present, the meeting became quorate.
The Chairman thanked the panel for their presentation. A memorandum on the presentation will be issued.
The meeting was suspended at 1.30pm and resumed at 2.35pm.
Child Protection Focus Group
Witnesses: Dr Alison Livingstone
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 3.10pm.
Mrs Courtney and Rev R Coulter left the meeting at 2.50pm and 3.10pm respectively.
At 3.10pm, following the end of oral evidence by the Child Protection Focus Group, Rev. Coulter sought leave to attend urgent business elsewhere. In the absence of a quorum the meeting was not properly constituted and the Committee could not transact formal Committee business. The Chairman sought the views of members. Members were content to continue in informal session in order to receive a presentation from NIPSA.
The meeting was suspended at 3.10pm and resumed at 3.30pm.
Northern Ireland Public Service Alliance
Witnesses: Ms Eileen Webster
The Chairman welcomed the panel and invited them to make their presentation. The Chairman thanked the panel for their contribution. A memorandum on the presentation will be issued.
DR J HENDRON
WEDNESDAY, 25 SEPTEMBER 2002
Present: Dr J Hendron (Chairman)
Apologies: Mr T Gallagher (Deputy Chairman)
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Child Protection Services: Oral Evidence
The entire proceedings relating to the oral evidence given by the two witnesses listed below are recorded separately in verbatim minutes of evidence.
Witness: Mr Scott Hollander, Executive Director, KidsVoice, Pittsburgh USA
Dr Hollander gave a brief presentation on his experience of child protection services from a US perspective. The main points are summarised as follows:
Witness: Dr Eileen Vizard, Consultant Child and Adolescent Psychiatrist, London
Dr Vizard gave a brief presentation on her work with the Young Offender's Project, which was followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. Dr Vizard's presentation is summarised as follows:
DR J HENDRON
THURSDAY, 26 SEPTEMBER 2002
Present: Dr J Hendron (Chairman)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Child Protection Services: Oral Evidence
Southern Area Child Protection Committee
Witnesses: Mr Tony Rodgers, Chairperson
Mrs Courtney and Mr Hamilton joined the meeting at 10.47am and 11.00am respectively.
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 11.20am.
Rev R Coulter and Mrs Robinson left the meeting at 11.20am.
The Deputy Chairman joined the meeting at 11.25am.
Volunteer Development Agency
Witnesses: Ms Sandra Adair, Assistant Director of Policy and Practice
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 11.52am.
The meeting was suspended at 11.52am and resumed at 12.00pm.
Mr Hamilton left the meeting at 12.32pm.
Rev R Coulter re-joined the meeting at 12.33pm.
Probation Board for Northern Ireland
Witnesses: Mr Oliver Brannigan, Chief Executive
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 12.46pm.
The meeting was suspended at 12.46pm and resumed at 1.37pm.
Mrs Robinson re-joined the meeting at 1.52pm.
Witnesses: Mr Ian Elliott, Divisional Director
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 2.10pm.
The Deputy Chairman left the meeting at 2.11pm.
Rev R Coulter left the meeting at 2.40pm.
Women's Aid Federation
Witnesses: Ms Angela Courtney, Director
The Chairman welcomed the panel and invited them to make a brief presentation, to be followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 3.00pm.
DR J HENDRON
WEDNESDAY, 02 OCTOBER 2002
Present: Dr J Hendron (Chairman)
Apologies: Mr P Berry
In Attendance: Mr P Hughes (Committee Clerk)
Dr Hendron took the Chair at 2:00 pm.
Inquiry into Child Protection Services in Northern Ireland: Oral Evidence
Association of Directors of Social Services:
Mr Hugh Connor, Dir.of Social Work, South & East Belfast HSS Trust
Ms Brenda Smyth, Dir. of Social Services, Homefirst
The Chairman welcomed the witnesses to the meeting, and Mr Connor gave a brief presentation on the main issues relating to child protection services from the perspective of a Social Services Agency. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel members, and they left the meeting at 4.20pm.
i. Motion to establish a sub-Committee for Health, Social Services and Public Safety
Question put and agreed to:
That the Committee for Health, Social Services and Public Safety agrees the establishment of a sub-committee to:
"Take evidence in connection with the Committee's Inquiry into Child Protection Services in Northern Ireland. It shall submit the minutes of evidence taken to the Committee for its consideration and adoption. It shall stand dissolved upon disposal of those matters. The sub-committee shall not take any decision on behalf of the Committee.
The Committee shall appoint a convenor to the sub-committee.
The sub-committee shall, as far as is practicable, reflect the party strengths in the Assembly, as represented on the Committee. Each party represented may nominate a member to sit on the sub-committee. The Committee shall appoint a convenor to the sub-committee. All members of the Committee may attend meetings of the sub-committee.
The quorum of the sub-committee shall be three."
Agreed: The Committee agreed that the Chairman should act as convenor.
DR J HENDRON
THURSDAY, 03 OCTOBER 2002
Present: Dr J Hendron (Convener)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Dr Hendron took the Chair at 10.25am.
Inquiry into Child Protection Services: Oral Evidence
Eastern Health and Social Services Board
Witnesses: Mr John Richards, Director of Social Services
The Chairman welcomed the panel and invited them to make a brief presentation. This was followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 11.30am.
North and West Belfast Health and Social Services Trust
Witnesses: Mr Noel Rooney, Director of Social Work
The Chairman welcomed the panel and invited them to make a brief presentation. This was followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 12.25pm.
The meeting was suspended at 12.25pm and resumed at 12.40pm.
Witnesses: Ms Koulla Yiasouma, Director
The Chairman welcomed the panel and invited them to make a brief presentation. This was followed by a question-and-answer session. The entire proceedings are recorded separately in verbatim minutes of evidence. The Chairman thanked the panel, and they left the meeting at 1.35pm.
WEDNESDAY, 09 OCTOBER 2002
Present: Dr J Hendron (Chairman)
Apologies: Mrs P Armitage
In Attendance: Mr P Hughes (Committee Clerk)
Inquiry into Child Protection Services in Northern Ireland
The Clerk advised members that the oral evidence-taking section of the Child Protection Inquiry had now been substantively completed. In order to inform the public of the range of views expressed by witnesses to the Inquiry, the Chairman recommended that the Committee approve for publication the written submissions, corrected minutes of evidence, and explanatory memoranda.
Question put and agreed to:
That the written submissions received, minutes of evidence (as amended) and explanatory memoranda, and the minutes of proceedings relating to the Committee's Inquiry into Child Protection Services in Northern Ireland be printed.
DR J HENDRON
Minutes of Evidence
List of Witnesses that gave Oral Evidence
Tuesday 24 September 2002
NI Guardian Ad Litem Agency 25
Inner City South Belfast Sure Start 29
Child Protection Focus Group (NI)* 35
Wednesday 25 September 2002
Mr Scott Hollander, Kidsvoice 41
Dr Eileen Vizard, Consultant Child and Adolescent Psychiatrist 49
Thursday 26 September 2002
Southern Area Child Protection Committee 55
Volunteer Development Agency 61
Probation Board for Northern Ireland 67
NSPCC (NI) 75
Women's Aid Federation (NI) 81
Wednesday 02 October 2002
Association of Directors of Social Services* 89
Thursday 03 October 2002
Eastern Health and Social Services Board* 95
North and West Belfast Health and Social Services Trust* 103
Include Youth 111
* Transcript of Oral Evidence not examined due to the Suspension of the Northern Ireland Assembly on Monday 14 October 2002.
Record of Informal Briefings
Tuesday 24 September 2002
Barnardo's (NI) 121
MINUTES OF EVIDENCE
Tuesday 24 September 2002
Dr Hendron (Chairperson)
Rev Robert Coulter
Mr J Kelly
Mr S Knox )
Mr R Williamson ) Northern Ireland Guardian
The Chairperson: Thank you very much for attending today, and I am sorry about the delay. I accept most of the blame, and I apologise to you and my Colleagues. Thank you for your submission, which I hope my Colleagues have read. Perhaps you could introduce yourselves briefly and we will then get straight into the questions. A full presentation is not necessary, because members have already read the submission. However, if you wish to highlight some areas, please go ahead.
Mr Williamson: I thank the Committee for the invitation to give evidence. As you say, we have provided a written submission and we appreciate that time is short, so I will not give the full presentation that I had intended to give. However, I will briefly place the Northern Ireland Guardian Ad Litem Agency in the context of the child protection framework for the Committee.
The agency provides representation for children in public law and adoption court cases. Many of the cases involve children who have been abused or neglected. Children for whom adoption orders are being sought often come from the "looked-after" children population, and a decision has been made that they cannot return to their birth family and that an alternative family must be sought.
Mr Knox and I have both worked in health and social services trusts. Over two decades I have chaired case conferences, and have done much stand-by work, even removing children into care in the early hours of the morning. I have built up a broad understanding of the child protection system. I have also worked for six years as an adviser to an area child protection committee.
We have taken the bigger picture into account, and have considered the issues that the Committee wishes to focus on, which are the arrangements for child protection in Northern Ireland. Our recommendations are made in that context. We have tried to take account of departmental initiatives, such as 'Developing Better Services: Modernising Hospitals and Reforming Structures', which is at consultation stage.
When multidisciplinary arrangements work, they work extremely well. However, when a child dies because of physical abuse or serious sexual abuse and mismanagement of a case is indicated, inquiries consistently highlight poor inter-agency communication, lack of proper assessments, inadequate multidisciplinary resources and a failure to focus on the child.
As you suggest, Mr Chairman, I will not detail our recommendations one by one. Social workers face a dilemma because over the past 25 to 30 years, they have been thrust into a social policing role. At the same time, particularly since the mid-1990s, a greater emphasis has been placed on family support and the need to enter into a trusting relationship and partnership with parents and children. It is difficult to wear those two hats simultaneously, so I appreciate the demands coming from some quarters for the introduction of a national child protection agency, which hives off child protection from personal social services, and from the health and social services trusts in Northern Ireland. There is also a demand for the lead investigative role to be taken perhaps by the Police Service of Northern Ireland or, indeed, a voluntary organisation. In this overall context, we determined some recommendations.
Ms Ramsey: Much of your written submission advocates the involvement of children and young people in the development of child protection policies. You also referred to inter-agency work and to groups being criticised for not taking sufficient preventive action. The Guardian Ad Litem Agency is seen as an independent adviser responsible for the welfare of children and young people. How, therefore, do you see children being involved in the development of policies and procedures, and where does the role of the children's commissioner fit into that?
Mr Williamson: The Guardian Ad Litem Agency is taking steps that will allow children to have a greater voice on the quality of service that they receive through the use of a computerised programme, and that information is then fed back to the agency. That is being progressed, and there are also other interesting initiatives.
There could be useful consultation on policies and procedures and on the system of child protection that we are trying to introduce for children in Northern Ireland. The agency uses organisations such as the Voice of Young People in Care (VOYPIC) to obtain the views of children. More thought could be given to a Northern Ireland consultative forum for children. We must be open-minded to such areas of work.
Mechanisms must be put in place to ensure that the voice of the child is heard throughout the child protection process. If things go wrong, the focus tends to move away from the child. However, that would never happen if those mechanisms were in place, because someone would have responsibility for ensuring that the wishes, feelings and interests of the child are fed into the process. Greater emphasis must be placed on that.
The agency is recommending an amendment to the primary legislation in the Children (Northern Ireland) Order 1995. The courts should be required to review childcare plans for some children, and there should be criteria for a further review in some situations. A Court of Appeal granted that in England and Wales, but the House of Lords subsequently overruled it. However, Lord Nicholls, in his appeal judgement, stated that there should be public debate in that regard, and it could provide a measure by which there would be a substantial improvement in the quality of care plans for children. We commend to the Committee that that area should be explored.
Mr Berry: Your submission refers to the Minister of Health, Social Services and Public Safety's proposals for modernising hospital services and reforming the structures. What is the basis for the Guardian Ad Litem Agency's recommendation for the establishment of fully integrated services and a children's division in a reduced number of trusts? Trusts are already responsible for social work and health services. In your experience, are those services integrated?
Mr Williamson: There has been an integrated health and social services management ethos since 1973. The Guardian Ad Litem Agency has given the proposal a great deal of thought. We examined it in a radical way. Mr Knox and I have been in the service for many years and have seen different inquiries come and go. Largely, and frustratingly, those enquiries come to the same determinations and failures time and time again. Why can we not learn from that? Why does that continue to happen? The agency wants more radical proposals to be considered. We are prepared to entertain a well-thought-out proposal for a radical departure - a national child protection agency, perhaps. That idea is being considered in England and Wales. However, it must be extremely well thought out.
Nevertheless, I envisage problems with that proposal, which is why the agency's thinking has moved towards better integration of existing services in Northern Ireland. One or two trusts have moved in that direction and have children's divisions. However, that is not replicated elsewhere. Therefore, some trusts still have mental health services, childcare services, services for the elderly, services for medical health nursing, psychiatric services, and so on.
I spoke recently to representatives of one trust. They reinforced the view that I had held when I left the work of boards and trusts in 1996. There is still not enough co-operation between those different disciplines, even though they are under one management facility in a health and social services trust. For example, when a childcare officer requests a psychiatrist's report on the parenting capacity of an individual, the psychiatric service replies that it deals with the person's psychiatric illness and the preparation of a parenting assessment is not a priority. That is not the sort of engagement that child protection services need. They must urgently be given priority. If there were greater integration of services and different disciplines in health and social services trusts, that type of situation would be eliminated.
Mr Knox: Mr Williamson mentioned that certain trusts have children's divisions. A key element of many effective child protection services is the ability of people who know and trust each other's expertise and skills in order to be able to work together closely. The creation of children's divisions as places in which people could work together closely would certainly be beneficial.
Rev Robert Coulter: You mentioned an amendment to primary legislation, and in the course of your remarks you referred to Lord Nicholls's statement about giving the courts a greater supervisory role. The argument for court involvement can be made when deficiency is identified. For example, the courts could oversee child protection investigations. However, that creates the problem of expense. An extension of jurisdiction will inevitably take resources from core responsibilities. How could standards of performance be improved without involving expensive court proceedings?
Mr Williamson: The idea was that a court review mechanism would come after a care order, and after the court accepted that a care plan was appropriate. However, there are circumstances where a care order cannot be carried out. There are key elements in it that cannot, and do not, happen for a particular child. In such circumstances we wanted children to have the right to have their case re-examined by a court. Questions would have to be asked: why was the care plan, as indicated to the court, not carried out in the first instance? We are not proposing that the court oversees child protection investigations. It would apply to a select number of cases a year in Northern Ireland; however, it would benefit several children. The proposal, therefore, would not substantially add to the expense or drain the public purse.
Rev Robert Coulter: Has such an exercise been costed?
Mr Williamson: Not as yet. The proposal came through in England and Wales as a result of case law that went to the Court of Appeal. Dame Elizabeth Butler-Sloss, president of the family division in England and Wales, was consulted at that point. It was considered an appropriate interpretation of the Children Act 1989, as it then was. However, in its wisdom, the House of Lords determined that that interpretation was going too far. If it was to be brought in, and there was merit in its introduction, primary legislation would have to be changed. That debate should be carried out in Northern Ireland, as it has been in England and Wales, when called for by Lord Nicholls in the House of Lords.
Ms Armitage: You have experience of examining practice in cases that proceeded to court and of trusts appearing in proceedings. What are your views on the level of competence and ability to perform before judicial tribunals? Can you also comment on the general conduct of judicial proceedings?
In your submission you highlight key tasks for the guardian of the child to ensure that the child's views are made clear to the court. Can you provide more information on that? Is it a straightforward task to inspect trust records? Are the records well kept? I have been involved in medical issues, where the records are not kept well.
Mr Knox: We have outlined some of the duties of the guardian ad litem, which are laid down in law. Those duties must be carried out to ensure that the child's voice is heard during court proceedings. During the investigation trust records will be inspected and copies taken. We are a regional service and, therefore, we can see practice across the Province. Liaison arrangements have been set up between our senior managers and senior managers of the trusts to discuss issues of mutual concern and about practice in general.
It is difficult to give an overall picture. Some social services are good, and guardians ad litem would commend that. However, some trust records are difficult to follow and make sense of. Therefore, much time is spent wading through piles of thick files in order to access information. There are examples of good and bad practice.
Practices will be discussed when the Guardian Ad Litem Agency meets the 11 community trusts. Trusts will have the opportunity to discuss how the agency conducts itself and we will have the opportunity to address recurring difficulties.
Social workers' involvement with the courts has become increasingly complex. For instance, the preparation of a care order is a lengthy, detailed and complex process, and social workers who are involved in court proceedings need more training.
Mr Williamson: The agency is worried about inconsistencies in the interpretation of threshold criteria for determining when a child protection investigation should take place. Different trusts have different interpretations. There are also inconsistencies in the interpretation of criteria for placing a child's name on a child protection register and, therefore, having a child protection plan for that child. That is indefensible. More dramatic strides must be made to ensure that there is equity in how children and their families are treated across the Province. The inconsistencies must be eradicated.
The Chairperson: Thank you very much indeed. Your comments on a national child protection agency were fascinating. I am sorry that other Committee members were not present for the meeting, but they had other obligations. They might have had other queries, so if you have no objections the Committee will write to you with those questions.
MINUTES OF EVIDENCE
Tuesday 24 September 2002
Dr Hendron (Chairperson)
Ms J Poots ) Inner City South Belfast Sure Start
Ms T Gregory ) Clan Mor Sure Start
The Chairperson: I welcome Ms Poots and Ms Gregory from Sure Start. I am sorry for the long delay; many meetings are taking place today. Thank you for your documentation, which has been very helpful. Please take a couple of minutes to highlight the main points and we will move straight into questions.
Ms Poots: Thank you for the opportunity to give evidence. Like other organisations and individuals who work at a grass-roots level with local communities, we think that there are many issues and concerns but no way to voice them. The inquiry has come at an opportune time. We represent the eight Sure Start programmes that operate in the Eastern Health and Social Services Board area.
My name is Joy Poots. I represent the Inner City South Belfast Sure Start project. Tina Gregory represents the Clan Mor Sure Start project. Representatives from the eight Sure Start programmes in the eastern board area have met together to discuss and produce a joint submission. We had previously enquired about giving a presentation on Sure Start programmes to the Committee. As the inquiry into child protection services is important to Sure Start's work, we felt that we should contribute.
Sure Start's submission deals with its experience of working with families and communities, and the issues that can be drawn from that with regard to child protection. We have not attempted to give you many statistics or data, because those are not what Sure Start deals with. Also, it is difficult to get the type of evidence that backs up the common knowledge in communities about issues regarding child protection. Many parents have experienced childhood abuse - emotional abuse, physical abuse, sexual abuse, neglect, or a combination of those. Through its work with families, Sure Start has found that that is common, especially since we work more often with mothers than with fathers. Parents having children of their own can be the catalyst for them confronting unresolved issues from their own childhood.
We are interested in the inquiry because we come across such situations daily. People tell us about their experiences and the effect that they have had on them as parents. They also tell us that the vast majority of such situations are unreported and have never been brought to the attention of any professional body or organisation. If that was the case when those parents were children, what has really changed? There must be many unreported cases of abuse that have not been dealt with. Sure Start believes that the devolved Assembly brings with it an opportunity. The Belfast Agreement referred to children being the future of Northern Ireland. It is as important to deal with the issue of child protection as it is to deal with the consequences of 30 years of conflict. The costs of both are huge. However, the cost of child abuse is largely unrecorded. It must be examined in order to determine what resources are needed to tackle it, and to prevent it.
Because Sure Start has first-hand knowledge, it wants the Committee to consider a strategic response to child protection. The inquiry is welcome. However, it must be seen as a first step. Sure Start received information about the inquiry and made a response to it, but there are many other people in the community who would have much to say, but do not have the opportunity, the resources or the confidence to tell the Committee what is happening.
A strategic response would need to have inter-sectoral and interdepartmental weight in order to make it work. It would draw together all available resources, people who have an interest in children and people who work with children and families, with the political weight of the Assembly. It would also have targets. The community sector often has to work towards targets, performance indicators and measurements. I wonder what the targets are with regard to child abuse. What level of reduction are people aiming for? People believe that child abuse is bad, and they want to do something about it. However, what targets demonstrate that?
Sure Start believes that a children's commissioner would have a strong position with regard to child protection issues. However, all the responsibility cannot fall to one person. The children's commissioner will have a range of duties, of which child protection issues are only one. Support must be given to the children's commissioner and the children's unit in order to drive forward that agenda. Other players must be involved.
Communities receive mixed messages about child abuse and child protection issues. Some messages come from the experience of people who have worked with statutory services; some messages come from the media and its perception of the sentences being imposed; and some messages come from people's upbringing and what has been tolerated in society. In this campaign, a cultural shift in attitudes to child protection issues is required.
Some people who have been abused state that, in their experience, some communities tolerate abuse. I am not saying that it is condoned, but people tolerate it and try to come to terms with the problem, because they do not think that the statutory response is effective. That attitude may or may not work.
If a strategy were to be put in place, there must be proper information to back it up. That could be difficult because the available information is not collated so as to allow the entire picture to be seen. A good example is when recourse to the court system is sought and, although we are not saying that the legal system is the answer to the problem, there are situations in which the legal system must demonstrate that there is justice for children. Information is not available on how many allegations are made each year, how many of those allegations are investigated by social services, how many the police are involved in, how many are forwarded to the Director of Public Prosecutions (DPP), and what percentage of those are investigated by the DPP. Other information is not collated: the number of cases that get to court; what convictions are handed down for what type of abuse; the age range in different categories. This information must be available if we are to set targets. The success of the legal and other systems must be quantified.
Mr J Kelly: Your submission refers to the need to collect more qualitative and longitudinal information. What information must be included, and who is best placed to deal with it? Do you suggest that no change should be made until the research base supports it, and if that is not the case, which issues could wait and which issues require immediate action?
Your submission refers to
"some anecdotal evidence that a 'postcode lottery' exists in relation to the types of intervention available to protect children and this factor also requires research".
Is the resource issue a question of competence or managerial attitudes, or a combination of these factors?
Ms Gregory: In our experience, different social services departments will grade child protection issues on a scale of one to 10. In some departments, a child placed on point 2 will be investigated. However, in under-resourced departments, the child would have to be on point 8 before the same investigation is carried out.
Mr J Kelly: Does the postcode have anything to do with that?
Ms Gregory: It is not so much the postcode, but it does depend on what area you live in; it is a bit of a lottery. For example, in west Belfast a case might be assessed at point 8 in order to have a full investigation, whereas in a more affluent area a case might merit a point 2 and be investigated.
Mr J Kelly: So point 8 is even more serious than point 2?
Ms Gregory: A case assessed as point 2 needs an investigation and point 8 needs serious intervention.
Mr J Kelly: Could many things in the gap between point 2 and point 8 be missed?
Ms Gregory: Due to pressure on certain sectors, many things are missed. For example, social workers with heavy caseloads in specific areas may overlook cases. I am not saying that they do not have the same number of cases, but the problem is not perceived to be as serious as in other areas.
Mr J Kelly: Is that a question of incompetence, or managerial or financial difficulties?
Ms Gregory: It is a question of resources. Recently, social workers went on strike - an unprecedented move - and they made the point that resources are not available to cope with the existing caseloads. They cannot access day care facilities or community groups. They should be doing that, but they are not. They buy places in nursery day care provision instead of accessing a local community group. They pay £120 a week in some cases for a child to go into a day care facility when they could access the community provision that is much closer to where the family lives. There is a range of issues concerning resourcing, especially in social services.
The child protection training programme run by social services tries to raise awareness of child abuse and child protection. It also tries to raise standards within the community and voluntary sector. It is not just about prevention and protection. As Ms Poots has already said, there also needs to be input into broadening the range of issues involved.
Ms Poots: We would certainly not advocate waiting to collect all the information before doing something about the problem. If you were to take a strategic approach, you would determine the level of reduction you would like to see in child abuse. Given that much abuse is hidden, what we learn through the involvement of social services is probably only the tip of the iceberg. Any strategy is likely to increase the number of referrals to social services.
We need a strategic response, but it needs to be supported by evidence so that targets can be set. A good deal of information is available: the problem lies in collecting it so that we can see the overall picture. A working group or task force might be able to gather that information. However, there are difficulties with the information that is available through the court system and the legal system. It is a reserved matter, which is why we need an interdepartmental approach.
Some work has been undertaken to establish the cost of the troubles and how much victim-hood costs our society. That work will take some time to complete, but it is important that a start is made on that type of longitudinal research and establish how one person's experiences impinge on all the services - health, education, employment and so forth. We need to start with the information held and then add to it.
Ms Armitage: Your submission advocates funding to provide counselling and support for all persons who have experienced child abuse. What is your experience of the therapeutic services currently available? How can the Committee assess the scale of the need in this area? You also advocate more effective partnership with non-statutory organisations. What are the benefits of involving non-statutory agencies?
Ms Poots: Parents may tell you that something has happened to them in their childhood and they are having a hard time with it. You may have had many meetings with them, and it can take a long time for information like that to emerge. However, when they do reach that point, we could suggest that they should seek help. We would tell them where to get such help.
In Belfast there are only two organisations that can help them. Help cannot be found in the statutory sector. There is the Nexus Institute, whose personnel might tell you that you can have an introductory meeting, but there is a 10-month waiting list for counselling services. There is also the Rape Crisis Centre. Last week we were informed that the Rape Crisis Centre did not have enough money to keep its telephone lines going. Some time ago, I heard that the organisation received about £40,000 a year from the Department of Health, Social Services and Public Safety. I do not know how much Nexus receives: it would be a very small amount.
Let us look at the situation from the point of view of what perpetrators receive and the amount of resources and investment involved. We have small groups of perpetrators who are working through the probation services. Comparing the costs of working with a group of perpetrators with the resources being given to the victim/survivors would highlight a huge disparity in funding.
We have difficulty in finding places for people to receive counselling and support. With appropriate counselling support, people can often make life changes and move on. This is not necessarily the end of the world for somebody. It is worth investing in counselling support, because it affects a person's ability to cope with life, to move forward, to work, and to protect their own children and so forth.
Ms Gregory: People must be at least 17 years old before representatives of the Nexus Institute will speak to them; it also has a 10-month waiting list.
Ms Poots: The child protection procedure deals with protection, the cessation of abuse and the allocation of children to a safe place. Very little follow-up is available for the child to help him or her to deal with what has happened and move forward. The focus of the procedure is on removing the threat.
Mr Berry: Your submission refers to the need for a greater emphasis on preventative work. We have heard about the lack of resources and how more resources are needed. Which services prevent child abuse, and how can they be provided without stigmatising particular families or spreading the resources so thinly that they have no impact? Is that what happens with the resources that are provided for interdepartmental groups?
Ms Gregory: Interdepartmental projects such as Sure Start and Child Protection: Keeping Safe are multi-agency groups that examine those issues. All Sure Start organisations are managed by, or have directors from, the North and West Belfast Health and Social Services Trust and the other trust areas, the Belfast Education and Library Board, the education sector, housing organisations and so on - they are managed by people from right across such organisations.
We are starting to examine how best we can work in seamless partnership with all organisations, and we are examining issues that affect parents. Much money has gone into crisis management and into protection, as opposed to prevention. We must consider how more resources should be poured into those awareness-raising programmes that Ms Poots mentioned, such as Child Protection: Keeping Safe, and into projects that do not stigmatise, such as Sure Start and other worthwhile community initiatives.
Mrs Courtney: Your submission refers to the need for a comprehensive review of the entire judicial system that will redress the imbalance between adults' rights and children's rights. Can you give an example of how that imbalance operates adversely for children?
Ms Gregory: We examined last year's consultation document on the Protection of Children and Vulnerable Adults Bill. It considered disqualification orders that were made only in cases for which prison sentences or terms of detention for 12 months were passed down. In many cases, detention sentences are less than 12 months, which means that disqualification orders are not applicable. Some offenders receive reduced-risk sentences but still pose a substantial risk to children and vulnerable adults. It is essential that the Children (Northern Ireland) Order 1995, in which the child is paramount, should be taken into consideration as opposed to defending the rights of the alleged perpetrator.
Ms Poots: Adults can get a solicitor, establish their defence, and make their best case. A child is dependent on someone doing that for them. Successful prosecutions for abuse of young children are rare. Indeed, you may ask where children under six years of age are in the statistics. Those children are being abused, but how often do you hear of someone being convicted for abusing a child who is under six years of age?
People do not like to talk about that because they call it the paedophile's charter. Justice must be seen to be done. If you consider the number of allegations, the number that the DPP turns down and the number of eventual convictions, it is evident that only a small proportion is finally convicted. That does not mean that a small proportion of the allegations were unsound; it simply means that the process has whittled down the possibility of justice being done.
The Chairperson: Your submission states that it is essential to have a completely new culture of zero tolerance towards child abuse/neglect. That is a worthy aim, but it is ambitious. What steps could the Committee take towards achieving that goal?
Ms Gregory: In child prostitution cases, children are sometimes seen as being culpable for their own abuses. What protection and prevention services are provided for these children? What are the long-term implications for their health and well-being? There must be child protection in families and also in society. What will those children be doing in 20 years' time?
Peer abuse and bullying also needs to be researched. A Childline study conducted between 1994 and 1997 discovered that bullying was the greatest concern for 14% of the children who phoned Childline.
Ms Poots: There must be a change in attitude, and that has happened before. The anti-drink-driving campaigns took a long time to change the culture, but society now accepts that drink-driving is not right, even though some people still do it. In Scotland, there was a zero tolerance campaign on domestic violence. That would be a good model to follow.
It could take a concerted effort from everyone with a vision, including the political, statutory, community and voluntary sector, to take part in a media campaign for change in Northern Ireland. Abuse has been a long-standing problem, and Sure Start wants to change that. That is what we are about - a new future for children. If the Assembly takes the lead in sending out a clear message, it will start to get through. People are getting mixed messages, and they are unsure what to make of it. Much of the problem is a hidden taboo.
The Chairperson: Thank you very much for your helpful presentation. I apologise again for detaining you. Sure Start is heavily involved in inner city south Belfast, and the Committee thanks you for your work there. Some of our Colleagues are absent because there are many meetings on today. If Committee members have any further questions, they will write to you. We thank you most sincerely for your documentation and presentation, and thank you for responding to our questions.
MINUTES OF EVIDENCE
Tuesday 24 September 2002
Dr Hendron (Chairperson)
Rev Robert Coulter
Dr Alison Livingstone )
Dr Joanne Nelson ) Child Protection
Dr Sandi Hutton ) Focus Group (NI)
The Chairperson: I welcome Dr Livingstone, Dr Nelson and Dr Hutton who are from the Child Protection Focus Group. Thank you for the helpful documents that you provided.
Dr Livingstone: I thank the Committee for inviting us here today. I shall give a little background to the Child Protection Focus Group. It was formed in 1999 by a group of interested senior paediatricians who worked in the field of child protection. The group includes representatives from all four health and social services boards. Meetings are held every three months. One of the purposes of the group is to provide peer support and advice on child protection issues. We also like to review recent evidence, journals, training opportunities and so on. As paediatricians working in this field, the group is useful because our roles can be stressful and can leave us isolated - it is useful to share experiences. When we heard about the inquiry we felt that it was important to give our views on the situation in the Province.
The group consists of 14 members, all of whom have looked at the paper. I have produced a brief summary paper. Those whose names are listed in our submission, including Dr Kim Troughton and Dr Daphne Primrose, have responded to the paper and added additional comments. The other paediatricians on the list, from Dr Calum MacLeod to Dr Kusum Sharma, are members of the group who have not responded but are aware of the paper.
The first area covered in the paper is the roles and responsibilities of medical staff who assess children for abuse. It is important that all medical staff who deal with children have basic core training in child protection; can recognise when a child has been abused; and can refer such children to the appropriate professionals. Most doctors have some experience of child protection, but it is important that everyone receives basic core training. Existing training is a little patchy. When children are assessed for abuse, the medical evaluation should depend more on the child's problem than on the professional. The professional should have the skills necessary to assess that case; it is not sufficient that they have a particular medical background.
Two weeks ago, Dr Nelson attended a Royal College of Paediatrics and Child Health and National Society for the Prevention of Cruelty to Children (NSPCC) training initiative on child protection. This is the first time that the issue of core training for all professionals has been considered nationally, and we hope that workshops will be held to consider more advanced training. That will have implications for training in Northern Ireland.
Ms McWilliams: I am interested in the Child Protection Focus Group, whose work represents good practice. Is the group an informal one? Have there been discussions about putting it on a more formal footing?
Dr Livingstone: There have not been any to date. We have links with similar groups in England - the British Association of Community Child Health and the Royal College of Paediatrics and Child Health - which probably operate on a more formal basis. They have special interest groups that deal with child protection, and our representatives attend those meetings. However, our group does not currently meet on a formal basis. It came about because a group of people wanted to share experiences and consider best practice and guidelines.
Dr Nelson: Regional and national focus groups are encouraged by the Royal College of Paediatrics and Child Health, and any professional working in the area should subject themselves to peer review and support at regional and national levels. The practice throughout the whole of the UK is that any professional practising to any level in this field is part of a focus or interest group.
Ms McWilliams: The reason I ask is that, in the past, there were so many separate ways of working. Professionals came at the issue from different directions. There has now been an attempt to overcome that and to obtain greater co-operation and a better understanding of other people's work in this field. If you were to consider what you have learnt through this inter-agency work, what would you now say about Northern Ireland and its position in relation to the competencies among other professionals in dealing with child protection? You now have good experience of work in that field.
Dr Nelson: Training is the key issue. The current training programme for medical professionals and non-medical personnel is extremely variable across the Province. Until the training is standardised, that will impact at all levels of professionals' practice. There are pockets of gold-standard practice in Northern Ireland in some areas. Dr Hutton is practising at a very high standard; her practice involves inter-agency working, a multidisciplinary team, and joint medical examinations carried out by paediatricians and forensic medical officers. There is willingness in other areas, but the training issues have not been clarified. It is a multidisciplinary operation, and you cannot practice in isolation in this field. Training is one of our priorities.
The second priority is to ensure equity in resource provision throughout the Province. Some areas have access to appropriate equipment that meets gold-standard recommendations. A piece of equipment called a colposcope is important. It is like a giant magnifying glass with photographic equipment; you can take pictures of examinations to use in court, peer reviews, or for consultancy. The Southern Health and Social Services Board has three colposcopes; the Eastern Health and Social Services Board has none. Until there is equity in provision of such equipment and until standards in child-friendly settings are identified, there cannot be regional best practice.
Dr Livingstone: There are now clear guidelines. In April 2002, the Royal College of Paediatrics and Child Health and the Association of Police Surgeons produced clear guidelines for forensic assessment of children for sexual abuse. The equipment issue is obviously a feature in the guidelines. Paediatricians and forensic medical officers are covered by those professional bodies.
Dr Hutton: Perhaps I should comment on our practice in the Foyle Health and Social Services Trust area in Derry, which covers Strabane and Limavady. As Dr Nelson mentioned, we have good working practice on the ground. I have been the only consultant paediatrician in Foyle Health and Social Services Trust for the past 10 years. I have not yet managed to get another paediatrician appointed there. Over those 10 years, and because of the good working practice prior to my arrival at the Foyle Trust between my colleagues in Altnagelvin Hospital and the forensic medical officers, an excellent working relationship has been established on the ground between me, as paediatrician, and both social services and the police care unit.
We operate a practice whereby any child whom we suspect is being sexually or physically abused receives a medical examination from me, as the consultant, and from the forensic medical officer. That practice brings two areas of expertise to the examination and contributes hugely to its thoroughness. The skills of the forensic medical officer and the essential paediatric skills, which Dr Livingstone mentioned, are crucial when dealing with children. In other words, we must consider not just a piece of evidence, but the child as a whole, as well as the follow-up to the examination.
However, I emphasise that the practice is working because all health professionals who work in that area have mutual respect for one another, and not because our work is adequately resourced or funded, or even given recognition. I want to draw the Committee's attention to the fact that the submissions from the Western Health and Social Services Board and the Foyle and the Sperrin Lakeland Health and Social Services Trusts make no mention whatsoever of the work that I, or other paediatricians, do in the field of child protection. Nor does it mention my colleague Dr Erin Knowles, an associate specialist, who has done much work in the broader remit of drawing up frameworks for risk assessment. Healthcare was not even thought to be an issue in child protection. I did not know about that submission until after it had been sent. It was extremely social-services-orientated, and that is the problem with much of our work. I do not know whether healthcare professionals were involved at either board or trust level.
There is a huge gap between health and social services, and there are gaps in training and resources. The need for appropriate numbers of doctors to be available to carry out examinations when they are required by social services must be addressed. We provide a service through goodwill, but it is not recognised.
The Chairperson: It is good to know that, Dr Hutton.
Ms Ramsey: You said that it has been hard to recruit people over the past 10 years in the Foyle area. Is there a problem in encouraging paediatricians to get involved in this type of work, and, if so, can the Committee do anything to help? Much of the evidence that you submitted deals with child sex abuse. I am no expert in this field, but I am concerned. If I were a parent who was physically abusing my child, and I took the child to my GP because he or she had a broken arm, and, three months later, I took the child to an accident and emergency department with another broken arm, would the consultants and junior medical staff have access to one case file for that child that would list all the incidents?
Dr Livingstone: I work in Antrim Hospital, and the junior doctors who start work there each year attend a training session on all aspects of child protection to raise awareness of the problems. That training involves accident and emergency staff, paediatricians and surgeons, and it is gradually being expanded. The accident and emergency staff have access to computer systems, and, if they are concerned about an injury, they can look at the records. Therefore much work is being done to raise awareness.
Ms Ramsey: Is that information available to the GP as well?
Dr Livingstone: The accident and emergency consultant examines injuries every day, and if there were any concerns about a case, he or she would pursue the matter.
Dr Nelson: There is no mechanism to highlight the fact that a child has been taken to several different casualty departments. A child could be taken to Antrim Hospital one week, the Royal Victoria Hospital the next week, and the Mater Hospital the week after that. Although the child's GP receives a copy of attendance - in a sense, the GP is the focus - there is no computer system to join all the records. Therefore, if we were to see a child several months after the injuries started, it would be difficult to find out how many injuries that child had suffered, unless he or she was taken to the same hospital each time.
Dr Livingstone: Health visitors often pick up on multiple injuries, because they are sent copies of all hospital attendance records of people under the age of 18. Therefore they often pick up on the fact that a child has been admitted to hospital five or six times.
Dr Hutton: That is a training issue that must be addressed. Health visitors and designated child protection nurses are excellent. However, staff training must be adequately resourced.
On your original question, for my trust and the other poorly-staffed trusts, the problem is not recruitment - it is a question of funding. Community paediatrics in my trust has not received funding for another consultant or for adequate non-consultant staff. That issue must be addressed regionally if we are to provide 24-hour cover at that level. That cover is provided through goodwill in Foyle, but it must be established with a proper rota and facilities.
Dr Livingstone: If I am on call for acute consultant cover at Antrim Area Hospital and an acute child protection case presents, it can take two to three hours to deal with that situation. Therefore, it is not possible to provide routine cover for sick children as well as child protection. The rotas must be separated.
Ms Ramsey: The situation is that a patient can attend any hospital, but the GP will receive a record of the injuries. We are dealing not only with a lack of money, but with a lack of resources. Some cases of physical abuse could be missed because GPs are overworked - I am not thinking of the Chairperson as a GP in this context.
Dr Livingstone: Health visitors would pick up on that problem as they have a great deal of training in child protection.
Dr Hutton: I am involved in training teachers to deal with school-age children, as Dr Livingstone probably is in the Western Education and Library Board. All the special educational needs co-ordinators (SENCOs) receive regular specific training on physical abuse of children and non-accidental injury. Teachers are key, frontline people who see the children just as much, or more, than their parents do - they must have that awareness.
Ms Ramsey: Teachers must also be trained.
Dr Hutton: That is very important for teachers involved in the multi-agency work that we have referred to.
Dr Nelson: It is important to find a fail-safe method of communication so that there is a unified health system that can identify the fact that a child has presented in different places. One suggestion is that a National Health card be issued that could be marked each time a child presents.
Mrs Courtney: Coming from that area, I am aware of Dr Hutton's work in the Western Board area. On page 7 of your submission you recommend the establishment of a departmental working group to devise a regional policy and medical evaluation of child abuse. Specific areas are identified where the quality of service, skills, procedures and processes need urgent attention. Why were those issues not addressed in the past? Are adequate mechanisms in place for these matters to be considered continuously? If mechanisms do exist, why have they not been used? Dr Hutton spoke about the lack of resources - is that part of the problem?
Dr Nelson: Following a recent sub-advisory committee meeting at Castle Buildings, the Department of Health, Social Services and Public Safety commissioned the working group, which is on the point of being established. I am delighted about that. It did not happen sooner because child protection has always been dealt with at trust level. If I produced a business case for equipment it would be the trust's lowest priority, and until the priorities are set at regional and national levels nothing will change. I am delighted that the Department of Health, Social Services and Public Safety takes the matter seriously. In the Royal College of Paediatrics and Child Health, training is a topical issue. However, very little movement has taken place over the three years that I have been in post. Dr Hutton, have you seen much progress in the past 10 years?
Dr Hutton: None at all.
Dr Livingstone: A great deal of social services work focuses on child protection issues, but we are talking about the medical evaluation. We work in a multi-disciplinary way, but not much work has been done to unify the whole medical process in order to draw up procedures.
Dr Nelson: The medical evaluation looks not only at physical health; it looks at the child holistically in terms of development, nourishment and social interaction. That is where different skill mixes are very important, and that is why multi-disciplinary working comes into it.
The Chairperson: Most of the forensic medical officers that I know are general practitioners; very few of them are full-time forensic medical officers. Do they have any special training, apart from the training that they receive as medical students and primary care doctors in hospitals? They would be expected to have more expertise than the average general practitioner when they work with the PSNI.
Dr Livingstone: It is hard to know. We meet as a group, but I am not aware that the forensic medical officers meet as a group. Some of them are employed as general practitioners and work separately.
Dr Nelson: Training is required to be a forensic medical officer - they must have a qualification to take swabs and samples for DNA evidence. However, there is no standard level of training thereafter. No formal qualification is required for specifically looking at physical injuries to children. Training is done on an individual basis; it is a continuous professional development. We would like to have joint training for paediatricians starting at a junior level and continuing through to those who are practising regularly. They could train with our colleagues, and co-working could start at that stage.
The Royal College of Paediatrics and Child Health and the Association of Police Surgeons recommend that a register be drawn up of people practising at a higher level in this field. That would specify registration requirements; how much training is needed; how many cases are seen each year; what case mix is undertaken; and how professional development is maintained. However, that has not happened yet. Some of the forensic medical officers in the Belfast area are highly experienced in dealing with child sexual abuse; one has practised with a recognised leading expert in England. However, the others do not have any more expertise than other primary care physicians.
The Chairperson: You mentioned the Association of Police Surgeons in England. They were called police surgeons here until a few years ago, when, for obvious reasons, the name was changed to forensic medical officers. You have answered my question; some forensic medical officers have had experience and are very good, but no special training is given.
Dr Nelson: It is important that the Committee ask the forensic medical officers to clarify that. We cannot answer for them.
The Chairperson: I appreciate that.
Dr Hutton, you said that you are the only paediatrician in Altnagelvin Hospital and the entire Western Board, apart from a specialist adviser.
Dr Hutton: No, I am the only paediatrician in the Foyle Trust. There are five consultant paediatricians in the Altnagelvin Hospitals Health and Social Services Trust who, when I started working, agreed that any child brought to Altnagelvin Hospital with physical injuries of any sort would be seen by them in the course of their work. There is not a problem with that. However, child sexual abuse is an area where expertise must be maintained and a certain number of cases must be seen to maintain that.
I deal with cases in the community, and my colleagues in the hospital feel that they should not be involved in that. However, if a child presents with suspected sexual abuse they will involve me. Often the work can be scheduled in working hours or in the early evenings. It is rare that an acute assault would happen at the weekend that would need to be seen immediately. However, it does happen, and someone must be available because the level of expertise among the forensic medical officers is variable.
I tend to work with one or two highly-skilled forensic medical officers. I would like to think that we mutually respect each other's skill, and that that is fundamental to good joint working. I respect their forensic background, their knowledge of taking swabs, and their knowledge of wider forensic issues, including rape cases amongst older women, although we are not involved in such cases. The forensic medical officers respect my paediatric knowledge, which can be a great help in interpreting other findings.
Such knowledge can be useful when interpreting other issues for the courts. For example, in one case, a child suffered from attention deficit disorder, which was wrongly interpreted by the defence as attention-seeking disorder. The balance of the defence was that the child was merely seeking attention by making spurious disclosures. Due to my evidence on what attention deficit disorder really is, the alleged perpetrator considered the matter overnight and changed his plea to guilty. That was a great result. It is only one example of how paediatric input is important in the totality of a case, including the evidential side of it.
Rev Robert Coulter: The report is helpful. Are you aware of whether difficulties are caused by uncertainty about the current approach to confidentiality? If so, can you suggest what action might improve the situation?
Dr Livingstone: There are huge issues surrounding confidentiality.
Rev Robert Coulter: Will you send the Committee a written answer when you have considered the question further?
Dr Hutton: Yes. Do you refer to confidentiality with regard to raising an initial suspicion of abuse, or with regard to documentation?
Rev Robert Coulter: I refer to confidentiality matters in general.
Dr Hutton: I believe that your question is answered in the Children (Northern Ireland) Order 1995, in which a child's welfare is paramount. Confidentiality is considered to go hand in hand with that. However, there are different interpretations of confidentiality. The General Medical Council (GMC) has made its recommendations on confidentiality, and the Department of Health, Social Services and Public Safety has published a paper that contains its recommendations. When those documents are studied legally, there are minor discrepancies.
The Committee is probably aware that a paediatrician is being taken through the GMC because of what is considered to be a breach of confidentiality, even though he acted in the child's best interest. The Child Protection Focus Group would not be able to give an overview on that because the case will not be resolved easily. However, it is important that information is shared to avoid the scenario in which a child's information is not disclosed when he or she turns up at a different centre.
Dr Livingstone: When certain cases come to case conference, GPs can hold information about parents that nobody else is aware of. That has an impact on the child's health.
Rev Robert Coulter: That is a matter of concern.
Ms Ramsey: The Children (Northern Ireland) Order 1995 makes the welfare of the child paramount. On page 5 of your submission you state that a child-friendly facility is vital. You mentioned the need for additional money and resources. How many examinations are carried out in facilities that are not child-friendly?
Dr Livingstone: That is not relevant to us because we carry out examinations in child-friendly settings. That point refers to examinations that are carried out, for example, in accident and emergency departments, where forensic medical officers are involved, and in care units.
Dr Hutton: We examine children in paediatric clinics or outpatient centres that have been designed for children. However, those facilities do not have the additional equipment that is required to carry out examinations for sexual abuse, such as the colposcope.
Ms McWilliams: There ought to be better protocols with regard to confidentiality. Many problems have ended in tragedy. Some of those problems may have been due to incompetence or a lack of sharing of practice, but during my research - my expertise concerned research into domestic violence rather than sexual abuse - I discovered that there was huge reluctance within the medical profession to breach confidentiality. Some of those tragedies may have been due to that factor. However, much progress has been made, and guidelines have been developed that put in place the process of sharing information. Previously, people knew what information others had, but did not want to share that information. Women used to say to me "I knew that he knew, and he knew that I knew, but he knew that I knew that I didn't want him to know." It was a sort of game - there was a fear of telling and a fear of talking. I asked doctors - most of whom were male - whether it would be better to confront the issue, and they said that it would. They also said that information must be passed on and referrals made.
The Jasmine McGowan case is one of the issues that led the Committee to hold the inquiry. There was some criticism that, although a paediatrician examined Jasmine, but the fact that there was a problem was not highlighted. That may have been due to problems with confidentiality or the sharing of information. I hope that the guidelines that are being drawn up for paediatricians demonstrate a good practice of information sharing so that people do not keep information to themselves.
It is important to learn lessons from children's deaths, but there is no protocol for child death reviews. What is your opinion on that? Will the guidelines lead to clarification of the confidentiality issue? Until that is included in training there will be a huge reluctance to share information. Some uncertainty also surrounds the medical evidence required to prove shaken baby syndrome. In some cases people have said that they are not sure whether it was deliberate. Would a child death review help to address those issues?
Dr Livingstone: A group has been formed, through the deputy coroner in Belfast, to examine sudden and unexpected deaths in infancy. That group involves paediatricians from the four health and social services boards and the children's hospital, as well as pathologists and radiologists. It will examine other protocols and introduce guidelines. In England, there are protocols that must be followed in the event of such occurrences. The group has met about three times, and seems to be meeting monthly.
Dr Nelson: That deals with the medical review only.
Dr Livingstone: It deals with the protocols that should be followed when a child arrives in hospital, what investigations should be carried out, and who should gather the evidence.
MINUTES OF EVIDENCE
Wednesday 25 September 2002
Dr Hendron (Chairperson)
Rev Robert Coulter
Mr J Kelly
Mrs I Robinson
Mr S Hollander ) KidsVoice
The Chairperson: Mr Hollander is the executive director of KidsVoice and is based in Pittsburgh in the United States. Mr Hollander, you are very welcome. You are a famous man.
Mr Hollander: Thank you. It is my pleasure to be here.
The Chairperson: You have come a long way. I heard that you were enjoying some of our scenery over the weekend, but we will not go into that now.
Mr Hollander: I appreciate the fine weather you have arranged for me on this trip.
The Chairperson: It was no problem, we do that all the time here.
We are conducting a child protection inquiry, and I know you have much experience in such matters. Please make some comments, and then members will ask you questions.
Mr Hollander: I will preface my remarks by saying that I recognise that there are fundamental differences between the resources, structure, systems and policies of the United States and those of Northern Ireland. I will try to focus my comments on the general areas of overlap. In the United States, every system that deals with children and child welfare is under-resourced, and I am sure that the same is true in Northern Ireland. Our children do not vote, and they do not create accountability for anyone that deals with them - that is for someone else to do. They often fall through the cracks and things do not change.
In the United States, politicians pay lip-service to children's issues, because, fundamentally, they have to be re-elected every two, four, or six years. It would take longer than that to truly change the way in which the system works, and to see the resulting dividends for children. However, attention is given to where savings can be made, because this is all resource driven. Many of the changes that have been implemented in the United States have been around making good choices for children and their families, and, where that happens, ensuring that there is a net saving of money to the Government, so that everybody wins. I find that unless you do both, it does not happen. I would be excited to hear that things are different in Northern Ireland and that additional resources are being provided to children regardless of the cost to the state, but I would be surprised if that is the case.
I will talk about our organisation so that you will have an understanding of the perspective that I bring when I make these comments and answer your questions. KidsVoice is a legal advocacy organisation. It provides legal representation and advocacy to children who are mainly involved in abuse and neglect cases in the Pittsburgh/Pennsylvania area in Allegheny County. In the United States, every child who is involved in a court case involving abuse and neglect proceedings - or what we call "dependency proceedings" - is required to have an attorney to represent them. In some states, they represent the child's wishes in a traditional attorney and client relationship, which is how I recognise that a courtroom lawyer advocates for children in Northern Ireland. In other states, an attorney serves as a guardian ad litem advocating in court for what is in the child's best interests, even though that may be different from what the child may want.
In Allegheny County, we represent 5,000 children every year in court cases. Over 2,000 of them are in foster care every year. I have a staff of 40 professionals who work on those cases. Twenty of them are attorneys, and the others are called child advocacy specialists, because we have not come up with a better name. They have backgrounds in social work, child development, psychology, substance abuse treatment and domestic violence treatment. They have all been service providers in their own right, or they have come from private foster care agencies that work with children and foster parents. They work with the attorneys so that we can come up with an individualised recommendation about what is best for each child and family, and we walk into court with that. We request particular resources, because our social services system contracts with agencies to do high volume work. Therefore, an agency will agree to take on all the sexual abuse cases and provide counselling for children, and another agency may provide mental retardation services. If a child is sexually abused, they go to the appropriate provider. However, if a child is sexual abused and mentally retarded, I do not have a good choice for them - they have to go to one place or the other. We do not have that cross over. We are able to find something that is more individualised and appropriate.
All of that means that we spend more money upfront on cases where our office gets involved.
We have switched our system to what I call "front-loading". We spend more time and money at the beginning of the cases, with the idea that we will walk out of the first court hearing - or care-planning meeting in your case - with a detailed plan that provides services for the child and the family that are outside the normal services. If the family is going to be successful, it will happen sooner. If that happens, the child will come out of foster care sooner and go home sooner. We stop paying money for foster care, and the net result is that we save money. That is our approach, which is a little different.
The Chairperson: You have talked about state and private resources. Are there any state-resourced advocacy services for children in the jurisdictions that you practice in?
Mr Hollander: Yes. Our agency is a private non-profit and independent organisation. However, because state law requires that children receive representation from attorneys, we have a contract with the county to provide that service. The county uses a combination of federal and state dollars to pay for our services.
Mrs Courtney: You work closely with experts from various disciplines. How are their services paid for? If you are successful, do you recover the costs? What happens if you are unsuccessful?
Mr Hollander: That is a good question. I wish we could recover the costs in all cases. That is all on us. We are paid an annual per child rate of $450 to represent children, which is a pathetic amount. On average, those are cases that go into court four times a year. It is exciting, because the agency has almost quadrupled the rate since 2000. We have had a massive influx of resources, but it is still not enough for our needs.
We have experts in our office. That is how we grew and added the other component. When we quadrupled our funding we could think about how we wanted our advocacy to be. For other experts though, we depend on the generosity and goodwill of people who care about kids. We have good relationships with the paediatricians at our local children's hospital, and with psychiatrists, psychologists and experts on substance abuse who often call us to help them on cases or to take their cases into court when they feel that social services have not investigated a case thoroughly, or when a case needs more attention. We have a quid pro quo arrangement, which allows us to get additional help from them. Once in a while, we have to dig into our coffers and pay for that expert. We can also go into court and ask for a psychological evaluation to be conducted at the expense of the social services agency. Sometimes the court will pay for those services.
Rev Robert Coulter: Do you act for children who are too young to express opinions? In that situation, how do you form judgements about what is in the best interests of the child?
Mr Hollander: The children that we represent range from newborns to 18-year-olds. In our system, if the case begins prior to the child's eighteenth birthday, and the child is still in a course of treatment or education, he or she can stay in the system until the age of 21.
There are many instances of children who are too young to express their wishes. It is difficult to ask a three and a half-year-old what they want, or to explain a complicated situation to them involving their family, or drug problems or custody disputes, and expect an informed answer from them. It is important to try to educate them when possible. It is not our philosophy to advocate solely for the child's wishes, although that is a huge factor when determining the best interests of the child. We spend a great deal of time developing a relationship with the child, and we are often able to educate the child enough to realise that the hearing may not have their desired outcome. Virtually every child wants to return home to his or her parents, regardless of how severe the abuse or neglect in the home. Sometimes the child can begin to see that that is not in their best interests, so that educational aspect is important. Our recommendations are based on what we have learnt from talking to family members, coaches, day-care providers and anyone else who plays an important role in the child's life. Our approach is thorough, so we have a good sense of what is going on.
I stress that the child's wishes are very important. In every case, regardless of whether we agree with what the child wants in advocating their best interests or whether we disagree with what they want, we let the court know what the child wants and the reasons for that. I can promise the child that I will communicate their wishes to the court and that the court will hear them. They are used to someone else calling the shots in these cases, which go to court every three months. If the child knows that what they tell me will be heard in court, a rapport develops, even though they may be angry because I have disagreed with them. That is an important part of our work.
Mr J Kelly: I shall give an example of a case, which may help you answer my question. I received a phone call yesterday from a single mother who, because of an ongoing situation, wants her 12-year-old son to be taken into care. I then have to ring the social services. In that case, the child's opinion has not been sought - the decision has been made for him. You mentioned an advocacy system. Can you talk a little more about that?
Mr Hollander: The arrangement that has been described in that hypothetical case - or perhaps not so hypothetical - is voluntary. Such arrangements are common; people call up and ask for help all the time. In America, parents can have a child placed for up to 30 days without bringing the case into the system. Parents may ask for help, but do not want their child to be placed in care, and so the family remains intact. Those cases go into the social services system but never go to court because the families are co-operating and managing the situation themselves. As long as that happens and the child remains at home, the case will not be brought to court. The case would be brought before the court only if the child were removed from the home. In some cases, the parent may simply be frustrated with the child, and would like to have them placed in a residential treatment programme or facility for a time. Some really good options may not have been explored. For example, the child could be placed in the care of a relative, family friend, minister, priest or someone in the congregation who would be willing to take care of them. We would become involved at that point, and our role would be to advocate solely for the child's needs. We do not worry about the cost or who covers it, the public reaction or the parents' wishes, although it is important to be aware of all those things. We simply consider the child's situation. The child could be sent to a group home or a foster placement miles away. They could be in a new school district, and they might be separated from their siblings and family members. They may then feel awful about what has happened. Perhaps that all arises simply because mom could not cope at the time. For example, if she is recovering from substance abuse, she may feel overwhelmed and need help. Perhaps coping with her troubled teenager will put her over the edge. In that case, she has made a wise decision for herself - a stressful home life may cause her to relapse.
Mr J Kelly: In those circumstances, you go with that situation.
Mr Hollander: After the 30-day period, the case would come into court, if it were a voluntary placement. KidsVoice would meet with the child and find out what made sense. If it were an involuntary situation, we would be on the case immediately. The case would come to court within 72 hours, and KidsVoice could challenge the placement that was made.
Mr J Kelly: Can KidsVoice take a case to court?
Mr Hollander: It can take a case to court. For example, the child in that case might be upset about what has happened and feel that social services were complicit with the parents in trying to put the child somewhere, when the real problem is with the parents and the fact that the services are not in place for that child to be able to go home after 30 days. They might, for example, want to stay with their Uncle Bill. KidsVoice might bring the case to court and argue that there is a better option, and that Uncle Bill is willing to take the child. The American system pays relative caregivers the same as foster parents.
Ms McWilliams: That is the difference.
Mr Hollander: Although there is a cost for that, it is a lesser cost than that of putting a child in a residential treatment facility, which would charge a much higher daily rate. The child is back in the school district, lives in the same neighbourhood and has contact with his or her family. I have no doubt which is the better choice in that scenario. It happens to be one that also works out best financially.
The Chairperson: That is helpful.
Mrs I Robinson: Mr Hollander, you mentioned the issue that I want to raise - that of a situation in which a child is able to give instruction and it differs from what you feel is in the child's best interests. You mentioned that you would make it known in court proceedings that there is a difference of opinion. Is it always the case that the adults get what they want, as opposed to what the child wants?
Mr Hollander: That is not the case every time, but it is most of the time. It has taken KidsVoice a while to bolster the quality of its advocacy and the depth of information that its recommendations are based on, to the extent that the court will defer to KidsVoice over social services in some cases. It is much harder for a child to do that. However, it does happen. The child will talk about what he or she wants and is given the chance to sit down in the courtroom and talk into the microphone about how frustrated he or she is. Sometimes the child has done everything that has been asked of him or her, but the parents have not. Therefore, the child cannot go back home.
However, in some cases the judge will say to the child: "Fine, we will let you go home, and we will follow that recommendation". Often, if the case is a close call, the judge will allow the child's point of view to be heard and wishes to be granted. However, the judge will recognise that there are strict measures that must be followed, and monitoring that must happen in order for the placement to continue, or for the result to be what the child wants.
Mrs I Robinson: If a case goes against a child's expressed wishes, does that child become a problem when he or she is relocated? Do children, for example, run away or do damage to themselves to get attention?
Mr Hollander: There are problems. I like to say that children vote with their feet; if they do not agree with a recommendation they will run away. Ironically, the American system rewards that.
I dealt with a case a few months ago in which a child who could not stay at home wanted to stay with a friend's parents. That was also an inappropriate placement as there was a history of drug use, and of not monitoring either that child, or her friend, in her friend's home. The child was, therefore, placed in another group home. She ran away. KidsVoice did not know where she was. She was found prostituting herself on the street to get money to live on. The case came back to court. I then had a real problem. However, if I have a choice between leaving a child on the street to fend for herself, and putting her in a home that may not be ideally appropriate, it is not a hard choice.
With regard to the cause that you suggested - I do not believe that children run away because of their wishes versus their best interests. They just do not like the result of a case. Whether I advocate for them as a traditional lawyer would, and say, for example, that a child needs to live in particular home, and lose the argument, or whether I advocate for their best interests and win the argument, and they do not stay where they want to stay, they will run away.
The difference is - and this approach is important to our philosophy - that I will tell the child that I know that he or she really wants to live with the family and does not want to be in the group home. I will say that although I cannot recommend that placement in good faith at present, if the child will stay in the group home for the next two or three months, I will work with the family that they want to live with to see if there are services that they need, and whether they are willing to take the child. We cannot assume that the family is willing, because often they are not. Or, in the meantime, we will arrange for the family to visit the child in the current placement, and, after a month or so, the child might be allowed an overnight visit, which might extend to weekend visits. Therefore, with each hearing as the case progresses, the child can see that I am working towards what they want, even if they cannot have it all immediately, which may be difficult for a teenager to accept.
Part of it depends on how you relate that to the child. Hope can prevent the child from running away, although that does not happen all the time. Children get frustrated, or something bad happens in the group home, or they get disciplined, and they run away. We cannot lock children up unless they commit a delinquent act. Every system must deal with that difficult issue, and there are no easy answers.
Ms McWilliams: I was interested to note that you devote a great deal of support services towards own-family placements. Here, foster parents get remunerated, but, if a member of the child's family were to look after the child, they must cope with the expense in addition to the expense of looking after their own children. Yesterday we asked social workers about that issue, and they said that that is exactly where the problem lies. They cannot give enough support services to the child's extended family, who are the first people that you might think of turning to. Hence, children here often end up in foster placements. How did you switch that around in the United States to fund payments and support services for placement with the extended family rather than with strangers?
Mr Hollander: That is a good question. I talked to some people in the last few days, and I have heard different reports about the funding that is available for family members. Rules may differ from trust to trust. The Committee should examine that and clarify the system. I understand that some laws or Regulations may allow relatives to claim a similar allowance to that given to foster parents.
Assuming that that is not the case, I will talk about what happened in the States. We have had a shift in attitude. Until about five years ago, we did not think that placing children with family members was a good option at all. There was guilt by association - for example, why place a child with the grandparents who brought up the parents who were unable look after the child? There was also a concern that a family member would let the parent have access to the child, thus skirting the issue.
We started to ask where the children wanted to be, and how we could keep them safe, and we looked at the cost issues. Children were failing in foster and group placements. There were many benefits in having a family member who was willing to take the child. As I said in response to Mr Kelly's question, the opportunity to keep the child in the community around people they know, and the potential to place siblings together - which we can almost never do - is much greater if we place them with family members. That was part of the beginning of the shift.
The system began, and it was successful. However, it was limited because the family members did not have the resources to look after the child. They were not wealthy families. When you add another individual child, or sibling group, into the family without providing financial support or services, the issues become very complicated. Therefore, we began to examine that. Our first response, as a society, culture or child welfare system, was to say that we should not pay families to take care of family members - that is their obligation.
That changed because we saw a need, and it was decided that, although there would be no foster-care payments, a lesser amount would be paid. Someone who cared for a family member became eligible for social security income of a little less than $200 a month for each child. That is far less than is paid for foster placement.
We shifted again, and decided that that was not enough and that we really had to make it work. Leaving the philosophical issues out of it, and looking at it from the cost point of view, children do better if funding and resources are provided for family members to care for them. There is a cost saving in that. First, it is very expensive for us to have to change placements. If a placement fails, a child has to go into shelter for a while, at a much higher rate, until another home is found. Sometimes that is at a higher level of care, because the placement failed. There may be psychological issues to deal with, and more is paid for that home. It is less expensive for us to keep the child with the family member who might not throw in the towel when things get rough and might agree that that is where family obligation kicks in and that he or she should not give up on a nephew or grandson.
That has been part of the overall shift, and family members are now paid as foster parents as a matter of course. It is really the best placement. Ideally, the best place for a child is with his or her parents, if that works. Our second preference is with family members who are supported and are given the services. Some families do not want the services; however, if the services come with the money that means that they are treated the same as other foster placements and are expected to provide a similar level of care. There are problems there too, but those families are more likely to take advantage of the services provided to ensure that the placement is successful.
Ms McWilliams: I am sure that you have come across cases of tragedy. This inquiry is a consequence of the Jasmine McGowan case, where a small baby died and one parent was prosecuted. There was a case review; however, in evidence yesterday the Committee heard that the findings of case reviews are not widely disseminated and that the recommendations do not often reach the social workers, health visitors and paediatricians who were involved in the case. What happens in the United States after a child's death with regard to building better practice? Has that changed dramatically over the years? Have those tragedies meant that the number has been reduced as a result of the protocols now in place?
Mr Hollander: You asked several questions, and I shall break them down. First, it depends on how the tragedy or death happened. If it was in the foster-care system or the child welfare system, there is a review process to examine such cases. They are confidential. Some of the recommendations or results may cause change in policy, but their source may not necessarily be known. I venture to say that that is probably because the United States is the most litigious society in the world; all kinds of liability concerns result from death review cases and people worry about that. Those concerns are not as prevalent in other countries; a driving factor there is taking what was learnt from a case, and explaining and implementing it to make a change so that other children are not hurt. If there is any medical involvement in the death of a child - even if there is no child welfare system involvement - there will also be a medical death review, because something was missed. The Briggs case here falls into that category. There was perhaps no child welfare involvement, but something in the medical involvement could have been done differently or better.
We learn much from such cases and policies do change because of that and because of the fear of liability. I wish I could tell the Committee that all of it comes from a desire to do better for children and families. Part of it, however, is that no one wants the system to be in a position of potential liability. Northern Ireland is not alone in scrutinising the system to see what is happening and how a death or tragedy could be prevented. That happens. There have been great changes in how cases are dealt with.
One recent example resulted in cases no longer being dealt with on paper. Our cases are reviewed at least every six months. Everyone has to go to court for as long as the case lasts. Cases can last from when a child comes into care until the case is closed or the child reaches the age where he or she is no longer covered by the system. Cases are usually reviewed every three months, but six months is the minimum. Those cases used to be dealt with on paper. My office would sign off on paper, as would everyone else, and the case would not come before the judge.
The details of one child's case were not accurate. The child was back home with the parents. The services that had been ordered had never been provided. However, the caseworker had told everyone that they were because the service provider told the caseworker that they were, but no one had checked. The child, who was two and a half-years-old, died from neglect and weighed seven pounds. Her body was mummified. The housing police had received reports but had never checked them out. The child had been dead in her home for a long period. It was a horrible case, so we stopped dealing with cases on paper. Everyone had to be present when dealing with the case, including the child. Those changes were made in response to that case.
I caution the Committee that those types of tragedies do not happen because of bad policy. It does not require a change at national, state or system-wide level to prevent that. It was not a bad policy that led to the child's death; the policy was not implemented well and was not followed through at local level. The resources were not available, and there was no accountability. That is your challenge - not to rewrite and change everything, but to ascertain where it is beneficial to add more resources to do things differently that will change the lives of children and families.
Ms Armitage: I assume that KidsVoice is run as a business and that you are the executive director. How many staff do you have? You used the term "cost savings" quite often, so you are obviously very cost-conscious. What is more important in your business: the child or the income?
You also said that you make the decisions. Are you ever concerned about the amount of responsibility that you are personally taking on in making decisions about children? How are you so convinced that you are making the right decision? Is your company responsible for the child from day one until that child is settled in with a body or organisation that you can call on? I find you interesting, but I am more interested than impressed.
KidsVoice appears to be a business. Are there other businesses like yours? What are the obstacles to operating such a service? Such a service, by its nature, must be independent of the state. Can you clarify the business element? Businesses obviously make money, and there is nothing wrong with that. However, I am concerned about the cost savings that you mentioned so often.
Mr Hollander: I have jotted down most of your questions, but feel free to jump in and repeat them. We are a non-profit organisation. We do not operate to make money; we are here to serve children.
Ms Armitage: Does your business make no money at all?
Mr Hollander: We make no money. I am paid a salary, but the business does not have profits or shareholders. We are a business. I have staff. I have to run a payroll and pay benefits. I must have people do the work. Every one of my staff could make more money doing something else. The starting salary for lawyers at KidsVoice is $35,000 a year. They could make three or four times that doing something else. They are there because they want to be able to make a difference in children's lives. They are willing to sacrifice their personal and family income to come and do that. I must figure out where the money comes from. I have to meet my budget.
Even at the level of funding that we are at now, it costs about $510 a child to provide a level of service. That is not adequate for all of our kids. We are able to serve three fifths of our children at that amount. The rest of our children are not working with the multidisciplinary team, but with one lawyer who has to advocate for 500 kids a year. It is not fair that they are in that situation. They are randomly selected to do that. I may be going a little far afield; if I have lost you, let me know.
We get paid $450 to provide that service. I pay $510 out of my budget to do that. No business would do that. If you were in business, and your customer paid you less than what it cost you to provide a service or a product, you would say "No". I must rely on raising money from foundations, from individual contributions and from the goodwill of my staff, who could do far more for themselves and their families somewhere else. We are not there to impress anyone. We are there to keep people interested in children, to keep their focus on children, and to recognise what is going on so that we can make a difference in children's lives.
You asked me who am I to make that decision.
Ms Armitage: It was a general question.
Mr Hollander: It is an excellent question, and one that we make an important part of our training. One of our guiding principles as an organisation is to recognise the awesome nature and responsibility of making recommendations to the court about what will happen in a child's life. We all have to take that with incredible sincerity and humility as we approach our cases, and that is what we do.
Lawyers are not trained to have humility. Lawyers are trained to be arrogant. They can go into court and handle a complex case in any area of law; they can take an expert witness who has 20 years of experience in the field, cross-examine them and make them look like a fool in their own area of expertise. That takes arrogance, not humility. So I have tried to create a multidisciplinary team to give us more information so that we can make better choices. As a lawyer, I cannot make as good a recommendation as I can when I am teamed with a psychiatrist, who can help me to understand what is happening from a child development perspective.
We had a case in which I thought the kid was doing well. I got the child development assessment, and it was in the ninetieth percentile across the board at every level. I showed it to my teammate on the case, who has a master's degree in child development and has been doing this type of work for 18 years. She told me that the area that brings the child down from 100% in each of those areas deals with a particular area of development of the brain that relates to the ability to develop language skills, and that if we did not put in place some services to address that, the child would be at a disadvantage. I never would have known that. We are able to bring that approach to everything that we do, when we talk to caseworkers, or when we ask the court to do something different. That child would never have received that service if our office did not have that capacity. When you are dealing with serious issues of abuse and neglect, that sort of case does not stand out as one that needs our limited resources. When you can say that the child will succeed if we do this, then the child gets the resources.
Ms Armitage: Not all of my questions were answered. What is more important to you, the child or the income?
Mr Hollander: I thought I had answered that. It is clearly the child.
Ms Armitage: Do you look after the child from day one?
Mr Hollander: From the first day that the case comes into court, we staff the courtroom every day. You have a 72-hour period where a child has to come into court if they are removed from care, or if there is a request to have a child removed from care. We take the case at that point. We take it through the system until the child becomes too old. We try to keep the same team of attorney and child advocacy specialists with the child to give continuity because there is tremendous turnover in this field. Having a team means that if someone leaves, a person who is unfamiliar with the case does not take it over. They come in and join with their teammate, who already has that continuity.That is part of what we are trying to achieve. That is very important for the judge as the decision-maker, and it is important for the advocates and the caseworker to be able to stay with that child and family.
Mrs I Robinson: One important question needs to be addressed. You deal with vulnerable young children, and you will be aware of all the controversy surrounding paedophilia and paedophiles' desire to work with children and get close to them. Does KidsVoice have an in-depth screening process that potential employees must go through before they can work with those children?
Mr Hollander: Unfortunately, it is not required by law for us as attorneys to do that. However, we carry out background checks on everyone who is to work in my office. Those checks include criminal histories and child abuse clearances. Those are not just for criminal cases involving child abuse; they also include any referral to social services for an investigation involving that person, whether as a parent or as someone who was investigated, regardless of the outcome. We can access some of that information, which we call Childline referrals. I would like to think that our interview process is also good.
Paedophiles and perpetrators of domestic violence can be remarkably charming and convincing. They have to be if they are to be successful in the horrible things they do to others. They are able to convince you, so it is important to have those checks. All kinds of cases come up where those checks were not made on a social worker or a service provider.
Our residential treatment facilities pay people little more than the minimum wage to deal with these children. There is huge turnover, and, therefore, such facilities are difficult places to staff. There have been cases of sexual abuse in those homes. Some young people right out of college, 21- or 22-year-olds, are dealing with 16- or 17-year-old kids who have been sexually abused in the past, who themselves are promiscuous and manipulative. There are situations where they get involved sexually with the same children whom they are supposed to be counsellors for in those facilities.
That relates to the question asked earlier about reporting. Do I know about that? Do we find out about that? They are required to notify the state when that occurs, but, critically, we do not have access to that information. Suppose I have another 15-year-old who has been sexually abused, and I have a choice of two different placements where I could put the child. If I do not know that one of the placement choices has a charged atmosphere because of a recent sexual relationship that has been reported, I would be doing my child a great disservice in placing her there versus somewhere else. I do not get that information unless I happen to find it out from a news story or something similar.
Mrs I Robinson: Are there any moves towards addressing that concern because you are dealing with the most vulnerable in society?
Mr Hollander: We are doing much more on that. It is required for all of us. We do not get the disclosures, but the background checks are being carried out in more and more areas. There is legislation that requires background checks on Boy Scout and Girl Scout troop leaders. Some of this is legislatively driven, some liability driven and sometimes it is just good practice. We have had several cases where coaches have had inappropriate sexual relationships with children. Therefore, more and more coaches are now being required to be checked before they can do their work.
Child abuse offender registries have come into play in the United States in the past five years. Those are based on a case of a little girl from New Jersey, named Megan, and are known as Megan's laws. Those things have occurred. It is challenging because almost every state that has done this has had the law struck down as unconstitutional, and it has had to be amended because of the civil rights issues that come into play. I shall not go into the whole history of that now.
Mr J Kelly: Pauline Armitage's question about kids was appropriate. If you did not do this work, are there state agencies to do it?
Mr Hollander: There are no state agencies; however, there are Public Defender Offices. Most of the counties without such significant populations as the 5,000 children that we have in Allegheny County in Pittsburgh contract with individual lawyers who do this as part of their work. Sadly, they cut their teeth on these cases because they cannot get other work, and they are paid a certain hourly rate. Some agencies do that, and some have more resources than we do. No one else, however, has the multidisciplinary approach, which is important to the issues of humility, good practice and advocacy that we discussed.
The Chairperson: Mr Hollander, this is all part of our child protection inquiry, and we are very grateful to you for coming today. You are obviously a man who has much experience and expertise in this matter. On behalf of the Committee I want to thank you; it has been very helpful to us.
Mr Hollander: I will leave you with one other thought concerning resources. In one respect I am jealous of what you have. In the United States our funding comes from different streams, and if I use mental health dollars I cannot use child welfare dollars or mental retardation dollars for that same child. Therefore, we have to figure out where to go and what services are available. As I understand it, Northern Ireland has a pooled fund of money to serve all children and families, and you can, therefore, come up with innovative solutions, perhaps in a better way than we can. Often I cannot get the dollars to allow that.
One of our biggest changes has been in managed care. The United States does not have a socialised medicine programme; there is private insurance. No one, therefore, wants to pay a great deal of money for the children in our system. Take for example, a child who has failed multiple placements and could be put in the old foster home, but the foster parents do not want her anymore because she is so difficult. If I ask those foster parents whether they will take her if they have respite care every weekend, intensive services in the home for 20 hours a week and hospital psychiatric treatment of 20 hours for six weeks for the child, they say "Yes". Previously, I could never get the funding to do that.
Your system allows for those innovative placements in which no more money is spent on a residential placement than is spent on an existing placement where many more creative resources could be placed in the home. The beauty of it is that money is saved by keeping the child out of the residential higher-cost placement. When the services become less, the child stays in the place where she is already doing well, as opposed to doing well in a very intensive, supervised environment and then having to experience a transition to somewhere else. Transitions are so difficult.
I encourage you to find ways through which you could really take advantage of a beautiful part of your system. It requires a good deal of thought and creativity, but it will not cost you money. If it is done well it will save money.
The Chairperson: Thank you; that is very helpful.
MINUTES OF EVIDENCE
Wednesday 25 September 2002
Dr Hendron (Chairperson)
Rev Robert Coulter
Mr J Kelly
Mrs I Robinson
Dr E Vizard ) Consultant Child and Adult Psychiatrist
The Chairperson: The Committee welcomes Dr Eileen Vizard, a consultant child and adolescent psychiatrist in London, who has a great deal of expertise in those matters. We look forward to hearing your presentation.
Dr Vizard: I thank the Committee for inviting me to address the child protection inquiry. As time is short, I have brought only certain materials with me. However, I have access to other published literature and material, which I can make available to the Committee, if it so wishes. The young abusers project in London, with which I work, would be happy to play host to a small delegation, as that would allow us to talk about complicated matters in more detail. If the Committee were interested, that could be arranged.
The Chairperson: Thank you very much. It is good to know that.
Dr Vizard: I can also circulate some research into children who sexually abuse. The handouts outline some preliminary findings. Moreover, because I was asked to, I shall circulate a brief curriculum vitae. If the Committee would like to know more about what I have done in the past 22 years, I shall happily oblige.
I hope that I do not seem presumptuous, but I have chosen topics that I thought that the Committee might be interested in. First, I shall talk about children who sexually abuse other children and about the need for services. I shall then provide some information on the situation for children who are defendants in the court - all defendants, not only those who are sexual offenders. I have brought with me two recent reports from conferences in England on the human rights and needs of child defendants. I also have a publication pack and much academic information to pass around. I apologise for bringing so many handouts.
The Chairperson: The more information that we can get, the better.
Dr Vizard: I shall also touch on the need for pre-trial therapy for those children who are witnesses and those who are defendants in abuse cases.
I shall talk about my experience in England of part 8 reviews - serious case reviews. I think that they are called part 12 reviews over here. I shall discuss the need for the children's commissioner to develop a strategy to provide medium and long-term training for staff that carry out that complicated work. I also wish to ask the Committee a question that it may find difficult to answer: what effect have the troubles had on the mental health of children and on child protection concerns? That is an important question.
The Chairperson: Child protection is a massive subject. Much work has already been carried out, but the process is ongoing. Children on both sides have been affected. However, if you wish to comment on the matter, please do.
Dr Vizard: Some information on children who sexually abuse other children is contained in the handouts. The problem is significant and prevalent. Between 30% and 50% of all sexual abuse of children is now thought to be undertaken by other young people under the age of 21, and much has been written about that. When discussing resources and service creation for that group, it is important that adequate resources are put towards the assessment of children and adolescents who perpetrate that sort of behaviour. Therefore, many children inflict significant harm, as defined in the Children Act 1989, on other children.
The second issue about children who sexually abuse other children is that there is a range of behaviours, but I do not have time to go into great detail on that. However, you will hear evidence tomorrow from my colleagues in the National Society for the Prevention of Cruelty to Children (NSPCC) in Northern Ireland who already run services for that group, and, if necessary, they can give you more information. We are talking about children possibly as young as six, seven or eight who are exhibiting over-sexualised, persistent, coercive behaviour that will not respond to the normal social sanctions. Those children then go on to perpetrate much more explicit, penetrative abuse of other children's bodies when they reach their early teens. They may then develop criminal records, given that the age of criminal responsibility is 10, although I think that it is eight years of age in Northern Ireland. The sexual offenders commit more serious offences in their mid- to late-teens, such as rape, buggery and much more serious offences, leading to sexual homicide.
I hope that it is all right for me to be completely clear and explicit in my terminology. We do not have much time and it is important to tell the Committee that we are not talking about services for normal children who explore their sexuality in a perfectly normal way. We are talking about children who have persistent problems that require assessment and subsequent treatment.
We have found that it is bad enough that those children exhibit sexually coercive or sexually abusive behaviour, but evidence shows that they have many other problems. The children come from disadvantaged families, and a very high proportion of them have been sexually, physically or emotionally abused themselves. They have moved from place to place while in local authority care, should they eventually go into local authority care. As a result, professionals have huge difficulties dealing with them, partly because we all have trouble dealing with "sexuality gone wrong", and never more so than when we talk about children who are showing the early signs of paedophiliac behaviour.
I encourage the Committee to set up far more services for those children, and not to leave it to voluntary sector organisations, such as the NSPCC, to set up those services. The main state sector should get involved. Much work must be done to raise awareness among professionals and the general public about the problem. The general public have very mixed feelings about children who are sexual offenders. I shall return to that when I talk about children who are defendants in criminal proceedings.
In setting up services for children who are sexual abusers, it must be borne in mind that professional and public opinion must be brought along, so that there is support for assessment and treatment services. I could say much more on that. However, if I am going to get through the list that I gave at the beginning, I shall move on to the next topic.
An issue close to my heart, and an important human rights issue, is the question of how we treat children from the ages of eight in Northern Ireland and 10 in England and Wales when they are charged with an offence in the criminal courts.
I have passed around reports from two conferences held by the Michael Sieff Foundation in the last year. The foundation is a childcare charity, of which I have been a trustee for around 15 years. Last summer, its conference considered the needs of child dependants and, in April 2002, some of the top legal minds in England contributed to a legal conference by giving advice on how the legal system could be reformed to cater for the needs of children who offend.
I am not sure how such matters transfer to the legal context in Northern Ireland, but in England and Wales the provision in the Children Act 1989 for referring to offending children as "children in need" does not apply to children who are, for example, in prison or in the juvenile secure estate. There is - rightly - controversy about that, because local authorities in England are only too happy to wash their hands of the welfare of children who are charged with criminal offence. They say that there is nothing that they can do about it because they must wait for the court case to finish. They maintain that the child will be fed, watered and looked after humanely in secure accommodation and, therefore there is no role for the local authority.
However, I take a contrary view, which is that the parental responsibility provision in the Children Act 1989 is crucial. There is an absence of moral parenting for those children who are in the juvenile secure estate, either in prison or in secure accommodation awaiting trial. That issue has not been considered. That is the sort of human rights issue that might well be considered by the children's commissioner. I understand that plans are well under way to appoint one here, which is wonderful.
Last night, I attended a lecture hosted by Barnardo's, at which Cherie Booth QC spoke about children's rights. I am glad to say that she came out strongly in favour of a children's commissioner in England. Furthermore, she went so far as to sketch out what the associated administrative structures might be for the children's commissioner's office. There was a link in her mind between the role of the children's commissioner's office and the administration of all the children's reviews that have taken place in England. Similar reviews have taken place here. That could be a fruitful way forward. You must forgive me if you have already had those thoughts and made those connections.
I shall not cover further the topic of child defendants and their human rights because the Committee may wish to ask me questions about it. I shall therefore move on to part 8 reviews. I understand that the terminology is different here so bear with me. Part 8 reviews are used in serious cases in which a child has died in suspicious circumstances. The English system is poor. If a child dies in suspicious circumstance, a part 8 review, which is a serious case review, is launched in an ad-hoc way by a subcommittee of the area child protection committee (ACPC). There is no central Government-based standing committee to co-ordinate the way in which serious case reviews are set up. In other words, there is no Department of Health Standing Committee at Westminster to keep a close eye on how serious case reviews are organised, nor is there guidance as to who should undertake them. Therefore, the situation is completely unsatisfactory. Independent agencies, which must make money otherwise they cannot exist, an individual or a team may be commissioned to do a serious case review.
It seems to be a question of asking who knows a good person who might be able to do the review. For instance, I have been recently approached to do a part 8 review, and I am very unhappy about the way in which that particular review has been set up. Without going into individual case details, if a practitioner or an agency with an issue to push is appointed - it may be a laudable issue to do with disability, race, gender, lack of mental health services - that may untowardly influence the review's outcome. On the other hand, the practitioner or agency may be excellent, and the outcome may be good. There must be a central Government Standing Committee that will continue to learn lessons from locally conducted serious case reviews. It must not lose the wisdom accumulated over many years and must produce some guidance as to which agencies or individuals are best placed to undertake those reviews. It is more to do with procedures and systems than with money.
Moreover, there have been an awful lot of inquiries. That may seem strange for a child psychiatrist who deals with child abuse cases to say that, and I do not know if it has been experienced in Northern Ireland. I am not sure that there should always be huge, wide-ranging, public inquiries into all those tragedies. We should be able to learn lessons from previous meticulous work and published reports. The issue is to implement those recommendations and lessons rather than to set up hugely expensive inquiries.
Our team was involved in an incident in which there was no co-ordination between the part 8 review into the death of a child and the concurrently running health authority or homicide inquiry into the murder of that child. There should have been co-ordination. The situation was badly handled because there was overlapping. Two teams of people therefore set up two expensive parallel reviews. One team had expertise in adult mental health and no knowledge of child protection or child development, and the other had some knowledge of child development and no knowledge of sexual offending or adult mental health. In order to keep what they thought was impartiality, there was no communication between the two teams, witnesses were not shared, the reviews were carried out separately and the reports were published separately. Why have a system like that? That strikes me as an absolute waste of money and a loss of expertise. If there is to be a public inquiry, it must be one with appropriately appointed people that covers all areas, rather than having two or perhaps more running concurrently.
If the Committee would find it helpful, and it is possible that NSPCC has already provided this information, the Crown Prosecution Service has published a small booklet, into which I and others had an input, on pre-trial therapy for children who are witnesses in criminal proceedings linked to child abuse. The booklet gives an insight into why children with major trauma should be given access to the treatment that they need before the criminal trial. Work is ongoing in the Department of Health to issue a similar booklet for children who face criminal charges so that they too may be able to have pre-trial therapy.
Furthermore, the Committee may be interested to know about the work that is being done to commission of a child defendant's pack. I am sure that you are aware of, and are using, the child witness pack materials for children who give evidence. It is to be hoped that we shall shortly see a child defendant's pack.
I shall conclude by mentioning the need for a carefully prepared medium- and long-term strategy for training professionals that need to be involved in the work the Committee is considering and about which I have spoken. Even if substantial amounts of money were available to open residential homes and to provide treatment and assessment facilities, strategic thought would have to be given to the numbers of professionals, the disciplines from which they would come, and the types of training that they would require in order to be able to staff those children's homes, provide skilled and appropriate treatment for children and provide the courts with appropriate reports.
By all disciplines I mean those that may be involved in protecting vulnerable children, such as judges in both the criminal and civil court systems; court staff; barristers; solicitors in both defence and civil practice; all sorts of mental health professionals; social services employees; and people with backgrounds in education or probation.
Training is a significant issue that needs to be grasped early in the process. I speak from direct experience of watching developments in England in the past 20 years, and I know that enthusiasm can get the better of wisdom. Although that happens sometimes in the public sector, it happens most often in the private sector where people have more money to spend. You might say good luck to them, but they open a treatment or assessment service that lasts for a matter of months, or a year or two, before it closes down. They do not always close because of abuse allegations. More often they close down because they simply have not understood the pathology and the nature of the children that they are dealing with's needs. Rather than see that scenario occur, one would want to use existing resources strategically to provide training for people from all disciplines and to create relevant new resources for the children.
The Chairperson: Thank you Dr Vizard; your presentation has been very helpful.
Mr Berry: Thank you for your presentation. What are the therapeutic needs of children who have experienced various forms of abuse, and what are the likely consequences if those needs are not met?
Dr Vizard: The therapeutic needs must be assessed first. I speak as a doctor, and we do not give treatment until we have assessed what the need is. That assessment of the child involves all the disciplines. For example, a social worker allocated from a local authority must be involved, because of child protection issues, and a child psychiatrist must assess the child's mental state. A child psychologist must be involved also, because the evidence shows that a high proportion of those children have a learning disability. As the overheads that I provided show, the child requires cognitive assessments. To assess what the child needs and the best form of treatment is the first step. Having done that, the type of treatment needed may depend on the child's age and developmental status. It also depends on the child's circumstances. A younger child who lives with the family of origin - where there is no active concern of continuing abuse - may benefit from non-residential, individual, outpatient psychotherapy, which probably would be delivered by a child psychotherapist from a child-and-family consultation service. That kind of treatment would not be suitable for someone at the other end of the spectrum; for example, an abusive late adolescent who has convictions for the rape of other children and who is being held in secure accommodation or prison. In that case, behavioural management would be considered, whereby the individual would be told what the consequences of further wrong behaviour would be.
Further down the developmental spectrum, a child in his or her earlier teens may have active over-sexualised behaviour but be amenable to treatment. Cognitive behavioural therapy is often helpful in such cases. It helps such children to straighten out their twisted thinking, so that they no longer justify their unlawful behaviour to themselves. We must consider carefully where the safest place to give those children treatment would be. Unfortunately, as the Committee will know, many children have been abused in their own home or by a member of their extended family. Again, training is crucial. We want to keep children with their families whenever possible, so early intervention is important. However, it would be naive to try to treat a child if we have reason to believe that they are in an unsafe environment; for example, if the child is in danger because of continuing abuse within the family. Treatment provisions are available depending on the child's age and developmental status, the level of risk that the child poses, and where he or she lives.
Ms Armitage: You mentioned specialist training, especially for those who run homes. That is important. Is such training already available in some areas, or do you envisage a completely new role and new training for those individuals as the situation evolves? Is it a case of starting all over again? I agree that there is no point in having wonderful homes if people are not properly trained to run them.
Dr Vizard: That is correct. It is not simply a matter of employing people who are good-hearted and willing - it is much more complicated that that. When children come together in residential settings, powerful dynamics emerge. A witness in an earlier session mentioned those issues. Staff must be trained, not only in providing therapy, but to be alert to child protection issues. We know from previous inquiries that over-sexualised children may target other children and try to set up paedophile rings in care facilities - in some cases they are encouraged or influenced by other older adolescents or adults. Staff must be alert to that and be trained to protect any vulnerable children who may be targeted.
In answer to the original question, much depends on how much reform one wants of the existing system. I suggest that, once the Committee's inquiry ends, another group should be set up to examine training needs in much more detail and to develop a training strategy for that type of work. As more information in the field emerges, new training initiatives will be required. The situation will require ongoing, constant attention.
Mrs I Robinson: According to your chart, children as young as three to six years of age can show, albeit unconsciously, signs of abusive behaviour. Are they born that way? What starts children on the road to becoming abusers - is it society, television, the environment in which they grow up or other factors?
Dr Vizard: That is a good question. The simple answer is that they certainly are not born with it. Children who abuse and offend are made, not born.
Mrs I Robinson: That is very important.
Dr Vizard: That is why I said earlier that, before setting up services, there must be much discussion and persuasion with professional colleagues and the general public - the "hearts and minds" argument. The public, as you know, can be whipped up into various states by the media. They need to have it explained that children are not born like that; they are not born serial killers. I do not believe in the concept of children as evil. That may be a contentious view.
The actions that children perpetrate as the result of their experiences may be evil, but we must be clear that children come into the world with a good chance of achieving something decent. They are not born as sexual abusers. That said, there are complications that we shall not have time to discuss. There is no doubt that some children are born into disadvantaged and vulnerable backgrounds. There are also some children whose constitutions may make them temperamentally vulnerable in many ways. However, there is no evidence to suggest the existence of a gene for sexually abusive behaviour, or anything like that.
Mrs I Robinson: That is very interesting. Society generally believes that when acts of perversion become full-blown paedophilia, the excuse is that they were born that way.
Dr Vizard: I refute that. It may be of interest to the Committee that we have recently been given a three-year grant by the Home Office to look into the early origins of something that they are calling DSPD (dangerous severe personality disorder). The client group that we see in the young abusers project is a very disturbed group. It is a UK-wide project, so we see very disturbed children from all over the country.
Rather than being born with a personality disorder or a tendency towards abusive behaviour, it is the environment in which a person is placed and that person's experiences that have a big impact on him or her when young. One's whole mode of development and thinking - possibly even one's personality - may be adversely affected. In that way, a child may grow up to exhibit dangerous behaviour.
We hope that our Home Office research will give rise to a good definition of which children are most at risk of growing up in that way. With that definition, we shall have high-risk indicators, which we can share with colleagues that will, I hope, allow preventative work to be done with children who are at risk of that kind of development.
Ms McWilliams: It is interesting that you have a gender breakdown of your sample that shows that 92·2% of sexually abusive children are male. That hits the nail on the head. Trans-generational abuse goes on and on. It is often the case that it is females who are abused, yet they make up only 7·8% of abusers.
Dr Vizard: I take the point. With the Home Office money we have a sample of 300 children, so the data will be slightly different. It is probable that as many as double that number of girls have now been seen. However, it is still correct that the behaviour is predominantly male. The Committee will be aware that the impact of trauma on children, whether they be boys or girls, is significant. It may be the case that more males abuse in different ways, but it is also the case that little girls become so damaged by the experience, and their self-esteem so bruised, that their capacity to make the right choices when they get older is severely damaged. They then become prey to paedophiles and violent men who may draw them into cycles of domestic violence.
The situation is complicated. I am not trying to let men off the hook in that sense, but we have to recognise that there are all kinds of dynamics going on across the generations to perpetuate the problem.
Ms McWilliams: The passive and the active.
Mr Scott Hollander made reference earlier to the issue of inappropriate placement - children who have been abused being placed with abusive children. You have also referred to that. In all your years working in this field, have you succeeded in having any protocols put in place or any policies changed?
Mr Hollander also described the lack of information exchanged between placements. In the evidence that we have taken to date, we have noticed a lack of communication. Of course, some of that is down to a lack of resources. We constantly take evidence from social workers who say that children are given any old placement that can be found, as opposed to the appropriate placement. What are your views on that? This is 2002, not the nineteenth century.
Dr Vizard: One aspect that is important, although it is not the complete answer, is funding. Local authorities are inconsistent in their views on when they are prepared to fund a placement for a child. For example, if we see a vulnerable, needy eight-year-old with over-sexualised behaviour who has not got to the very serious stage but is on the way, and if we recommend that the child needs a therapeutic residential placement with therapy piped in - assessment, careful reviews, everything - the local authority is likely to say "No" on the grounds of cost. It will say that it is too expensive and that the behaviour is not bad enough. They are not going to spell it out like that, but that is what they mean. I shall return to how I know that in a minute.
Local authorities will wait until the child is 15 or 16 and has raped someone, been convicted and then been charged with another serious offence. Then, in a great panic, local authorities will come to us, and suddenly we shall find that they are able to come up with £5,000 or more a week to put the child in an expensive private resource with ill-trained staff that has just opened. Alternatively, the child enters secure accommodation, at great cost, for six months.
There is a lack of strategic common sense in thinking about when to spend the money. The money is much better spent on the younger child, because one has a better chance of changing the child's behaviour. That is obvious. In the case of girls and boys who are victims, it is equally important that the money be spent on them when they are younger rather than older. It would be very helpful if the Committee could find some way to make that point in its report.
I have experienced a paradoxical situation with children that I am treating. A child will enter therapy - either group, cognitive, behavioural or individual therapy - with really bad, dangerous or out-of-control disturbed behaviour. After six months or a year in treatment, the behaviour may be much better. The local authority has been paying for that treatment, and it does not actually cost that much.
As soon as the behaviour improves, the local authority will say that the child does not need the treatment any more. We say that that is absolute nonsense. It is far too early to stop the treatment; the behaviour will return. Local authorities do not agree with us. They stop the treatment because they think short term about money for this year's budget. The child is then devastated by another rejection by adult authority. The anti-authority attitudes that he or she already possesses get worse, et cetera. It is short-term gain for long-term loss.
You asked whether we have seen good practice: we have. Good practice is possible. If a local authority builds up a relationship with a local service, preferably owned by the authority, invests in training of staff employed by the authority - or, if they are employed from the private sector, regularly audited and inspected - and ensures that children stay in that placement in the longer term until a formal assessment says that they can leave, excellence in service provision will be developed. Local authorities should not throw up their hands when the bill seems to be mounting up early; they should not give responsibility over to the private sector, as the private sector will not be able to take the long-term view.
I do not know whether that helps. It is complicated.
Ms McWilliams: That is very useful. Private sector involvement is a separate debate. In Northern Ireland, it is mostly statutory. We had a controversy recently when someone attempted to set up a private home. It must be a bigger issue in London.
Your point about appropriate placements, with continuity, is well taken.
Dr Vizard: Continuity, staff training, consistency and investment will pay dividends. I do not bash the private sector. We work productively with good colleagues from the private sector. However, the private sector has moved in because of the lack of strategic planning in the state sector. It has seen a deficit and moved in. The private sector does not necessarily have the commitment to long-term service provision that we expect the state to have.
The Chairperson: Thank you.
Dr Vizard: Please let me know if the Committee wants any further information, or perhaps to visit.
The Chairperson: We shall. Thank you.
MINUTES OF EVIDENCE
Thursday 26 September 2002
Dr J Hendron (Chairperson)
Rev Robert Coulter
Mrs A Courtney
Ms M McWilliams
Ms S Ramsey
Mrs I Robinson
Ms U Turbitt )
Mr T Rodgers ) Southern Area Child
Mr P Kellett )
The Chairperson: The Committee welcomes Ms Turbitt, Mr Rodgers, Mr Johnston and Mr Kellett from the Southern Area Child Protection Committee. Thank you for your documentation, which has been very helpful.
Mr Rodgers: Thank you for inviting us. Our group comprises representatives from the Southern Area Child Protection Committee and the child protection panels. We also have multidisciplinary representation.
I should like to make several points. Taking into account your Committee's remit, we held a case management review in the Southern Board, and an independent inquiry report is still awaited. We considered ownership and accountability. We also felt that, as in other case management reviews and inquiries, that there was a significant lack of communication in some of the disciplines. Work is in progress on a protocol for sudden unexplained deaths, which is particularly important. We welcome the Department's proposal to ensure that lessons from case management reviews are circulated widely. The interface between child protection and family support should be acknowledged fully.
The Committee will be aware that expenditure in family and childcare per capita is significantly lower in Northern Ireland than in England and Wales: that concerns everyone. Vital areas were removed from the public expenditure survey bid when the Children (Northern Ireland) Order 1995 was introduced, and since then we have been playing catch-up. The areas removed included child protection, residential childcare, family placement and the medical implications, all of which have been very high on the agenda since.
There is a lack of core funding in the programmes. There is emphasis on "short-termism", which creates difficulty. Any moneys for resource allocation are welcome, and the Executive programme funds have been welcome. However, there has been significant difficulty in accessing Executive programme funding, and the process has been cumbersome. One could even say, "cost-ineffective" for the process but not the outcome once funding has been received.
Chapter 5 of the 'Family & Child Care Services In Northern Ireland in 2000: A Four Board Perspective', which is included in our documents, covers resources and funding. It is also important to say that board and regional initiatives have been started with limited or no funding.
These include violence forums and social services inspection reports on adoption, foster care, secure accommodation and the multi-agency procedures on the management of sex offenders. In the Southern Board we have worked hard at ensuring joint working and positive multidisciplinary inter-agency working relationships. That is clear from our submission; it includes the review of thresholds, which was an external audit to examine multidisciplinary and multi-agency practice in case planning and child protection.
Our multi-agency guidance model informs staff about thresholds and where cases might appropriately sit in the child and family care continuum. The model also informs staff about the supports and resources that could be made available to families, depending on their level in the continuum.
We have also developed a policy on child protection in cases of domestic violence, and that has been neglected for many years. We are beginning to see results; however, it has created its own pressures, because some of the child protection registrations have arisen as a result of the policy initiative. We are particularly pleased about a risk analysis model that has been developed to facilitate professionals in case conferences. It was developed jointly by the Southern Area Child Protection Committee, panels and Greg Kelly of Queen's University.
We have a comprehensive training programme, but it is difficult for staff to undertake training because of recruitment and retention difficulties. It is also important that we are actively involved and that we continue to promote the involvement of parents and children, as appropriate, in the process.
The Chairperson: Does the Southern Area Child Protection Committee review contract specifications to ensure that they adequately cover the services needed for child protection and that they deliver the committee's objectives?
Mr Rodgers: The committee reviews specifications when it commissions services; it also reviews specifications when agencies commission services. Examples of that are the young abusers project and the community sector training project, which were commissioned by the committee. They have been externally evaluated to assure us that they are meeting the policy requirements for which they were established.
Ms Ramsey: What are the benefits of putting the area child protection committees on a statutory footing? Our inquiry is into child protection. If there are benefits, why can they not be achieved through proper inter-agency working? Many simple things could be changed if there were inter-agency working.
Mr Rodgers: Putting area child protection committees on a statutory basis mandates agencies to participate. Pressure is one of the main difficulties for many agencies. From an area child protection committee's perspective, and as chairperson of the Southern Health and Social Services Board, I am quite clear that child protection must be afforded the utmost priority. That would ensure that all agencies subscribe to it and that senior staff are committed to attending the area child protection committees and to giving the imprimatur from their organisation. It also addresses resource allocation.
Area child protection committees have been limited in their capacity to advance initiatives. It would also address accountability arrangements, and that would be particularly welcome.
Ms Ramsey: I agree with you, but the Children (Northern Ireland) Order 1995 states that the welfare of the child is paramount. In its evidence session on Tuesday, NIPSA informed us that the threshold is different in some trusts. Even though it would be better to put it on a statutory footing, I take your point about resources. However, the Children (Northern Ireland) Order 1995 is not being properly implemented because of lack of resources.
There should be consistency in the thresholds in each trust. I know that the threshold is higher in my constituency than in others. How far are thresholds governed by resources rather by than the judgement of a case?
Mr Rodgers: It is fair to say that it is somewhere in the middle. We want to ensure that the threshold is informed by professional judgement. There are some resource issues. People must say what they can and cannot do. That was one of the reasons that we looked to the external review of thresholds, which showed that there were inconsistencies in our board area. Even the annual reports of the area child protection committees show inconsistencies in each of the board areas. They exist in and across boards. We have tried to address that in the multi-agency guidance, which gives information to staff about the difficulties that may lead to a family needing child protection; the difficulties that can arise in case planning, and where that fits into the family support continuum. We hope that that will help to create greater consistency. Area child protection committees have agreed that, with professional judgement and decision-making, we must keep monitoring and auditing practice to ensure a reasonable standard.
Ms Ramsey: Is it possible that a social worker who is inundated with cases will not reach the threshold? Is it possible for a child abuse case to go undetected?
Mr Rodgers: That possibility may exist. However, if procedures are properly adhered to, it is less likely. Agencies may operate different thresholds in disciplines; social services may operate a higher threshold than their colleagues in education. However, procedurally we have determined that if an agency requests a case conference, that request will be granted. Many joint training initiatives are being undertaken so that local education representatives and local senior social workers will meet to discuss a situation. The difficulty is that other agencies, specifically health and social services, would be looking to intervene. They may believe that the threshold was not being met. Some of that concerns professional judgement, and some of it concerns their capacity to intervene.
Ms Ramsey: I agree with you that area child protection committees should be placed on a statutory footing. We were given evidence that the Probation Board pulled out of some case conferences because it does not consider them an important part of its work. At the same time, it is clear that not all disciplines are sharing information; paediatricians told us that there is not a great deal of information sharing.
Mrs I Robinson: Area child protection committees have responsibility for training. Child abuse is secret and those involved have an investment in deceit and denial. Therefore highly skilled staff are required to investigate suspicion of abuse. Are you confident that staff receive the necessary training and that the appropriate skills are in place? What are the monitoring and audit arrangements for reviewing the adequacy of training and ensuring that it has taken place?
Mr Rodgers: The Southern Area Child Protection Committee has a multidisciplinary trainer in post, which is a unique arrangement in that it is jointly funded by our board and by the local education and library board. We try to ensure that staff receive multidisciplinary training, and we receive regular updates from the trainer. Our multidisciplinary training sub-committee reports on its meetings. Training courses are evaluated every year, along with details of the attendance of staff; this is done by the multidisciplinary trainer. This year's report for the Southern Area Child Protection Committee is available, and I can leave it with the Committee.
Ms Turbitt: I will speak from the nursing perspective, concentrating on the huge nursing family. Nurses work at the core level with clients and are often involved in the early detection of child abuse or risk factors. Access to good training is paramount for all nurses. A multidisciplinary concept is useful, but the resources are not available to train the huge numbers of nurses to be trained - those who work in accident and emergency departments, practice nurses, health visitors who have first line contact, and midwives who deal with domestic violence. Focusing on child protection means that another priority will have to be put aside, for example, the nurse prescribing initiative, which is being emphasised. Decisions must be made within the confines of what is available. It is acknowledged that there are limited training opportunities for the family of nursing.
Mrs I Robinson: I understand your point, which is that money is required to provide more training to enable those in accident and emergency to pick up threads of evidence on what might later prove to be child abuse. Some tragic events have occurred here and on the mainland. There has been much bad press about the perceived inability of social workers and health visitors to pick up a risk that appears so obvious once the whole story has appeared in the press. How can public confidence be gained to back you when such tragic events occur? Much damage was done in cases such as that of Jasmine McGowan.
Mr Rodgers: I referred to our own experience of the case management review. Greater transparency and openness is required, and we must engage more with the public. We must continue to build public confidence rather than appeal to it only at times of crisis; and that is difficult.
We have a community sector training project that facilitates that to some degree by giving communities and community groups an understanding of child protection. We have also sought to engage the local health and social services council, and we must do more such work. We attended the health committee of one of the local councils and advised local councillors when concerns arose.
Mrs I Robinson: I am thinking mainly of when the public have telephoned with concerns and their calls have not been followed up. That is when confidence has diminished, as people then ask themselves what the point is of complaining. Tragedies have occurred despite evidence that the public alerted the people concerned.
Mr Rodgers: In those instances, the expectation is that the person making the referral should be informed of the outcome; a response should be made. Local officers should get in touch to report their findings and the action they intend to take.
Mrs I Robinson: Would you encourage the public to be nosy neighbours if they suspected that a child was being abused?
Mr Rodgers: Yes.
Mr Johnston: Some callers wish to remain anonymous; they will not say who they are or give an address. That can make it difficult to get back to them. If an anonymous call gives us cause for concern, we would certainly expect our social workers to make a visit. However, it may not be the start of an initial investigation: that may take time.
When we receive a referral we may be watchful and we may look to other professional colleagues, such as nurses and doctors, to see whether there is substance in it. Callers remaining anonymous can make it difficult for us to tell them how we have handled a case. It is always good to give feedback. We had a discussion with our teachers in Armagh and Dungannon Trust who said that we were slow at explaining outcomes; we said that we would try to improve communication. You can get so absorbed in the investigation, in the assessment and protection work that you forget that the person who gave you the referral would like to know what you did and how things worked out.
In 1997, we drew up a protocol with the local press on how we would distribute information to them.
Ms Turbitt: As regards secrecy, often referrals from the public come through the next day or two or three days later, and it is difficult to gather evidence if families do not want to engage health and social services. We must educate the public that there are telephone numbers that can be used after hours and we must encourage people to use them immediately so that someone can call and give evidence quickly.
Rev Robert Coulter: In paragraph 6, under "Communication" you make an interesting comment
"The concept of children in need emphasises the need for liaison between agencies and disciplines across the entire continuum of family support and child protection."
Sharing information between professionals is obviously crucial in this situation. However, some professionals are still uncertain about how much information they can share without damaging confidentiality. What obstacles prevent such sharing of information? Does the Southern Area Child Protection Committee require managers to instruct their staff to follow procedures so that they are in no doubt about what is required?
Mr Rodgers: Trust is vital in sharing information. We have sought to work on that in the joint training initiatives. At other times, disciplines and agencies must be quite clear that child protection takes precedence over confidentiality, and we have often stressed that. To date, the advice to managers from our committee has been explicit: staff are very clearly advised that there must be communication.
Rev Robert Coulter: What difficulties do you see?
Mr Rodgers: Trust is an issue. At times, people are under pressure. It is not that they do not wish to share information - it is just that they move from one issue to another, and that can create difficulties. Each agency, and particularly those represented here today, has its own code of ethics, but they are all explicit in saying that child protection is to the fore. Confidentiality is secondary to sharing information if a child is considered to be at risk.
Ms McWilliams: I am very taken by your proposal on a regional child protection training taskforce. We were appalled that the findings of case reviews are not widely disseminated; in fact, quite the opposite is true. They are kept hidden, and very little is learnt from them. Every time they are carried out is almost a repeat of the cycle. You propose that some of the lessons learnt could feed into a regional taskforce for training purposes so that you could pick up the recommendations. I take it that no such taskforce exists and that each board works separately?
Mr Rodgers: I would probably go as far as to say that it creates its own difficulties, even in each board area. The Department of Health, Social Services and Public Safety is considering establishing a child-protection review group to share lessons from case management reviews and has recently corresponded with area child protection committees.
Initial correspondence seemed to show that area child protection committees would attend the first meeting but perhaps be outside the loop thereafter, which did not make much sense to me. We plan a meeting to discuss that. Two years ago, it came to the attention of the Southern Area Child Protection Committee that a case management review had been undertaken in the Eastern area eight years previously. It was brought to us only at that stage and by a fairly circuitous route. What happens in such situations is one of the big difficulties. There is a big debate on blame culture vis-à-vis the sharing of lessons. Our own case management review has encountered similar difficulties. All the recommendations that could be addressed internally have been addressed. However, almost two years later, I suspect that most staff are unaware of most of the issues.
Ms McWilliams: That is very serious and should be addressed; it should not be allowed to go on like this. It was the case eight years ago and is still the case. One of the things that arose in the Jasmine McGowan case was that there had been community involvement with the family, particularly through the childcare activity of the Footprints Women's Centre in Poleglass, and you mentioned the importance of Sure Start. Did they pick up things because of their regular - almost daily - contact with the family? Information ought to have been fed in, and yet they often felt that they were not involved; sometimes they felt that they had no voice once the professionals had taken over.
How might they be included? I assume that they are not in the area child protection committees, and that is a problem. However, given the enormous expertise that such centres now have, and especially if Sure Start is put on a recurrent footing, community involvement will be important. Have you considered how such community knowledge might best be used?
Mr Rodgers: We probably have not given it sufficient thought, but there is a strong argument for some community representation. Sometimes discussions about how representative a representative is can fudge the issue. That has happened in other forums. Having said that, we are clear about the nature of the relationship between the area child protection committee and, for example, the childcare partnerships. Many such bodies are represented and are involved; they will be aware of child protection policies and will have their own. Moreover, they can update their training annually through community sector training, which is an area child protection committee initiative. More must be done about representation and there must be a more meaningful engagement with community groups.
Ms McWilliams: What have general practitioners done in this? There is specialist nursing in this area; however, is there sufficient awareness in undergraduate training?
Mr Kellett: There is work to be done. General practitioners are exposed during their one-year vocational training through the multidisciplinary team and their trainer, albeit for perhaps only a day. They may attend case conferences. It is hit-and-miss and depends on the practice a general practitioner is attached to for that year. However, education continues in general practice, as doctors must be trained in many different fields. Perhaps the training should be done in-house, especially with the new GP contract under, which people will be practice-based. A practice team includes receptionists, nurses and health visitors, and quite often a general practitioner may be tipped off by a receptionist. Out-of-hours care is now delivered differently and a general practitioner might not see a patient because he or she could go to a hospital accident and emergency department.
In cases of sudden infant death, the coroner receives the report and, quite often, paediatricians and the primary healthcare team hear nothing about it and that is the end of it. We are meeting our consultant colleagues, accident and emergency staff, social workers, parents, coroners and pathologists to arrange a follow-up system.
Ms McWilliams: That is good. My reason for asking is that I once had to do research in HM Coroner's Office for Greater Belfast and I came across cases of familicide and horrible cases of deaths of children. It saddened me greatly that doctors had a great deal of information, which, although a clear picture emerged, they seemed reluctant to share. Guidelines must be established, because there is a fear of giving information and of breaking confidentiality.
Mr Kellett: That attitude is breaking down as general practitioners are becoming used to working in multidisciplinary agencies. General practice is being delivered in new ways, and there are many part-time doctors, health visitors and nurses. Therefore it is all the more important for everyone to be aware of the issues; doctors must not be isolationist, believing that they alone should have information. That attitude is breaking down. People are conscious that the child's safety is paramount.
Mr Rodgers: The Southern Area Child Protection Committee's report highlighted the low level of general practitioners' involvement in child protection case conferences. We have sought to address that through a training initiative with our multidisciplinary trainer, and the board's primary care department is targeting practices to involve more general practitioners.
Mrs Courtney: Paragraph 4, page 3 of your submission says that the 'Framework for the Assessment of Children in Need and their Families' that was published by the Department of Health in England in 2000 is to be adopted in your board area and that such an approach will require adequate resources. That has huge implications for agencies if it is to be properly applied. How was that decision taken, and were the necessary resources identified?
Mr Rodgers: We discussed with the Department the redrafting of 'Co-operating to Safeguard Children', which will replace 'Co-operating to Protect Children' as the guidance that accompanies the Children (Northern Ireland) Order 1995. That document clearly stated that it is not possible for the Southern Area Child Protection Committee to develop the whole assessment framework. Pilot schemes for the assessment framework in each trust area were developed; we want to take the best bits of the pilots to see what we use. We have already informed the Department of those matters that are resource-intensive.
The assessment framework is being evaluated in England and Wales, and we have been advised that there have been drawbacks to implementing it fully. The Southern Area Child Protection Committee engaged with Jan Horwath, who was involved in drafting the assessment framework in the first instance. She is now drafting an assessment framework for the South of Ireland, and we had another seminar with her in June of this year. We want to develop our framework from there and to examine some of the lessons that we learned from the external review of thresholds, particularly the initial assessment work.
However, any assessment framework that we adopt will have significant resource implications, and we have informed the Department of that.
Mrs Courtney: Does the Southern Area Child Protection Committee publicise its work? Do you think that, given the public perception of the extent of abuse, publicising its work would be of benefit? How best might that be done?
Mr Rodgers: The Southern Area Child Protection Committee publishes an annual report, and I will leave a copy with the Committee. That attracts some local media coverage, but perhaps not enough.
As part of our objectives with the panels, we also said that we would seek to publish something in the local papers at least every month or every other month to raise the profile of agency involvement on child protection and the community's role. We have issued some of those articles, although there is room for improvement. The community sector training project has been enjoined with developing the community development policy and is actively involved in promoting the Southern Area Child Protection Committee in the panels and their work. However, we must do better.
Mrs Courtney: That is important. In the Western Board, one reads about cases only after they have happened. Seeing that help is available would be of great benefit.
Mr Rodgers: We have produced many leaflets on parenting, although there is a debate about the effectiveness of leaflets. With the childcare partnership team, we have tried to engage with local communities through the Sure Start programme, for example. It is about trying to make appropriate links.
Ms Ramsey: Some cases are very complex. Is counselling available to staff?
Ms Turbitt: There is a comprehensive supervision policy for nurses and social workers that gives health visitors and nursing staff access to at least bi-monthly supervision on child protection.
The role of the child protection nurse specialist was to provide support to nursing staff. That has been evaluated across the Southern Board and has proved very effective. The outcomes of the audit and evaluation were very positive. It is limited to what one person in a board or trust can do because he or she must consider looked-after children, children with a disability, children who are on the child protection register and children who are in need. Even the best supervision may not be as effective as it could if a workforce is overstretched or is often on sick leave. However, it is seen as very important.
Mr Johnston: We expect senior social workers to supervise other social workers. Social workers come together to form a core group so that one person does not have to bear the whole workload. A core group appointed for a case conference can do a great deal of the work together; its members can work together and support one another. Where a difficult family is involved in a case conference, we might ask that the health visitor and the social worker make joint visits so that they can support each other.
Ms Ramsey: It is crucial that staff are not lost because there is no support for them.
Ms Rodgers: Since 1992, there has been a joint protocol arrangement between the police and social services in investigating child abuse. We are seeking to develop an initiative through the regional core group, principally concerning video evidence for presentation in court, as children have given harrowing accounts of the abuse that they suffered. We are seeking to identify specialist staff and to initiate a personal development review programme. That has met some resistance because of the resource implication and the pressure. The personal development review programme provides what is almost a quasi-debriefing that facilitates staff and helps them through very stressful experiences.
The Chairperson: On behalf of the Committee, I thank the Southern Area Child Protection Committee, especially Mr Tony Rodgers, Ms Una Turbitt, Mr Leslie Johnston and Mr Patrick Kellet. You have been very helpful in what will be an important part of the Committee's inquiry into child protection.
MINUTES OF EVIDENCE
Thursday 26 September 2002
Dr Hendron (Chairperson)
Mr Gallagher (Deputy Chairperson)
Ms E Campbell )
Ms D Kelly ) Volunteer Development Agency
Ms S Adair )
The Chairperson: I welcome Ms Dee Kelly, Ms Emma Campbell and Ms Sandra Adair from the Volunteer Development Agency.
Ms D Kelly: The Volunteer Development Agency is not a statutory agency, and, therefore, may not be as well known to you as other organisations. I manage a project called "Our Duty To Care", which is based on guidelines commissioned by the then Department of Health and Social Services in 1995 following the 'In Abuse Of Trust' report. Our project is the resource behind that. Our remit is to raise awareness of child protection issues, particularly in the voluntary and community sector, and to promote good practice to ensure that organisations take it on board. We also provide operational guidance for police record-checking for the voluntary and community sector.
Our submission is made from a community perspective. We do not provide direct statutory provision. It is about our experience of the interface between the statutory sector and the community. Our target audience is the vast range of community organisations that provide an enormous number of activities for children and young people. Volunteers, rather than paid staff or professionals, provide most of our supervised activities.
One of our concerns has been that all those organisations are unregulated. There is an exemption clause in the Children (Northern Ireland) Order 1995, meaning that organisations that do not provide day-care services do not have to register with anybody. Therefore, there is no regulation around them. Any codes of practice that are in place are of a purely voluntary nature.
We are glad that the Protection of Children and Vulnerable Adults Bill has a clause relating to accreditation. That will not regulate, but it will endorse current standards and provide an official benchmark. Parents, funders, children and young people, and even people looking for a job will be able to see the endorsed, charter-marked organisations and know where the good practice is.
The code of good practice is a voluntary one. When we started in 1996, the voluntary and community sector embraced us with open arms. There is still a great deal of anxiety about how vulnerable organisations are. As regulation has come in and the statutory sector has tightened its regulations, those groups have been left more exposed. Anybody who wants access to children through activities is more likely to select them through the unregulated, and, therefore, more exposed organisations. The good practice guidelines that were put in place were as much for their workers' protection as they were for the children.
The thrust of our work has always been about prevention. We provide information about how to stop unsupervised persons from gaining access to children and young people, about recruitment and selection, and about police record-checking. How do you create safe environments that are open, transparent and child-friendly? That requires codes of behaviour and effective management of staff. How do you deal with an incident and refer it to the right people? You must have reporting procedures.
For all of that to happen, all those organisations must have information. They must be aware of what abuse is, who the abusers are and how they target people. They must understand the context in which they need to have good practice; otherwise it does not necessarily make sense for them.
They must also have more confidence in the statutory sector. They must know what happens when they make reports. That is an area that has to be demystified. They can only do that if the information is provided for them. They need to be much more comfortable and able to report and refer people. They have not been doing that and, unless they are, the information that they have is not being reported to the right people.
That is especially true of organisations staffed by volunteers. We are not talking about highly paid, highly trained professionals. We are talking about ordinary people - your constituents. They are acting in a voluntary capacity, but what they do and they activities that they provide make an enormous difference to the healthy development of young people in our community. We would be much the poorer if those services were badly provided or not provided at all.
Our programme is an awareness-raising programme. We challenge the myths about stranger danger. People need to know that most abused children are abused in the home by people that they know and trust. They do not know that, unless they get the information based on research. They need to know that abusers come from all walks of life, for they do not know unless they have that information, and it is based on fact, research and statistics rather than mere hearsay. They need an awareness of that information that encourages them to be alert and vigilant in the work they do.
I heard a really powerful message from a woman who was receiving a certificate in Ardoyne for taking part in training. She said very clearly that the training had provided her with a great deal of awareness in the voluntary work that she did. However, she was not just a volunteer but a mother and a grandmother; she was a member of her community. It had made her more aware, both within her family and in the wider community, so she was much more alert to the safety of children in general.
That one small programme among many has had a huge spin-off effect in keeping children safe in the community. That is ultimately where they need to be kept safe, for the statutory sector cannot work in isolation, which is what seems to have been happening for a long time. Communication is absolutely vital. We know from our work that there is still enormous hostility in the community towards social services. Experience working with groups tells us that it is mostly historical, rather than based on personal experience. Giving people information will break down some of that and get rid of misconceptions.
You probably know only too well that making any kind of report to the police is a non-starter in certain communities. Something people do not understand is that they need not report to the police directly. The joint protocol gives them an opportunity to go to social services, and information will go to the police where appropriate. However, people do not know that. Unless you tell them, they have no idea what the joint protocol is or what the procedures or systems are. They must know that if they are ever to have confidence and trust in the system. We ask them to pass on information, but they must have confidence in the system to which they pass it.
From our six years' experience we could tell you a great many stories about people working with children and young people who have known in their hearts that there was something wrong but did not know what to do with that information. There were fears in case they were mistaken because the person was a woman - the belief that "women do not abuse" - a pillar of the community or a local banker. They did not know what to do with the information and had real fears about being mistaken in what they felt to be true.
There were real and serious concerns about their personal safety, since they felt that some kind of referral - unless they were sure of its confidentiality - could rebound on them in the community. There were also real fears that they would be sued, so they need to understand that you can make a referral without its taking you to the point of litigation. In some communities it could be worse, and being sued would probably be an easy option.
Those fears are out there, but if you can give people the information, that provides a measure of safety and confidence. There is also still the old myth out there that social services are the enemy. There is the perception that if they come in, they will take your children away. When we train people and talk about the thrust of the Children (Northern Ireland) Order 1995, the aim is that vulnerable children should be kept within their families and communities. That is a whole new ball game for people, for no one has told them that. They have not heard of the 1995 Order; how can they know that there has been change unless people give them that information?
Ignorance is also based on a lack of contact with social services in any positive setting whatsoever. The only contact with social services is when they intervene. If we can provide people with opportunities for positive contact, working together and mutual understanding of each other's point of view - and that is what our training does in most cases - we begin to build confidence.
We see enormous merit in real partnership - not simply in theory, which is something we have seen enough of. I can quote you one model which we have, but that is only one model. Our "keeping safe" initiatives are a partnership in the community led by the local health and social services trust. It is a partnership with the statutory sector. The local health trust, the education and library board and the council come together with local community organisations and take responsibility for a joint strategy to deliver child-protection training and respond to needs. All the trainers go out in pairs - one statutory and one community - so that the partnership is reflected in the community. It works very well, and also means that they share resources. We live in a world of minimal and diminishing resources for quite important prevention work.
However, our concern is not at a local level, but at the regional structural level - the area child protection committee (ACPC) level. That kind of opportunity does not exist at that level. A section in 'Co-operating to Safeguard Children' states that they should include other people on the ACPCs. However, those other people are the larger voluntary organisations, and few of those would include anyone from the community or any non-professionals. At the end of the day, the professionals will not keep children safe; the non-professionals will do so in the community. That partnership needs to go up. It must be written into guidance. That is beginning to happen, but it must be included. Am I speaking too long?
The Chairperson: No, go ahead. We will get to questions soon.
Ms D Kelly: My final point is about resourcing. Prevention work does not get resources. When there is a lack of money, it drops off the end. While we absolutely support the vital need for intervention, intervention is about dealing with crisis; prevention is about avoiding that crisis. It would be rather short-sighted if enough money was not put into prevention and ring-fenced so that it did not disappear when there was a crisis.
The Chairperson: Thank you very much. That has been helpful. I will start the ball rolling with a question that you have partly answered. Paragraph 5 of your submission refers to a culture of suspicion and hostility within the community towards the statutory services. You referred to that earlier. Given that neighbours, relatives and community members are likely to know so much more, I was going to ask how that could be improved. However, you have already referred to that. Are there certain professionals who are more highly regarded than others by the community? Finally, are there differences between communities in their attitude to agency staff?
Ms D Kelly: Do you mean professionals in the statutory social services sector?
The Chairperson: Yes.
Ms D Kelly: Not in our experience. I could ask Ms Campbell whether that is her experience of training, but in our experience none are more highly regarded than others. People interface with social workers, so they are at the sharp end of the hostility. However, I am not sure that anyone from higher up in social services would receive a different reception. The problem is the perception of what social services stand for.
The Chairperson: Are there differences between the attitudes of the communities to agency staff?
Ms D Kelly: Not when you go into the heart of the community. It obviously depends where you are going, but if you go to the heart of some communities, especially the more deprived communities where there is a history of more contact with social services, it does not make any difference from which side of the community they come.
The Chairperson: I also wanted to ask about the Children (Northern Ireland) Order 1995 and the point you made about keeping the young person within the community if at all possible, perhaps with extended family living nearby. You said that people in the community just do not seem to appreciate that very important point. An American gentleman was over yesterday, and he was good at putting his point across strongly. What can be done to push to the communities the point about keeping a child within the community, ideally with their own family, but, if not, perhaps with an aunt living nearby?
Ms D Kelly: Do you mean how can we make that happen more effectively?
The Chairperson: Yes. How can you make people appreciate that social services wish to do that?
Ms D Kelly: You can make them appreciate that by bringing them together so they not only hear it said in our training but experience it happening with social workers and social services. That will only be brought about by coming together and working together. That also enables social services to gain confidence in the community's ability. It is a two-way process.
We have run what we call designated officer training, when one of our days involves social workers and community people working together on issues. We have heard comments from both sides at the end of those days. Those in the community began to appreciate some of the confidentiality issues. People ask why social workers never tell them what is happening, but they began to understand the reasons for that. We have also heard comments from social workers. They were unaware of the good practices out there, because they have never talked about them. They have never interfaced with each other. When they do, and when they share on common issues, then there will be confidence on both sides - and it must be on both sides.
Ms Ramsey: I was interested in your presentation, as I am from a community background. You said that it is the perception that social services are the enemy, and that is true in the community that I represent. However, social services must also take responsibility for that. There have been high-profile cases, especially the Cleveland inquiry in England, where social services appeared to go in and take children away from their homes. We should be acting as a bridge between the community and the statutory sector.
There is also frustration when community representatives know that a child is on the child protection register, but the incidents continue. There is a perception that social services are not intervening. I know of some community groups that have taken the initiative and started to filter the Department of Health and Children's 'Our Duty to Care' document into their organisations. Should we educate the statutory agencies, instead of the community? I see the community taking the lead on many issues because they are aware of incidents happening in their community.
You welcomed the Protection of Children and Vulnerable Adults Bill, but you were concerned about some issues. We are dealing with predators who see it as their full-time job to go out and abuse children. I am concerned that some groups will not fall under the remit of the Bill, and will not have to follow the same guidelines and criteria. At the minute the focus is on intervention when children need protection, but we must shift it to public education, raising awareness and prevention strategies.
You outlined what those programmes involved and how they could be brought forward. We could have legislation that would deal with this issue in general terms, but there is a strong and vibrant community and voluntary sector, and we must work in parallel with it.
Ms D Kelly: I am convinced that there must be more opportunities for that interface. You referred to the statutory sector taking on board some of the issues from the community and voluntary sector. They must get together in partnership. The community sees the partnership as imbalanced, with the statutory sector having all the power. It must be better balanced, and the role and responsibility of the community sector must be recognised - and it must recognise that itself.
Ms Ramsey: It is easy to say that we will have a partnership approach. You said that the statutory sector cannot work in isolation, and I agree. However, the ACPCs still have no community representation. Is it a proper partnership?
Ms D Kelly: It is happening. I was heartened for the first time when I received a letter this week from the Northern Ireland Council for Voluntary Action looking for community representatives to sit on the children and young people's committees, and the boards had asked for that. That is a huge breakthrough, and it has been done through intense lobbying by the community sector. I am concerned that that might not get written into guidance, and a few years down the line we could be in a different position.
It is an essential part of any partnership at every level, and it must be at every level. The community must be represented at the highest level when decisions are made, and then we will see everybody taking their responsibilities and everybody acknowledged. That can be difficult for the community. They must get over some of the hurdles and barriers in their perceptions. People must go through the whole process. However, that process cannot be gone through until opportunities are provided, and those opportunities are not always there.
To be honest, getting funding for our work is really difficult. Our designated officer training is not funded. People are trying to find pockets of money, and yet there is a huge opportunity for that interface to work. Funding and resources are needed, and the provision and support of initiatives providing that sort of opportunity will happen eventually. Over the six years that I have been operating, I have begun to see a change in the attitudes of social services and the community, but there is a long way to go.
Ms Adair: Public education was mentioned. One of the important pieces of work that we have been involved in was the production of a leaflet for parents to let them know that these problems exist, and what to look out for with regard to child protection when their children are not in the home. We have been distributing leaflets to primary 1 schoolchildren, but that is only the start of a big process.
Ms Ramsey: I am aware that the Northern and Western Health and Social Services Boards provide programmes called Kidscape and Teenscape. All boards probably offer those programmes. The schools and youth clubs need to keep requesting those. That provision should be on a statutory footing, so that programmes are made available to all children automatically. The social services provide that service free of charge, but people do not know about it.
Ms D Kelly: I agree absolutely. It is a matter of informing people.
Mr Hamilton: On page two of your submission you recommend that
"a higher priority should be given to public education and to programmes that will have a long-term impact on the quality of life for children, such as parenting programmes."
Are you familiar with models of parenting programmes elsewhere that it would be useful for us to examine?
Ms D Kelly: In the voluntary sector, Barnardo's has spent a great deal of time developing a good parenting programme. One of its programmes disappeared because of a lack of funding. That was a great shame, because, through parents, it was successful in cascading work in the community. There is a programme called Sure Start, and there are some programmes that are just up and running that deal with good parenting.
Mr Hamilton: Do you have any evidence that such programmes are effective?
Ms D Kelly: I do not have direct evidence, because it is not part of our programme to collect evidence.
Ms Campbell: I can provide evidence on a small scale. A couple of years ago, I did some training in the Markets area of Belfast. The session was very honest and open. There were a couple of men in the group who spoke about volunteering for parenting programmes because they felt that they needed help. I thought that that was remarkable. They gave the group feedback on how effective the programmes had been for their families. That is on a small scale, but the awareness is growing and people are more willing to take part in such programmes.
Mrs Courtney: In paragraph 7 of your submission you state that
"An understanding of everyone's role and responsibility in safeguarding children in the community would lead to a better working partnership".
There is no statutory duty on anyone to take action to protect children. This is not the case in all countries. Would it be helpful to place a formal duty on people to take action if they knew of circumstances that indicated that a child was being abused? There would then be a clear community responsibility, but would such a responsibility help to protect children?
Ms D Kelly: That depends on what is meant by "responsibility". Over the past few years, there has been a huge debate about mandatory reporting. Mandatory reporting is not necessarily the right route to take. People should have a responsibility to report such circumstances, but in order to do that, they must be confident in their knowledge and understand the systems through which they report.
I do not mean organisations, I mean everyone in the community. Before I became involved in this work 10 years ago, I would not have known what to do with information about someone in the community, who to take it to, or how it would have been received. Every individual has responsibility, but people must have information and must understand their roles in order to take responsibility. That is what is lacking.
Mrs Courtney: I agree totally. I was a nursing professional, mostly in the acute sector. For the last five years that I worked I was involved in a European health promotion project, one aspect of which was a full-day workshop called "Street Smart" for children from primary 6 and primary 7. We got all the agencies together - the police, the fire service, social workers and the Health Promotion Agency. We took the children through a mock house and showed them how to prevent the risk of fire, for example. However, the real message that we tried to get across was about "stranger danger". At the end of the day a car was parked outside, but, because the children had gone through the house and they had seen the driver there, they did not regard that person as a stranger. Of all the children, perhaps only one refused to go over to the car to get sweets.
Education is very important, because most people think that "stranger danger" literally means danger from "a stranger" - not danger from someone with whom they have become familiar. Part of the community's responsibility is to increase awareness of the dangers. It was sad to note that, in most instances, the children did not regard as a stranger someone who had been around all morning, and they went with him or her. Those were children who were about to go into secondary schools, and it was very difficult to make them more aware of danger. Such programmes are important, but they are not done often, because of resource implications and the difficulty in involving the Fire Brigade and other agencies. The Western Board carried out that excellent educational programme, but not all schools are aware that such programmes are available.
Ms D Kelly: The "danger in the home" message is more difficult for adults to convey to children than the "stranger danger" message. If it is difficult for children to learn that the person with whom they have become familiar that morning may be dangerous, how much more difficult is it for them to learn that they need to be a bit wary even of their neighbours?
Mrs Courtney: The difficulty is in trying to get the messages across.
Ms McWilliams: You said that you had some concerns about mandatory reporting, but that was not included in the written submissions. Have you picked up those concerns in the community?
Ms D Kelly: No, not particularly. Mandatory reporting has been more of an issue among professionals in recent years, especially in the South of Ireland.
Ms McWilliams: Will you say something about that? The Committee is concerned about child protection, and this is not the first time that it has come across such concerns. Dr Ewan McEwan, a psychiatrist from the Young People's Centre, gave evidence to previous inquiries about those issues.
Ms Campbell: A big debate is going on in the South about reporting. It is not yet mandatory in the South, but there is a lot of resistance to it from all sectors. Some people are calling for it, but the discussion is a hotbed at the moment.
Ms D Kelly: One of the arguments that we have heard against it is that, if there was mandatory reporting, people would just turn a blind eye, and it does not take account of the fact that there are serious repercussions for people who report in some communities.
Serious concerns revolve around the issue of confidentiality. If people pass on information, will the rest of the community know who it came from, and will they be called publicly? There will be much opposition to mandatory reporting, which will not force people to report, as they will turn a blind eye and not acknowledge what they have seen. Encouragement and confidence-building are more likely to get people to work together for social services. The community would echo that.
The Chairperson: Thank you for your presentation, which has been very helpful. We have taken note of the main points.
MINUTES OF EVIDENCE
Thursday 26 September 2002
Dr J Hendron (Chairperson)
Mr P Berry
Rev Robert Coulter
Mrs A Courtney
Ms M McWilliams
Ms S Ramsey
Mrs I Robinson
Mr P Doran )
Mr O Brannigan ) Probation Board for
Ms V Owens ) Northern Ireland
The Chairperson: I welcome Mr Oliver Brannigan, Mr Paul Doran and Ms Val Owens of the Probation Board for Northern Ireland. Thank you for your submission, which has been very helpful.
Mr Brannigan: Thank you for giving us this opportunity. We feel that we have an important role in child protection, and we see this as a very important part. You know the status of the Probation Board for Northern Ireland in the criminal justice system: we are a non-departmental public body with a board drawn from the community.
Our position in the field is unique in that we have statutory responsibility for perpetrators of sexual abuse under various laws and statutes. Linked to that, we have a moral, philosophical and citizen's responsibility to protect victims of sexual and violent abusers of all descriptions. We have a unique position in the system.
I wish to reassure the Committee that we take our role in child protection very seriously, and the evidence for that is that we have carried out extensive training with our staff. We have raised the profile of child protection and made it an important issue in our organisation. Our stance is that child protection must be driven by the organisation as a whole, rather than by individuals or strata within it. Therefore, every member of staff engaged in such difficult and complex work knows that he or she has the surveillance and support of the organisation. It is very important that the staff of any organisation get that support, for it is a very difficult area.
Communication, internal and external, is particularly important, and we shall say more about that later. The inquiries into the tragic cases that have come to the fore in the press show that in each and every one of those cases, dating back to that of Maria Caldwell, which was a long time ago, people in the system knew that something was wrong but did not do enough about it. Our slogan is that "Our behaviour must be an appropriate response to our knowledge." If we know something is wrong, there is an onus on us to communicate that concern or worry internally and externally. We have set up systems both within and without the Probation Board to ensure that it happens. Our organisation has a part to play, and internally and externally we want to play it.
Ms Owens: I should like to say a little about casework, communication and, particularly, the multi-agency process for managing the risk presented by sex offenders. Obviously, good casework is the bedrock of good decision-making on child-protection issues, whether in our agency or in social services.
Over the last few years we have developed a much more objective model of risk assessment and management than we had previously. The development of knowledge, as Mr Brannigan said, is something relevant to all agencies, but we have tried to build our casework policies and procedures on the basis of research and knowledge. Consistency is very important, and we should like to see a consistent method of recording and assessment used across the child-protection system so that, when agencies communicate with each other, we talk the same language in relation to risk assessment.
It is obviously a very difficult area to be totally objective on, for there are huge emotive issues, but a great deal of good research has been done in identifying specific risk factors in relation to reoffending. As our job is the prevention of reoffending, it is a major factor for us that we get our risk assessments right.
There have been developments in the multi-agency approach to the management of sex offenders. Informal inter-agency structures were in place for several years, but a formal system now operates between social services, the police, and the Probation Board to exercise risk assessment and risk management of people who have been convicted of sexual offences and who are on the register.
That system has been in place for several months, and the Probation Board is involved by chairing meetings of the six local committees in Northern Ireland. They meet regularly and routinely assess, and where necessary provide, management plans to social services, the police, and the Probation Board. As a result of those meetings, tasks are allocated to those agencies.
Cases are regularly reviewed, and those that are assessed as presenting the highest risk will be forwarded to the regional organisation, the Northern Ireland Sex Offender Strategic Management Committee, which audits how inter-agency work is carried out.
That system has the potential to offer a lot to child protection in Northern Ireland. A weakness is that it focuses exclusively on sex offenders, unlike the similar system of multi-agency panels that operates in England and Wales. Those also focus on violence against women and children. Therefore, an equivalent panel in England deals with many people who present a risk of violence. Those groups are not included in our committee's remit, but the structure and system exist to allow that to happen.
Mr Doran: Ms Owens mentioned the importance of behaviour matching knowledge. We listened to your session with the Volunteer Development Agency, which said that we must create a society that values child protection services. I agree about the importance of community confidence in the child protection agencies, and vice versa. The phrase that is often used in childcare is "Damned if you do and damned if you don't". We must change that so that childcare becomes a profession that society values because it recognises that child protection is everybody's responsibility.
Prisoners' families are often a forgotten group in the provision of child protection services. Obviously, as a criminal justice agency we recognise that. Although it is not part of our statutory responsibility, we have, in partnership with community voluntary organisations, provided a service to prisoners' families for many years. That is based on research that tells us that children who have a parent in prison are more likely to offend than those who do not. I am not suggesting that child abuse in those families will increase, but that group has been recognised as vulnerable. Prisoners' families do not receive support from social services as a group unless there are child protection issues. Our experience tells us that there may be behavioural problems connected with the loss of the imprisoned parent, as well as economic implications.
The probation service is committed to public protection; we made that clear in our submission last week and in our corporate plan. The management of sex offenders is emotive, and we work with other agencies in that task. It is important that we always remember that, as has been acknowledged, sexual offences against children are a small percentage of the total. Indeed, sexual offences represent less than 1% of all recorded offences in Northern Ireland. The extent of the problem must always be kept in focus.
Society and elected representatives, rightly, have a serious concern about protecting children and vulnerable people from people who may prey on them. For that reason, we believe that accommodation where people are monitored and are under surveillance is much preferable to situations where we do not know people's whereabouts. Since 1997, there has been a responsibility on those people on the register to notify the police if they change their address, in addition to other responsibilities.
Research suggests that someone who is homeless is two-and-a-half times more likely to commit an offence than someone who is not. For that reason, we value stable accommodation. We ask the community to understand that, sometimes, somebody living in a hostel is much less at risk than someone living in an unstructured environment.
We work closely with the police, social services, voluntary agencies and, where possible, the community to try to manage that risk, because family members, parents, partners, employers, voluntary organisations and church groups have a key role in the management of offenders. Offenders come from the community and, unless they stay in prison forever, they will return to the community. It is very much everyone's responsibility.
The probation service, mostly through the good work of Ms Owens, has developed a service for the partners of perpetrators of sexual abuse, because they are often very confused. Ms McWilliams has visited that group and has been encouraged by some of the support and understanding that we try to provide to those people.
The Chairperson: I was going to ask about a consistent method of assessment and management of risk, but that has already been answered.
Mrs Courtney: Paragraph 4 of your submission deals with communication, which Ms Owens also mentioned. It states that the Probation Board notifies social services in all situations where there is suspicion that a child is at risk. Is that a statement of expectation, or are cases audited? Is there some means of evaluating that?
Ms Owens: It is an expectation and part of our child protection policies and procedures that, when a member of staff has any concerns at all, we do not make an assessment at that stage as to whether those concerns have any grounds. We automatically refer to colleagues in social services, who carry out that assessment. Sometimes our concerns do not have any grounds, and we get feedback on that. On other occasions, a case will go through the child protection process and a child protection case conference. Child protection issues appear in our monitoring systems; our casework files are regularly monitored by our internal systems.
Mr Brannigan: Not only is it an expectation, it is a requirement. Internal procedures are drawn down if we discover that a member of staff had a concern that, for some reason, was not communicated to social services.
Mrs Courtney: Thank you for making that clear.
Mr Hamilton: Paragraph 5 of your submission says,
"In terms of sex offenders PBNI is committed to the multi-agency procedures for the assessment and management of risk posed by sex offenders."
It then goes on to say that those procedures only cover adult male sex offenders. Why that restriction? The situation is different in England and Wales.
Ms Owens: It is different from England and Wales in that the procedures cover violent offenders. Those procedures partly arose out of discussions, working party documentation and joint involvement of several agencies, but they also arose out of particular concerns posed by sex offenders.
The initial inquiry was commissioned during Mo Mowlam's time as Secretary of State. It arose out of a concern about a particular case where a sex offender had returned to a local community or had moved into a housing estate. The development of the procedures very much came about through sex offenders. The reason adult male sex offenders are mentioned, as opposed to young sex offenders - because there are obviously quite a large number of children -
Mr Hamilton: Should it just refer to "sex offenders"?
Ms Owens: Yes. Some women and children commit sexual offences. However, the risk assessment models that we are using, and which are also used in England and Wales, have been developed through research on adult male sex offenders only. Therefore, they cannot be applied easily to women or children who offend. There are developments in the pipeline to create an appropriate model for assessing young offenders and women offenders.
That is not to say that agencies do not get together to examine issues concerning those individuals now - they do. Although they may not be included in the procedures, there are regular inter-agency meetings, either through case conferences or case strategy meetings, in regard to women or children who offend. Action plans develop from those meetings. It is not the case that nothing happens to deal with those groups of people; it is just that they are not included in the current model.
Mr Hamilton: Are there any plans to develop an all-embracing model?
Ms Owens: There are problems with resources. The current model applies only to those on the sex offender register. Many people convicted for sexual offences before 1997 are not yet included. A greater number of offenders have not been convicted or reported. We are talking about large numbers. The Probation Board envisages that convicted offenders, as well as those people who are suspected but not convicted, will be included through gradual implementation of the procedures. However, how those people are handled in the procedures will depend on the provision of resources.
Mr Brannigan: The present model was a major step forward. It was felt that it would have to be expanded incrementally. Had there been a "big bang" attempt to get it all working at the same time, it might not have worked. The idea is that once the procedures, the system and the recording process are working well, the ripples in the pool will extend further. It is a complex issue. The work taking place now will be evaluated next year, and we will learn from it and move on. In the fullness of time it will embrace more people.
Ms Ramsey: I appreciate that the Probation Board faces difficulties in managing offenders and trying to protect the community. It is committed to public protection, and, as you say, it has a moral duty to protect victims. However, there is a fine line between the rights of the offender and the rights of the community or the victim.
On page 3 of your submission - and you have referred to it today - you say that it is preferable that offenders live in a settled community rather than living nomadic lifestyles, and Mr Doran explained that. However, your submission also says:
"PBNI support the principle of constructive community involvement in the management of potentially dangerous offenders. However, community access to a sex offender register in itself would not protect children".
Although I take your point about constructive community involvement, the submission seems contradictory, and I would like you to explain it. We hear in the media every other day about so-and-so being placed on a register. We all have a key responsibility, but the Probation Board should take the lead in educating the community about why it is better that people know where offenders live.
Media reports show, for example, that Mr A, who has various convictions, is living near a school. Although I appreciate that Mr A has rights, the community's response to his being near a school must also be appreciated. In some cases, the Probation Board contacts either the school or the local community group, but the whole community is not informed, thus creating tension with the Probation Board. Is that a formal arrangement? Mr Doran said that the Probation Board's actions must match its knowledge. The knowledge in that example is that Mr A has been convicted of various offences; therefore, the Probation Board's behaviour must match that knowledge.
Mr Brannigan: Absolutely.
Ms Ramsey: There are stipulations associated with the parole of sex offenders. Does the Probation Board have a formal duty to inform Mr A's victims that he is out on parole, even though he is not allowed to live near them? Who monitors such cases?
Mr Brannigan: The Probation Board does not have a legislative responsibility to notify victims. However, the criminal justice review has shown that victims must play a more prominent role in the system. When the review is implemented, while the offender is in prison, it is the responsibility of the prison department to notify the victim, bearing in mind the constraints. When the offender is released into the community, he or she becomes the statutory responsibility of the Probation Board, which is responsible for liasing with the victim. While the offender is going through the system, the Director of Public Prosecutions is responsible. The responsibility moves with the location of the perpetrator.
In an ideal world, the Probation Board would be in a full and frank partnership with the community. Ms Ramsey is right: on occasion, we notify small sections of the community. Whether we like it or not, the Probation Board's experience has been that, if it is common knowledge that a sex offender is living in a community, the sex offender is made so unwelcome that he or she must move on - it is a fact of life.
One of the most devastating labels in Northern Ireland is "sex offender". It jeopardises the person's employment, home and leisure time, which are three elements of the sex offender's life that the Probation Board monitors. If the board notifies a community, it has concluded that it can protect it on one, or all, of those issues. In the past, for example, the board has told employers that they have employed unsuitable people and it has told the management of leisure facilities that there are people using them who should not be. However, that is done only after the offender has been given the opportunity to desist from activities that the board believes are too great a risk.
We must get to a position in Northern Ireland where it is possible to be identified as a sex offender, either through self-identification, family identification or organisational identification, and still be allowed to function as a citizen. If sex offences take place in a family, as most of them do, the price of owning up and declaring them outside the family is devastating for the offender, and, perhaps more importantly, for the family, because, once the offences become apparent, the whole family's employment, leisure time and ability to live as citizens is threatened.
The victims of sex offenders include the perpetrator's family. An example of that is the recent case of the two girls in England. The families of the people arrested for those offences have suffered; they have lost their employment, homes and friends. It is not easy, but the community, statutory organisations and politicians must come together to facilitate sex offenders who seek help. The price for seeking help is so great that I cannot imagine anyone seeking it voluntarily. We must all look at that.
We want to involve the community, and I assure the Committee that if we believe that we cannot manage a risk we will involve whoever we have to in order to negate or to manage it. We would not allow a situation to continue where we felt that a community was being placed at risk, either collectively or individually, in order to protect the perpetrator. Offenders know that; it is made plain that confidentiality and their rights take second place to the rights of those who may become their victims. That is how we work with people. Ideally, we would work in full, open and frank partnership with the community. However, that is not yet possible.
Mr Doran: May I explain "notification" for people released from prison. Mr Brannigan has explained what is proposed in the Criminal Justice Bill. The Probation Board has a responsibility to notify social services when a person charged with or convicted of a sexual or physical offence against a child is released, whether on bail, home leave or after serving a sentence. We notify social services, who in turn may notify the victim.
Ms Ramsey: Does that include adult victims?
Mr Doran: Not at present.
Mr Gallagher: I agree that there should be constructive community involvement and that the rehabilitation of offenders is important. However, your arrangements do not seem to convince communities, and in particular parents, that their children are safe from ex-offenders. How can you improve them?
Mr Brannigan: The Probation Board fully accepts the legitimacy of the community's wanting to be involved. We also fully accept that we will have to earn the community's confidence and that we cannot do that through inaction. We must be proactive and demonstrate that we can be trusted to deal with what is probably the most emotional and frightening problem that any parent or community must deal with. We must set about earning that confidence.
The only way of earning their confidence is to build a body of knowledge about what constitutes danger and how it can be managed; we need the skill to implement that knowledge and, importantly, to do so consistently. We want the community to be able to say that we can be trusted to do what we said we would. We must earn that. If we fail, we do not deserve community confidence and we would be unable to play an important part in helping sex offenders to be citizens of the Province.
Mr Hamilton: You say that you notify leisure centres where required, but the bottom line is: how does anyone know? For example, if you notify a leisure centre about Joe Bloggs, how will the little girl or the young fellow standing in the kiosk collecting the money as people go in and out know who to look for?
Mr Brannigan: We inform the manager of the leisure centre of what Joe Bloggs - who always seems to take a hammering - looks like and tell him that we understand that Joe Bloggs is attending the leisure centre on a Tuesday when the local primary school is there and that he should not be let in. First, we would tell Joe Bloggs that if he continued to visit the leisure centre at that time, we would tell the manager and all the staff who he was and what he had done. We would tell him that this was not a suitable activity for him and that if he wished to visit the leisure centre, he should have his swim on a Wednesday night when the local rugby club attends.
Mr Hamilton: Would they be provided with photographic evidence to keep under the desk?
Mr Brannigan: They would be provided with enough information to identify the person who we felt was attending their centre inappropriately.
Ms Owens: Under the Sex Offenders Act 1997, it is possible to seek a civil order restricting a person from attending leisure centres or hanging around schools if their presence is a cause for concern - even if they have not committed an offence. If that is breached by further sightings, even if no criminal offence has been committed, it becomes a criminal offence subject to up to five years' imprisonment. The legislation is not without teeth: if, after his release, a sex offender continues to act in a manner that causes the community concern, sanctions can be brought to bear. One of the advantages of the multi-agency approach is that information, some of which comes from the community, is shared between agencies and this has led to several applications being made for such orders. These are expected to increase.
Ms Ramsey: How many times has that happened? How many people have had their parole revoked and for what reasons? I am, of course, conscious of confidentiality. How many civil orders have been applied for that led to criminal proceedings? We are trying to cover many issues in this inquiry, and it would be interesting to find out such details.
Ms Owens: Granting home leave has now been restricted for people who are considered a risk. On several occasions, it was decided not to grant home leave to people who have committed sexual offences. Obviously, that cannot affect their final release date, but decisions about granting home leave to people who are seen as a risk to children or to adults are made on whether the risk can be managed during their home leave. It often cannot. I cannot give you numbers, but those decisions are made by the prison with the Probation Board, police and with other agencies.
Mr Brannigan: That is correct. Some people are not getting parole now who would have got it a couple of years ago because of a systematic risk assessment that finds that the risk is too great for us to handle with the co-operation that they are prepared to give us, for example, about where they live. That is happening often.
Ms McWilliams: It is great to see how far we have come in this work; your submission and your appendices on inter-agency guidelines demonstrate that. It is interesting that most of it was developed in the 1990s, which shows how much our knowledge has advanced. It will undoubtedly continue to advance, particularly through your work with offenders. Some of those programmes are releasing information that is adding constantly to the guidance; hence the importance of your role. I am glad that you have put on record the importance of surveillance of offenders. There is a great deal of discussion in the Assembly about "Sarah's Law", which I oppose, as some of this guidance will keep children much safer than a law that would simply let everyone know who those individuals may be. The detailed inter-agency guidance on the release of offenders, which was developed in 1996, is very useful in relation to schedule 1 offenders. Has it been updated or broadened?
Ms Owens: It is being updated to form part of the 'Co-operating to Protect Children' document. Initially, that was in the sex offender risk assessment and risk management procedures, but was then removed because schedule 1 offenders are those who also physically abuse children and commit acts of cruelty. It needed a broader base, but it has not been revised completely.
Mr Doran: I understand that the document is ready, but it was felt that the recommendations of the Committee's inquiry would have serious implications for the guidance.
Ms McWilliams: I attended the launch of the Northern Ireland Sex Offender Strategic Management Committee's guidelines and have read all the material, which is useful. I have been concerned that those who work with victims and who are knowledgeable in their field, in the same way that you are from working with offenders, are not involved in the process. Over the years, Women's Aid has fed a great deal into your programmes, and it is always good to check with the victims to ascertain whether those programmes work. However, victims do not generally sit on those committees, although the National Society for the Prevention of Cruelty to Children (NSPCC) has victims' representatives on its committees. The expertise of those groups has fed into the Northern Ireland Regional Forum on Domestic Violence over the years, which works with sex offenders in much the same way. There should be more inclusivity; organisations such as the Prison Service, the PSNI and the Department of Education all have important roles to play.
Mr Brannigan: You will put your own value on this, and it has been discussed many times, but one of the functions of MASRAM is occasionally to discuss cases that cause concern. I cannot speak for MASRAM, as I am only a member of it.
Ms McWillams: What does MASRAM stand for?
Mr Doran: It stands for "multi-agency procedures for the assessment and management of risk by sex offenders". The acronym is not perfect.
Mr Brannigan: We were not sure where a victims' organisation fitted into the discussion of cases; we are wrestling with that problem.
Ms McWilliams: We must stop using acronyms, because if we want to raise public awareness we must say what we mean. The area child protection committees say that it would be great to have community involvement and expertise. The local women's organisation, Footprints Women's Centre, knew a great deal about the Jasmine McGowan case, yet it was revealed only later that it had repeatedly tried to raise awareness about that family to get something done. The group felt that its voice was not taken as seriously as those of the professionals.
Inquiries constantly find that local people knew that children were in danger but did not know who to contact or how to share their knowledge. Local and regional committees fail to seek local knowledge; local knowledge must be involved.
Mr Brannigan: We should not undervalue the information that such bodies have; their voices should be heard. As an interim measure, we must ensure that there are well-publicised methods for people to voice their concerns. We have a big responsibility - and rightly so - to ensure that such concerns are communicated to whoever can address them. Our organisation's argument is that if a person knows something, he or she must inform those who need to know. Everyone must follow that guidance.
With regard to the unfortunate Jasmine McGowan case, we should examine whether the information was communicated to someone who failed to act on it or whether there was no opportunity to communicate the information. Those are two debates. It is one thing if the information was communicated and not responded to appropriately; but it is another matter if there was no way of communicating that information. The two debates must be brought together.
Ms McWilliams: It was a bit of both. There was one problem among the professionals and another outside the professional network. As we often find, what happened was a combination of both problems.
Ms Owens: I share your concern that information from those who work with victims and survivors of sexual abuse is not finding its way directly into the system. However, I can give you some reassurance that, at local level, when cases are discussed, people who work with victims and survivors attend meetings and provide feedback. They have raised new concerns. For example, this week we were made aware of a victim who has come forward because the perpetrator has threatened to take revenge on her for reporting the abuse. She had the confidence to report that he might have been stalking her again.
The confidence to come forward is important in this debate, because the public health approach to sexual abuse, which the witnesses from the Volunteer Development Agency spoke about earlier, is vital. It is not organised properly at present, which brings us back to the question of how we get information to the community on how the processes work.
Ms McWilliams: I asked the Volunteer Development Agency about mandatory reporting because I am concerned that there is a great deal of confusion about what it involves. Obviously, there is a problem, as people think that the speed at which the process moves after they have reported abuse takes control out of their hands. I note from your evidence that you regard reporting abuse as a duty. The witnesses from the Volunteer Development Agency were unsure about what was meant by the term "mandatory reporting". What is your position on that?
Ms Owens: There are difficulties with reporting sexual abuse of children, because, unfortunately, a child who is being sexually abused is most likely to tell another child. Mandatory reporting in such circumstances would create many difficulties. We must consider how it will affect the child who has the information. It also says a great deal about abused children's lack of confidence in adults.
I am not convinced that making it a legal requirement to report abuse would make people any more likely to do so. However, people would have more confidence to report abuse if approachable helplines were set up and if there were more public education on the nature of abuse and what happens to those involved once abuse has been disclosed.
Ms McWilliams: Public awareness information is missing; advice is available on reporting but not on the steps necessary to assist the process.
Mr Brannigan: I agree. The debate is between duty and responsibility as opposed to a legislative requirement. It would be good if people felt a duty and a responsibility to report incidents and could be assured that if they reported a sex offender they would not be starting on a roller coaster ride; that there would be checks and balances on the way. It is often those nearest the perpetrator who know what is going on. However, if they feel that they will be punished rather than facilitated and praised for reporting the offence they will be unlikely to do anything. We must ensure that people who report sex offences in a family are supported and facilitated rather than suffer repercussions. It must be a duty and a responsibility to report offences; however, I am not sure how the legislation could be policed to enforce reporting, as those involved must understand the implications.
Mr Doran: It is important to remember that the focus is on sexual abuse, and most abuse is not sexual. It is worth recalling that recent estimates show that 30% of sexual abuse against children is perpetrated by other children; that must be borne in mind when considering the introduction of mandatory reporting. I know that Childline struggles with that problem.
Mrs Courtney: Is it the case that there is no duty to inform the Housing Executive or housing associations when rehousing offenders? A story will go round a community very fast; a public meeting will be held and, before you know it, the whole community is up in arms because a sex offender is living in the area. There is no duty on the Housing Executive to advise local councillors.
Mr Brannigan: If a sex offender is to be rehoused, the Probation Board, the PSNI and social services work closely with the Housing Executive, which has a clear strategy of checks and balances. The unpalatable truth is that there are as many sex offenders who are owner occupiers or who are in private accommodation, such as houses in multiple occupation, as there are in Housing Executive accommodation, where only a small percentage of sex offenders are housed. Our job is made very difficult if sex offenders disappear into private landlord bedsit accommodation because they cannot live normal lives.
The Chairperson: We are very grateful to the witnesses from the Probation Board for Northern Ireland; thank you for your helpful presentation.
MINUTES OF EVIDENCE
Thursday 26 September 2002
Dr J Hendron (Chairperson)
Mr T Gallagher (Deputy Chairperson)
Rev Robert Coulter
Mrs A Courtney
Ms M McWilliams
Ms S Ramsey
Mrs I Robinson
Mr I Elliott )
Mr C Reid ) NSPCC (NI)
Mr J Marshall )
The Chairperson: I welcome Mr Elliott, Mr Reid and Mr Marshall from the National Society for the Prevention of Cruelty to Children (NSPCC). Thank you for your documentation, which my colleagues have read and about which they are very anxious to ask you questions. Please make a few general points, after which we shall go straight into questions.
Mr Elliott: Thank you for the invitation to present oral evidence to supplement the paperwork which we have already lodged with the Committee. On behalf of the NSPCC, I welcome the Committee's interest in the subject, and I congratulate you. There is no issue more pressing or important than the protection of children. You will find 42 recommendations in our written submission. I do not intend to detail them, but we shall answer any questions which you may have about them or other issues.
I shall keep my remarks brief to maximise the time so that we can explore issues through questions. We intend to seek new solutions to old problems. In essence, our recommendations can be brought together under three headings: first, greater investment in child protection; secondly, the need for a clearer strategy in how we address the issues; and thirdly, a more effective and strengthened structure.
The present situation is unacceptable, and we seek change. The level of child abuse experienced by young people in the community is unacceptable, and we want to play our part in reducing it. We view this inquiry as a very important development. It is opportune, and it can facilitate change which is long overdue. We are available to support that process of change.
Ms Ramsey: Thank you for providing recommendations; that is very helpful. The Committee has had several presentations on this issue, and the area child-protection committees (ACPCs) will be coming soon. We have heard from paediatricians and social workers about their involvement. Sometimes it does not seem important that other organisations are not getting involved.
There is an argument for making the involvement of organisations statutory, since that would give them a clearer vision about the subject. Do you think that it should happen?
Mr Elliott: The ACPCs are not statutory. They are referred to in the guidance to the Children (Northern Ireland) Order 1995 but not in the Order itself. We welcome the fact that there are moves to address that and put the committees on a statutory basis. It is important, for the message which it will communicate will be that their work and the contribution which they make are absolutely crucial to the service being delivered to protect children.
It is important that the service not be seen as the sole responsibility of the social services, the designated child-protection agencies, the police and the NSPCC. Several disciplines and agencies have roles to play. We need that multi-disciplinary inter-agency forum to bring the issues together, underpinned by statute so that people have a clear understanding that it is core business. It is not an optional extra; it is something that has to happen so that children are protected. We welcome those moves very much.
Mrs Courtney: In page 6, paragraph 4 of your submission you state that your organisation recommends the establishment of child-death review teams. How would those be made up? What would their remit be, and would legislation be required to bring about the service you describe? To whom would they be accountable?
Mr Reid: Child-death review teams operate in many parts of the world, primarily in America and countries in the southern hemisphere. Their remit is to review unexplained child deaths. Some review all children's deaths, and some review unexplained deaths of children. We see them as important forums for the exchange of information on a multi-agency basis. Particularly in the case of babies who have been shaken or young children who have died, all research shows that there is often misdiagnosis. Retrospective studies have often shown that, in situations where it did not seem that there was abuse, it was likely that there was. We see child-death review teams as an important mechanism to exchange information and complete a jigsaw when a child tragically dies.
Our colleagues in the medical sector now advise us that the coroner's process operates virtually in isolation from the wider paediatric and social service environment, and the exchange of information is not good. A child-death review team would bring together those processes and agencies. Following a child's death, moves are afoot in the Southern Health and Social Services Board to establish a child-death review team or process. We have supported that.
Legislation would not necessarily be required. A clear procedural protocol operating between all agencies - as exists in other parts of the world - is essential. Some counties in England have child-death review processes. The police, coroner service and health and social services must all be involved in the creation of a clear protocol.
Mrs Courtney: I agree. There were a couple of related cases, particularly the one in America which involved a girl who was looking after children. That was such a lengthy, drawn-out case that it was brought to everyone's attention. Perhaps that is why I thought it an important aspect to establish, and I am grateful to you for bringing that to our attention today.
Rev Robert Coulter: The fifth paragraph on page 6 of your written submission states:
"Most children are unwilling to discuss their problems with professionals."
You suggest that ways must be found to encourage children to engage with the system. That would certainly assist those who are old enough to do so, but what about the very young? You describe the system as reactive. Is that because of the nature of the statutory duties - responding to information rather than seeking out abused children in places or circumstances where we know abuse or neglect is likely - or is it a question of resources and trying positively to avoid cases?
Mr Elliott: We are drawing attention to the fact that it is fundamental that every young person understands that they have someone available to turn to and that, if they have a worry or concern, they know to whom they can speak to have that worry addressed.
It is also important that we try to identify and eliminate any barriers which may exist that make accessing that service difficult or even impossible for the young person. We welcome the growth of helplines, for instance. Our national child-protection helpline is an attempt to make a trusted and trained adult available who can respond to a child's needs, at least over the phone.
We want to emphasise that the responsibility lies with us adults to try to address young people's needs, and we must examine a variety of ways in which we can do that.
You emphasised the important issue of resources. It is important that all child-protection agencies invest heavily in being as open as possible and in reaching out to young people to ensure that they share their concerns or worries with us and tell us if are experiencing abuse. Research has shown that a significant number of young people have had such experiences, and when they are going through them, they do not share that information.
The reference to the child-protection system as being reactive in nature is merely to emphasise the importance of information. If information does not come to us, we are largely powerless as we are currently structured. We are giving serious thought to that issue.
Rev Robert Coulter: What about the very young?
Mr Elliott: We must improve our ability to communicate with children and to listen and to reach out to them. Did you have an age group in mind?
Rev Robert Coulter: I am thinking of very young children at the baby stage and immediately afterwards who cannot articulate properly or request help. What is happening in that sector?
Mr Marshall: In monitoring the health of the very young and the most vulnerable in our society, we recommend that everyone involved with babies, from the antenatal stage onwards, be fully up to speed on child-protection issues, that reporting protocols be in place, that there be good practice and that they learn from some of the inquiries not just what went wrong, but also what works in child protection. Society places an onus on professionals to guard the very young who cannot talk for themselves. The professionals involved have to be up to speed on child-protection issues.
Ms McWilliams: If it were within our remit to get the resources for all 43 recommendations, we should do so this afternoon. The recommendations are very thorough. I have been reading your statistics and the UK-wide statistics on prevalence. You constantly make the point that we should try and get some consistency in recording and keeping files, and I agree. It is surprising that there is so much inconsistency across Northern Ireland and the area boards. If you were to introduce that, would it be considered, given the level of under-resourcing which we hear about every day we take evidence? You have called for the introduction of child maltreatment measures, but alongside that you ask for some of the indicators to be extended, as it is not just physical or sexual abuse which we are looking at. Do you think that it might be interpreted as adding another layer of bureaucracy, or might it highlight some of the preventative strategies which we could begin to put in place?
Mr Elliott: You have drawn attention to an important issue, which is that we have an incomplete understanding of the problem's extent. That is because there are several different ways of measuring it and several different perspectives. That is why we recommend that there be consistency throughout the community. As a result of applying that consistency, we can make clear statements about the extent of the problem. When we have that understanding, it is to be hoped that some resources will follow.
It is not intended to be a barrier or an added layer of bureaucracy. It is an attempt to gain clear insight and understanding into the extent of the problem.
Ms McWilliams: How would that feed into your other recommendations on the need to develop a clear strategy for child protection?
Mr Elliott: It is complementary in the sense that the strategy must be based on the firmest possible evidence available to us. That has to come from the use of child well-being indicators across the board. As a result, we shall have an understanding of the extent of the problem; the two go hand in hand.
Mr Reid: There is a common misconception about sexual abuse, for example. Sexual abuse will often predominate in the news. That is a serious problem. We carried out a UK-wide survey into the likely prevalence of abuse and found that children were seven times more likely to be physically abused by their parents. That must be considered when services are being planned. We must remember that this inquiry resulted from a shaken baby case, and there have been several such cases in Northern Ireland. We must obtain good statistical information on which to plan our services, and the Department of Health, Social Services and Public Safety must lead those services. In conjunction with ACPCs, the Department has a clear strategic role in setting the context of planning children's services. It needs good information, and it must be resourced to develop a strategy in child protection, for it does not have one.
Ms McWilliams: The evidence which the Committee has taken and your recommendations show that many bodies are being established - if they have not already been so - but they are all disparate, and that concerns me. For example, the Sex Offender Strategic Management Committee is new, but that was criticised because there seems to be a lack of community involvement in it. We also have ACPCs at the Department, and the child-protection review may be established as a result of your recommendations. How do you see all those coming together? At the end of this inquiry we should be able to implement a strategy based in the Department, and other procedures will result from that. Is that not the case, and what could we recommend that might be an alternative to those disparate groups?
Mr Elliott: Yes is the simple answer. You are right to draw attention to the fact that our structure lacks coherence and does not have a central point which can be used as the forum to establish a clear strategy for the child-protection system.
We recommend that the child-protection review group, which the Department is establishing, becomes such a central point through its membership. It also has the potential to bring together the learning which is taking place in the system but is not being shared. An example is the dissemination of learning through case management reviews. Case management reviews report to ACPCs, but the lessons learnt from each of those reviews do not have a major impact on the system because that learning is not shared. We must disseminate information in a much better way and ensure that we learn from experience.
Ms McWilliams: Does that fit in with the views of the southern ACPC? It recommends a regional taskforce, which is something different again. It is aware that the departmental child-protection review is going on. Are we in danger of duplication if we have a taskforce and a review group?
Mr Elliott: A decision must be made on that. The Department has already made a move to establish a child-protection review group, but it has not yet met. However, it has released details regarding the make-up and membership of that body. The group has the potential to create a central forum for the oversight of the entire child-protection system. We sought to address the lack of strategy in the child-protection system, and the group has the potential to act in a co-ordinating role and establish the coherence which is lacking in the structure.
Ms McWilliams: Northern Ireland is a small enough country for us to be able to do that.
Mr Elliott: We are talking about 1·5 million people, which includes 460,000 young people. That is not a massive body in UK terms. We have the potential to do it, and the structure is embryonic form, as the Department is in the process of creating it. It has potential, but the decision to give it that role must be made. That is what we shall do.
Mr Gallagher: The submission contained some good information and involved a great deal of preparation. I was interested in the response to Ms McWilliams's question about a strategy. I am not sure that we are close to developing a clear or coherent strategy. We must bear in mind that such a strategy is for the benefit of the public, and young people and parents in particular. Teachers also play a part and are conscious of those issues and alert to the dangers. They have a strategy with a small "s" to deal with those problems in their working environment, yet even they have no understanding of the greater strategy which we aspire to create. Can you bring any simplicity to that difficult area? What three elements would form the bedrock of a clear and coherent strategy?
Mr Marshall: The NSPCC is involved in ACPCs in all areas and is one of the few organisations which has an overarching view of the situation in Northern Ireland. The NSPCC sees duplication, complications and a child-protection system which the public and professional groups do not understand. Such groups do not know where they stand or what the structures are. "Rationalisation and simplification" is the best way I can put it. Sharing good practice and procedures is also important.
Mr Reid: It is important to have a balanced structure. That balance must be achieved at departmental level, on a local level through ACPCs and on the ground with child-protection teams and through professional liaison. Each of those structures has a role to play, and they are linked by good communication. I take Ms McWilliams's point that many disparate groups seem to be involved, but they all play an important role. The secret is establishing good communication to ensure that no group operates in isolation. A top-down triangle-like structure links groups together coherently.
Ms Ramsey: It is good to get recommendations and know why they are needed. I want to congratulate the NSPCC on its most recent publicity campaign "Real Children Don't Bounce Back", which has helped to educate the public. Responsibility for the care of children does not simply lie with the child-protection agencies, social workers, police officers and the NSPCC - it is everyone's responsibility. It is important to make that clear. Everyone in the community must understand the issues involved. They must first accept that abuse happens and think what contribution they can make to prevent it. That is exactly what the campaign sought to do.
Mr Reid: The consultation on physical punishment in the home is ongoing. Irrespective of people's view on that, the smacking and shaking of young babies is still an issue. Parents must be educated to understand that they must not smack young babies. Research shows that at least 50% of parents have smacked a baby aged 12 months or younger. The Department of Health, Social Services and Public Safety, through its health and social services professionals, could launch a co-ordinated campaign to help parents understand that they must not do that. The campaign could educate parents about the dangers of shaking young babies, help them find other methods to deal with their children, and encourage them to seek help if they have a difficult baby. One small thing that would make a difference would be if the Department of Health, Social Services and Public Safety co-ordinated and used it in all its professional bodies. There is no point in one organisation doing it - the Health Service, social services and everyone else must sing from the same hymn sheet.
Ms McWilliams: You recommended mandatory training for accident-and-emergency (A&E) staff. That results from a concern about a possible lack of training and worries that staff may be unable to pick up signs of abuse early enough. You go on to argue for protocols and better guidance for all A&E staff. The NSPCC is a lead agency in knowing what is wrong in the system.
Mr Reid: Barnardo's, in conjunction with the Department of Health, Social Services and Public Safety, has been carrying out a survey of A&E departments. They are due to write that up soon.
We surveyed all lead consultants and lead casualty sisters and asked them about child-protection procedures - what procedures they used, their experience, and whether they used the child-protection register. The results are not fully written up, but it is clear from what we have received from front-line staff that diagnosis and recognition - and what must be done after diagnosis - are problematic. If a doctor diagnoses that child protection is necessary, clear procedures state what must be done next. All the academic research shows that child abuse is very difficult to diagnose.
Lack of specific guidance for A&E staff on the medical diagnosis of child abuse is an issue. There should also be mandatory training for all lead staff in A&E departments. In the Northern Health and Social Services Board, one hospital has introduced a mandatory training course for all its casualty staff run every six months. It is regarded as highly successful and very good at helping the staff deal with problems. We must develop those types of procedures. Thirty thousand children were admitted to the Royal Belfast Hospital for Sick Children last year. Accident-and-emergency departments are the key places through which children gain access to hospitals. Therefore, if staff do not have the procedure correct, many signs of abuse will be missed.
Mr Elliott: Until recently we assumed that people understood that those who come in contact with children in such situations would be trained accordingly. When we examined that and looked at what training was available, we were surprised at the evidence, not just for A&E doctors, but for teachers in training. People in such professions must be able to recognise the signs and symptoms of abuse. That reinforces Rev Coulter's point; staff must have the ability to understand or suspect that a child has been harmed, as well as the knowledge of what should follow and a willingness to carry out the procedures. Often professionals do not receive that training and therefore do not have that knowledge, consequently being unable to act on the problem.
Mrs I Robinson: I should like to apologise for missing the presentation, but I have read the submission, which is very helpful.
Does a lack of funding prevent the use of high-profile campaigns to educate the public about the dangers of shaking babies or smacking them at an early age?
Mr Marshall: The Department of Health, Social Services and Public Safety recognises that the NSPCC is taking a lead in campaigning, on television, through leaflets and by other means. As Mr Reid mentioned, campaigning could be taken on centrally. For example, many resources are put into antenatal care and similar services, and people ask all kinds of questions, such as what is the best car seat to buy, but they are not told what to do with a crying baby, for example. That is not the fault of health professionals or those on the front line. They are under pressure to deliver on many other issues.
Mrs I Robinson: Such campaigning could be incorporated into the treatment which a woman receives when she is first told that she is pregnant - her education could begin then.
Mr Marshall: That is correct - preparing for parenthood. Other countries have a better system than we.
The Chairperson: That certainly makes sense. I should also like to reiterate what Ms Ramsey said. I should like to thank you, not only for coming today, but for all your work over the years. We have great admiration for you. You have also been very helpful to the Committee in the past, and we greatly appreciate your documentation.
Mr Reid: We shall publish that, and we have written it in such a way that we hope makes it relevant to political parties when they come to develop policies. They may use sections of it - they need not use the whole thing.
The Chairperson: One dare not speak for any political parties. That is helpful. Thank you.
MINUTES OF EVIDENCE
Thursday 26 September 2002
Dr J Hendron (Chairperson)
Rev Robert Coulter
Mrs A Courtney
Ms M McWilliams
Ms S Ramsey
Mrs I Robinson
Ms Angela Courtney )
Ms D Mehaffey ) Women's Aid Federation (NI)
Ms M Brown )
The Chairperson: I welcome Ms Angela Courtney, Ms Debbie Mehaffy and Ms Marie Brown from the Women's Aid Federation. My colleagues have read your documentation, which has been very helpful. Please give us the main principles rather than going through the whole document, after which we shall ask questions.
Ms Angela Courtney: I deal with the strategic, consultation and policy issues on behalf of a federation which is one of the Women's Aid Federation groups throughout Northern Ireland. Marie Brown is a team leader in Foyle Women's Aid, and she will speak to the body of the paper and answer your questions. Debbie Mehaffey is responsible for the Northern Ireland Women's Aid Federation young persons' project, and much of that deals with preventative work. Until recently she was a childcare worker in one of the main refuges in Belfast.
Ms Brown: The report has been compiled using the experience of 11 groups throughout Northern Ireland, and I shall start with the key points on casework.
A lack of resources in some areas means that no identified social worker is attached to families at risk, and children are not being protected. We highlight children at risk who cannot get a social worker for some time because of the lack of social workers and duty social workers. Families may have to wait for two or three months before they are allocated a social worker, and that concerns us.
Domestic violence is treated as a specialist issue, and as a result social workers in contact with families may have little or no understanding of the wider context of domestic violence. We have raised that issue through the social care councils. It is not a specialist issue, for it involves seven tenths of a social worker's caseload, and the problem of domestic violence throughout Northern Ireland speaks for itself.
Other agencies do not understand the work of Women's Aid and the wide service which we provide. A demanding workload for the already stretched social services means that children at risk are not necessarily identified and protected from harm. There are strategies and developments in the Police Service of Northern Ireland (PSNI) and other agencies. However, quite often no training or information is fed through to social services, and they cannot avail of such support.
The professional judgement of our service in carrying out child-protection procedures is not always respected or accepted. Women's Aid is the leading agency supporting women and children who suffer from domestic violence, and it has considerable expertise in that area. Co-operation between agencies makes good sense when resources are stretched. We should highlight children at risk, but quite often that need is ignored.
After domestic violence has been identified in the family, women have sometimes been accused of failing to protect their children from the direct or indirect dangers of the abuse which they suffered. Instead, they should be helped to make themselves and their family safe. We must encourage women to come forward and get support before the family suffers a crisis. There must be an understanding of the need to protect the woman and understand her role in protecting her children.
We do not know how many children suffer from the experience of domestic violence, since not all agencies record it. The Scottish Women's Aid report for 2002 estimated that 100,000 children and young people in Scotland are living with domestic violence. The regional forum on domestic violence commissioned PricewaterhouseCoopers to carry out research in Northern Ireland. It produced a figure of 11,000, which is widely regarded as an underestimate. PricewaterhouseCoopers suggested that to estimate the extent of domestic violence adequately it would be important to have a clear understanding of what domestic violence is. There are only a few agencies here which audit the figures for children, and therefore Northern Ireland does not have a picture of how many children experience domestic violence.
Responses by social services are inconsistent. A social worker trained to have an understanding of the implications of domestic violence for children might respond in a more positive way than one with little or no understanding. The pressure placed on family and childcare teams means that it is often the least experienced members of staff who deal with the very complex issue of protecting children in an environment of domestic violence. That has been shown in research and by what we have heard from women.
No single agency can totally support a family, especially in cases of domestic violence where the protection of survivors, the prevention of further abuse and the prosecution of perpetrators depends on effective inter-agency work.
Communication between social services and Women's Aid staff has often been effective in a crisis situation where domestic violence has been highlighted, and children and their mothers avail of refuge. However, communication may break down owing to heavy workloads or a lack of social services resources. In place of a multi-agency approach, that essential work tends to be handed over to workers in Women's Aid. Some families who go through a refuge have children on "at risk" registers, and quite often that can be ignored.
Families may be rehoused, seeking safety from abuse in areas beyond the social worker's remit, leading to problems with ongoing support services for children. Children need to know what is happening to them, and quite often when decisions are made they are the last to know. Children and young people's voices must be heard. The ethos of the UN Convention on the Rights of the Child reflects the importance of listening to the child. However, experience has shown that those children have no voice, are not being heard, and may not even be counted. In giving children a voice, services must develop an environment which provides privacy and establishes a relationship of trust so that the child feels able to talk about his or her experiences.
The link between agencies involved in the protection of children must be consistent. Training in all areas of child protection should be developed and delivered to adults working directly or indirectly with children, and the vetting procedure should be mandatory.
Clear distinctions must be made between abusive fathers and non-abusive mothers in domestic violence cases. Non-abusive mothers should be identified as an invaluable source of long-term support for their children, and they should be given support themselves.
Statistics show that one in four women will experience domestic violence at some time in her life. Agencies dealing with child-protection issues in a domestic violence context must raise their own awareness regarding the complexity of abuse within the home with continuous staff training.
Women's and children's experiences of the legal system have at times meant that they have suffered further trauma through the lack of knowledge and understanding among appropriate individuals or organisations. The links between education, youth work and women's aid must be further developed throughout Northern Ireland to highlight the prevention of abusive relationships. Questions must be asked about the nature of a healthy relationship and when it becomes unhealthy. Work already undertaken on that has been welcomed and implemented. However, some organisations still have difficulty recognising the implications of domestic violence in relation to child protection, and there are further fears about implementing prevention programmes.
The work of the area child-protection committees (ACPCs) is invaluable. However, Women's Aid is not fully represented in those groups, and that should be considered a must. Women's Aid works directly with children and should be represented on all ACPCs.
According to Saunders and Humphreys (2002) the estimated overlap between domestic violence and the direct abuse of children - physical and sexual - is high and ranges from 27% to 62%, depending on the study. The awareness rate is particularly affected by whether questions are actively asked about domestic violence. A National Society for the Prevention of Cruelty to Children centre introduced a simple domestic violence monitoring form where children were known to have been abused; it showed an increase from one third to two thirds of children who had lived with domestic violence. The results depend on monitoring and asking children questions.
The Chairperson: You mentioned many key points; which of those are critical to child protection?
Ms Brown: Increased resources in child-protection teams and domestic violence training are critical. It should be mandatory that all staff are trained. Training should not be done on an ad-hoc basis. It is key that staff recognise the problem. It is not a specialism; social workers and health visitors will often come across domestic violence in their caseloads. It must therefore be recognised that they need ongoing training in that throughout their careers - not a one-off training session - so that they can have an effective impact on children. Auditing is a huge part, for if we do not know how many children are affected, how can we plan services for them?
The Chairperson: Thank you. We have your documentation, and it is outstandingly helpful. Do any colleagues wish to come in at this stage?
Ms Ramsey: Thank you for the in-depth research which you have taken on board and your attempts to focus our attention on the issues of domestic violence and child abuse. Education is also key; we must make it socially unacceptable for domestic violence to continue. I must also mention your community work, such as that building on the media launch in the New Lodge area. Several weeks ago you went into the pubs and clubs. It was great to see men going in, challenging people and putting up posters, and you must be congratulated on that.
I have one or two questions. On page 3, it is highlighted that over 11,000 children - possibly more on the basis of what PricewaterhouseCoopers is saying - are living with domestic violence. That in turn means over 11,000 children in need of services. You will appreciate that we are trying to finalise a holistic approach to the protection of children. I am conscious that you may not have them with you now, but I should appreciate it if you could give the statistics for those children receiving services and the types of services which they receive. You have said that they sometimes get only a social worker and nothing else, and that it might take six, seven or eight months before even that happens. We must try to paint a picture of what that means.
Ms Angela Courtney: That would be a big piece of research for Women's Aid. Our statistical gathering is good. I have the report here which is referred to. Researchers recognise the figure of 11,000 to be the tip of the iceberg. By researching what services children are getting, we can give a general sense. However, to document all children would be a large study. There is a need for more research.
There is also a huge need for resources on the ground. Many of the projects - the outreach projects and the refuge services - come under the Supporting People fund. However, there is only short-term funding for the pilot work, which Debbie Mehaffey can tell you about: the community work; preventative education; and working towards healthier relationships. There was 50% two-year funding from the Department of Education for the work.
We previously received funding from a foundation. The project is at serious risk of folding if follow-on funding is not found. Even then, we must still find 50% of the costs from other sources. All the refuges and outreach centres are similarly dependent on precarious funding. We know a huge amount about children and domestic violence because we have been developing the services over 25 years, but it has been piecemeal, ad hoc and underfunded. It is well worth taking on board all the report's recommendations. Marie Brown has referred to some of those, such as data collection and training.
Ms Brown: There is no auditing system in any of the other services which would detect women suffering from domestic violence. That is something that should start. We are under-resourced; we do not have enough childcare workers in refuges to help children who have difficult problems. There is a complete lack of any intervention for children affected by domestic violence.
Ms Ramsey: Your submission refers to the lack of continuity of services when children move for whatever reason. You also mentioned that Women's Aid is not involved in the ACPCs. Have you raised any of those issues at formal or informal meetings?
Ms Brown: We are starting to do so.
Ms Ramsey: What was the outcome?
Ms Brown: Foyle Women's Aid is moving onto an ACPC now. However, it should be recognised that those who work directly with children at risk must be included, and we should not be fighting our way onto such bodies. We are increasingly raising the voice of children. We have a waiting list of children who would like to take part in our programmes, but we have no workers to conduct them. We want to do that in partnership with statutory agencies, for everyone must be trained to recognise domestic violence, not just Women's Aid.
Ms Angela Courtney: There are differences between board areas. The Northern Health and Social Services Board has taken many of the findings on board and has developed some partnership approaches as pilot models in Cookstown and Dungannon. Women's Aid is working with the Homefirst Community Health and Social Services Trust. There are models of good practice, but they usually happen because key people in agencies recognise the problem and deal with it. A strategic approach is required across the board, including the PSNI, the courts and at statutory level. The Raising the Standards group has recently been established. The message must be brought to the Assembly to give recognition of domestic violence a key part in the Programme for Government. It is a serious problem, as many of you are aware.
Mrs Annie Courtney: I am familiar with Ms Brown and the amount of work which she has done in my council area. She has not only provided for Women's Aid but organised a training programme for Derry City Council, which is the only council to have it. We are grateful to Ms Brown and her team.
In your written submission, you state that
"Children represent the majority of occupants in our refuges at any particular time".
You also say that ACPCs are invaluable in the protection of children. Is your organisation represented on all ACPCs? Do you have child-protection procedures which operate and dovetail with the statutory agencies?
Ms Angela Courtney: No. As I explained, it depends on the invitations coming from the boards. There are some worthy models of good practice. We must develop joint protocols, and the invaluable community resource of the skill and expertise of Women's Aid must be recognised. We are still suffering from the lack of a central approach to the problem of domestic violence.
Ms Brown: There is a lack of vital information coming from the domestic violence forums to the child-protection teams. Court welfare is the latest service to be set up locally. That court welfare officer has not been trained to recognise domestic violence. We have highlighted that issue, and it is being addressed, but if there were co-operation, that sort of thing would not happen. Training in the protection of women and contact issues must happen so that services for children are safe.
Mrs Annie Courtney: I appreciate all the work being done. Ms Brown also sits on an inter-agency forum, and it has done a great deal of invaluable work in the Foyle Health and Social Services Trust area. Many issues have never been brought to the fore. It is not easy living in a local community and raising awareness of issues such as the case of a young woman named Caroline Crossan who was murdered by her husband. A day has now been dedicated to her: "Caroline's Day". The families of the murderer and the victim still live locally, and it is difficult for them knowing that everyone's attention is focused on them. One of the families was extremely well-known throughout Northern Ireland.
I congratulate Women's Aid for bringing such difficult issues to the fore. I accept the difficulty in having days when people gather to remember victims, and I accept that it is mainly women who gather. I know that the organisation is called Women's Aid, but the perpetrator of the violence is quite often a man. It is a difficult subject, and I commend Women's Aid for trying to raise awareness of it throughout Northern Ireland.
Ms Brown: Caroline's Day has highlighted that women have brothers, and many men contact us now about their sisters who are victims of domestic violence, and fathers also contact us for advice. It is not only a women's issue; it arises in other areas, and it has become a community theme. We should like to see more work happening in that area.
Rev Robert Coulter: On page 2 of your submission you mention the lack of knowledge among other agencies regarding Women's Aid. How might that be addressed?
Ms Mehaffey: First, we must focus on the fact that domestic violence exists, as many organisations still do not recognise it. My work is at the prevention end, and my colleagues go to schools to give talks, but sometimes they are told that they cannot talk about domestic violence. However, that only happens in some schools.
Domestic violence is the intentional and persistent physical or emotional abuse of a woman and her children in a way that causes pain, distress and injury. We have drawn attention to the words "intentional and persistent" because we believe that we can all be abusive in relationships, but we have a choice to respond when we are told that what we are doing is wrong - either we take responsibility for it or we blame the other person.
Our biggest problem is getting in to talk to agencies. When I left Refuge someone told me that I should take an army with me, and I feel that it is sitting here with me today. It includes all the children and young people who have told me of their experiences. I am in a very privileged position because when there is abuse, it is not easy to talk about; nor is such talk easy to listen to. It is also very difficult to do something about it. People will make judgements on whether they want to open the door and let us in to talk about experiences.
Women's Aid has been promoting women's issues for a long time, and the children have been there, but we are only really beginning to focus on the work which we need to do with children, and it is not easy. Children have been abused even while they are in the womb. Children have been victims. They have overheard, witnessed, intervened and colluded. They are used as weapons, and some become perpetrators. I could match a story to each of the children, as could my colleagues throughout Northern Ireland.
God only knows that we have dealt with more horror in our lifetimes in Northern Ireland than those in most countries. When bombs explode, trauma teams go in to help the people, but who helps the children of domestic violence? That is a daily trauma, and it becomes a bigger trauma because children's mothers, whom they love, are being hit by someone else whom they love - their fathers.
Quite often when children come to Refuge they do not want to leave their daddies, and they want to go back to their families. We can work with agencies by helping to protect children if they wish to go back to their families.
It is not about breaking up families; it is about saying that violence is wrong and that domestic violence is a crime. Ultimately, if we can help the family, especially the children, we should do so. I say that to everyone.
My job is partly funded by the education and library board. We have developed packs for this area of work. There is the protective behaviours' pack, which caters for primary-school children, and there is one for older children, which covers healthy and unhealthy relationships.
It is up to schools to let us, or indeed the teachers, deliver the message. I go to as many schools as possible and try to reach teachers and social workers when they are being trained, for if we can get them to understand that domestic violence is a problem, we are half way towards being able to respond in the right way. Women and children are asking us to believe them when they tell us what is happening to them.
Ms Angela Courtney: It is the federation's job to take the issue to the strategic level. It is a new project, and we are seeking a meeting with the Department of Education, the Council for the Curriculum, Examinations and Assessment and the education and library boards to achieve that. We have had to develop the pack, for instance, using money gathered through private donations - not public money. The cost was £20,000. However, the pack needs to be taken up throughout the education system. It is so good that it is being piloted in Thurrock and is due to be piloted in the Prime Minister's constituency of Sedgefield. The value of our work is being recognised, but we need the strategic direction that can only come at Government level.
We are very good at producing information material. We have brought our annual report and children's leaflet. I invite the Committee to come to University Street and see the work which is going on. I cannot emphasise enough that the work must be taken to a strategic level. There is a great deal happening operationally on an ad-hoc, under-resourced basis. However, we need the Government to take the work on board.
Ms McWilliams: You have covered protection, prevention and provision. You are saying that provision is happening mainly through private funding. A regional domestic violence forum has put many protocols and guidelines in place.
You say that you have struggled with the issue of contact by fathers. This inquiry into child protection arose from the Jasmine McGowan case, where it transpired that the father had a previous history of domestic violence. That history had been unknown. However, when the records were uncovered after the child's death, the father's previous partner disclosed a very serious history of domestic violence which never seemed to have come to the attention of social workers.
There is a serious issue in that, on the one hand, we have the Children (Northern Ireland) Order 1995, which was pioneered here. The witnessing of domestic violence should have been taken into account when making a contact order. However, many women were being held in contempt of court here because they were frightened about handing over their children. This has been a long battle, led mainly by Women's Aid. How far have we come in getting that taken seriously? You and I attended a conference last week which dealt with the legal aspects. There is much debate going on about what priority should be given to domestic violence, the presumption of domestic violence, and the facts and evidence required.
The dispute seems to be about that rather than about the child's best interests. You commented on the impact of domestic violence on those children. Do you want to say something about that? Given the existing legislation, have we gone as far as we should? Are social workers and the courts taking it as seriously as they should?
Ms Brown: Foyle Women's Aid has done a great deal of work on that. Other groups are experiencing difficulties with child contact and protecting children. I have a piece of local research, which I am happy to give the Committee, about the courts. For example, the children of one woman who had been stabbed were still allowed contact, and she was scared for them.
There are other partnerships, for example, involving the PSNI. Mr Elliot and I are starting a crisis group to write to social services where we feel that nothing is being done about women or children who are at risk. That partnership office highlights serious cases where we try to pressurise social services into taking action.
The Children (Northern Ireland) Order 1995 was designed to help protect children, but there is a great deal of fear about social workers going into court under pressure. There are not enough social workers, which means that young students who work in family and childcare situations must write reports which are pulled apart in court. Those social workers will often omit domestic violence so that it is easier to write a report. It is a huge area.
Given the increasing number of partnerships, it is not only Women's Aid which is frustrated at the lack of protection. The entire criminal justice system and protection of children must be examined. Domestic violence is not a feature of every case. Quite often, a father is not abusive to his children, and contact can go on, but it must be recognised that in some cases women and children are increasingly being put at risk. We are starting to document the children who we think are at risk, highlighting that information because we do not want a situation like that in England, where children are being murdered on contact.
Ms McWilliams: How seriously are you taken? You made the point that, even with all the years of expertise, Women's Aid still has some difficulty being taken seriously by professionals. After 20 years of research and 25 years of refuges, one would have thought that such expertise would be acknowledged now. However, I do not get that impression from reading the submission.
Ms Angela Courtney: Yes, that is true. That impression exists on the ground. Women's Aid is not being taken seriously. Last Friday I was invited to speak at the Children Law UK relaunch, where Mr Justice Gillen was very encouraging. However, in such audiences, one is often preaching to the converted, as you know. The audience was made up completely of social workers. Among the 120 people, there were solicitors and a few social workers. It is only recently that we have been invited onto such platforms. In fact, the invitation came not from here, but from England. People in England will consider our activities and realise that we are doing some wonderful work. They will also look to the Office of Law Reform.
We have some of the best legislation in Europe, but the problem of attitudes and things being done as they always have still remains. There is a strong sense on the ground, which is reflected in the paper, that no attempt is being made to maximise resources by acknowledging the problem and resourcing Women's Aid to ensure those very high standards of practice.
Ms McWilliams: You had a funding crisis over supporting people on one Bill. Other pieces of legislation, one of which this Committee is supporting, are coming forward concerning the regulation and accreditation of organisations such as Women's Aid. You are becoming increasingly regulated, but there is not much funding accompanying that. Do you want to comment?
Ms Angela Courtney: Yes. The social care agenda includes having a qualified workforce. We have piloted and have an infrastructure for NVQs in social care. We can roll that out into the criminal justice system and into housing. Ms Brown is a verifier for that qualification.
We have built up a good infrastructure, but there is no money to continue that type of education. Our groups cannot afford to pay the costs involved. I have some details from a meeting this morning - NVQ standards in childcare, currently funded by the Social Services Inspectorate through the Care Assessment Centre for Northern Ireland. It costs £2,500 per candidate for underpinning knowledge. A group could not afford to send a person for training because the travelling costs alone are exorbitant; we are trapped.
We are consulted by the boardsUK-wide. They come to us for our expertise, but the resources are not there. We have developed our NVQs through short-term funding from Proteus (NI) Ltd. We conducted two pilots, and very few people dropped out. They were geared towards volunteering because that was the arrangement for the money - learning opportunities for volunteering, known as the LOV project. We were able to get some paid workers to the level of accreditation where they could be work-based assessors and internal verifiers.
To develop the process and continue gearing up, we should have the resources to allow us to keep rolling out the programmes.
Ms Brown: We have other difficulties with resources. Consider the support required for people in Housing Executive accommodation. Money is provided for women, but it is not matched by similar funding for children. The gap in funding is huge, and it is not being picked up because the trusts are underfunded. Although we have had huge support from our trust, and both directors sit on our domestic violence forum, the money does not come down to fill the gap.
There are two children in our refuge, one of whom has a psychologist attending because he tried to commit suicide there. The other is a 10-year-old who does not speak. We do not have any funding in place for our childcare workers. They were previously paid through EU funding. It is unacceptable that EU funding be used to shore up what should be a service for children who have been traumatised to such a degree. For those working with children, that is a very important issue. What about the children who have not reached that point yet? We could do much valuable work. We are open to working with teams and taking referrals from them, and we are open to working with children because such work, along with what we are developing, will stop future violence.
We have very good partnerships with the Probation Board for Northern Ireland, and we have run three programmes with them. However, all the services fall short when it comes to funding. We have cases of repeated violence. We can be working with one man and the three women against whom he is being violent. There may be as many as 10 children involved, yet no work is done with them. There is no funding, and no money is put in. We recognise that the men come from the court and that the children live in the same house, yet no work is put in for the children.
We have to change our approach to children. Interventions must be made for their sakes. Quite often we are working with volunteers, or borrowing from Peter to pay Paul to keep our childcare workers in post in the hope that Executive programme funding will pay for them. If it does not, we shall have no people working directly with suicidal children.
Mrs I Robinson: Do you undertake a counselling role where there has been a domestic violence incident but it has not gone so far as to be irretrievable?
Ms Brown: Domestic violence is now recognised as a crime, and I should hate to move away from that. Men attending the men overcoming domestic violence programme are the responsibility of the Probation Board for Northern Ireland and social services. Although men have sometimes not gone to court, it does not mean that it is not a serious crime. Those men do not need counselling; they must recognise their behaviour, look at changing it and take responsibility for it. If we get into therapeutic work, they will never take any responsibility for their behaviour. They are not ill, and they are not sick.
Mrs I Robinson: Is there any role for you in that?
Ms Brown: We work with women by supporting them to look at what they have been through, recognising domestic violence, how to move away from it and how to stay safe. We work on protective behaviours with the women's children, such as how to get help when it happens and how to tell someone that it is happening. That is the only way which we can work to protect the children.
Mrs I Robinson: I take that point. However, how do you begin to work with a woman who has been systematically abused, whether verbally, physically or mentally? On the one hand she feels humiliated and degraded, and on the other she has a guilt complex because she was unable to protect or look after her children in that abusive situation. How do you begin to undo that and give her back her self-esteem?
Ms Brown: Historically, women do that for themselves, and we have been around for 25 years helping them to do so. Women's Aid is trying to provide a community where women are not blamed for the abuse if they are not physically able to protect their children because they have been so badly beaten. That becomes an issue for our community to look at - what are we doing, what sanctions have we imposed, and what education are we putting in? I go into the men overcoming domestic violence programme and highlight the impact that they have on their children. That is often a shock to many of the men. When they were beating their wives, they thought that it was normal and accepted. However, they are shocked when you tell them about the psychological and emotional impact, for no one has ever told them that. Society does not tell them that, and the courts quite often do not impose any sanctions on them. They are therefore not getting the message that it is wrong. All the relevant agencies must start to tell them that it is wrong.
Mrs I Robinson: How close are we - although "how far away" may be more appropriate - to getting the courts to dish out sentences which match the crimes which have been happening in a domestic setting? For example, the sentences which have been meted out for rape are often unbelievable. How close are we to getting the law, as it stands, to address those issues properly and to sentence according to the crime?
Ms Angela Courtney: I want to talk about the criminal justice subgroup of the Northern Ireland Regional Forum on Domestic Violence, of which I have been a member for several years. The judicial system is almost a law unto itself because it does not have to operate within guidelines in Northern Ireland. Good voluntary guidelines have been produced in England. Dame Elizabeth Butler-Sloss and Mr Justice Wall worked hard on that within the English and Welsh judicial systems, and there are linkages. Mr Justice Gillen, head of the family division, is held in high esteem by judges across the water. They had training from a Northern Crown Circuit Judge, Marilyn Mornington. She is leading the Raising the Standards group, which has brought together key agencies such as the justice system, the Northern Ireland Office, the Home Office, housing authorities and the Scottish and Welsh equivalents at a statutory level. Those meetings are intergovernmental, and the Irish Republic is included.
A week or two ago I attended a conference in Liverpool to which the non-governmental organisations were invited. The right things are beginning to happen. That is the best that I can say at this stage. There are good intentions, but we all know about good intentions. It is about turning the good intentions into good practice, which is the title of another report on inter-agency work. It contains wonderful guidelines which recognise the value of non-governmental organisations and Women's Aid in particular. Those should be central, and we go out like missionaries whenever we speak to inter-agency forums. There is an excellent one in Foyle. I have recently been to the Causeway Health and Social Services Trust and Armagh and Dungannon presenting those materials as the ideal. There are minds which are open to taking them on board, but against those willing minds is the dead weight of bureaucracy and denial. Society is still in denial; people think that if they do not admit it happens, it will never happen to them.
Ms Brown: We must examine the time which we have for the judicial system to come round. I encourage women to take their cases to the PSNI, which has changed and has done a great deal about domestic violence. In the research, women say that they have been more traumatised in court than in their relationship. We must make progress, because I fear that women will stop going to the police and will stay in and live with the abuse - that it will get worse. We do not have time. The judicial system must listen, for women say that abuse is continuing and that they are being abused again in court proceedings, some of which last three and four years. That must be taken on board. I am happy to leave the research with you.
The Chairperson: That would be helpful. The Committee appreciates the great work which the Women's Aid Federation has been doing for some time now. I note your point about setting guidelines. You are like missionaries, but the financial resources are not in place. We shall take those points on board. You have been outstandingly helpful to us. Thank you very much.
MINUTES OF EVIDENCE
Wednesday 2 October 2002
Dr J Hendron (Chairperson)
Mr T Gallagher (Deputy Chairperson)
Mrs A Courtney
Mr T Hamilton
Mr J Kelly
Ms S Ramsey
Ms B Smyth ) Association of Directors
Mr H Connor ) of Social Services
The Chairperson: The Committee welcomes Ms Brenda Smyth, director of social services for Homefirst Community Trust, and Mr Hugh Connor, director of social services for the South and East Belfast Health and Social Services Trust. Mr Connor is also chairperson of the Association of Directors of Social Services. Thank you for your documentation. As the Committee is anxious to ask questions, I suggest that you give a 10-minute presentation.
Mr Connor: The Association of Directors of Social Services welcomes the opportunity to speak to the Health Committee on the important subject of child protection.
All to often, child protection issues come to public attention as the result of a tragedy. At such times, there is understandable public concern about what has happened and how the system has failed the children involved. Everyone shares that view. A tragedy involving one child begs the question of how many other children are below the tip of the iceberg, and the association readily understands that. However, the problem with media coverage is that it does not recognise the hundreds, if not thousands, of children who are supported, protected and, in some situations, rescued. Therefore, the association wants to alert the Health Committee to the need for balance in such matters.
The association views child protection solely from the view of social work, which is one of the key professions involved. The legal duty for the protection of children rests with social work. The association is taking a narrow view, although it recognises the important contributions that others make to child protection work. However, from a social work and social services perspective, all to often the concentration on what is, in theory, a multi-disciplinary task ends up on a uni-professional task.
To make the rhetoric of multi-disciplinary work a reality, much more work must be done in the integrated health and social services, and by educational and probationary organisations and the police. Comments on that are included in our submission.
We are concerned that inexperienced social workers, fresh out of university, are often on the front line dealing with some very difficult situations. At times, they may deal with difficult, distressed and hostile parents. Child protection work seems to be left to that individual, rather than placed in a more multi-disciplinary context. We want the Committee to consider the development of multi-disciplinary, corporate child protection teams, which would include social workers, paediatricians, nurses, and family psychologists and psychiatrists.
We hope that the Committee will take evidence from representatives of the legal profession, because there are situations in which children cannot be supported at home, and the trend is to find alternative accommodation for them. In our experience, the legal profession has become confrontational and not particularly helpful, the process is long-drawn out and destructive for parents in those situations. Therefore, inter-agency work and its impact on the legal system must be considered.
As social workers, we draw the Committee's attention to fundamental resourcing issues. We know that people talk to the Committee about resources week in, week out. I suspect that the Committee does not realise that, implicitly, the Children (Northern Ireland) Order 1995 has never been adequately funded, and we mentioned that in our submission. Funding allocated to the Order was £12 million short of what was requested, which is approximately one third.
In 1995, the former Department of Health and Social Services held a conservative view of the Order's implications, and it chose not to include areas such as child protection, residential care and family placement. The Committee, which has examined issues such as secure accommodation and residential care, will be aware of the enormous crisis faced by them.
Inadequate funding is an issue and, on behalf of the association, I ask the Committee to ask the Department to provide a proper financial estimate of what must be allocated, not only for child protection, but perhaps for children's work in general.
Our submission states that funding for children's work in the Province is 50% lower than the average in an English local authority. In some situations, some trusts in the Province work on 40% of the average trust's funds.
In our submission we describe the numerous issues with which social workers deal. We are keen that the Committee realises that we do not have dedicated social workers who work with child protection. Social workers may have many tasks to deal with, such as child protection; children in residential homes; children in foster care; preparing reports for court; dealing with children who have left care; and early years work and family support. Child protection is just one of the many issues that social workers must deal with at any given time.
The association wants to raise the importance of community. Community services are a vital means of achieving an overview of child protection issues. Often a choice must be made between prevention and crisis management. Inadequate resources result in crisis management. Therefore, less work is done on prevention, and more children are placed on the register or in the care system. The balance is wrong at present, probably because there is not enough money in the system.
As directors of social services, we are conscious of our responsibilities and we take them seriously. We were keen to speak to the Committee. Much more can, and should, be done to standardise the way in which we work across this small Province. More work should be commissioned by Departments, boards and trusts to ensure a standardised approach to defining the children who are most at risk; the services that they can expect to receive; and helping children in need.
The association has a role to play, and must take the lead in working with other agencies. It does not believe that a uni-professional approach is the answer to child protection. Although our primary task is to represent the Association of Directors of Social Services, that is not the answer. The association must expand and develop an inter-agency, community-based, co-operative approach.
The Chairperson: That was a helpful presentation, thank you. The question of resources, understandably, arises all the time. The idea of standardising services across the boards is important.
Ms Ramsey: I commend the work of social services. I have a good working relationship with them, and I see the good work. Sometimes, when a tragedy occurs, the focus is on the social services, which may be aware of the background to a particular case and how it arose. I agree totally that a multi-agency approach must be developed, rather than having individual organisations that focus inwards. Everyone must play his or her part. I received information that GPs, health visitors and social services were involved in a specific case, which fell out of the loop.
I agree that there is underfunding, but social services directors and trusts and boards must play their parts too. Although we accept that the Health Service is under funded, part of its budget goes to boards and trusts.
The Committee is taking a holistic approach to child protection. Although it is concentrating on evidence from directors of social services today, it has heard from people in the accident and emergency services, GPs and union representatives. It struck me that the threshold of risk seems to be different across board and trust areas, and the Committee was told that the definition of child protection is different across board and trust areas. You said that sometimes, if not all the time, social workers, who are fresh out of university, must deal with some tragic cases, and their caseloads are getting bigger. I am concerned that senior managers define cases based on what they believe the threshold of risk to be, but that threshold might change tomorrow.
I am also concerned about some of the points that were raised in your presentation and your submission. Perhaps I am wrong, but it seems to me that the directors of social services did not support the Northern Ireland Public Service Alliance's (NIPSA) strikes to call for additional resources. The Committee took evidence from NIPSA at the time.
There seems to be a gap between social worker level and management level, and people do not seem to be singing from the same hymn sheet. Why is there a difference in the threshold and who defines a child who is not at risk today but could be tomorrow?
Ms B Smyth: Thank you for your supportive comments about the work of social workers. I understand what you are saying, and it is a question that any reasonable person would ask. It is not that the thresholds vary per se; they are in the legislation, and a child in need is a child in need, according to the law. In any busy office, people's reactions will depend on the other pressures that there are. That, we would all accept, is not desirable, but it is, unfortunately, the reality.
Work rarely comes along labelled "child protection". We do get referrals from accident and emergency departments that a child has come in with injuries inconsistent with the story given. That is fair enough, because that button is pushed. A great deal of child protection work emerges in the course of other work. Depending on the other pressures on staff, such as court work or crisis work, their reactions vary, because they are human. Heavy workloads and other pressures lead to exhausted staff. That is not an excuse, but it is an explanation. In recent years, we have moved to looking at things regionally so that we can have some consistency on those matters.
At the moment, any statistics provided are not much use because there is no comparison of like with like. The numbers on registers vary, because not everybody uses exactly the same threshold. That does not really explain it. It may not be appropriate, but the association feels that the Committee should make the time to talk to front line staff, who could make the situation real. We have an overview, and are supportive of this opportunity, but the Committee should speak to those pressurised staff, who can explain why they make some of those decisions that might not look sensible.
The Chairperson: That seems to be a good idea.
Mr Connor: In relation to the resource issue, the association totally supports NIPSA. As senior managers in an organisation with responsibility for continuity of service for individuals, we worked alongside NIPSA to arrange adequate cover. We believe that there should be a review of the resources and the terms and conditions of individual members of staff.
We have increasingly moved together to ensure that we do not bring families to child protection case conferences, if at all possible. That is because child protection carries an enormous stigma for families. Our primary responsibility is the protection of children. We want to ensure that we sift families through that process, and that we assess a situation so that it does not immediately go to a case conference. We want to exercise judgements along the way. That partly explains some of the differences across the Province.
Another difference is that, if the community infrastructure or preventative strategies are inadequate, more children will appear on the list, because they are not picked up by the system. The mechanism would give them priority. When resources are scarce in an organisation such as ours, the first thing that goes out the door is prevention, because there is a statutory duty.
Ms Ramsey: I take your point that you are talking about services throughout the North. However, there is a strong community infrastructure in my constituency, which has been working hand in glove with social services over the past few years.
However, there is also a sense of frustration. As recently as six weeks ago, the community was working with social services. The child was on the protection of children register, yet social services were still slow to respond. The community cannot see any point in alerting social services. People are sticking their neck out and challenging their neighbours to ensure that children are protected, but social services always seem to fail to come in at the right time. It is a balancing act.
Mr Connor: That is right. Our comments are based on collective experience. I have no reason to doubt the individual case that you mentioned. We have come to recognise how reliant we are upon the community sector and just how perilous community sector funding is. Schemes operating today are not guaranteed to be there tomorrow. We recognise the implications of that on child protection issues.
Mr Hamilton: Why do social services directors appear to find managing the operation of the child protection service so problematic?
Mr Connor: Child protection work, by its very nature, is problematic. The majority of people with whom we deal have real aspirations to do the best for their children. At the other end of the spectrum, we also deal with some people who are extremely evil.
Most of our work is about judgement. As Ms Smyth said, cases are rarely packaged as child protection work. Recent research in the United Kingdom on child inquiries and case reviews involving deaths showed that in 87% of cases where children died, they had been known to social services, largely through the referrals that Ms Smyth mentioned. Those were not child protection situations. Rather, someone somewhere had expressed a concern and the case had been reviewed, assessed and set aside because of other priorities in the system.
Our work deals with human beings, judgements, and resource constraints. It is often like trying to fit together a jigsaw without understanding the overall picture. I was involved in one such case years ago, which was one of the most vivid learning experiences of my life. When people make such judgements and assessments, they do not have all the information. Year on year, each child inquiry has highlighted that information that was known to someone was not adequately shared. It is not a straightforward exercise; risk cannot be managed unless it is understood. There is an enormous layer of complexities. Sometimes, there are poor social workers or poor social work managers; sometimes social workers are beaten into the ground and worn out by dealing with distressing situations and aggressive parents year after year. Managing child protection work is an art rather than a science. It will never be a science.
Mr J Kelly: I commend your work. You mentioned how university graduates appear to be thrown in at the deep end. Would more case work during their university training help?
What is your view on the more radical changes for the delivery of services proposed by some agencies? The creation of child safeguarding teams and child death review teams are two examples. How do you see the role of the commissioner for children fitting in to that?
Ms Smyth: Not enough emphasis is given to child protection and training. The new training for social workers and the pre-registration year are to be welcomed. It is like passing your driving test - you only really learn to drive after you pass the test.
In complex court situations, you must have that theory and be able to substantiate what you say. Things often go wrong because people have not developed that judgement. It is difficult to define. However, if that judgement is lacking, an experienced social worker or manager can support another social worker as they reflect on what they might have seen in a household. As Mr Connor said, to stress that social work is complex is not to excuse it or to imply that people do not understand it. However, it almost needs to be experienced. Three people could visit a house for different reasons, and leave it almost not realising what they had seen.
A combination of improved and longer training, including a probationary period, during which social workers have the chance to learn as they practice in a more protected environment, is vital. That does not happen at present because of the pressures that we mentioned. However, it will happen in the future.
Mr J Kelly: What is the association's view on the role of the commissioner for children and young people?
Mr Connor: The association warmly welcomes the commissioner and believes that, despite the rhetoric about joined-up Government, it does not exist. The association strongly endorses inter-agency working at ground level and at area child protection committee level. The submission states that people who represent one agency are not empowered to change the practice in another agency. The same is true at departmental level.
The association believes that there needs to be consistency and uniformity, which the commissioner would help to achieve. It also believes that there should be standardisation, which is poor at present; there is much more road to travel. The commissioner could help to put systems in place and should be involved in areas of public concern. The association does not, however, believe that the commissioner should become yet another watchdog. There is enough evaluation bureaucracy associated with social work. However, if the commissioner took a more strategic and practical overview, it would be an enormous improvement for children's services. The association would support it.
Mr Hamilton: Ms Smyth, did you say that graduates do not undertake a probationary year before they enter the system?
Ms Smyth: There will be a probationary year from next year on. Although they will be qualified social workers when they finish university, they will have a probationary year that is similar to that of a teacher. The arrangements for the new council mean that newly qualified social workers must be registered, and the probationary year will form part of the registration. Theoretically, at present, any agency would offer a new qualified social worker a limited and protected caseload. However, if three members of a team of five are absent, those who are present must be sent to cases. It is not a system that the association advocates, but it is the reality.
Mr Connor: The submission refers to the recruitment crisis in social work. At any given time, not only in Northern Ireland, but across the United Kingdom, an average of 15% of posts are unfilled. If an average of 15% of posts are unfilled, and staff are off sick, inexperienced staff are thrown in at the deep end far too quickly, which is not good for practice. The association is a statutory agency, with a duty to do its best to protect children. What is it to do? It wants to reach a situation in which the four-year training programme will give people a protected year.
Ms Ramsey: There is a statutory duty on the association, but reality must come into play. The Children (Northern Ireland) Order 1995 is not being fully implemented, and we are hearing that from all sides. Therefore, the association is failing in its statutory duty, and it could possibly be breaking the law. Can it put up its hands and say that it is downing tools and doing no more? Life experience shows us that people depend on pulling your heartstrings based on the work that you do, but if the Committee were to down tools and say that it was breaking the law because it was not implementing the Order, I assume that the Executive and the Department of Finance and Personnel would go out of their way to find the money to implement it.
The Chairperson: That is a fair point.
Mr Connor: In 1999-2000, ring-fenced Children (Northern Ireland) Order 1995 money was given to boards. At that time, boards were under enormous financial pressure to manage acute hospitals. All the boards, especially the Eastern board, chose not to spend that money immediately on children's services but to spend it on managing hospital deficits. The following year that money was released. The association carries a responsibility. It is part of those boards and a member of those structures. It is bound by a sense of professional and corporate responsibility and has made its views clearly known.
Ms Ramsey: With respect, the Eastern board chose to spend the money on the debt that it had incurred on children's services. Therefore, no additional money went into children's services.
The Chairperson: Was the money truly ring-fenced?
Ms Ramsey: The board used the money to pay its debt.
The Chairperson: Was the money earmarked rather than ring-fenced?
Mr Connor: When the money left the Department it was ring-fenced, but it turned out to be earmarked monies, which were spent elsewhere. Against the backdrop of insufficient resources, money that had been allocated to the Children (Northern Ireland) Order 1995 was not used for children's services.
The Chairperson: If the legislation and accompanying guidance is not known and appreciated by the service deliverers, it will be unsurprising if policies appear to be making no compact. Bearing that in mind, are arrangements in place to ensure that new legislation and guidance is examined so that those in the organisation who need to know are informed?
Ms Smyth: The association's staff are fairly up to date with legislation. The most inexperienced members of staff often spend lengthy, and occasionally uncomfortable, times in court, during which they hone their legislative knowledge. Sometimes, when staff are out in a crisis, dealing with something that had been referred for another reason, they do not always - although they should - make all the connections. The legislation and protocol does not perhaps come to the forefront of their minds. The training facilities in all boards and trusts are fairly good, and all staff receive an induction programme.
Mr Gallagher: You mentioned problems such as inexperienced staff in the front line in contact with children who are in difficult circumstances, suffering from suspected assault or abuse. You also mentioned that it is hard to find the more experienced members of the team, because there are demands on their time; for example, they may be in court. Therefore, there is a resource problem, and the Committee recognises that.
I want to ask you about the management side. Even with scarce resources, management is a key part of this. We are all aware of the references to managers in the Health Service. Is sufficient priority being given to this area at management level?
Mr Connor: My answer is an emphatic yes. Anyone associated with children's services is constantly fearful of a child's death and the resulting pillory in the press. Therefore, if only out of a survival instinct, there is constant attention to the issue.
We are not coming to the Committee believing that no managerial efficiencies can be made in the Health Service. As a result of the inquiry into Kincora boys' home many years ago a regulation stated that there be one senior social worker for four social-work staff. That creates its own problems, because when one is off sick and one is on holiday, the team is down to two. Obviously work is then done on a priority basis.
There is one senior social worker for every four social workers and one assistant principal for every four senior social workers. The assistant principal is responsible for managing all the statutory reviews regarding child-protection work or looked-after children. It is an enormous workload.
We do not believe that efficiencies can be made there. We do not need more managers. We are strongly of the view that, if there were extra resources, one would need to put them into retaining more expertise at practitioner level. We should like to see further enhancement of the senior practitioner grade, which will keep people closer to practice for longer and, indeed, a consultant practitioner grade, something that is being tested by other professions. We want to keep people closer to the ground and building skills. We are not asking for more management. However, we counsel against the suggestion that there is too much management in the system.
Mr J Kelly: You said that you had learnt some things from Kincora about staffing.
Mr Connor: One of the recommendations to come out of the Kincora inquiry was that the future structure of statutory social services should be four social workers to one team leader. That was the recommendation, and we have lived with that for the last 17 years. In practice that creates its own problems, since someone can be sick or on leave, and suddenly a team of four becomes a team of two. There is not enough flexibility then to deal with all the work.
Mr J Kelly: There is no flexibility, but was anything else learnt from Kincora in that area?
Mr Connor: We have learnt an enormous amount from Kincora. One thing we have learnt is never to be naïve and never to say "never".
Mr J Kelly: What conclusions did you come to about Kincora, apart from those regarding your staffing problems and so on?
Mr Connor: The Kincora review was held 17 years ago. Kincora raised the profile of child sexual abuse and of institutional abuse whereby people who worked in those services could abuse children. Those were two very important lessons.
Mr J Kelly: Did it deal comprehensively enough with those who were responsible for all that - those who were in charge or those who organised it?
Mr Connor: I do not know. You would have to ask the Committee.
Mr J Kelly: From your own personal point of view?
Mr Connor: I do not know. I was not that closely involved.
The Chairperson: Your submission refers to a loophole in the current law. It states that
"A recent case has highlighted a loophole in the current law, which means that an adult convicted of a very serious physical assault on a child can be lost from the system, on discharge from Prison. There is currently no mechanism, as there is for sex offenders, to track such dangerous individuals. The result of this is that such a person can be in regular contact with children, without Agencies, such as Social Services, Education, Police and Probation, being aware of this. The Association of Directors recommends that this loophole should be closed."
That certainly is a serious loophole, and we will take that up with the departmental officials when they come back next week.
Thank you for coming and bringing your submission, and for answering our questions. It has been very helpful.
Mr Connor: Thank you for the opportunity to talk to the Committee. We apologise for the lateness our submission. Committee members are welcome to come to the local trust, and we would be pleased to show you what is happening on the ground.
MINUTES OF EVIDENCE
Thursday 3 October 2002
Dr J Hendron (Convenor)
Mrs A Courtney
Ms M McWilliams
Ms M Waddell )
Mr J Richards ) Eastern Health and
Ms T Nixon ) Social Services Board
The Convenor: Our Committee decided to set up a subcommittee, which has the full authority of a Committee. I welcome Ms Waddell, Mr Richards and Ms Nixon from the Eastern Health and Social Services Board. You have gone to a lot of trouble with your documentation, and we thank you for that.
Mr Richards: Thank you very much. It is good that the North and West Belfast Trust will follow us, because that will highlight the differences in the roles and responsibilities between boards and trusts and between policies, strategy and operations. It will also show how they operate together.
We know that the Committee has heard from voluntary organisations and other trusts and professional groups. We do not want to rehearse or repeat the arguments that have been covered by others. We will square the circle on the roles and responsibilities of the board on child protection. The formal child protection processes, which have been detailed in our report, have to be viewed in the wider continuum of services for children - the welfare system itself.
Our written evidence has been referred to, and we hope that its format is helpful, with the chapter synopsis at the top, followed by the narrative and then the key issues. The Committee may wish to discuss some of those issues with us. In my brief presentation, I will focus on the organisational context, discuss the level of work on protecting children, comment on the workforce, which will develop the themes introduced to the Committee by the Association of Directors of Social Services yesterday, and include a bit about finance. Finally, I will discuss operational issues that affect both boards and trusts.
In relation to the organisational context, the role of boards and trusts must be made clear. The legislation uses the word "authority", and in the glossary of terms in the Children (Northern Ireland) Order 1995, that authority is the board. As the Committee knows, the Health and Personal Social Services Order (Northern Ireland) 1994 provides for the boards to delegate the statutory functions they hold to the trusts. The board holds the primary statutory responsibility in law, but that responsibility is then delegated. The relationship between the boards and the trusts is not just about commissioning services; there is also the statutory responsibility relationship. The Committee may wish to pick up on some of the accountability and monitoring issues later.
In our submission, we state that we are keen to ensure that the monitoring of the delegation of statutory functions by all boards to all trusts is consistent. This afternoon, I am the chairman of a four-board regional group, which is to determine how best the statutory functions should be reported on in future. That leads to the circular, Roles and Responsibilities of Directors for the Care and Protection of Children (CC302), which was issued recently by the Department.
On page 13, we have outlined the panoply of organisational structures around children's services planning. That may seem over bureaucratic, but that page shows that the Children's and Young People's Committee is the centre of planning for children's services and has responsibility for influencing the commission of children's services throughout the eastern board area. That is a statutory committee set up under the Children (Northern Ireland) Order 1995, which must be chaired by a director of social services. Both the Childcare Partnership, which deals with schemes such as Sure Start and New Opportunity Funds, and the Area Child Protection Committee (ACPC) have a relationship with the Children and Young People's Committee. The different set-ups involve 84 individuals and 37 organisations in planning and developing services for children and young people, and coherence and co-ordination is required at a local level.
A key message is that there could be similar, co-ordinated and cohesive structures at departmental level, which we have been saying for some time. There was a powerful and influential interdepartmental group working for children which seemed to go into abeyance but is starting again. We want to see the development of co-ordination and cohesion for the policy on a strategic level to mirror the structures in the Eastern Board and other boards. The ACPC is not a statutory committee, and it should be. We would like to see the ACPC Bill become law.
There are concerns about the ACPC, which are at the heart of protecting children. There are immense competing demands on members of the committee's original agencies, so their capacity to take on the additional work required by the ACPC is affected. We do not have any executive authority on the ACPC, and the individuals who attend represent their agencies - it is not a corporate body with executive responsibilities. As the ACPC is not a statutory body, the notion of child protection as a social services issue is likely to continue. In our submission we said that we see it as multi-professional and multi-disciplinary agency. That is the organisational context of child protection in a wider framework of child welfare and children and family services.
We have referred to the level of work in protecting children in the Eastern Board on pages 29 and 30, and Members will see that it is high. On every working day in the Eastern Board area, at least 11 child protection case conferences take place. That gives an impression of the volume of work. The case conferences are the formal process, and there is an enormous amount of work between professionals, families and children before and after them, so 11 case conferences a day only indicates the formal work that is going on. While the number of referrals fell between 1996 and 2001, the number of investigations also fell. However, although they have fluctuated, the number of initial case conferences has remained constant. Most importantly, the number of children on the child protection register has remained at between one third and three quarters of the number of children going through case conferences. The number on the child protection register has also remained constant over the past five years.
The volume of work on child protection is reflected not only in that data, but also in the court work surrounding child welfare. In the submission we referred to the amount of court work and its implications for social workers. The complexity of their work has increased, because current legislation requires higher levels of proof for the courts as well as a clear indication of the benefits to children. Although that is extremely good for children and young people, it places significant additional burdens on social workers, and their reports can run to 20 or 30 pages.
Also, the length of the court process has increased dramatically, and the average disposal time in family proceedings courts is estimated to be 9·7 weeks. With colleagues in other boards, I recently analysed the number of times that children and families appear in court, and, sometimes, between an emergency protection order and the final family proceedings court hearing, there were up to 10 appearances, so the volume of work associated with child protection is vast.
To move on to the workforce, recruitment and retention and the qualifications and skills of social workers are critical to delivering a quality service. We have also said that, although we had nearly 2,000 qualified social workers in 2001, we estimate that there will be a shortfall of 150 for the next couple of years. Last week, a debate in the ministerial Children Matter task force suggested that if the Minister decides that Children Matter phase II should be implemented, that figure is an underestimation, so there will be a shortfall of at least 150 social workers.
Of the nearly 2,000 social workers, 57% work in family and childcare. We have a 15% vacancy rate for family and children's services social workers, which is very high. It fluctuates from month to month and from year to year, but, for the first time, we are in a similar position to that in England. The turnover of social work staff in trusts is about 8%, and because of the shortage of staff, which are more often in family and children's services, many newly qualified social workers find themselves doing child protection work, which requires additional supervision and support from other team members and has repercussions on the whole system.
I draw the Committee's attention to the fact that David Bingham, the Department of Health, Social Services and Public Safety's human resources manager, is reviewing social work terms and conditions of service and career structures and grades. There is an important link between the Committee's findings and the work of David Bingham and his team.
In line with a multi-professional approach, I will explain the circumstances of health visitors. A recent audit showed that child protection occupies health visitors for up to one day a week, which is said to be a result of implementing the Children (Northern Ireland) Order 1995, and no additional funds were allocated to the health visiting service despite its increased responsibilities.
The links between different staff groups are critical, which is apparent from the findings of case management reviews and inquiries. That is especially so in community health; for example, midwives who work with prospective parents; health visitors who work with early years children; and school workers who work with school-age children. The board is of the view that appropriate support to those staff is best provided by child protection nurse advisors. They assist in preparing for court, report writing and, most importantly, clinical and case supervision. We recommend having child protection nurse advisors in every trust to make a difference to those groups of staff.
Many child protection problems come through accident and emergency departments. Their staffing levels should meet the Clothier report recommendations, and an increase in the number of nurses and health visitors would help to give improved responses to child protection problems.
Over the last five years, significant financial allocations have been made to boards as a result of the Children (Northern Ireland) Order 1995. A total of £9·65 million has been allocated to the Eastern Health and Social Services Board. It would be churlish not to say that we appreciated that and that it was needed. However, prior to the implementation of the Children Order, we were asked what additional resources were needed. We know that between what was needed and what was allocated there was a shortfall of some £7·8 million in the Eastern Board area alone. Others have probably told you that the shortfall in Northern Ireland as a whole is around £17 million.
The Department did not accept the original estimate for increased resources for child protection work. It felt that the baselines were sufficient to cover the new responsibilities. We have shown, with the volume of work and the additional court work that I have described, that additional resources are needed. You probably know that comparisons can be made with England. Per capita, we are shown to be about 50% below the English figure. Colleagues in England say that they do not have the right per capita amount for children and family services. If they do not, we have to question how far away we are from a proper per capita figure.
If there was any new investment, what might we do with it? It would be carefully targeted at increasing the number of social workers and health visitors, increasing administrative support, promoting the career structures, improving workload management systems and increasing training and development. That sums up current investment and how we might target increases.
Several operational issues are worth highlighting. Those are the importance of assessing need and assessing and managing risk. We have drawn attention to the multiagency framework for assessing children in need, which is being piloted in the Eastern Board area. That will make a significant difference if instituted throughout Northern Ireland. We recommend social workers and other professionals to use those guidelines and that framework when assessing children.
I spoke earlier about the relationships between health and social services boards and trusts. Although the statutory responsibilities have been delegated to trusts, we share the risk. When a trust cannot provide the optimum solution to a child's needs, it tells us verbally and in writing what the risk management strategy is likely to be for that child. We approve that as a board, so the risk is shared between board and trust. That is crucial. Although trusts are finally responsible, we are too, which is right and proper given the responsibilities of corporate parents, which is what board directors are.
I draw your attention to the differences between the South of Ireland's jurisdiction and that of Northern Ireland. We regard that as serious. Many children from the South have been placed in Northern Ireland, and the regulations about accommodation and the review of children are very different. We in Northern Ireland are left with the statutory responsibility, and that creates significant problems for children and young people, staff in the trusts and the children's families in the South. It would be useful if the Committee could recommend working in partnership with colleagues in the South to ensure more parity between their regulations and procedures and ours. The Social Services Inspectorate and our trusts are trying to introduce changes, and if we receive any guidance from either the Social Services Inspectorate in the North or the Irish Social Services Inspectorate before the Committee has finished its deliberations, I will let you know.
The Convenor: You drew our attention to the diagram on page 13 of the children services planning structure. That was helpful. The ACPC, which is linked to the children and young people's committee and to the childcare partnership, has no executive or corporate responsibility. The submission describes the delegation of statutory functions to the trusts, but it states that the boards are responsible for monitoring the discharge of those responsibilities. You agree with that, and I understand that. How do boards audit or monitor the effectiveness of those statutory functions?
Mr Richards: We do so in several ways. The trusts must submit an annual report to the board that demonstrates how they have exercised their statutory functions with regard to children, vulnerable adults, older people and people with mental health problems. They have a responsibility to say how they have utilised the money that has been given to them during the year. We meet with the board and trust staff to examine the difficulties that they encountered in fulfilling their statutory functions. For example, two or three years ago, the North and West Belfast Trust told us that it was having serious difficulties meeting its statutory requirements, so we established a joint implementation group and worked through the difficulties with it. I am sure that if you ask it the same question, it will give a similar answer. That is one way of monitoring the effectiveness of the statutory functions. Another way of doing so is to use contract monitoring reports, which are regularly sent to the board. Regular meetings are also held between senior board officers and senior trust officers, and people such as Ms Nixon and her team liaise daily with trust staff.
The Convenor: Your submission explains your monitoring role and how need is assessed. It also says that child protection services cannot be provided effectively due to a lack of skilled staff and resources. How can you require services to be provided when there are insufficient resources?
Ms Nixon: The Eastern Health and Social Services Board has a quarterly monitoring return, which comes from the contracts department. That shows the efforts that trusts are making to recruit and retain staff, and it also shows gaps in provision. The board has an assistant director of training who is responsible for examining all aspects of training and commissioning training for social workers. We had meetings with trusts, and they identified the gaps and suggested what we could do to employ more social workers and have adequate training in place for them.
The Convenor: It must be difficult to decide priorities with limited resources even though, under legislation, you are obliged to do certain things.
Ms Nixon: This year, the Department set a target to increase the number of residential social workers working with looked-after children, but it has proved to be difficult. We hoped to have at least 13 new social workers trained, but only nine came through the system. At times, they fall out of the system due to the heavy workload. It is an ongoing problem, but we are monitoring it closely and taking steps to find out what the Department can do about it.
The Convenor: In your submission, you recommend that all trusts should audit and monitor their adherence to ACPC policies and guidance on child protection. Surely you do not need to do that. You can, and should, require that through your commissioning, monitoring and auditing responsibilities.
Ms Nixon: There is a link between the ACPC and the trust child protection panels. We have included that because we need to ensure that the information that we receive from those panels is robust and that they give us a full report and annual return which we can use to deliver the ACPC report. There are sometimes gaps in the provision of information, and that is why we said we should audit that. Trusts should also audit their responsibilities and report on them to their boards. Everything needs to be tightened. This is about information flowing between boards and trusts.
Mrs Courtney: You set out comparative funding figures which identified initiatives in the rest of the United Kingdom that are not funded in Northern Ireland. They are important, but none of the initiatives concerns core child protection functions, and they probably draw experienced staff from the mainstream services. The rest of the United Kingdom still has major child protection problems. How can the Committee address that?
Mr Richards: I recommend that an equality protection initiative be started in Northern Ireland. In England, the corporate parenting guidance was issued alongside a quality protects initiative. That required local authorities in England to improve the health and education of looked-after children, to reduce the number of child placements and to increase the number of services for them.
We have been asking for corporate parenting guidance for the last three to four years. That was issued about three months ago but without a quality protects initiative. The board has written to the permanent secretary and the Minister asking if there could be a link between the corporate parenting responsibilities and the quality protects initiative. If some resources were made available for the benefit of children, young people and families in that way, it would begin to reduce the gap between the per capita spending in Northern Ireland and that in England.
We have Sure Start initiatives, but I remind the Committee that the funding of Sure Start is still not guaranteed here. That is one of the concerns. All the preventive, promotional and family support work that is being done under Sure Start does not have security of funding. I would recommend the quality protects initiative, the guarantee of funding for Sure Start and new investment, which should be seriously targeted at those issues I raised earlier in my presentation. The Committee could recommend a more targeted, focused, ring-fenced approach to funding.
Ms Nixon: An example of that is taking care of the educational needs of looked-after children. The money identified for the board last year was about £47,000. That is in the context of a considerable number of children in care from deprived families; they are socially disadvantaged, have poor literacy levels and are unable to attend school. To try to increase their educational advantage is difficult in the context of that low level of investment. That is also true of the health needs of looked-after children. That is just an example of what we are trying to do against the background of what other trusts in England have to do so. I just wanted to raise that as a priority.
The Chairperson: Thank you.
Mrs Courtney: My question relates to page 19, paragraph 2. You recommend top slicing mainstream funds to meet identified areas of need associated with emerging from conflict. Is there not a danger that this will exacerbate the problem of the underfunding of the mainstream budget?
Mr Richards: That is a good question. The reason that I have recommended that is that we, along with North and West Belfast Trust, undertook a major piece of research through the Institute for Conflict Research. We wanted to see if, under the capitation formula, we could include some variables that linked the amount of resources coming to boards and trusts with conflict and trauma caused by the troubles. Part of that research showed that that was not possible. The variables could not be separated, so the research suggested that there should be top slicing so that additional money went straight to the areas in greatest need due to the conflict. We have been recommending that message because the board and North and West Belfast Trust agreed that report. We are not talking about huge amounts of money. Given how resources are distributed to benefit areas that have been so affected, there would not be much disbenefit for other areas.
Ms Courtney: Many newly recruited social workers on family and childcare services have no experience of child protection and no training in this area. You said that you are committed to recruiting and retaining highly qualified and experienced staff. The problem of inexperienced social workers working as front line staff is not new, as has been apparent from every inquiry for years. Why has that not been addressed in the commissioning arrangements, and do you allow unqualified staff to work in complex provision areas? You commission services from agencies when you know that they do not have competent staff, so how do you propose to meet your commitment?
Mr Richards: There is no question of unqualified staff working with complex child protection cases. Part of the delegation of statutory functions requires qualified staff to work with children and families, so that is not an issue. However, you are right to say that we commission the services and allow social workers with less experience to work with children and families, but that is on the understanding that they get more supervision support than they would ordinarily get from their team leaders. There is a balance between inexperience and support and supervision.
You raised the wider question about the training of social workers. One of my other roles is to chair QUEST, the social work training course at Queen's University, and you probably know that the social work training course is moving to a four-year programme, the final year of which will be a probationary period with trusts. When we have the four-year social work qualification, such a situation should not happen after the first year of students coming out of the new course.
We have an opportunity to influence the content of the curriculum for social work training as well, and we are doing that through the Northern Ireland Social Care Council. My colleagues and I are a part of the team developing the curriculum to ensure that social workers have more knowledge, skills and understanding in those complex areas.
Ms Courtney: We have dwelt with that matter in this inquiry.
Ms Nixon: Trusts are introducing standard settings for the supervision of social workers and expect to introduce senior practitioner grades to bring about cohesive practice and various people at the front line. They are also making efforts to do more about it.
Ms McWilliams: I have read your detailed and extensive submission from cover to cover. You are very honest in places about where some of the problems lie, and in other places we have to read between the lines to tease it out. However, we have a fair grasp of what some of the major problems are.
One of my first concerns is the diagram on page 13 where a lot of things seem to be missing, and I wonder where we can start to make connections. For instance the Children Order Advisory Group is looking at the legal costs. I am very surprised that we do not have those costs, given that they have some idea of them in Britain.
Last week, we took evidence from an American man. He went to court to observe and was amazed at the number of people involved and the time that the process took. The case was adjourned. You said that the number of delays and the amount of report writing are being addressed. A strategic overview is needed because there are serious problems with the system. Judge Gillen is trying to address them through the Children Order Advisory Committee on which people from the board and the Department sit.
Mr Richards: Our representative on that group is Dominic Burke.
You have raised a very important issue. The costs of legal services and court cases have been buried in children and family services budgets. It is not until we consider the amount of court appearances and the number of people involved, and ask exactly what the costs are, that we realise that an investigation is needed. We are tackling the problem in two ways. One is through the Insitutute of Child Care Research, for which we have a contract, and the other is through the Children Order implementation group. Judge Gillen is very exercised by these issues, and I hope that a report will be published within the next six months.
Ms McWilliams: I am trying to understand all the bodies dealing with this: the Children Order implementation group; the Children Order Advisory Committee; a strategic management group that sits as a result of abuse inquiries, and to which your submission refers; there was an interdepartmental group; and another group has been proposed - a plethora of groups, and we are still not getting it right. Should these groups not be amalgamated so that they can share information?
My other concern is that there is very little community involvement in these groups - they are professionally led. One of the matters that the Jasmine McGowan case raised was community involvement. The community involved in that case never felt that its voice was heard.
Mr Richards: The children and young people's committee recognises the lack of community involvement, and particularly that of children and young people. Through the district partnerships, we asked for community representation on that committee, the main body. Voice of Young People in Care (VOYPIC) will become involved, and organisations such as the NSPCC will be members in their own right. We are trying to address that problem.
With regard to combining some of those subgroups, we followed the Department's guidance on setting up planning structures for children. That guidance recognises that, although they are all children, and children in need, the needs within some of those different groups are quite specific to particular children. For example, children with disabilities, and children and young people with mental health problems have specific needs. Although I would like to follow Ms McWilliams's suggestion about combining groups, one of the dangers is that we would no longer provide for the specific needs of some children within the different cohorts. However, I certainly agree that a review is needed of all the various planning forums for children. It might be the case that the children's strategy, which is being developed through the Office of the First Minister and the Deputy First Minister, will make some recommendations on that.
Ms McWilliams: That brings us back to the lack of communication. I was concerned by the reference in the submission to the Jasmine McGowan case. There is now concern about how much information people feel that they can make available, and with what degree of confidentiality. If written reports are being submitted, rather than oral reports being made while someone else is present, how will they be treated? Therein lies a problem. We must get this right, because children's lives are at risk. If some professions are withholding, or are reluctant to share, information, other professions cannot get the information they need. That is the macro situation, and if those factors are fed down through the system, the same situation will exist at local level.
You said that there are now fewer case conferences but that you hope that they are more targeted, which means that the risk should be more focused. However, we have clearly missed some cases. The Jasmine McGowan case overlooked evidence. One would have expected an early case conference there. How did such an oversight occur?
Mr Richards: It is difficult to comment on that particular case.
Ms McWilliams: I am not asking you to comment on an individual case. Do you think that there is a danger of evidence being overlooked? A great deal of the problem may be caused by a lack of resources rather than by people focusing on higher-risk cases.
Mr Richards: We are considering two case management reviews at the moment, and there is the potential for a lack of communication and a lack of coherence in the sharing of information in both of them. As we have said, we must truly learn from inquiries and case management reviews and ensure that messages are spread widely and coherently and acted upon, possibly through statutory functions
Ms Nixon: We have just released the first draft of the indicators of vulnerability for family support. This critical piece of work was discussed recently by the four health and social services boards and is now out for consultation. We will work strenuously on that and hope that it will complement the guidelines for the multi-agency assessment of children in need. That should give us a more robust method for considering the indicators of vulnerability and taking action at an early stage.
Ms McWilliams: Is this the report that your submission said would be ready by September 2002? Is it now ready?
Ms Nixon: The draft report is out for consultation. We are still working on it with the four boards.
Ms McWilliams: Will that introduce a common standard across all health and social services boards?
Ms Nixon: Yes. There will be a standard for the thresholds for providing family support. We aimed to produce the multi-agency guidelines for assessing children in need by September this year. That is now being piloted. The second part concerns the indicators of vulnerability and the point at which we should intervene to provide family support.
Ms McWilliams: Having read such documents and other evidence that the Committee has received, I am concerned that the thresholds are different, depending on where people work.
Ms Nixon: Yes. We are aware of the variations across the region. That is why this crucial bit of work has to be done and bedded down as quickly as possible.
Ms McWilliams: It has taken a considerable time to put such an important tool in place, and the Guardian Ad Litem Agency waiting lists are of some concern. Introducing waiting lists will clearly have an impact on the work that you are commissioning.
Ms Nixon: We have just been given notice by the Guardian Ad Litem Agency that it is going to introduce a waiting list. Trusts are indicating how they can respond to that. It is creating a backlog and added pressures, which cause problems for families in that process.
Ms McWilliams: That sets alarm bells ringing. Cases involving a Guardian Ad Litem Agency are clearly urgent. Those people are waiting to go to court. We may be storing up serious problems for the future .
Mr Richards: That will exacerbate the court pressures that I referred to earlier.
An important issue that we just touched on in the submission is tracking offenders. As you know, sexual offenders are tracked. There was a case in the Eastern Health and Social Services Board recently in which a child was severely physically abused by someone who had previously committed murder, and that is the subject of a case review. There are no processes in place to track those sorts of people. We, along with PSNI and the probation service, are looking to see how we can develop processes to help protect children in such situations.
Ms McWilliams: Was that a man who had a conviction for murder?
Mr Richards: The man had been in prison, and when he got out he became with a family and abused the child.
Ms Nixon: There is no equivalent of the sex offenders register for that type of case.
Mr Richards: That is a major gap in information sharing and tracking. The case review that we are undertaking should have some recommendations, but that will not be ready until January 2003. We would like to share them with the Committee when they are available.
Ms McWilliams: Reconciling the rights of parents and the rights of children will come up more often. We had interesting evidence about what was in the interests of the child, and they often conflict with the Guardian Ad Litem role, and the parents and the children are often in conflict. Do you wish to review the balance, and is that as a result of concern about what is happening in the structures or concern about the new legislation?
Ms Nixon: With regard to human rights legislation, social workers are highlighting the fact that taking action, having the balance of evidence in court to justify taking that action in a conflicting situation, and having concerns about the difficulty of engaging and motivating parents is an ongoing problem. It is a fine judgement to get the balance right, to take it as far as they can and to have the legal system aware of the issues involved.
Ms McWilliams: It would be sad if human rights legislation were to lead to less protection of children. Have you any concerns about that?
Ms Nixon: We would have concern if that happened. However, from our point of view it is the expert witnesses who have to be brought in to justify the decisions taken and the amount of time involved in the court process to protect children that are the problems.
Ms McWilliams: Is the Children Order Advisory Committee looking at that?
Ms Nixon: Mr Rooney from the North and West Belfast Trust is on the Children Order Advisory Committee. There is an awareness of the court process and the issue of social workers in court. There are also problems with intimidation, verbal threats and violence to social workers, and, against that backcloth, with trying to gain entry to families to make decisions about protecting children.
Ms McWilliams: The strategic management group is an Eastern Health and Social Services Board initiative, and it is not taking place across all boards. That is worrying. The group is only dealing with organised abuse. Could its remit be extended?
Mr Richards: It was set up to respond to a particular police inquiry that spanned trusts and the board, so we needed to have it in place. You will be aware of the Macedon children's home inquiry, which will be coming to trial in January 2003. The strategic management group was able to work alongside the police, the voluntary sector and trust colleagues to ensure that the inquiry was undertaken in accordance with the new ways of working that we had been developing. It is a standing committee only in so far as inquiries are continuing in our board area.
Ms McWilliams: The group seems to be picking up mistakes that have been made and is working alongside the police on the lessons learned. It is right to call it a strategic management group. However, surely it could deal with problems other than organised abuse. That worries me. There are so many bodies involved that there is a need for a strategic management approach. However, the only time I see those words written down is when I see the two words "organised abuse".
Mr Richards: We recommend a children's strategy in which there is a cross-departmental, cross-professional and cross-disciplinary approach towards children in Northern Ireland, which will mirror that in the South of Ireland. I would like your concerns about the panoply of planning forums to be addressed by that strategy. All of the children's and young people's committees are feeding into OFMDFM so that the right balance is struck. This is an opportunity to take a fundamental look at how children's services are planned for and developed.
Ms McWilliams: Health visitors are the only people allowed to go into a house without a white coat, stethoscope and briefcase. They do not look scary. During my work on domestic violence I realised that they were often the first to pick up on what was happening. Are they at the centre of this work?
Ms Waddell: Yes.
Ms McWilliams: So far, concentration has been on social workers, the pressures they are under, their resources and their lack of training. Are health visitors different? Are they getting more training? Do they have fewer resource problems? Are they sharing the information they gather?
Ms Waddell: Mr Richards made an important point earlier about perception. Sometimes, child protection is perceived to be a social work issue. We would like to lay that perception to rest. Child protection is everybody's business, and it is important to make that point in every organisation.
Child protection is of special interest to one particular group of nursing staff - health visitors. They have a statutory responsibility for the nought-to-five age group. Like all groups, they have a resource problem. Although I have not spoken to my colleagues from North and West Belfast Health and Social Services Trust on today's presentation, it is something that they will mention.
Health visiting has a particular resource problem. When the Children Order came into being in 1995, the enhanced role for health visitors was not resourced. Trusts are attempting to do the work without any additional funding. Although they have managed to do this successfully - and there are many good models of care - more money is needed for education and training.
I would like to mention practice nurses. They are increasingly becoming an important body of people together with community paediatric nurses. They all need to be part of a communications network. Communication seems to be a problem, particularly when it breaks down.
There is no statutory training on child protection for practice nurses in the Eastern Board; it is an add-on. There have been instances recently when a practice nurse has been the person who has noted something wrong and has gone to the relevant department. However, there are some good models of communication. There is a partnership between the Mater Infirmorum Hospital and the North and West Belfast Trust in which education, training and support is provided. That model was discussed at a recent nursing advisory committee.
The outcome of inquiries is not shared in a robust way with everybody, nor is there a structured approach to implementing practice guidelines. We should focus on that and with timescales and accountability for so doing - and I hope that it will be adequately resourced.
The Convenor: During my years in primary care I always appreciated the work of social workers and their many difficulties. I have also had many years experience of the outstanding work of health visitors and nurses. There did seem to be problems in the relationships between the two. Is that still the case?
Ms Waddell: I have not been aware recently of any situation I which there was not reasonable inter-personal relationships. The child is pivotal in all situations, and good inter-personal relationships exist because the two professions recognise each other's specialist roles.
Mrs Courtney: What Ms Waddell said is very important. Due to the importance of confidentiality, there always seems to be a reticence about sharing information between the agencies. Is that being addressed?
Mrs Waddell: We could honestly do better on benchmarking ourselves against best practice and the recommendations on good practice of inquiries.
The Convenor: Thank you for your presentation this morning.
MINUTES OF EVIDENCE
Thursday 3 October 2002
Dr J Hendron (Convenor)
Mrs A Courtney
Ms M McWilliams
Ms J Kennedy )
Ms T McAllister ) North and West Belfast Health
Mr N Rooney ) and Social Services Trust
The Convenor: I welcome Ms Kennedy, Ms McAllister and Mr Rooney from the North and West Belfast Health and Social Services Trust and thank them for their helpful document.
The Committee for Education is also meeting today, and some Members are on both Committees, so we have formed a subcommittee, which is permitted under legislation, and for which a quorum is present.
Mr Rooney: Thank you for inviting us to give a presentation on child protection, a topic that is close to the hearts of people in north and west Belfast. My colleagues are Ms Judy Kennedy, head of family and childcare services for north and west Belfast, and Ms Teresa McAllister, head of the child protection team.
The North and West Belfast Trust serves a population of about 160,000 in an inner city area. The area displays some of the major indicators of deprivation, and most research shows significant deprivation in most of the electoral wards there. Research also shows that areas with such deprivation also have many child protection issues, high numbers of children being looked after and many children on the child protection register. I will return to those issues later.
Before I ask Ms Kennedy to talk about what it is like to operate family childcare services in such an area, I want to highlight three issues. First, there is the problem of resources. You may have heard that from my colleagues in the Association of Directors of Social Services. There is a significant shortfall in the resources allocated to family and childcare services, which was estimated at £12 million in 2000. North and West Belfast and other trusts in the Eastern Board area, such as Lisburn and Down, would benefit significantly from that £12 million.
Secondly, we have many problems with recruiting professional staff, especially in the stressful family and childcare area. I will talk about the reasons for that during the question-and-answer session. Thirdly, there are difficulties in working in north and west Belfast in the context of the troubles. I will talk about those three areas later. Ms Kennedy will talk about her work.
Ms Kennedy: As Mr Rooney said, I am the programme head of the family and childcare services for the North and West Belfast Trust. My responsibilities cover the whole range of child protection services, from children who are being looked after to managing a substantial grant-aid system. My branch has experienced some pressures over recent years, such as the volume of work. Given the high rates of deprivation and the impact of the troubles, many children are being looked after, and many are on the child protection register. Many children are in need, and we are always concerned that many of them are not getting the services that they require.
Although we welcomed the legislation, implementing the Children (NI) Order 1995 has affected every level of my programme's activity. Other pressures, which have made the last few years stressful, have been the unplanned reduction of residential care, the impact of changes to the juvenile justice system and a deficit in specialist services, particularly psychology and psychiatry. Mr Rooney referred to the historical underfunding of family and childcare services. In 1998 money was moved from that programme to ease pressures in the acute sector.
That situation has affected the child protection services, particularly those dealing with the prevention of abuse and family support. We aspire to achieving a balanced approach to investing in child protection, which includes encouraging the community to promote a safe environment for children. There is a successful project called Keeping Children Safe, but we would like to invest much more in that type of work. We place considerable emphasis on the early identification of problems so that family support can help to prevent situations deteriorating. More investment is required in that. Extremely high priority is given to the early identification of serious abuse. In 1997, we established a specialist child protection team, with Ms McAllister as manager.
The need for investment in specialist assessment and treatment services is recognised, as is the deficit in the policing end and in specialist forensic psychology. Investment must also be made in high quality alternative care and therapy for children who cannot remain with their parents, as they are very damaged and need a high-quality environment in which to live, along with long-term treatment from highly trained professional psychiatrists, psychologists and social workers.
Ms McAllister: As the operational manager for the child protection team in the trusts, I hope to provide an insight into the social workers' management of initial child protection investigations. In April 1997, following the deliberations of the working party in 1995-96 and the recommendations of the child abuse inquiry in Cleveland, Rochdale and Orkney, where the system had gone wrong, the specialist investigative child protection team was born. The purpose of specialising the prevention programme in childcare was eightfold: To enhance service provision, that is, new investigations would be undertaken by experienced staff; to promote increased specialist multi-disciplinary liaison with other agencies, particularly the Police Service, and enhance the joint protocol working relationship; to endeavour to centralise specialist trained joint protocol social workers who would work trust-wide and overarch provision across the three sub-offices; to provide strategic information on investigative trends; to assess and service identified investigative needs; to provide consultancy and training for other primary social work teams within the trust and programme; to discharge the trust's role in respect of schedule one offenders; and, finally, to retain experienced staff in a difficult, complex and stressful area of work, by the creation of the senior practitioner grade of the social work practitioner.
The team comprises eight staff; myself as manager, and I am a principal social worker, three senior practitioners, two social workers and two administrative staff to service the team, which is located in Lawther Buildings, Cupar Street, Belfast, but services the entire trust area.
Initially, the five practitioners in the team were specially trained to undertake joint interviews about child abuse with trained police officers. That led to a close and established working relationships with the two police CARE units that service the north and west area of Belfast, namely Newtownabbey and Woodbourne. However, as research has focused on further specialist joint protocol training, only two workers are currently trained to undertake that specific form of joint interview. We felt that that level of training was inadequate, given the volume of investigative interviews undertaken by the trust in comparison to that of other trusts in the region, so we have made representation to the child protection panel, the area child protection committee and directly to the Eastern Health and Social Services Board. We are concerned that the existing training provision does not recognise the volume of interviews undertaken or provide for the transition, movement and promotion of staff into other fields.
When the child protection team completes an initial investigation, the practitioner, following liaison with the assistant principal social worker, could decide on a number of potential options. Those options are: transfer the child situation to a prevention team in one of the three sub-offices; refer it directly on to therapeutic services, for example, the childcare centre or adolescent services, or the case may be appropriate for closure.
It is recognised that the child protection team does not hold the exclusive remit to manage child protection investigations. In social workers' current caseloads across the three sub-offices, child protection issues may emerge at any juncture. In such situations, the lead responsibility belongs to the carrying social worker and the child protection team will offer a consultative capacity to those workers.
In the submission, I took a snapshot of the child protection team's caseload, from 1 July 2001 to 30 June 2002. During that time, the team managed 352 new referrals, 130 of which related to sexual abuse or inappropriate sexual activity between children or adults to children; 60 referrals were in respect of physical abuse from adults to children; 90 were in respect of Schedule One offenders; 60 related to alleged Schedule One offenders and nine others were accounted for.
The Convenor: Under the Children Order (Northern Ireland) 1995, the Eastern Health and Social Services Board has delegated functions to the trusts and commissioned the delivery of services in support of the functions. Are there any contract specifications for these services?
Mr Rooney: Yes, the board commissioned family childcare services and has delegated statutory responsibilities to the trust. The Department issued circular CC302 recently, entitled 'Roles and Responsibilities of Directors for the Care and Protection of Children', which deals with corporate parenting, and clarifies the roles of the boards and the trusts. The trust has a contract with the Eastern Health and Social Services Board, which is negotiated annually. It stipulates the income the trust receives and the services to be provided. The trust is moving to a different scenario, but the contract situation still operates.
The Convenor: How does the trust decide on the allocation of responsibilities under the Children Order (Northern Ireland) 1995? Are responsibilities delegated to the social services staff or is there an overarching responsibility exercised to ensure that all trust services are meeting the requirements of the Order?
Mr Rooney: As is required in the legislation, a director of social work is appointed to the trust board. As that director, I have the delegated statutory responsibility and accountability to the board for the discharge of statutory functions. The Department's circular on corporate parenting states that
"All directors, whether non-executive or executive, have a corporate, individual personal responsibility for children looked after in their care."
That clarification, which we have been seeking for some time, shows that corporate parenting is not just the responsibility of the director of social work, but will have a significant implication for all the directors - the medical directors, the nurse directors and non-executive appointments as well. We are working through the implications of that directive with the board and the Department.
The Convenor: How are the health contributions to the process identified and accessed? For example, do social workers feel that they work for the same agency delivering health services and vise versa?
Mr Rooney: As indicated in our presentation, and in all the inquiries here and in the United Kingdom, the interaction of the nurse, the social worker and particularly the general practitioner is crucial to the identification and the highlighting of child protection issues. In Northern Ireland, integrated health and social services work closely with nursing colleagues. The GPs also work closely with us, but we have concerns, as our submission suggests, about the number of case conferences GPs attend.
For single-handed GPs, there are concerns about the numbers of case conferences to be attended. We had in the region of 300 case conferences over a certain time and it is impossible for GPs to attend all of those. However, significant issues on that subject need to be resolved. The relationship with health visitors, school nurses and practice managers works very well.
Ms Kennedy: In the early 1990s, we established a child protection panel and now all trusts are required to have one. We meet with the local GPs, the nurses, the doctors and the police, and we train together and oversee the development of the services. Also in the North and West Belfast Health and Social Services Trust, we have a senior health officer who is a child protection adviser, based in one of our social work offices. As Mr Rooney said, we have excellent working relationships with the nurses who have problems with recruiting staff as well. We would also like to see closer working relationships with GPs.
The Convenor: In relation to the question of GPs' attendance at case conferences, I have had some experience there. I am not a spokesperson for GPs, and I am not in general practice anymore, but one problem is the time the case conferences are held, as Mr Rooney said. For efficiency's sake a day and time is fixed and problems may arise with that, but once the new groups get going, as more doctors work together, they may be able to organise their diary. It is very important that the GPs attend those case conferences.
Mrs Courtney: Page 2, paragraph 6, of your submission states that
"Central to the community's pivotal role is its individual and collective acceptance and actioning of its responsibilities to vulnerable children."
In law, individuals and communities have no responsibility for vulnerable children, therefore, should there be a clear obligation backed by statute?
Mr Rooney: The trust pays a great deal of attention to community involvement in the area of family services generally and we would welcome the involvement of communities and families in the issue of child protection, as it would be a significant step forward. We do work closely with community organisations, specifically in the area of children's services. Whether that can be made a statutory responsibility is another area that I am not clear about. Encouragement for the engagement of communities is to be welcomed.
Mrs Kennedy: We actively seek the support of the community. I referred to our cross-sector child protection panel, for which we have involved and trained members of the community, as it is important that awareness of the issues is raised and that the community supports our actions. We also advise people who come forward that they are entitled to anonymity and confidentiality.
Mrs Courtney: Is it your view would be that legislation should enacted to make people responsible for reporting?
Mr Rooney: There is a fine balance. Often, one of the problems for social services staff is that when these things hit the headlines there is always the issue of blame for statutory organisations. We need to get the balance right between the responsibility of the statutory organisation, families and the community. If we get that right that would make for a much more mature debate about some of the issues.
Mrs Courtney: Your submission states that North and West Belfast Social Services Trust has difficulty recruiting health visitors. This is concerning because health visitors can be essential for any parenting programmes aimed at prevention. How is the problem being addressed?
Mr Rooney: It is a very significant issue for us and it is compounded by some of the issues that I stated earlier on. It is difficult enough to recruit social work family and childcare staff because of the stressful nature of the work. Indeed when things go wrong, there are major public outcries. It is difficult to recruit health visiting staff, but it is more difficult in an area such as north and west Belfast because the community is significantly divided. We are working across both communities and we have problems about the attractiveness of the area. There are five posts vacant in north Belfast and we cannot recruit staff for them. Given a level playing field, people will decide to go elsewhere.
Mrs Courtney: In other places, health visitors express frustration at the reluctance of social services to accept referral for children who need assessments for child protection investigations. I assume this situation is familiar to you?
Ms Kennedy: We have no outstanding child protection investigations. That would not apply in our trust area, but we are conscious that there is a range of children in need who should be getting services and are not getting them. Such cases are given a high priority and are always investigated.
Mr Rooney: Sufficient services are not available in some areas. I refer to child and adolescent psychiatry services and child psychology services. It is almost impossible to recruit child psychology services. We have had several advertisements in the paper over the past year. For child and adolescent psychiatry services there can be considerable time between referral from school or nursery and being seen. We sympathise with people's frustrations in that area. Particular areas of service can be very difficult to access. However, we do not have a waiting list of assessments for children.
The Chairperson: How closely are the services commissioned related to the non ability to deliver and does the trust ever indicate to the commissioning board that it cannot deliver?
Mr Rooney: Ms Kennedy referred to the situation in 1998 when the £12 million was needed to implement the Children's Order. That money was not made entirely available, and some of what was made available was redirected to the acute sector. That happened in the Eastern Health and Social Services Board area at the time. Our board made formal representations to the Eastern board about that and subsequently in recent years the situation has changed and service resources have came back again.
That tells me that there are significant issues about ring-fencing resources. I hope the children's commissioner will begin to look at some of these areas because there have been consequences as a result of resources not being available in 1998. For example, secure accommodation has not been available and there have been articles in the press concerning our colleagues in the courts asking for that. Residential accommodation has not been available to us, and we have not been able to employ social workers for court work and child protection work. The decisions in 1998 had a considerable impact on us. Your Committee has been looking at several of the issues and is now beginning to resolve them and resource them.
My plea in that situation would be that the committee should be looking at making sure that the resources for these types of areas go to where they are supposed to.
Ms McWilliams: Pardon me; I have a bit of a cold. Do you privately purchase the services that you need for disturbed children from psychologists and psychiatrists or are they part of the trust's commissioning?
Ms Kennedy: In the past few years, even though we have had the necessary resources, it has been difficult to recruit psychologists. The trust is building up its psychology department, and I can access time from it, but we also have a contract with the psychology department in the Royal Victoria Hospital. However, we do not have as many psychologists as we need.
Ms McAllister: We commission some private work, especially for abusive parents or parents who have admitted to their abuse. Given the difficulty in accessing that mainstream, we purchase services from clinical psychologists on a private basis.
Ms McWilliams: Have you had to commission treatment for kids at facilities outside Northern Ireland?
Ms Kennedy: Yes. At the moment, the trust has one child who is being assessed in a highly specialist secure psychiatric facility outside Northern Ireland. I understand that two other children from Northern Ireland are there as well.
Ms McWilliams: Is it expensive?
Ms Kennedy: It costs £536 a day.
Mr Rooney: The lack of specialist child and adolescent inpatient services has been in the public arena for some time. There are plans, which are becoming operational, for 10 additional beds in Northern Ireland in Knockbracken. Those beds should allow us to move to a situation where we do not have to place severely damaged children in parts of the UK. However, we have placed one child in a facility outside Northern Ireland, and I know of two children, from another part of Belfast, who have been placed outside Northern Ireland. It is very expensive, and it is to be hoped that the services that are coming into play will prevent us from having to do it.
Ms Kennedy: We are also bidding for Executive programme funds for a specialist regional unit for children with severe emotional psychological difficulties, which will provide an additional eight places. The children at that end have specific needs, and there may be some specialist services that Northern Ireland will not be able to provide, as is the case for physical illnesses. There are some highly specialist treatments that children must go across the water for, and, therefore, there will probably always be some occasions when a child will have to travel, because we do not have the population to justify setting up a particular type of service.
Ms McWilliams: I accept that. However, in the absence of adequate beds and some of those services, which seem to have highlighted the gaps in the system, we want to work towards, even on a human rights basis, keeping the child where his or her family can visit without too much difficulty.
Ms Kennedy: The gaps that we are beginning to identify centre around secured psychiatric services.
Ms McWilliams: It will be interesting, because a secure unit for adults is to be built, but we are talking about secure units for adolescents, which is a different facility altogether.
Ms Kennedy: For a period of time.
Mr Rooney: Yes. It will be 10 secure inpatient beds for adolescents, not for adults. As I understand it, it is currently being designed and shaped.
Mr Rooney: Yes. It is part of the Children Matter Task Force and part of the continuum of different specialist residential provision that is currently in place. When all of that is in operation, some of the major issues may begin to resolve themselves. However, we are in transition and we have significant difficulties. At the moment we have to place people in England, at significant cost, who would otherwise be in those types of facilities.
Ms McWilliams: I am interested in the point about abusive parents. There have been cases where there has been no successful prosecution where the child has been left with one parent. How successful is your work with parents in cases like that?
Ms McAllister: Success is difficult to measure in any aspect of social work. Where there is no criminal conviction but significant concern, we present that situation to the family courts in an attempt to have recourse to protect the child.
Ms McWilliams: What does that involve?
Ms McAlllister: We would attempt to assess the ability of the non-abusive parent to protect the child. If we feel at the initial assessment stage that a parent is unable, then we must seek alternative provision for the child. If we are uncertain, which often happens because the presenting situation may not be clear, we may look for alternative care for the child within the family or extended family. We would usually offer specialist pieces of work for the non-abusive parents, psychological assessment, and individual protective work with the children resource team at one of the family centres in conjunction with the NSPCC. The responsibility for the decision making in the assessment process is shared at a case conference forum across the multi-professional group, which includes health visiting and psychology, and in consultation with the GP. That assessment process has a shared responsibility and accountability. We are obliged to constantly consider the reunification in a safe situation with the non-abusive parent.
Ms McWilliams: I am thinking of a case in which there has been one child death, but there are other siblings, and there are questions over whether the parent - other than the person that has been prosecuted - is abusive. A great deal of work and surveillance would have to take place. How would that happen?
Ms McAllister: That is the bread and butter of the investigative team. We would start with a psychological assessment of that parent to determine if that parent can co-operate with an assessment process. If that outcome were positive, we would move to a specialist 12-week outpatient community assessment at one of our resource teams staffed by psychologists, social workers and child psychiatrists. Following that we would probably move to a residential facility for the parent and the child. The facilities at Thorndale and Parents and Children Together (PACT) are staffed 24 hours a day. We would request a minimum 12-week participation in an assessment programme. The multi-disciplinary forum would then examine that situation.
Ms McWilliams: You mentioned the extended family. We took evidence last week from an American child advocate, who told us that in the States the extended family is used extensively if the parent or parents are unable to care, and where there are serious issues around protection. That arrangement is funded and resourced. Do you do that?
Ms McAllister: The North and West Belfast Health and Social Services Trust have always used the extended family culture, which has been around forever. We are moving to the assessment of relative carers for children, which is a designated assessment process.
A social work assessment will be carried out, which involves checking personal and medical references, and a panel will then will meet to approve or not a relative carer. We also finance that, but there are strategic issues involved in financing relative carers on a larger scale.
Ms Kennedy: We support them financially, and we also provide social work support. Ms McAllister is correct; we are moving towards negotiating for funding that is more in line with that which foster carers get.
Ms McWilliams: That is what I was trying to find out.
Ms Kennedy: We are heading towards that because we recognise its value.
Ms McWilliams: Do you also recognise the discrepancy that exists?
Ms Kennedy: Yes.
Ms McWilliams: You said that case files are getting smaller. Time constraints mean that less information is recorded and administration takes up a lot of time. You also mentioned case reports and case files. Are there concerns about that? The point of this inquiry was to examine cases such as the family about which we are concerned. One would have thought in that case that there would have been a case file with extensive notes. Health visitors and social workers made repeated visits to the family, yet those were not recorded. Are social workers under such pressure that case files are getting smaller?
Mr Rooney: Case files and case reporting are mentioned in nearly every inquiry that I have read. Busy social work departments have little administrative support because secretaries and so forth are not seen as a priority. Many of the inquiries that I have read have commented that there was a lot of disorganised information on file, or there was little information but people had worked on the case. In other words the family may have been visited but the social worker did not have the time to follow up administratively. We recognise that scenario from our own work and that of the four boards, and we want to continue looking at that. Significant investment in trainng and technology is necessary because we must be able to use technology to record information and so on.
Ms Kennedy: We had a review a few years ago in which it was recommended that we tidy up our files, so they have become organisationally manageable. The trust invested in that organisation. Our middle managers also formally audit files, ensuring that they are up to date, and there is no problem with that in the North and West Belfast Health and Social Services Trust. We are examining the content of the files. The information tends to be very factual and can be a bit light, therefore we are considering what should be in files.
Ms McWilliams: You mentioned supervision, and it seems that the less senior, more junior, therefore less experienced front line staff are working on fairly serious, complex and multifactorial cases in which many things happen. I was concerned to read that there is not always adequate supervision for health visitors; the North and West Belfast Health and Social Services Trust said that there is one supervisor for forty staff. I know that you would like to have the trust's child protection adviser involved in supervision. That is a stark request; it is what you would like but it does not happen. That might be a problem because those who are inexperienced, not picking up the job, light on the case file et cetera should have that kind of supervision, but it is missing.
Mr Rooney: As I said at the beginning, a key issue for us is that social workers, when they come into the profession, work on a range of areas - the elderly, mental health, learning disability and childcare. We have recently noticed the stresses on the social work and childcare scenario. I mentioned earlier my role on the Children Order Advisory Committee, on which I sit with Justice Gillen. He recognises the significant demands that are being put on childcare staff in the courts. Judges should be involved in the Children (Northern Ireland) Order 1995. The number of reports that we are being asked to complete has gone through the roof. Forty page reports are now required when once one or two page reports were sufficient.
There are significant issues, and experienced staff are moving out of childcare and across to other programmes. We are recruiting newly qualified staff into childcare work. That is an issue.
Supervision is also an issue. For example, we will have difficulties with the development of the guardian ad litem service, which you mentioned earlier. Experienced childcare staff also go into that area of work. That is seen as a different area of work - less stressful and more supportive of families - and you end up with the inexperienced staff in the hard areas. That is a significant issue that must be raised and addressed by the Committee.
Justice Gillen has raised the matter at the Children Order Advisory Committee, and he would be keen to explore that with us. I would suggest that Justice Gillen in his role should speak to the Committee.
Ms McWilliams: Mr last question relates to a point that was made in the Eastern Board's submission. It stated that we are facing new issues because of the troubles. During the transition period, it states that as we move from violence to no violence, different patterns of violence will emerge. The submission refers to gang warfare, much disturbed behaviour from adolescents and the issue of drugs. Those all interact. You would have a great deal of experience with those problems in north and west Belfast. Do you agree that this is a new area of work that needs a great deal more resources and training?
Ms Kennedy: We noticed a rise in child protection referrals since the ceasefire. We have had a 25% increase in referrals to our north Belfast office. The police similarly reported a rise in domestic violence. We have had particular problems in the greater Shankill area and north Belfast.
We work closely with primary school principals, and they are noticing behavioural problems in younger and younger children. We should be intervening in nursery schools. One teacher on the Shankill Road showed us a list of the seven-year-olds in her class, and over half of them had serious problems at home, including the suicide of a parent and such issues. The teachers report that many children are disturbed; they come to school upset and anxious.
In our work with the schools - both in primary schools and under the communities in schools initiative, which is a secondary school initiative - all professions are beginning to exchange information and are getting clearer about what the problems are. It is definitely about us all working together. There must be help in the schools, and we must arrange the professionals around the schools and the families that need help. We need to target families early on.
The Chairperson: On behalf of the Committee, thank you very much for your documentation, presentation and for answering our questions. That has been helpful in our work on the child protection inquiry.
Ms McWilliams: Could Ms Kennedy give us some written documentation on the communities in schools initiative?
The Chairperson: Yes. That would be helpful.
MINUTES OF EVIDENCE
Thursday 3 October 2002
Dr Hendron (Convenor)
Ms K Yiasouma ) Include Youth
Ms E Quinn )
The Convenor: As part of our inquiry into child protection services, we welcome representatives from Include Youth, Ms Edel Quinn and Ms Koulla Yiasouma - I hope I pronounced that correctly.
Ms Yiasouma: Yes. Well done.
The Convenor: Thank you for the documentation. After your presentation, the subcommittee would like to ask some questions.
Ms Quinn: As the policy co-ordinator of Include Youth, I thank the subcommittee for giving us the opportunity to give evidence. I draw your attention to our key areas of concern about child protection. I shall try to be brief to allow time for questions.
Many of the young people that Include Youth comes into contact with, and on whose behalf we work, fall into the older age bracket of over 13 years. In our experience, many of them have significant child protection problems, so we ask whether enough is being done to safeguard older children from child abuse, as defined in the Children (Northern Ireland) Order 1995.
There is a reluctance to categorise older children as being at risk for the purpose of placing them on the child protection register. In addition, there is an absence of comprehensive statistics on the number of children for whom there are potential, suspected or confirmed child protection problems that have been brought to the attention of the social services. Therefore, it is difficult to know how many are at risk. How many children over 14 years of age are on the child protection register? Why are they registered, and under what categories? How are older children who disclose past or present sexual abuse categorised? Are they involved in "at risk" behaviour, such as drinking, drug taking, and sexual exploitation through prostitution or crime?
Another missing statistic is the number of children over 14 years of age with whom the social services have contact about child protection matters, but who are not on the child protection register, such as children who are homeless or in care. Homelessness among young people has enormous child protection implications. Social services work with young people who present as homeless and take referrals from the Northern Ireland Housing Executive. However, as far as we are aware, neither organisation records the number of 16- and 17-year olds who present as homeless.
Furthermore, we understand that when a child or young person goes into care he or she can be removed from the register, as he or she may, rightly or wrongly, no longer be considered to be at risk. We are also unsure whether the child or young person is re-registered when he or she leaves care. That undoubtedly lowers the number of children on the register, especially the number of older children, as they make up the bulk of children in residential care. That may, at least in part, account for the very low numbers of older children on the register. However, the problem is that we just do not know.
We suggest that resources be directed into a comprehensive assessment of the number of older children with child protection needs. That is essential for planning appropriate services, and monitoring their delivery and the success of intervention. In that regard, we concur with the recommendations made to the Health Committee by our colleagues in the NSPCC.
I now wish to turn our attention to children who come into contact with the police. It is Include Youth's understanding that the Police Service of Northern Ireland (PSNI) has no overall child protection policy. That is a serious omission. We understand that a child protection policy exists specifically for use in the community involvement branch and that a joint protocol operates between the PSNI, through its care unit, and social services to deal with allegations of a child protection nature.
It is PSNI policy that care units investigate all cases of child sexual abuse, all cases of interfamilial physical abuse, emotional abuse and neglect, and all other serious assaults on children. However, cases of a less serious nature fall to the district command unit to investigate, usually through uniformed beat and patrol officers. That policy provides inadequate protection for children who are victims of abuse and who are at risk of further abuse. Expertise has been developed on child abuse and sexual offences in those care units, but it is not used in the many cases that are deemed to be non-serious assaults on children. Instead, those are investigated by less skilled officers.
Moreover, the lack of early involvement of specialist officers may have a negative impact on prevention as such officers are more likely to identify situations that carry risks of escalating abuse. The training for operational police officers is wholly inadequate. On a related matter, children who wish to make a complaint against the PSNI must have confidence that it is accessible, transparent, thorough, and independent in how it conducts investigations and is maintained by well-trained staff. A young person whom we spoke to said:
"At the age of 11, I was arrested for riotous behaviour. I was taken down to the police station. Two officers questioned me alone with no parents present. I was beaten by one of the officers. After the officer beat me, then they called my mum, and she came down to the police station. We were there for hours. When I was let go my mum and I went home. I got a drink of juice, and I left the house and went back to the police station to complain to the officer who had beaten me. I asked to speak to the senior officer in charge. When I told him what had happened he showed no interest in my complaint. This experience has left me with no confidence in the police."
Include Youth is firmly of the view that the PSNI's policy is not sufficient and that an overarching child protection policy should be developed as soon as possible.
The next area that I shall examine is that of children in custody who also experience child protection problems. As we explained in our written submission, young people up to the age of 17 are detained in juvenile justice centres. However, young males who are over the age of 17 are held at young offenders centres, which are part of the Prison Service. In addition, females as young as 15 years of age have been held in custody at Maghaberry Prison, and that is in clear breach of human rights.
We have seen no evidence of a child protection policy in the Prison Service, Hydebank Wood Young Offenders Centre or Maghaberry Prison. Include Youth wants to see an immediate end to housing children in adult penal facilities. However, it also contends that, while the system remains as it is, appropriate child protection policy and practice must underline any treatment of the young people in question. We ask the Committee to seek clarification from the Prison Service on that issue.
We also have concerns about child protection for young people who are detained in juvenile justice centres, and we highlighted such concerns in our submission. We understand that the Northern Ireland Office (NIO) and the Juvenile Justice Board are working from a 1995 child protection policy titled 'Training Schools' Child Protection Policy and Procedures'. That policy is out of date, as the training school regime ended some years ago. We have, however, been informed that the policy is being updated in line with recommendations from the Social Services Inspectorate and the Northern Ireland Human Rights Commission (NIHRC) as part of the changes to the juvenile justice estate.
Include Youth has also been informed that the only recent staff training in juvenile justice centres involves sessions on bullying and child management techniques. The development of any child protection policy must be accompanied by thorough and ongoing training to ensure that policies are implemented in an appropriate manner. When boys from Lisnevin make allegations of a child protection nature, uniformed officers rather than police care teams investigate them. That results in inadequate protection measures. We have, however, been informed that the Social Services Inspectorate is confident that the joint protocol is being used in cases in which an allegation involves abuse of children by adults in juvenile justice centres. The following statement from a young person illustrates some of the problems that those children experience while in custody:
"When I was 15 years old I was taken to Lisnevin. Everyone else was older than me and were pushing me around. There was always someone looking to start a fight. The stress of fighting back was too much. I was put in a room on my own for two weeks. This room became my world. I was very lonely and even had to eat my food in this room. I wish there had been someone to stick up for my rights then."
We suggest that the Juvenile Justice Board be invited to give evidence to the Committee on the development and implementation of its child protection policy.
Finally, I draw the Committee's attention to the impact of paramilitary violence on young people. In our written submission, we referred to the statistics for 2000, and the statistics for 2001 reveal that the problem has increased in the past year.
Last year, the Northern Ireland Association for the Care and Resettlement of Offenders' (NIACRO) base 2 project, which provides an intervention service to those under paramilitary threat, recorded 136 referrals from children under 17 years of age who were under threat of physical punishment from paramilitary organisations - 14% of the total referrals received. In the same year, PSNI figures reveal that 23 children under 18 years of age were shot by paramilitaries, and there were a further 36 reported young casualties of paramilitary-type assault. The youngest victim of paramilitary assault, according to the police, was a 12-year-old, while the youngest child to be shot was 14 years of age.
Such attacks or threat of attack causes significant harm to young people, and the physical, psychological and emotional effects can last a lifetime. We acknowledge that the problem is regularly debated in the wider context of Northern Ireland's constitutional politics, but the focus of the debate should shift to adopt a more child-centred approach. We strongly contend that paramilitary threats, shootings and assaults on young people are child protection matters, and must be approached by all relevant agencies as such. We must explore different ways to interact with those young people.
Include Youth is delighted that the Committee has undertaken the child protection inquiry, and it is to be hoped that a more strategic and co-ordinated multidisciplinary and child-centred approach to safeguarding all our children from abuse, harm and neglect will emerge.
Ms Yiasouma: First, I am concerned about the commercial and sexual exploitation of children and young people through prostitution. Secondly, I want to discuss young people who display inappropriate sexual behaviour, about which we sent the Committee some supplementary information.
When considering abuse and child protection issues, we do not always include young people who are involved in prostitution, when, of course, we should. Include Youth and the South and East Belfast health and Social Services Trust held a seminar in April 2001 at which it became clear that there is sexual exploitation of children and young people through prostitution in Northern Ireland. It is, however, hidden, and, consequently, we have been able to ignore it for years. It is ignored because the young people involved cannot come forward, and, when they do, it is almost impossible to obtain concrete evidence. First, it is hidden because adults who abuse children, by either selling or buying them, hide themselves or are protected by others. Secondly, it is hidden because all the evidence is anecdotal, and there are no structures in place for social services or the police to record incidents. Thirdly, it is hidden because policing is too passive and relies heavily on the evidence of the abused young person.
An inter-agency protocol to support young people and punish the adults who are involved with them must be adopted. There are many reasons for young people being in that situation. We must then turn to the guidance attached to the Children (Northern Ireland) Order 1995, which is generally helpful in the area of child prostitution.
However, that guidance contradicts itself in a most unfortunate way by suggesting that there may be circumstances in which young people who voluntarily and persistently return to prostitution should be prosecuted. Young people do not behave in that way voluntarily. They may find themselves so frightened of the abusers, or addicted to the money or to the activity, that they cannot perceive that an alternative lifestyle is an option for them. Therefore, a get-out clause for agencies does not serve the welfare of children who are involved in prostitution. It just gives agencies an opportunity to give up on those young people simply because too much work may be involved.
We endorse the introduction of a local multi-agency protocol that may reflect the regional strategy, which should be developed by the main agencies. Co-ordinated services must be established, record keeping must be improved, and those children must not be criminalised in any way.
It has been estimated that approximately one third of all sexual abuse is committed by children and young people. Although much of that problem remains hidden, approximately 100 young people receive some sort of therapeutic intervention as perpetrators every year. More than 75% of them, who are generally aged between 14- and 16-years-old, do not receive any criminal disposal. There appears to be no correlation between the severity of the act and the outcome for the child. By that I mean that there is no correlation between whether they are prosecuted or not. The majority of them are dealt with by social services-run or social services-sponsored projects, of which four operate from five locations across the North.
A significant number of young people are involved in a dangerous set of activities, so it is reasonable to assume that there is a regional policy that gives clear guidance to all agencies. However, there is not. We have known for some time that co-operating to safeguard children was to suggest their removal from the child protection processes, unless they were victims of abuse themselves.
However, there is nothing to replace it. Instead, there are the four boards, which, fortunately, work closely together but have no strategic guidance. There are services that are run primarily by two different voluntary organisations and two trusts, using different assessment monitoring and recording methods. Include Youth facilitates the risky children or children at risk and explores those issues, so it is aware of the excellent work that has been undertaken with those young people by committed and highly skilled workers. That work is done without there being a co-ordinated regional framework.
Include Youth gathered the figures that I have given to the Committee. To my knowledge, they are the only regional figures that exist. If we are to prevent any further victims of those young people and enable them to adopt a non-abusive lifestyle into adulthood, we must work together.
The Convenor: I want to start with a question for general information. What is Include Youth's constitutional base? What is its ethical stance? How does it receive referrals or acquire a client base?
Ms Yiasouma: Include Youth is constituted as a charitable company limited by guarantee that was set up in 1978. It acts as an umbrella body and lobbying organisation for a range of children and young people who are at risk of social exclusion. In that capacity, Include Youth works with practitioners and organisations that work with children. It also runs a project called the Give and Take scheme, which works directly with vulnerable young people to enhance their employment and training skills. With that remit, it gets referrals directly from social services, as well as from the Probation Board for Northern Ireland, which sponsors and buys places for its young people. Include Youth works formally with around 45 young people from across three board areas. It will soon move into the fourth board area - the Western Board - by the end of 2002.
The Convenor: You referred to the need for an overarching child protection policy for the police and the juvenile justice system. What principles should underpin such a policy?
Ms Yiasouma: Include Youth wants all child protection policies underpinned by the principles identified in the Children (Northern Ireland) Order 1995. It would prefer the term, "best interests of the child are paramount in any interaction with any child". Include Youth accepts that, due to the way in which the criminal justice system is constituted, it does not always view the child as its paramount priority if there are victims of that child's behaviour. We strongly believe that the physical and emotional needs and the protection of the child should be the underpinning ethos of the system, which should refer to instruments such as the United Nations Convention on the Rights of the Child.
The Convenor: You spoke a great deal about how young people are treated in custody and in prison. I have had experience of going to Castlereagh Police Station over the years. I do wish to talk about paramilitaries; however, everyone is innocent until proven guilty. Many young people who were brought there were not involved in anything. Child protection is therefore a big issue. I know of young people who received the kind of treatment in police stations that you mentioned. However, when I, as a public representative, went to those police stations and insisted on speaking to a senior officer, the young people were then treated with great respect. I am not hitting out at the police here; it could happen in any police station. I am sure that it happens equally as often in the South.
How does Include Youth envisage the links among the police, the juvenile justice system and social services being strengthened to protect the rights of young people?
Ms Quinn: Several forums exist through which social services and devolved Departments can work with the PSNI, the NIO and the Juvenile Justice Board to protect the best interests of young people who find themselves in custody or in trouble with the police. The fact that those matters are reserved does not have to be a bar to working together. We encourage cross-cutting and interdepartmental work. Basic measures, such as collecting data from all Departments - including those that work with the police and the juvenile justice centres - can have a huge impact on child protection. The introduction of a children's commissioner will have enormous benefits for all children here. Children who are in trouble must be central to that and be adequately protected.
Mrs Courtney: I was not aware of Include Youth, as I come from the Western Board area. You said that Include Youth is about to set up there. Will it be aligned with the Foyle Health and Social Services Trust or the Western Board? Is the organisation independent, and how is it funded?
Ms Yiasouma: Include Youth is an independent, charitable organisation. The Give and Take scheme, our direct service for young people, is about to move into the west, and that is part of Include Youth. We used to be called the Northern Ireland Intermediate Treatment Association (NIITA). We have a regional perspective, but like many regional organisations our office is in Belfast, and for a long time we had only one worker. Derry, Omagh, Enniskillen and Limavady were sometimes considered too far away. We have links with the Western Board and a close working relationship with it. The Give and Take scheme will go into the west, and, touch wood, we shall take referrals from the Sperrin Lakeland Health and Social Services Trust and the Foyle Health and Social Services Trust.
Mrs Courtney: It is good to know that. Your submission says that
"there appears, we would suggest to be somewhat of a reluctance to categorise older children as 'at risk' for the purpose of placing them on the child protection register."
Is that because no one knows what to do with those children? Is there a perception that they are in some way responsible for the position in which they find themselves?
Ms Yiasouma: That is correct. There comes a point in a child's life when we stop seeing him or her as a victim. It is great that we are good at protecting the wee ones - I do not advocate that we should not protect them - but older children are still children too. Services are sometimes so stretched that older ones slip through the net. What happened to them when they were younger is still relevant, and as they get older they display their distress in more aggressive ways - they challenge us and are more of a danger to us. When they turn 12-, 13- or 14-years-old we stop seeing them as victims and start seeing them as victimisers. That is why the criminal justice system is happy to take over responsibility for their needs and services. The rest of us stand back and let that happen.
Mrs Courtney: Young people who are involved in crime and do not attend school are at risk. Do the current arrangements for youth justice isolate them from mainstream services? Has Include Youth tried to engage with them on that basis? Children who play truant are certainly in danger.
Ms Yiasouma: We know that children take part in risky activities when they are not attending school. I am not sure what you mean about engaging with them.
Mrs Courtney: Coming from Derry and from the streets, I do not see anybody approaching young people during the day. It is difficult to approach a young person now. People are worried that they might be accused of criminal assault or of infringing their human rights. Does your group approach young people who hang about the streets during school hours and ask them why they are not at school?
Ms Yiasouma: There are a couple of outreach service projects in Derry, but we are involved with the Belfast Door project, which seeks to offer safety and resources to children who are on the streets day and night. However, that is a dilemma for the education and library boards, which are reluctant to allow anybody else to offer children a service during the day because it is their responsibility to occupy them. Therefore, we must co-operate with the boards to find the young people on the streets.
Ms McWilliams: Have you done that?
Ms Yiasouma: We talk to the boards about it, but not done much work on it. We are meeting the education and library board through such projects as the Belfast Door project, and should we get the young people through the door, we can try to work with them. However, we must get them through the door, and no one should tell us that we cannot invite them in. That would be unreasonable; the young people are not going anywhere, but they are glue-sniffing on the streets. That is the case in Belfast; I cannot speak on behalf of any other city.
Mrs Courtney: The Law Centre has an office in Derry also, and it is probably doing the same job there.
Ms Yiasouma: Yes, but the children are at terrible risk; they glue-sniff and shoplift.
Mrs Courtney: Your submission refers to paramilitary violence. Include Youth argues that it is time that the child protection provisions were made to apply without reference to the source of the harm. How can that best be achieved, given the extent of paramilitary violence?
Ms Quinn: That is a complicated question. Difficult as it is to acknowledge the world in which we live, the debate in the community and wider political circles must shift to acknowledge that 12-year-olds are being assaulted and that 14-year-olds are being shot. The focus must be put on the damage that is being caused to children. We must look at different ways to engage with those young children and look at the reasons why they are considered to be at risk of attack from paramilitaries. Those are complex problems that include antisocial behaviour. We must examine those problems and find how they can be eased. Some restorative justice projects that, when done properly, have positive benefits for the young, their victims and their communities.
Ms Yiasouma: Reference to paramilitary violence was included because if a child were similarly treated in a youth club, at home, in care or in the juvenile justice system, there would be untold inquiries. Instead, political point-scoring takes place, and we seem to forget that a child is in the middle. The headline is not about the terrible thing that happened to the child; it is about the IRA, the UVF or whoever carried out the assault. Include Youth wants communities to take responsibility for what they do to their children to see whether the outcome will be the same. We must concentrate on the victims rather than on political point-scoring.
Mrs Courtney: I appreciate what you say, but no schemes that involve statutory agencies are to be found in the Derry and the wider Foyle constituency. The Probation Board is not even involved, and that is one reason my party, the SDLP, would not support the scheme. Communities and parents should play a part, but sometimes they are too scared to do so.
Ms Yiasouma: Much work remains to be done in that area.
The Convenor: Do you have any direct access to the area child protection committees (ACPCs)?
Ms Yiasouma: We engage with the ACPCs only when "risky children" work is involved, which is work that we do with young people who sexually abuse others. In the absence of a regional framework, we have lobbied them for a uniform protocol on how to work with such young people.
Ms McWilliams: As much of your work is policy oriented, you should be involved in departmental strategies. You have already said that members of your organisation do not sit on the ACPCs, and we have discussed how their remit should include community groups and non-governmental organisations (NGOs). On which bodies do you sit, and where do you fit into the policy-making process?
It seems that Include Youth has another role as an advocate for young people. What is its relationship with social workers, health visitors and lawyers? You also said that you direct or manage one project. If you had the resources, in which projects would you invest them? Someone in your position must be aware of huge gaps and needs.
What difference will Westminster's Justice (Northern Ireland) Act 2002 make? We know about legislation passed that has been passed in the Assembly, but you are obviously involved in that area.
Ms Yiasouma: I am obsessed with the Justice (Northern Ireland) Act 2002. Please do not make me sit on any more strategic organisations. We attempt to work in partnership with many of our colleagues in the childcare sector. For example, we work with the NSPCC on the minutiae of childcare in the ACPCs. I thank the Committee for establishing its inquiry because, although we had always been aware of the need for child protection for older children, it has helped us formulate our policies on it.
Ms McWilliams: I am aware that you work closely with the NSPCC and, no doubt, like other NGOs, you are inundated with submissions. However, we heard evidence today from representatives of the Eastern Health and Social Services Board who told us about the Children Order implementation group and the Children Order advisory group, which is led by Justice Gillen. A departmental review group will also be established. Those bodies will all work at strategic level. Are you involved with any of them?
Ms Yiasouma: I was aware of the Children Order advisory group led by Justice John Gillen. I sit on the management committee of Child Care Northern Ireland and am aware that it has been given one place - the voluntary sector place, on the committee. Tara Caul from the Children's Law Centre represents Child Care Northern Ireland on that committee. We do not sit on any of the bodies that you mentioned. We sit on the Southern Board's children and young people's committee and are involved in planning children's services. We have also worked closely with the NIO on criminal justice matters. However, strategic groups are a fairly closed shop for voluntary organisations, especially for ones such as ours that straddle many different Departments. Our line has always been that children do not fit neatly into categories, especially in social care and criminal justice matters.
A question was asked earlier about working with the social services. Once a child commits a crime and enters the criminal justice system, many social service agencies are happy to sit back and forget the child. They believe that we have more money than they have, so they leave us to help him. They are happy to ignore any agency that has a remit that does not neatly fit into a set category, and they get along without us in many ways.
Ms McWilliams: Your submission identified many gaps and made some recommendations, but the fact that you do not sit on the policy-making and strategic bodies that review policies is an issue. I understand from your remarks that a consortium of voluntary groups made a representation but that your group was left out because it is independent.
Ms Yiasouma: No, we are involved with the consortium of voluntary organisations. However, the voluntary sector must knock on the statutory sector's door. In many instances we have had to ask those in the statutory sector why they acted in a certain way and why they did not involve us earlier. From the start, voluntary organisations were involved in discussions about the children's commissioner, and that is a good template for how to consult and work with them. Why they have not learned from OFMDFM remains a mystery to me. It is distressing - you may think that the devolved Departments are bad, but the NIO is worse. It is hard for us to become involved.
Ms McWilliams: I also want to know about your relationship with social workers, health visitors et cetera. How does a young person's advocate truly become an advocate in the current system?
Ms Yiasouma: It is difficult to become an effective advocate. One reason is that staff and financial resources are stretched. For example, a 16-year-old child who was having difficulty finding accommodation came into our office and told us that her mum had thrown her out and that she had nowhere to live. One of our people worked with social services to try to find accommodation for her. We often remind social services that they have a statutory responsibility to house the child, and the social worker says that he knows that but has no accommodation to offer. In that case, my colleague and the girl were still in the office at 7·00 pm trying to find accommodation. Eventually the social worker said that the girl would be put up at the Stormont Hotel. That vulnerable young woman was sent to a hotel where guests come from the business set - not that there is anything wrong with the business set. My colleague said that she had never seen anyone look so frightened, alone and wary as that girl did the next morning. We can act as advocates and Include Youth and the Give and Take scheme have a certain credibility - in a way, because they have given us funding, they have to listen to us. The problem really lies with the lack of available resources.
It is not a lack of will on the part of social workers. If a family and childcare department has to deal with 25 four-year-olds who are at risk and 25 teenagers 15- or 16-year-olds who are at risk, all its resources will be spent on the four-year olds. I do not suggest that that is wrong, but what will be done for those older children? I am pleased that the Children (Leaving Care) Bill may help a certain group of children. However, similar services, such as those provided by the young people's adviser, are crucial for older children who have been deemed vulnerable and who through luck - or bad luck - have stayed at home and have not formally entered the care system. They are crucial for those who have had spells in and out of care but who are not legally considered to have entered the system because they have stayed for less than the three months that legislation requires. They slip through the net and often end up in the criminal justice system. It does not take a great deal of research to work out that the overwhelming majority of children in custody are children in need. Moreover, they have been children in need for many years - the problem does not arise suddenly.
Ms Mc Williams: If resources were available, on which projects would they be spent?
Ms Yiasouma: Resources would be spent on accommodation, advocacy and personal development programmes. Such community-based programmes help build a child's self-esteem and self-confidence through activities and group work, or through a mixture of both. We would also channel resources into early years learning and would probably extend the Sure Start programme to include those from birth to 10 years old. It is essential that every family, with the help of whichever social worker it is engaged with, has access to that generic universal provision. We must shore up provision at both ends for children and their families, and there must be community involvement from the beginning. If you want to give me loads of money, I could do all that.
Ms McWilliams: You mentioned the gap in services for young women involved in prostitution. Projects such as Exit in Britain are not available here. Can you be a little more explicit?
Ms Yiasouma: No co-ordinated services exist for young people involved in prostitution. The documents that we sent to the Committee contain a proposal by the Eastern Health and Social Services Board and Barnardo's for work in Belfast, the aims of which are to identify the extent of the problem, to reach out to children and young people, and to work closely with the PSNI to help it target and prosecute the adults involved.
A pilot study could be conducted to see how the work that has been done across the water and across the border could be implemented in the North and what aspects would need to be tweaked. We could then consider a regional approach. It is a mystery why that proposal, which does not directly involve Include Youth, has failed to obtain funding. I am at a loss to understand that. Perhaps we just do not want to accept that young people are involved in such activities.
Ms McWilliams: We can look into that. You may not know that money from the Executive programme funds has been allocated to the children's fund. Innovative projects have been set up to address antisocial behaviour and outreach issues. My final question concerns the Justice Bill.
Ms Yiasouma: The Justice Bill became an Act in July. The Justice (Northern Ireland) Act 2002 will improve the situation in some areas and will introduce youth conferencing at the police caution stage. If a prosecutor gets a case for prosecution and is not sure how it will work, but feels that the child should go to a youth conference instead of to court, the case can be diverted. The measure will primarily be used at the pre-sentence stage in court, and it will be based on the authority of the conferencing model. All those involved work together and come up with a set of proposals for the judge or magistrate about what should happen to the young person. The young person and his or her family are included in the process, and that is the best part of that legislation.
Custody care orders are another good piece of the legislation. Children from the ages of 10 to 13 who get custody - around two or three a year - will now enter secure accommodation to become the responsibility of the health and social services trusts. That is a fundamental change. The Act is much better than the Bill as introduced was, and we are now ensuring that those children come under the remit of the Children (Northern Ireland) Order 1995, whereas what had been suggested originally would have been unfair.
The Justice (Northern Ireland) Act 2002 provides for a couple more orders to be issued before children go into court. That means that the period before they go into custody will be extended. If more orders are issued, there will be more rungs on the ladder and they will have more time to change. The more possibilities for intervention with children and young people, the more likelihood there is that they will change their behaviour and not end up in custody.
The Convenor: What is the title of document that you showed to the subcommittee?
Ms Yiasouma: It is titled, 'Out of the Shadows. Young people and sexual exploitation through prostitution: A conference report'.
The Convenor: Thank you for your documentation and for answering our questions. It has been very helpful to our review of child protection services.
Record of Informal Briefings
RECORD OF AN INFORMAL BRIEFING ON CHILD PROTECTION ISSUES
Dr Hendron (Chairperson), Mr Berry, Rev Robert Coulter, Mrs Courtney, Ms McWilliams,
Mr Maurice Leeson, Mr Cathal Mullan, Ms Linda McClure
Members of the Committee for Health, Social Services and Public Safety were given an informal briefing by representatives of Barnardo's (NI) on its response to the Committee's Inquiry into Child Protection Services in Northern Ireland.
The Chairperson welcomed Barnardo's and apologised for the delay in proceedings. He thanked Barnardo's for their documentation, which members had read. He asked Mr Leeson to highlight what he saw as the main points in Barnardo's submission prior to members asking questions. A detailed record of the presentation and responses to questions asked is given below.
Mr Leeson: I would like to begin by thanking Members for the opportunity to make this submission, and for the ongoing level of interest that they have shown in childcare issues. Our document contains quite a range of recommendations and points, and we would be pleased to take questions on any of them.
I would like to echo Inner City South Belfast Sure Start's point that, in terms of getting it right at a regional level, there needs to be an overall strategy for child protection. We think that the DHSS&PS is the appropriate department to lead on that, and we are pleased to see that within their draft strategy for children and social services they have begun to develop that strategy. Barnardos, like a number of other voluntary organisations, have indicated that they would be happy to contribute towards that development.
Like Inner City South Belfast Sure Start, we feel that the provision of good information about what we are doing in terms of child protection is very important. One example of this, as the Committee may know, is case management reviews that are undertaken by Trusts or Area Child Protection Committees whenever there has been either a child death or a serious injury where there is reason to believe that child abuse may have been a factor. I understand that on average there are four or five of those each year.
I have been a manager in Barnardo's for over 10 years, and in that time I have seen one of those reports. It was given to me by a colleague from one of the Trusts, almost apologetically, telling me that, while he was not sure whether I should see it, there was very important information in it that he thought organisations like Barnardo's needed to be mindful of.
If we are going to protect children in Northern Ireland to the best of our ability, we need to be very sure that the system for protecting them can be adapted to take account of learning experiences. We cannot learn unless we are very clear about what we are trying to achieve and have good quality information that allows us to assess how well we are doing and what targets we are meeting.
I trained as a social worker between 1980 and 1982 and I can tell you that when I was doing my training there was no input on the course on sexual abuse. It is just a matter that over time our understanding of what we need to do in terms of child protection changes. For those reasons I would emphasise the need to get the strategy and underpinning management information right, and ensure all the organisations involved in this task have the opportunity to learn from new developments and from case management reviews.
You will not be surprised to see in our presentation quite a lot about resources. I can well imagine that all your other witnesses will raise the issue of resources at some point.
I do not want to rehearse all of the arguments, as I am sure you have read them in many of the submissions. However, we face a challenging situation in that we underfund children's services. It is the view of the voluntary sector that we do not spend as much on children's services generally as in the rest of the United Kingdom, and that is a particular issue. It is pertinent to this inquiry because, as our submission argues, we need to see child protection as part of a childcare system and ensure that we resource preventative services.
The statistics show that Northern Ireland has a higher rate of child protection registration than Great Britain. I cannot explain why that is, but I know there is a glaring need for increased investment in prevention within the voluntary sector. There is a range of good examples of initiatives in preventative services that are working with families in non-stigmatising ways. They are sending out a message that the support services they offer are available to all families, with particular services to families who have special needs, such as child protection.
I urge the Committee to be mindful of the fact that within the wider debate on the allocation of healthcare resources, childcare services needs an injection of money. Money is not the only issue, but I would argue that it is an important part of the equation.
One of the issues that has exercised people in the voluntary sector - and it may be a controversial point in some respects - is that there is increasingly a view that children have not done particularly well in children's services out of our integrated provision. There is a perception that the pressures of the underfunding of the health service have meant that allocations of money for children's services are often being top sliced to meet other pressures. There is increasingly a view that the current provision and administrative structures are not necessary doing as well for children as they could. We have argued that the money should be ring-fenced and that additional resources be found for child protection and children services. I understand there are many difficulties with that approach, but I would urge the Committee to think clearly about the fact that the resourcing of this issue is very important.
I want to raise a particular issue around the cross-border dimension. Barnardo's Northern Ireland, Barnardo's Ireland, the NSPCC and the ISPCC hosted a conference last week on the issue of child protection on the island of Ireland. We wanted to draw attention to the fact that, as we have a land border and operate in two different jurisdictions, we need to look carefully on a cross-border basis at all issues relating to child protection.
In particular, we wanted to highlight the issue of the management of sex offenders and the issues of vetting. After all, it is not uncommon now for people living in this jurisdiction to wish to work in childcare in the South and visa versa. The issue of childcare, and particularly of child protection, needs to be placed higher on the cross-border agenda because there are great difficulties with it. This will require a considerable amount of political will to push it forward. Since there are different jurisdictions, there are many differences in the way we approach things. One of the speakers at the conference reminded us that while the border remains a problematic issue for us, it becomes an opportunity for paedophiles and other dangerous individuals.
Our submission refers to anecdotal evidence from our services that it becoming increasingly difficult for our statutory colleagues to recruit staff, particularly for child protection. We are concerned that a situation is emerging in some trusts where the least experienced members of staff are dealing with the most complex area of the social work task, and that is something we need to bear in mind. Our submission suggests that particular measures may be needed to encourage people who are involved in practice to stay there. Those may revolve around the career issues and the creation of a senior practitioner grade, but we need to look at the difficulties of recruitment.
While we as a voluntary organisation do not have a crisis in recruitment, nonetheless, over the last couple of years, we have seen a levelling off in applications. Whereas two or three years ago, there would have been four or five people short-listed for a job, now we are looking at one or two. So there are clearly issues there. We are very mindful of the fact that effective training support and management of staff involved in child protection is critical to getting it right. One of the features of the inquiries in England has been the frequent demand that follows to totally throw everything up in the air and start again. We, on the other hand, would feel that there are some very basic and important things that we can get right, particularly around the support and the management and supervision of child protection staff.
The Chairperson: Thank you. We move then straight into questions. Mr John Kelly.
Mr Kelly: Good afternoon and thank you for your presentation.
Given that the trusts have the statutory responsibility for child protection, in your dealings with child protection issues do you think that the corporate responsibility of the trusts through the social care and health functions reflects that responsibility? Would you be in favour of a clear statutory requirement for all organisations to adopt this purpose including voluntary organisations, and what difficulties would this pose?
At page 20, paragraph 4, your submission recommends the development of a senior practitioner grade for staff involved in safeguarding work as a way of retaining experienced staff in practice in the health service. Clinical supervisors continue this practice. Is there a case for a similar model in social care?
Mr Leeson: To answer the second part first, I would say yes. We have to be concerned by the fact that our most experienced practitioners are leaving childcare. I think that we would begin to see a pattern emerge where people qualify and they do a little bit of time in childcare. By childcare, I mean in social services in the childcare teams, and once the opportunity arises they could move on into other areas of the work. We feel that that is an issue that really needs to be addressed.
We understand the difficulties the trusts face because obviously that brings in then the issue of resources. However, as I said in the submission, we ought to be concerned about that fact that, increasingly, newly qualified and inexperienced staff are involved in this kind of work.
Mr Kelly: The other part of my question related to the trusts' having a statutory responsibility for child protection. Would you favour a clear requirement for all organisations to adopt the responsibility of trusts, and for the social care and health functions to reflect that responsibility? Would you be in favour of the clear statutory for all organisations to adopt this purpose including voluntary organisations?
Mr Leeson: We said in the submission - and I feel very strongly about it - that if the debate about protecting children becomes one about social services, we are missing the real issue. I feel that all organisations should have as part of their key objectives the safeguarding of children. I have argued that the OFMDFM strategy for children's right and needs ought to have child protection as a cross-cutting theme, because our first responsibility is the safety of children. We can't have a situation in which people think that responsibility for child protection rests with just one department, and for everyone else it's a secondary thing.
The Chairperson: Your submission refers on page 6, paragraph 2 to the benefit that would derive from a set of child well-being indicators in terms of helping to measure improvements over time. Where do these indicators currently operate, and is there a model available that could be developed in Northern Ireland?
Mr Leeson: Currently there isn't a place, as I understand, where all of the statistics and the information that we have about children come together in the one place. In terms of examining the general state of children and how they are doing in Northern Ireland, their safety is obviously a key point for consideration. We would encourage the Committee to consider such a model and work carried out in England on other models, which we have made reference to in the paper.
It would allow us to see in general how well we are doing with children's issues. It might also be a useful way to broaden out the debate around child protection issues because the public do not fully understand the safeguarding and child protection task. Unfortunately their exposure to discussions around child protection tends to come in the context of there being a problem.
Mrs Courtney: You highlighted child protection problems in relation to the operation of two jurisdictions on the island. Do you have any views on the harmonisation of any processes? Do you have experience of families with child protection concerns moving from one jurisdiction to the other?
Your submission advocates a strategy for dissemination of case management reviews and for the Department to publish summaries. Is your organisation represented on area child protection committees? Dissemination of lessons is presumably the responsibility of the child protection committee when it receives a report. Can you explain why area child protection committees apparently do not do this, and has your organisation tried to promote this approach?
Mr Leeson: In terms of the area child protection committees, we are not represented on any of these. Under the draft guidelines for co-operating to safeguard children, there is no provision for voluntary organisations other than the NSPCC to be a member. I do not understand the reason for that. I suspect that it is probably related to the fact that the NSPCC are unique amongst voluntary organisations in having statutory powers in terms of child protection issues.
The pattern of organisations that are involved in childcare work and child protection work is much more varied than it has ever been. These include are voluntary organisations, community-based organisations, and even private sector organisations. I think the area child protection committees potentially miss something when a broad constituency that is involved in this work are not represented. If they broadened the membership they would better reflect the workers.
Mrs Courtney: Would that be something you would like us to highlight?
Mr Leeson: I would like you to highlight that. I have had sight of my proposed Private Member's Bill around the regulation of area child protection committees, and our organisation is extremely supportive of that. In the comments we sent back, we highlighted the fact that there ought to be a broader representation of other organisations.
On the issue of the case management reviews, there has been an argument in the past for not disseminating them in a small place such as Northern Ireland because it might be possible for individuals who are professionally involved in social work to identify unnamed individuals in reports. The problem with that is that where a serious issue has arisen, there may be lessons to be learned for the professionals who are involved in child protection. We would advocate wider dissemination because, if we are involved in this kind of work, we need to understand where things have not gone so well. We do not want to be repeating a mistake or an error that has occurred somewhere else.
The question of the Department producing summaries is a very good one and would be enormously helpful. It is obviously not something they do every year; that would depend on the number of inquiries. W need to be advising people involved in this work of the need to look at their own organisation and make sure that that it not happening there.
Ms Armitage: In your submission you say that recordings should be a core standard underpinned by clear guidelines and regular management samplings. Surely, recording is a basic requirement of work with vulnerable groups. Is this covered in the social work training? Is monitoring not a basic supervisory responsibility? What leads to a failure in this area that seems to arise in most inquiries into child protection cases?
Mr Leeson: Yes, recording is a basic requirement for people in this work, but no less than in any other profession. We need to be sure that it consistently meets the standard that we would expect. In our organisation we have it as a core standard, which is sampled. For example, Mr Mullan who is the manager of a family centre is responsible for sampling the files of the social workers to ensure that amongst other things that the recording is of a satisfactory standard. The assistant directors, in turn, have also responsibility for monitoring files, particularly child protection files. It is important that we assure ourselves that the standard of the work is as good as we would expect it to be.
We conduct an annual audit of the practice in our services, sometimes by the project manager, sometimes by the assistant directors, or sometimes by our own audit functions, which is part of our organisation, but detached from the line management structure so it can have an overview of issues. In this work it is important to ensure that you are always reflective of what you are doing and that work practices matches the standard expected.
Mr Mullan: Social work colleagues working in statutory social services advise that, although they recognise the importance of recording, because of the other pressures and stress of their work, this aspect of work gets least attention. This can mean that when things go wrong they do not have the paperwork to back up their decisions. This relates to the issue of resources generally. If people are under pressure, decision-making and recording goes awry, and these are the things that need to be tightened up.
On the issue about social workers not staying in the profession, this again comes back to resources. If people cannot access the support services that families need, those social workers carry immense responsibilities and pressures, which then shows in how they feel about their job. Ultimately it causes a lot of very experienced practitioners to move out of the child protection arena.
Ms Armitage: How would you be held accountable if that core standard was not recorded?
Mr Mullan: It is through the supervision process with my own staff. Barnardo's insists on good quality supervision. If we see that standards are not being met, we talk to the staff member about those issues. If there are not improvements, you are then into a disciplinary-type arena. Hopefully it does not get to that stage, because part of my responsibility is to monitor supervision standards and responsibilities, and ensure they are carried through. If people do not carry them through, they are not fulfilling a crucial part of their job, and they are answerable for that.
Ms McClure: Through our research as an organisation, we have learnt that by focusing on the fact that the recording will be monitored, audited and sampled, staff will then see that this is a priority. However, you need to keep that on an ongoing basis and ensure that people are supported to do that in an effective way.
Mr Leeson: It goes back to what I was saying earlier on that we firmly believe that the effective support, management and supervision of staff is critical in terms of ensuring good outcomes, so we know the work is of the standard that we expect. Our organisation has learned that we need to treat this as a top priority to ensures the necessary scrutiny and support.
Ms Armitage: It is a basic core standard as well.
Mr Leeson: Absolutely.
The Chairperson: We have been joined by Ms McWilliams who might like to ask a question.
Ms McWilliams: Obviously you understand that we are having this inquiry in order to put in place some recommendations to address some of the tragedies that have led to the need for this inquiry in the first place.
The issue of supervisory management and of recording and ensuring that good supervision is in place at all times is paramount, particularly when young social workers come into the field for the first time. Is there an overall view that everyone is working in the same way? What would you do, for instance, if you noticed some of the people in placement or in work were not meeting these standards?
Mr Leeson: The way we have approached that in our organisation is to adopt a standards-based approach, where we communicate clearly a series of expectations in terms of the standard of recording and supervision. There would be an expectation that someone is seen formally for supervision monthly. The manager is then responsible and has clear guidelines on what to do, in terms of making notes of the meetings, communicating to staff the expectations about what needs to happen as a result of that meeting, and ensuring that records are kept.
Assistant Directors are then responsible to ensure that it happens and formally, once a year, to have an inspection of the service to ensure things are as they should be, with the appropriate records and files maintained and up-to-date. So we have adopted a standard approach to that.
Ms McWilliams: My question relates more to what happens when you discover that this is not the case. In tragedies it has obviously been the case that something has gone wrong which has not been picked up early enough, and this occasionally ends up with a fatality. What happens if you pick that up?
Mr Leeson: That is potentially a disciplinary matter if there are gaps. We have our own disciplinary and codes of conduct for staff. Obviously there are steps in between, but that is the bottom line.
Ms McWilliams: Has that ever happened?
Mr Leeson: Yes, there have been occasions when action has had to be taken against people for failure to meet the standards across a range of things. It is not just confined to this; we have a whole set of standards that we feel are particularly important in terms of ensuring that the organisation that we work in is safe for children. We treat that very seriously, and, as I say, it is a disciplinary matter.
Mr Mullan: Barnardo's also has an annual audit of core standards, which includes recording and supervision practice. If those standards are not being met, you must take remedial action to ensure there are proper systems in place.
I cannot speak about what is happening in social services. I can only use my own experience of when I was a social worker. Then, because of the other pressures on senior social workers in particular, supervision was one of the core standards that went to the wall. Social workers were so busy dealing with crisis management type situations that supervision - that was so important in decision-making and in ensuring good practice - was one of the key areas that suffered.
Ms McClure: Social work staff have a responsibility not only to receive but also to seek supervision. If that supervision is not there, it equally must be pursued by another level of management to ensure the necessary support and prevent the potential for things to go adrift or wrong.
Mr Leeson: We have put a lot of emphasis in our submission on the issue of management. We have seen circumstances in which people have talked about having reorganisations as a result of some of the tragedies. If we pay attention to some of the basic management skills and the support and proper accountability for staff, this has the potential to make an enormous difference to child protection work.
The Chairperson: Maurice, Cathal and Linda, thanks you again for your documentation, presentation and for answering our questions. You have been very helpful indeed. If there are any further questions that we want answered, we can write to you with them.
RECORD OF AN INFORMAL BRIEFING ON CHILD PROTECTION ISSUES
Dr Hendron (Chairperson), Ms Armitage, Ms McWilliams, Ms Ramsey
Ms Eileen Webster, Mr Johnathon Giles, Mr Kevin Lawrenson
Members of the Committee for Health, Social Services and Public Safety were given an informal briefing by representatives of NIPSA on its response to the Committee's Inquiry into Child Protection Services in Northern Ireland.
The Chairperson welcomed the panel and apologised for the delay in proceedings. He thanked NIPSA for their documentation, which members had read. He asked the representatives to highlight what they saw as the main points in NIPSA's submission prior to members asking questions. A detailed record of the presentation and responses to questions asked is given below.
Mr Lawrenson: I would like to thank the Members of the Committee for inviting us here today to make this presentation, which will help to contribute to the inquiry and inform the wider debate around the whole issue of child protection. We fully understand that you are aware of many of the issues that have already been raised by other members making presentations on behalf of NIPSA. I would like to make a couple of general points, and I know that both John and Eileen are willing go into much more detail on some of the issues.
It is a fact - and this is outlined in the Department's Children Strategy for Social Services- that over a quarter of the population of Northern Ireland, in fact 28%, is under the age of 18. If you take into consideration those people that fall into care leavers category, that percentage rises because the age group increases to 21. The important point about this is the spend per head of the population in family and childcare in Northern Ireland is around 25% lower than that in England.
Also, if we look at the derivational factors in Northern Ireland, research has shown that they are much higher here, yet the allocation we receive is 25% less than in Great Britain. That is clearly outlined by the fact that there is a much higher per cent in receipt of free school meals, job seeker's allowance and income support. There is a clear correlation between that area of social deprivation and those children who would fall within child protection in the statutory sector.
Finally, I want to make the distinction between this area and other programmes of care. Other programmes of care statistics are not quite as stark as they are within family and childcare. There is not the stark reality of the correlation between social deprivation and that of the elderly population in care or mentally ill people in care, or even with those with physical health and disability in care. I think this further emphasises the fact that a current crisis exists, and has done for some time.
Finally, I had already mentioned the matter of allocations, which we have flagged up well in advance of the implementation of the Children Order 1996. It was acknowledged by the Department, the Boards and the Social Services Inspectorate at that time that there would need to be massive investment if we were going to implement effectively the legislation. This was in addition to the necessary preventative services that would attempt to deal with some of the serious difficulties in the communities in Northern Ireland by preventing children moving into residential care. Unless we put preventative services in place in local communities, these children's homes will continue to fill. So it is important to highlight the serious issues in terms of investing in preventative services.
The Chairperson: Thank you very much, Kevin. Over to my colleagues, and we will start with Ms Pauline Armitage.
Ms Armitage: A number of questions arise concerning gaps in the original legislation. You mention problems with the child protection procedures. Can you be more precise about the source of those concerns? What do you think would need to be put right with the legislation and the procedures? Following on from what you have said, in the terms of preventative service, it is difficult to predict how serious the abuse is. Programmes of prevention addressed at the whole population may be so very thinly spread as to have any meaningful impact. What services would have the most impact? Should we concentrate on those? Can you give us guidance on how you view the best way forward?
Ms Webster: Obviously we welcome this inquiry into Child Protection Services in Northern Ireland by the Health Committee. It is the most media-covered issue in child care services. It is the most stressful and the most high-risk area. Yet NIPSA would contend that child protection cannot be seen in isolation; it is clearly part of a continuum, which includes family support and preventative services, and looked after children.
Children and families can move in and out of these different processes. At the moment Northern Ireland does not the resources to provide for all that the Children Order encompasses, in terms of prevention and assessing children and families in need, as well as the clear directions in Article 66, which is the child protection investigation.
In Foyle Trust our senior management have agreed with that conclusion and are currently put in place a process that will gear all of our services in family and child care to those children and families in greatest need. That means we are moving away from the part of the universal services that we provided, like the drop-in family centre, the mother and toddlers group, and the universal playgroup. That has mostly been left now to the community, voluntary and the private sector.
Our referrals to family day centres, for instance, are solely going to be around the child protection process or the Court process, when the Court is looking for a parenting assessment. In other words, those families deemed to be at lower risk but in need would not receive a service. In the context of finite resources, what choice do we have if we cannot gear our resources to those children and families in greatest need? Then we are not doing the thing right. We cannot spread it so thinly that we are leaving our child protection cases unattended.
Prioritisation and targeting our existing resources towards those children most in need and at risk of significant harm is a realistic stab at a solution to the present crisis. However, we are storing up difficulties and problems for the future when we move away from that ability to provide universal childcare and parental support, parental guidance, leaving it to the voluntary sector - if they are able to pick up the tab. We must adhere to the ethos and the theme of the Children Order, which was to re-focus child protection. We should try to move away from the procedures and the Court setting, and put in the early support and preventative mechanisms.
The reality is that we are now doing the opposite in our Trust area. So the resource implications are clearly there.
Ms Armitage: If there were enough resources and money for preventive services, how would you see the back up or the follow-up? Could money be saved there? If money was spent on prevention, would this mean less resources required thereafter?
Ms Webster: We would not have to take the Court proceedings, which are very costly. We may not even have to get into child protection proceedings if we had a range of innovative, creative family support resources in the community. The Children Order asks us to maintain children and families in their communities, families and schools where possible. We do not have enough overnight respite facilities. Childminding, babysitting, and hands-on family aid are spread very thinly. In an area like Foyle Trust we have five family aids for Derry, Limavady and Strabane, and they are part-time. That is a very thin resource to talk about hands-on family support.
We can get into a child protection investigation. We can assess a family and children at risk of significant farm. We can develop a child protection plan, but in many instances, we cannot even fulfil the plan because the resources are not there. One daycentre in Derry currently has eight families on a waiting list. Court proceedings are being delayed because the parenting assessment cannot be completed in a timely fashion.
Ms Armitage: Are the Courts are aware of that when they make decisions?
Ms Webster: The Courts aware of that and certainly Justice Gillen is aware of that.
Mr Giles: Could you repeat your previous questions please?
Ms Armitage: I referred to the concerns you have with gaps in the original legislation, which goes on through to the child protection procedures. Could you be more precise about the source of those concerns?
Mr Giles: I can give you an example that was brought up this morning during the team meeting between two prevention teams in my office. Part of child protection sometimes means that we take children into care. We do so through care orders, and they are legislative-based. We then put in place a protection plan for that child, as well as a rehabilitation plan, to try to get that child back home within the shortest period of time as possible.
Good practice tells us that a short period is roughly six months. Anything beyond six months we should be looking at a permanence plan for that child. In order to implement a permanence plan if rehabilitation is not going to work after the six months period, we seek a further period for the rehabilitation to be exhausted, and then seek to place that child in secure placement. Not a foster placement, but a very secure long-term placement.
It can generally take a social worker between eight and twelve months to go to Court to get a Care Order. This is because of a number of factors such as resource implications, the legislation itself, and because of other legislation which impinges on the social human rights legislation as well. Once that Care Order is granted, if everything is straightforward, the process for long-term care can be looked at.
In the case of adoption, for example, the process could take another year to two years, depending on the consent of the parent and on the circumstances of the case. From a child coming into care and going into a legislative process where the Trust is trying to protect that child, you could be looking at anywhere between two to three-and-a-half years. The optimum period for most adoption and foster services would be somewhere between 12 and 19 months, and would be more for an older child.
That is one example of how the legislation can impinge upon practice and make child protection very difficult to follow policies and procedures that are designed to protect children. We need to streamline the whole legislative process and get it in tune with the way social services works. At present, legislation and social work are two different professions. They are not working along the same lines. They are not working towards the same goals. We need a better way forward for that specifically. Magistrates and solicitors are very aware of this, but there is very little that they can do.
It needs a radical shake-up of how we streamline the whole legislative process into the framework and the policies for child protection.
Ms Armitage: Who do you see as being responsible for putting the legislation and the procedures right?
Mr Giles: I think it needs to be a joint effort between quite a number of agencies. Child protection requires a multi-disciplinary approach. It is going to need the legal professions, the social work profession, GPs, Health Visitors, everybody involved in child protection procedures to look at a way forward.
Ms Ramsey: My questions follow on from what Ms Armitage was saying, but I want to try to go back to your presentation to the Committee in June, when you outlined the problems faced by staff in particular.
First, as this is an inquiry into the protection of children, and we are concerned to take a holistic approach, I would like to get an update on whether there have been any improvements in relation to the problems faced by staff involved in child protection. Your submission refers to a concern about staff having to prioritise cases. This morning the Guardian Ad Litem Agency said that there was considerable disagreement between senior social workers as to what constitutes child protection referral. Their submission then went on to say that there are variations in the rates of child protection registration between Trusts. The figures show that they vary from 61.7 children per ten thousand in North and West Belfast to 6.0 children per ten thousand in Craigavon and Banbridge. Do you need to be on a higher scale of risk in one Trust before you get on the child protection register than in others?
I would also like to ask how are the cases prioritised? Are there formal criteria? Is senior management involved? And is the procedure inter-agency approved?
Ms Webster: I will deal with the question of what constitutes a child protection referral. That is one of the issues where social work staff and managers are crying out for clarity. We were inveigled by the Children Order and by Volume 6 of the Department's Guidance and Regulations on child protection to refocus and move away from procedural-led social work, to therapeutic interventions and preventative social work around areas of childcare concerns.
The Department issued an arbitrary target - I cannot remember the year, but it was post-Children Order - to reduce child protection registration figures by 20% or 25% over the next three-year period. That terrified the life out of social workers, who thought they were now into statistics, because child protection assessment is a judgement call: it is a professional decision.
Therefore, there is a lack of clarity from Trust to Trust as to what constitutes a child protection referral and a child concern referral. We do not feel that we have had the leadership from the Department to sort that one out.
What is the threshold for intervention? That is something that our Trust is struggling with in terms of what we should or should not be involved in given our finite resources. In terms of the prioritisation in Foyle Trust, this scheme has been developed out of the Ford/Evans review of family and child care services in the Trust following a NIPSA industrial action a couple of years ago. It has been laid by Dominic Burke, the Director of Social Care at the Western Board, and the Senior Management in Foyle Trust are also on board, if you like, on this prioritisation scheme.
In addition, in terms of what we can and cannot deliver on family and child care services, is a new caseload waiting system designed to protect staff from work overload. Responsibility for decision-making on the size of caseloads that a child protection worker can safely carry, and the nature of the work that they do, rests with the entire Trust, including senior management.
In terms of the assessment of needs and risks, it is a huge task. It is a complex, time-consuming, very stressful task. The Children Order emphasises the importance of assessment and support at home rather than Court, and the child becoming looked after. Court Orders should only be sought in the last resort when it is clearly better for the child. Child protection is everybody's business, in theory. It has become a bit of a mantra around family and child care services over the years. In practice, social work practitioners would feel they are still the lead statutory responsibility. But much of the assessment work still falls to the social work practitioner, whereas our area child protection committees in the four Boards are made up of all the agencies that should be involved with child protection. These include the Education & Library Boards, the Probation Board, the voluntary sector, the NSPCC, Health Visiting and schools.
Yet when it comes to convening a child protection conference, GPs, for instance, have a huge difficulty in attending. They just do not attend these conferences. They say they do not have time, and it is not a priority. Health visitors and schools are usually fairly good attenders. Outside of that, very little in terms of other agencies and other disciplines that are supposed to be part of the child protection continuum of business, as constituted by the area child protection committees. That is why I feel that these committees should be put on a statutory footing, so that those disciplines, agencies and organisations have a clearer statutory responsibility. That is another failing in the Children Order. It does not place a clear statutory responsibility on those other organisations.
Ms Ramsey: I agreed with what you are saying about the lack of clarity across the Trusts. Statistically, that has been proven. Then you talked about the threshold for intervention. I take it that if there is a lack of clarity, the threshold can differ across Trusts.
Ms Webster: There is no policy on thresholds for intervention. It does not exist. We make it up as we go along. Our Trusts are trying to do their bit.
Ms Ramsey: Then you talked about the issue in Foyle. A lot of the speakers we have had today talked about the Children Order and about the welfare of the child being paramount. So we are trying to get this right. If senior managers are involved in prioritising cases, where is the welfare of the child? Where is the Children Order if it is supposed to be paramount? How do you decide today that a case might not be a priority, and tomorrow decide that it could be a priority? I know social workers constantly get it in the neck when it goes wrong. We need to take on board the point that the area child protection committees are not on a statutory footing, and about the fact that GPs and others are not attending case conferences. I am aware of a number of cases where the GP and health visitors have been involved right until the point of the case, but still social workers were getting it in the neck. So I think we need to look at that.
Ms Webster: I will give you another example. Our Trust's child protection panel is very important, as it is responsible to the area child protection committee of the Board. However, the Probation Service has recently withdrawn from Foyle Trust Child Protection Panel because it is not a priority for them. To me that is a very serious development. That is official.
Ms Ramsey: I would like to examine further the senior management involvement in prioritising cases.
Mr Giles: Again I will give a practice-based example of how cases are allocated, examined and what decisions are taken away. Cases are taken on a preventative basis. Prevention deals with all the new intakes in the North & West Trust where I work. Those prevention teams take in the referrals. Those referrals are looked at every week by senior social workers and the team leaders who allocate the cases.
The basis for the allocation is the priority of the case, how heavy a caseload the social workers have at that time, and the resource implications for that case allocation. If a very important case comes in on duty some day, then there is a clear child protection aspect that needs to be dealt with, usually immediately.
The impact on social work staff from that process is not clearly visible. For example, in West Belfast there are two prevention teams of five social workers. So, there are 10 social workers to cope with the whole of West Belfast, each covering a caseload of maybe 20 to 25 cases. Out of those 20 to 25 cases there may be 5 to 10 child protection cases. If another child protection case comes in on a Monday morning, and I have five social workers working on 25 child protection cases, somebody is going to get another case. That case will be dealt with, but on what level, because the social workers are already overloaded.
That is why line management must then make a decision on prioritising cases within that caseload. That is generally done between the Assistant Principal Social Worker, the Senior Social Worker and then the line management - the Principal Social Workers - and right up to Director of Services and Director of Trust, if necessary.
It still does not take away from the whole process that you have of finding out limited resource. You can only do with what actually comes in. The level of how you deal with that is open to interpretation.
Ms Ramsey: Absolutely, but I think we need to be getting that message out there. I am aware that social workers, especially now in constituency areas, are under a great deal of pressure with little resources, but unless we start challenging that, it is not going to change.
Mr Lawrenson: The reality is that there are different thresholds of risk throughout Trusts, and they can vary and fluctuate at any one time. There is no common caseload waiting in place across all these Trusts. So there is no effective monitoring of any of those cases as such. If you look, for example, within the Boards at the monitoring reviews, you will see very starkly that they can change. It is difficult to make comparisons because the numbers on Trusts' child protection registers can change from month to month, depending on the pressures that rise at any one time.
So there is no consistent approach. There is no real effect on the monitoring list, and although Ms Bell referred to the fact that in Foyle there is a caseload waiting system in place, that is probably the only place where that currently exists. It does not exist in any other of the 10 Trusts that have statutory responsibility for child protection.
Mr Giles: Not many lessons have been learned from the number of child protection cases that have come into the public domain recently. One such case in England was the Victoria Climbié case, in which a child died as a result of a very serious incident that took place. The caseload of that social worker was not up to the level of social workers in Northern Ireland, and yet the inquiry made it very clear that social workers should not be dealing with more than 16 cases. If a social worker had a caseload of 16 in my Trust, they would be more than happy to deal with it. Frequently, we are dealing with caseloads of 20 to 25, and sometimes more depending on the circumstances. You could have a bad month where you get a lot of allocations through.
Ms McWilliams: Thank you very much, Jonathan, Eileen and Kevin. It does not seem as though much has changed since you last came to give evidence, which is extremely disappointing given the fact that we have tried endlessly to raise your concerns. I will come to that in a minute, because we have got some indicators from the Programme for Government, which was launched yesterday, and the Budget today, which a lot of your submission is based around. And you have raised, quite rightly, the question of resources.
Your submission touched on a number of things. You say that the Northern Ireland Social Care Council, which is going to be locally registered from next year, will have a negative impact on children's services. Can you clarify why you think the implementation of the Social Care Council is going to be negative rather than positive?
Mr Lawrenson: There are a number of reasons. Particularly since the introduction of the Children Order there has been a clear lack of resources in terms of social workers. The recommendation, prior to the implementation of the Order, was for an extra 200 social workers, and that has not happened. Social workers, especially those involved in child protection, have been heavily scrutinised through the legal process since the introduction of that legislation. Furthermore, when registration takes place, they will be further scrutinised through conduct committees and the whole process of registration. That will put further pressure on a fairly under-resourced workforce. They feel the impact of that, along with the current crises they have to face in their daily jobs. This result in their being more worried about protecting themselves in order to stay within the codes of conduct put in place by the Council, which will have an impact on their work.
Ms Webster: I think it has to do with morale and how we welcome the Social Care Council in terms of promoting quality standards and social work practice. That is what we all aspire to. However, at the moment, while the standards are there, staff cannot aspire to them because of the lack of resources. They cannot implement child protection plans. They can do the assessments and have reports ready, but where are the resources?
Ms McWilliams: So you are saying that it is important that the Council be put in place and social work regulated as a profession. Not everyone describes himself or herself as a social worker, which was the case in the past when they had not been qualified and trained as a social worker. Your argument is that because of the current pressure on the service, you are not able to meet the kind of standards that are laid down. It is a bit like what you have been saying about the Children Order. The legislation is there, but there is no way that it has been implemented on a statutory basis.
Mr Lawrenson: There is genuine fear that social workers are not fulfilling their statutory obligations and will not meet the terms and codes of practice that have been outlined in the Social Care Council.
Ms McWilliams: So there is a concern that they could be disciplined for not meeting these standards, but on the other hand they are not being facilitated to meet them in the first place. That is very worrying. Obviously if that message goes out it is going to attract less into the profession.
Mr Giles: I remember going through the process of qualifying and becoming a social worker. One of the big debates in many of the tutorial groups was how social work is promoted as a profession rather than a vocation. Now we are at a point where we are going to do something about that. Social workers are worried about becoming professionally scrutinised over a service that they are not entirely happy about themselves.
Ms McWilliams: What about the work force planning initiative, where are the recommendations. We have received some documentation on radiologists and speech therapists to date. There is a plan for social work. How do you think that is going to do to help you?
Ms Webster: First, take the human being involved as a professional worker in child protection. Messages from research will tell us time and time again that the rapport and relationship between the worker and client, the child and the family, is a big determining factor on the good outcome of that case. Then look at the reality on the ground in our child protection teams. New, inexperienced workers, huge turnover, agency workers from London, Poland, the south of Ireland and from New Zealand.
Ms McWilliams: Here in Northern Ireland?
Ms Webster: Yes. In Foyle Trust working in child protection teams because there is no staff. They cannot fill posts. Temporary workers and even the qualified permanent staff in our child protection are newly qualified inexperienced workers fulfilling the highest risk and most stressful area of family and childcare. You will find the experienced staff in the fostering and adoptions teams, the family support team, and the leaving and aftercare teams.
That is the case throughout the Trusts. They are the experienced social workers, and the least experienced workers, newly qualified staff, are in the child protection investigation, prevention teams, and fieldwork teams. Even at that, staff turnover is the real difficulty. The Workforce Planning Initiative has already shown that the majority of social workers leaving Northern Ireland Health and Social Services are from the family and childcare sector. That has already been part of their findings. So it poses a huge problem for senior social workers, because supervision is a key element in the child protection process. There is a senior social worker making decisions and agreeing with assessments, and risk assessments in particular, in the child protection process.
Ms McWilliams: Can I stop you there for a moment and we will come back to it? It is likely in the Jasmine McGowan case that we are talking about a fieldwork social worker. You have just said that this is an area that is under-staffed but also likely to be inexperienced. What would happen in a case like that? Ms Ramsey has made the point already that the social workers are getting a lot of blame in these cases, but rarely are people assessing what has led to perhaps a non-qualified, inexperienced worker being in such a position. Could you talk me through what might happen in a case like that?
Ms Webster: I am not totally familiar with the recent diploma in social worker training. It is a long time since I qualified as a social worker, but I do not believe that there is a huge element on the course dealing specifically with child protection and its procedures, the investigative process, the assessment process, risk management and all of those issues. The training is still quite genetic, as far as I understand it, in the Diploma of Social Work.
To put newly qualified social workers into the child protection investigation field is extremely dangerous. Period. Our clients are invariably involuntary, unlike other programmes of childcare where people are seeking our help in, for example, getting a child a pre-school playgroup or after-school place to take pressure off parents.
In child protection, our clients are involuntary. We are going out there to do an Article 66 investigation because we have reason to believe that the child is suffering or is likely to suffer significant harm. It can be dangerous to put a young inexperienced worker on the doorstep on their own saying "Excuse me, we have had an allegation". That is the reality of child protection in many areas.
Of course senior social workers try to do their best in perhaps getting an initial joint visit with a more experienced social worker. That is not always possible, but even then, that would not be an ongoing process of two social workers dealing with one case. The senior worker is torn every way in trying to supervise. Our policy would be that if you are qualified for less than a year you should have supervision on a fortnightly basis. Those qualified for longer than a year, monthly. It just does happen in the real world. The policies are not implemented.
Seniors have too much control and too many workers to supervise. The pressures are just too great on them, as well in terms of prioritising. In Foyle Trust at the moment we have 300 unallocated cases in Derry, Limavady and Strabane. We hope that none of those are serious child protection cases. The senior social worker reviews them every day, worried sick about not being able to allocate the 300 cases. Who is to say, to go back to Sue's question, that that childcare concern sitting unallocated will not be child protection case tonight.
Ms McWilliams: Can I clarify for the record that is just one Trust?
Ms Webster: That is the Foyle Trust area. One Trust has 300 unallocated childcare cases as of today.
Ms McWilliams: Through you, Mr Chairman, can I ask if Mr Clarke in the Department could provide us with the figures across all Trusts, so that we get some sense of the numbers right across Northern Ireland? If it is 300 for one Trust, there are 18 Trusts.
Mr Lawrenson: That is not necessarily the case. This is where the difficulty arises. There may be 300 unallocated cases in Foyle, but other Trusts may have all other cases allocated, but it does not mean to say that those cases are being worked by a social worker just because they are associated with that job. In other words, they are not allocated right. So the responsibility in the Trust would go up the line management chain. The problem is very often in other areas where the social worker has just been inundated with all this pressure. They accept referrals, but in effect they are not being dealt with anyway.
Ms McWilliams: That is fine, thanks Kevin. It is probably the tip of the iceberg in what you are saying, but at least if some Trusts are willing, for the sake of this inquiry, to get a level of transparency there, we might be able to realise the seriousness of what we are talking about. I will finish here in terms of the Budget and the Programme for Government today and yesterday. We have 2,500 children looked after in our Programme for Government, including 300 in residential care, 1,500 in foster care, and 500 with a member of their own family.
The Programme for Government talks about increasing the number of residential places from 372, which is the current figure in this month, to 412. It does not give a date and there lies the problem for when that increase might take place. They are providing 51 replacement places, but I do not fully understand what they are talking about. So you might want to just clarify that. Given the crises that you have come to us with time and time again, I would like you to say something about those figures.
We have concentrated quite a bit, as you know, on the residential side of things in our previous inquiry. Today you mentioned foster places and adoption. Here it talks about members of their own family. We have an American child advocate who is due to give evidence to us tomorrow. One of the points that he has been making is that in the United States they are going down the road of trying to place children with their own family and they have brought in legislation.
Ms Webster: The Children Order says -, and that was the difference I suppose between it and the Children and Young Persons Act 1968 - that authorities should as far as possible maintain children within their own extended families and communities. So we are legally obliged in the first instance. If we feel a child is not safe or is at risk of significant harm in their birth family and they need to be moved, we have to make serious inquiries around the extended family and community before we consider an anonymous care place, like a residential place or a stranger foster.
If that extended family, granny, auntie, cousin, older sister or whatever are assessed in a very preliminary way as being safe and suitable, we can place the child there. The child would still be looked after and would be accommodated. Those people would be deemed foster parents and then we would assess them as such. That is what the law says at the moment.
We try to do that. The difficulty with that is lies with this question of support in the community, places in the after-school groups and all the support mechanisms. You might be putting a child into a family that already has six children. They are ready and willing to take them, but we need the support structures. We seem to have more options to put the child into the residential care, which costs a fortune, than a few pounds to pay to those friends and families who get less than a foster carer's rate.
Mr Lawrenson: The situation in child protection is focused on the very high-risk cases instead of focussing on very simple resolutions to problems. I have already mentioned childminders and pre-school provision - all those support services where investment could be made to prevent the child getting to the real high risk case that social workers are dealing with more and more often because those preventative services are simply not in place.
Mr Giles: Our system is not geared towards looking at families in a realistic way to care for their own children.
If I place a child with a relative carer, that carer will very often get limited financial support, if any. They will get a lot of support in terms of the social worker calling out and trying to solve problems.
Ms McWilliams: Limited financial support. Do you mean it is discretionary?
Mr Giles: Let me finish, and I will then go on to explain how it works. If I place the child with a foster parent, that foster parent gets a boarding out allowance, a clothing allowance, allowance towards uniforms, allowance towards travelling and expenses and so on. However, a relative carer is not expected to down that same route. Within out Trust, we have started to give payments out to relative carers, but it is not on the same scale as a fostering allowance. For them to qualify for that allowance we have to complete a short-term assessment on the family. So we have to approach a family and say "We are assessing your ability to look after your own relative before we can give you any money to look after them. For you to qualify for a typical fostering budget allowance we are going to have to do a long-term assessment after the short-term assessment to tell us whether or not you are in a position to look after your relative."
So you can see the difficulty that that creates for the relative, and it can be quite hard for them to understand why they need to sit down and answer a lot of questions, go through a lot of forms, sometimes in quite personal detail just to look after their own relative and qualify for the maintenance.
Ms Ramsey: I am aware of a case where the grandmother was not getting anything, but the mother of the child who had been removed from her care was still getting her social security benefits. That was creating a lot of difficulties, because I know that the grandmother was out of pocket as she had taken the child in, while the mother was still doing what she wanted.
Ms Webster: That is a matter for social security; it is not within our remit.
Mr Giles: We have no control over that.
Ms Ramsey: But if we are talking about an inter-agency approach here?
Mr Giles: We do not have that inter-agency co-operation between social security and ourselves. The same problem arises if we start paying a family to look after a child. They are getting a boarding out allowance, but strictly they are not foster parents, so do they qualify for child benefit? There is an issue around benefits entitlement and where payments stop and start. That could be all streamlined as well.
Ms Armitage: Can you briefly take me through that procedure when a social worker calls at a home where there is suspected child abuse? Can the person in that house just shut the door? I have a problem like this that I am trying to deal with in my constituency.
Mr Giles: Again it would depend on the level of allegation being made. I will take an extreme hypothetical example. If someone alleges that a child is being physically abused, and they have seen it and witnessed it on a regular basis, the social worker will first call to the family home to get the parents' reaction to that allegation. They will also back that up with multi-disciplinary checks. They will check with the health visitor, if a health visitor is involved. They will check with the GP on the last time the child was seen by the GP. They will check with the school and with school nursing to see whether or not there are any indications of abuse.
If the parent refused to allow the social worker into the home, we generally try to work in partnership to bring them around. Sometimes it would mean the senior social worker going out with social worker and explaining the implications of not allowing somebody into the home. Making the parent aware that they could make things even worse if they do not face up to the allegation. In a very extreme case where you are severely worried, you could ask the police to help you gain entry to the house.
Ms Armitage: What sort of time would be involved in this?
Ms Webster: An hour or less.
Mr Armitage: As quickly as that?
Ms Webster: If it were a serious allegation of physical abuse, yes, we would act very quickly.
Ms Armitage: So the parents have the right to shut the door and say good-bye.
Ms Webster: They do, but the police have powers. They can take a child into police protection and then we can accommodate the child.
Ms Armitage: Would that happen often?
Mr Giles: In severe cases it does happen, yes. You would also have an Emergency Protection Order. If you felt that there was enough evidence to back up an Emergency Protection Order, you could go through the Court.
Mr Lawrenson: I suppose it would happen more out of hours than it would during the day, because you have less access to other disciplines and resources if it is out of hours.
Ms McWilliams: Just two final questions. What is your relationship like with paediatricians?
Ms Webster: You may or may not know that on our day of action on 19 June we had a letter of support and placards from our consultant community paediatrician and other community medical officers in Foyle Trust. That is just my Trust but they wrote to us and asked to be associated with our day of action.
Ms McWilliams: We have just taken evidence from that same person before you. One of the issues we were asking was around inter-Agency co-operation. Clearly if they are aware of the pressure you are under, it would be useful for all the professions to be working together to co-operate in raising that awareness.
My other question is why these reviews that are carried out into child protection after a particular tragedy are still not disseminating widely, including their recommendations? Eileen, you are very senior now in your profession. What happens when there is a case management review? Are you advised of the recommendations that relate to you to implement, but you have no idea what is happening with the other people that were involved in this case?
Ms Webster: That is right. As a practitioner, I have been involved in one case that, unfortunately, was a very intimidating experience.
The set-up is that they involve a non-Executive Director from the Trust Board and an independent person. There is usually someone from the Inspectorate. All the people involved in the case are interviewed on an individual basis during the course of the investigation. We are not kept informed of developments as they proceed. It is a very scary process. We have no entitlement to see the final result of that case management review, even though we were intimately involved in the case.
We can see the recommendations, but they are internal to the Trust. The body of the investigation we have no rights to have access to.
Ms Ramsay: It would be concerning if you are involved in the review but are not entitled to see the outcome of the review and its recommendations. As a social worker you might make a mistake here and a mistake there, but you will not know because you are not aware.
Ms Webster: Guarding anonymity may be difficult in this neck of the woods because there might not be too many of review cases. The recommendations and conclusions arising out of those reviews should be universally accessible, to help raise standards and formulate good practices. That does not happen at all. There is no legal requirement to do that.
The Chairperson: Firstly, Kevin, Jonathan and Eileen, you have helped us before and we thank you again for all your help and in answering our questions. The representatives of NIPSA, and the paediatricians, including the lady from the Foyle Trust, who represent the four Trusts, were expressing similar frustrations. They made many of the points you are making. It is very important that we take all these issues on board.
Mr Lawrenson: Could I just make one final point? I know that our response to the inquiry was fairly brief. That is not to suggest that the issues we would like to raise are not important. I think they are fairly widespread. We would be available towards the end of the inquiry to answer, if necessary, any more detailed questions on issues surrounding child protection.
The Chairperson: That is very helpful Kevin. We will keep that point in mind. Thank you very much indeed.
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