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SESSION 2002/2003 Committee for Health, Social Inquiry into Child Protection Services in Ordered by the Committee for Health, Social Services and Public
Safety to be printed 9th October 2002
WRITTEN SUBMISSION BY: 9 August 2002 INTRODUCTION 2. Your inquiry appears to be wide-ranging
in its remit, however, I can only contribute in relation to my own specific
policy area, i.e. criminal justice policy in relation to sex offenders. I hope
that the following information, therefore, which focuses on current legislation
and policy in relation to protecting the public from the dangers posed by sex
offenders, in useful and informative in the context of your inquiry. LEGISLATION 3. The Government has been committed for some time to a programme
of legislative reform and other measures designed to reduce the levels
of sexual abuse and protect the public, especially children and vulnerable
adults, from the dangers posed by sex offenders. 4. That commitment is demonstrated by the
Sex Offender Act 1997, longer sentences for convicted sex offenders under the
Criminal Justice (Northern Ireland) Order 1998, and a new Sex Offender Order
that can impose wide-ranging prohibitions, for example, requiring known offenders
to stay away from schools or other locations, or face a substantial term of
imprisonment for non compliance. 5. Important measures to strengthen the
Sex Offenders Act 1997 were also introduced last year as amendments to the
Criminal Justice and Court Services Act 2000. Among these were measures enabling
the courts to impose a 'restraining order' placing restrictions on sex offenders
at the time of sentencing; tougher penalties of up to five years imprisonment
for offenders who evade registration, and a tightening of the registration
requirements for sex offenders required to register at designated police stations. 6. Following a Review of Part 1 of the
Sex Offenders Act 1997 and a subsequent UK-wide public consultation exercise
last Autumn on the recommendations of that review, the Government has obtained
permission to introduce a Sex Offenders Bill to strengthen the Sex Offenders
Act 1997 even further. MULTI AGENCY APPROACH 7. The Government has also taken additional
steps by introducing multi-agency procedures for the assessment and management of risk for
sex offenders in Northern Ireland. These procedures are based on the recommendations
of a multi-agency working group comprising representatives from the police,
the Probation Board for Northern Ireland, the Northern Ireland Prison Service,
the NSPCC, the DHSS&PS, Health & Social Services Boards, the Department
of Education, the Housing Executive, the Social Security Inspectorate and the
Northern Ireland Office. These multi-agency procedures are based on best practice
from other models. 8. The Northern Ireland Sex Offender Strategic
Management Committee - a multi-agency committee chaired by a senior police
officer and comprising senior managers from each of the agencies named above
- has strategic responsibility for the assessment and management of risk associated
with known sex offenders in Northern Ireland. As a result of the introduction
of multi-agency procedures (known as MASRAM), all registered sex offenders
are now subject to formal procedures, and those assessed as dangerous are subject
to a risk management plan that may include requirements to stay in a hostel,
to participate in a treatment programme and to keep in close contact with the
police. At an operational level this work is carried out by six Area Sex Offender
Risk Management Committees based on the police boundaries in Northern Ireland. 9. Also, each sex offender who is the subject
of a risk management plan must work with a Designated Risk Manager who has
responsibility to ensure that the plan is carried out. In the small number
of cases where there are immediate concerns that there may be harm to the public,
an emergency conference is convened. This involves senior managers from the
police, probation, prison services and other relevant agencies, and at this
stage consideration is given as to the most appropriate action necessary which
may include informing the public about a specific offender. 10. Government policy in relation to public
disclosure of details on known sex offenders is kept under regular review.
In managing sex offenders, a difficult and delicate balance needs to be struck
between disclosing information to protect the public, especially children and
vulnerable adults, and avoiding the possibility of unlawful action against
offenders (or offenders families who can also be the victims). The actuality
or threat of such unlawful action may place the public at greater risk because
treatment programmes may be disrupted and some offenders may 'go to ground'
seriously hindering the ability of police to keep track of them. The current
multi-agency arrangements are working well in Northern Ireland. ROLE OF THE WIDER COMMUNITY 11. There is a real danger that children and
vulnerable adults will not be best protected if we focus too much attention
on those individuals already on sex offender registers. Sex offenders come
from all walks of life and do not fit into any stereotypical image. They are
much more likely to be a close relative, a close friend, a neighbour or someone
else known to and trusted by the victim. 12. The wider community can play an important
and constructive role in protecting children and vulnerable adults through
education and by reporting concerns to the appropriate authorities. Parents
in particular need to know where their children are and who they are with,
and parents must be helped to teach their children to tell them if someone
tries to touch, frighten or confuse them. Educating the public should therefore
be seen as an important part of the equation. 13. The Northern Ireland Sex Offender Strategic
Management Committee have produced a publication entitled "Protecting our Children
- A Guide for Parents" designed to educate the community to the dangers posed
by sex offenders, and the Committee is currently considering a distribution
strategy for this publication. I understand that copies of this booklet and
the MASRAM manual have been provided by the Strategic Management Committee
and are available in the Library of the House should Members wish to refer
to them. Further information regarding the work of the Northern Ireland Sex
Offender Strategic Management Committee can be obtained by contacting the Committee's
Secretary, D/Chief Inspector W J McAuley, c/o PSNI, Child Abuse & Rape
Enquiry Unit, Knocknagoney House, Belfast BT4 2PP. 14. I hope this is helpful.
BRENDAN O'MAHONY
WRITTEN SUBMISSION BY: 13 August 2002 Thank you for your
invitation to the Northern Ireland Prison Service (NIPS) to contribute to the
above inquiry. NIPS has a two-fold interest in this matter. Firstly, although
numbers vary, around 25 inmates aged under 18, (mostly 17 year olds), are in
prison custody currently. Whilst their sentence length will vary, NIPS has
a responsibility to ensure their stay is safe, humane and secure. This is reflected in our Corporate and
Business plans and has been underscored by the Criminal Justice Review
that reported in 2000. In practice this means ensuring the prison regime is
sensitively administered in terms of accommodation, and social interaction
as well as providing prisoner programmes. These programmes address particular difficulties such
as numeracy and literacy, employment/training, offending behaviour and associated
lifestyle issues such as drug and alcohol abuse. These are complemented
with anti-bullying policies and other systems that reduce the vulnerability
of children in the prison system. A range of professionals are employed or
engaged by NIPS, including Probation Officers and Psychologists, to protect
the interests of these young offenders. Secondly, the successful
reintegration of adult prisoners
back into society is best achieved when family relations including those with
children, are maintained during a period of custody. Hence, NIPS has been participating
in the "Children of Prisoners Interagency Group". Others contributing are the
Probation Board, and various voluntary sector organisations such as NIACRO,
the Ulster Quaker Service Committee, Prison Fellowship, Save the Children,
and Barnardos. A key objective of the group is to ensure that the profile of
issues relating to prisoner's children are raised with the relevant statutory
authorities such as those in health, education and social services. In brief,
the group considers that many statutory agencies do not appreciate the particular
pressures on children who have a parent in custody. This can manifest itself
in bullying from peers or children covering up for their parent's imprisonment
resulting in feelings of shame and guilt. This is in the context of these children
already living in socially marginalised communities. The group has been attempting
to engage with statutory organisations with limited success to date. I hope this information
is helpful, but do not hesitate to contact me if you require further clarification.
BRENDAN FORDE WRITTEN
SUBMISSION BY: Acknowledgements This report has been produced by the Divisional Management Team of NSPCC Northern Ireland with assistance from teams and projects. Particular thanks go to Colin Reid (Policy Advisor), Teresa Devlin (Area Children Services Manager), James Marshall (Training Manager), Avery Bowser (Team Manager Young Witness Service), Kevin Lenehan (Team Manager), Caroline Weir (PA Policy Advisor) and Barbara McDermott (Independent Consultant). The National Society for the Prevention of Cruelty to Children (NSPCC) is the UK's leading charity specialising in child protection and the prevention of cruelty to children. The NSPCC's mission is to end cruelty to children. The NSPCC Full Stop Campaign comprises a range of new initiatives based on partnership with other organisations and mass involvement for the public. © NSPCC 2002
NSPCC (Northern Ireland) Tel 02890 351135 Website: www.nspcc.org.uk or visit www.nspcc.org.uk/publicaffairs Registered Charity Number
216401 Foreword by Ian Elliott Executive Summary Recommendations 1. Introduction 2. NSPCC Northern Ireland 3. Child Abuse In Northern Ireland: Statistical Context 4. A Stronger Child Protection System 4.1 The Department of Health, Social Services and
Public Safety 4.2 The Child Protection Review Group (CPRG) 4.3 Implementation of the Children (NI) Order and
Funding 4.4 Structural Arrangements for the Delivery of
Child Protection Services 4.5 Family Support and Prevention 4.6 Giving Children Someone to Turn to 4.7 ACPCs and Case Management Reviews 4.8 Child Death Review Teams (CDRTs) 4.9 North-South Issues 4.10 The Commissioner for Children and Young People 4.11 Child Protection Training and Development Issues 5. Policy And Practice Areas 5.1 Shaken Baby Syndrome 5.2 Accident and Emergency Procedures 5.3 Use of the Child Protection Register 5.4 Criminal Justice Issues 5.5 Child Protection and the media 5.5 Recording practices 6. Conclusion
Appendix 1: Terms of Reference of the Assembly Health Social Services and Public Safety Inquiry into Child Protection Services In Northern Ireland
Foreword by Ian Elliott Divisional Director A number of very serious and tragic child abuse cases in Northern Ireland have starkly highlighted the need to ensure that the protection of children is addressed at the highest level in government. Northern Ireland has a poor record on child protection, with family and child care services suffering chronic historic under-investment in a policy vacuum that has made the effective implementation of the Children (NI) Order 1995 extremely difficult. NSPCC very much welcomes the Inquiry by the Health Committee into Child Protection Services in Northern Ireland. It will provide an opportunity to examine Northern Ireland's current difficulties and provide an opportunity to ensure better protection of children in Northern Ireland. In responding to the Assembly Health Committee's Inquiry, the NSPCC focuses on the key structural problems in the delivery of child protection services as well as some important policy and practice issues. We make a number of recommendations, which we believe create a stronger and more consistent approach to the protection and welfare of children. Many of the improvements and recommendations we suggest in this report do not require huge investment, rather they need commitment, leadership and the will to make them happen. This leadership must come not only from the DHSSPS but also from the Executive of the Northern Ireland Assembly if we are to truly tackle the level of child abuse in Northern Ireland. We hope that this Report together with submissions from other organisations will stimulate a serious debate about how to protect children, charting a clearer path for government and clearer priorities for Northern Ireland in the challenging time ahead. Ian Elliott Divisional Director Executive
Summary There are unacceptable levels of abuse in Northern Ireland.
It is, however, difficult to obtain a clear picture, as there are
gaps in our knowledge regarding key indices of child abuse. More comprehensive
information and the measurement of outcomes for children is needed in
order to assess the level of need and develop services. One way forward would be to develop Child Well-Being Indicators in the context
of better statistical information on children's welfare. One of the barriers to producing
clear success measures for protecting children and young people is that there
is no accurate picture
of the extent of child maltreatment in this country, and the extent of children
and young people's need for protection and support. There is no comprehensive picture of how many children
are maltreated at any one time. Most abuse goes unreported: there are no agreed measures of the incidence of abuse, and
child deaths are recorded in different ways. The only available figures, the
number of children on child protection registers, are not synonymous with the
number of children experiencing abuse and neglect. Without a picture of the
scale and nature of the problem, it is difficult to assess and satisfy unmet
need. The Department of Health,
Social Services and Public Safety plays a key role in setting the strategic
context for child protection with the Executive and the wider HPSS. We need
the Department, in conjunction with Area Child Protection Committees (ACPC)
and Children and Young People's Committees, to develop a clear strategy. The
Department must be resourced for this task and needs to ensure that child protection
is seen as a clear priority, not overshadowed by the wider health agenda. We need to reassess our structure of service delivery
for child protection. There is much to commend our integrated Health
and Personal Social Services (HPSS) model, where there is joint work and communication
between disciplines. However, there is a strong argument for looking
at a more integrated multi-agency approach. We recommend that multi-agency
Child Safeguarding Teams (CSTs) should be established in Northern Ireland to
bring together all relevant local agencies responsible for the assessment of,
and investigation into children's welfare. CSTs would provide the basis
for an integrated approach to children, ensuring that a child's need for support
and protection were
assessed simultaneously. A structure that brings people together would enhance
operational efficiency and improve information exchange, co-ordination and response
throughout the investigation and assessment stages. ACPCs play a pivotal role
in setting the strategic direction of child protection at a local level and
yet are neither recognised in the legislation or funded seriously undermining
their potential effectiveness. Current proposals to place ACPC onto a statutory
basis through a Private Member's Bill are fully supported by NSPCC. There is a need for a powerful local body to develop
a strategic overview for safeguarding children, which also has the authority
to ensure that local multi-agency arrangements are working effectively. For
that reason, NSPCC welcomes the creation of the Child Protection Review Group under
the auspices of the Department. Potentially, this new committee can
make a vital contribution to establishing a more effective child protection
system within Northern Ireland. Stronger mechanisms are needed
to ensure that professionals working with children, whatever their individual
perspectives and priorities, work together effectively and are held accountable
for their actions. Placing ACPCs on a statutory basis would ensure that ACPCs
have a much stronger, clearer and extended function. This could improve outcomes
for children and play a key role in the prevention of, and response to maltreatment. Their key role in commissioning Case Management Reviews
will be significantly strengthened by the Child Protection Review Group publishing 'Overview Reports' of these on an
annual basis. We also need new structures and processes to deal with
children who tragically die for no apparent reason particularly since research shows the difficulty in recognising shaken
baby syndrome and diagnosing child abuse. NSPCC proposes that Child Death Review
Teams should be established to provide consistent, regular and thorough analysis
of the deaths of all children to help reduce deaths from abuse and to inform
future policy and practice. Most children are unwilling to discuss their problems with professionals. [i] [ii] [iii] The vast majority of victims of abuse never disclose, and it is very unusual for a child to disclose to a professional. [iv] [v] The unwillingness of children and families to engage with the child protection system means the system is not working effectively in their interests or in the interests of society as a whole. To ensure that children receive the help they need, we must develop a child protection system in which they, their families, professionals, childcare organisations and the wider community have confidence and trust. The child protection system is essentially reactive in nature. It depends on information being passed to it to enable it to respond to the needs of children. Without this flow of information, it is rendered powerless and ineffective. Therefore, we must examine the barriers that currently exist that inhibit those who need the service from accessing it. This means developing services, which give children 'someone to turn to' by providing innovative ways in which children can be enabled to seek help when they need protection. We need to find an answer to why so many children do not report abuse and seek help. The Border presents particular challenges for child protection with particular reference to movements of population and personnel. Opportunities exist for collaboration between Northern Ireland and the Republic through the structures established by the Northern Ireland Act 1998 and child protection is an area of important mutual benefit. We need a much more dynamic and transparent debate on this through the 'North-South Child Protection Working Group' established under the auspices of the North South Ministerial Council. All those who work with children must have the necessary skills, knowledge support and experience to do the job. Training for those disciplines who work with children is vital. There must be a co-ordinated government funded child protection training strategy with monitored minimum standards. Retention and recruitment of a skilled child protection workforce should be contingent on workforce planning and improved terms and conditions that encourage staff to work and remain in child protection. The public also need to appreciate that work in the field of child protection is complex and demanding; castigating personnel when things go wrong is unhelpful and further deters staff from working in this field. We examine a range of policy and practice areas where changes would lead to better protection measures and outcomes for children. These include education and training around Shaken Baby Syndrome: better guidance at Accident and Emergency Departments, the role of the media and improved recording practices. We have also made the decision to include a section on children in the criminal justice system. Although this lies outside the terms of reference of the inquiry (see Appendix 1) the NSPCC believes that it warrants the attention of the Committee. There is also a pressing need to raise the level of understanding that exists amongst the general public with regard to the causes and appropriate responses to a range of child protection concerns. Informed debate and discussion within the media could be highly effective in this regard, as are public education campaigns. Finally, for those who work in child protection recording practices and standards are extremely important but there needs to be a regionalisation of expectations and standardisation of case file layout. The adoption of best practice standards and approaches would facilitate the monitoring of service across all of the agencies involved. Recommendations 3. Child Abuse the Northern Ireland Statistical Context 1. The Department, the Northern Ireland Executive and the Northern Ireland Office should collaborate in providing good baseline data on child abuse and child protection including a comprehensive incidence study of child maltreatment. 2. Consideration should be given to the creation of Child Well-Being Indicators that would assist in setting future policy goals and track outcomes for children. 3. Social Services Inspectorate (SSI), in conjunction with the Northern Ireland Statistics and Research Agency, should carry out an audit of Trust child protection data to ensure consistency of approach and application of common definitions across Northern Ireland. 4. A Stronger
Child Protection System: 4. The DHSSPS should establish a clear strategic plan for children's protection and welfare, which sets out the responsibilities for child protection of other Government Departments. 5. The Minister for Health, Social Services and Public Safety should consider innovative ways of complementing the resources and expertise in the Department with those from the statutory and voluntary sectors, such as the use of secondments, placements, joint working arrangements. 6. The Assembly should ensure that the Child Protection Review Group established by the Department, provides a strong focus through its new role for issues relating to the welfare and protection of children. 4.3 The Implementation of the Children (NI) Order 1995 and Funding 7. The Department, in conjunction with the Boards, should review the adequacy of funding for family and childcare services in Northern Ireland. 8. The Department should develop, as part of its Strategy for Children's Social Services, ways to improve investment levels in child protection, family support and childcare. 4.4 Structural Arrangements for the Delivery of Child Protection Services 9. The Boards, in conjunction with Trusts, should review current arrangements for the provision of child protection services. In particular, they should consider establishing inter - disciplinary, multi-agency 'Child Safeguarding Teams' to bring together all the relevant local agencies responsible for the assessment and investigation into children's welfare. These teams should be piloted and evaluated. 10. The Assembly Health, Social Services and Public Safety Committee should consider how it might amend Article 46 of the Children (NI) Order 1995 in order to strengthen multi-agency co-operation in child protection. 11. The Department should review the role of GPs as independent contractors in order to encourage their more effective involvement in the child protection system. 4.5 Family Support and Prevention 12. The DHSSPS should establish a Departmental Taskforce with the Boards to set in place a comprehensive, coherent and properly funded regional strategy on prevention and family support to: n Consider the adequacy of current structures to deliver preventative services, and develop a multi-agency threshold model for the delivery of these services. n Establish systems to ensure better Department and Board expenditure and funding for prevention. n Ensure the development of agreed regional policies and subsequent procedures to allow for the standardised assessment of need. 4.6 Giving Children Someone To Turn To 13. In the development of the Department's Children's Strategy for Social Services priority should be given to innovative ways of helping children protect themselves through access to independent counselling in schools, peer support, and independent advocacy for all children in receipt of social services. The development of adequate independent visiting schemes to help to safeguard the interests of these vulnerable young people should be seen as a major priority. 4.7 ACPCs and Case Management Reviews 14. ACPCs should be placed on a statutory footing to require all the agencies named in the Children's (NI) Order 1995 and giving each a statutory responsibility to provide representatives and resources enabling them to have a much stronger, clearer and extended function. This would improve outcomes for children and play a key role in the prevention of, and response to maltreatment. 15. There should be a statutory duty on the Department to complete 'Overview Reports' annually which complement recent proposals on the creation of a Child Protection Review Group. 4.8 Child Death Review Teams and developments in Northern Ireland 16. DHSSPS should establish a Child Death Review Team in the Southern Health & Social Services Board (SHSSB) area and ensure a common approach to child deaths is developed in conjunction with other government departments throughout Northern Ireland. 4.9 North-South Issues 17. The North-South Child Protection Working Group should establish structures to include the statutory and voluntary sectors and develop an agenda and transparency which meets the need for child protection on a cross-border basis. 4.11 Child Protection Training, Development and Workforce Issues 18. All staff who work with children should receive training on identifying indicators of abuse and neglect and know how to protect the child. There should be a co-ordinated, government-funded child protection training strategy for Northern Ireland. 19. Child protection training should be mandatory for key professionals who work in children's services, including health and education. 20. Child protection should be multi-disciplinary and interagency in its delivery. 21. All current child protection training should be reviewed and a quality assurance system established. 22. The new social work qualification should recognise the specialist nature of child protection work and this should be reflected in a core curriculum and adequate practice opportunities. 23. NISCC should monitor social care registration requirements against key post-qualifying training areas, including child protection. 24. All training content should reflect lessons from inquiries balanced with evidence-based practice and 'what works' in child protection. 25. The use of experienced child protection consultants should be considered to assist with professional development for front line staff. 4.11.6 Recruitment & Retention 26. NISCC and the DHSSPS should continue to monitor of the supply and demand of social workers in NI. 27. Organisations should be encouraged and supported in undertaking effective workforce planning. 28. An urgent review of pay and conditions of existing staff should take place and if necessary, special provision made to incentivise staff who work in child protection services. 29. The public education/ recruitment programme, targeted at young people, should be continued with renewed vigour. 30. The new social work qualification in NI should be readily accessible and should provide flexible routes to qualification. 5. Shaken Baby Syndrome 32. The DHSSPS with ACPCs should establish a multi-agency forum or task group to examine the specific issue of how to protect young babies in Northern Ireland. 33. The DHSSPS should seek to develop a strategic crosscutting government approach to quantifying, analysing the causes and preventing babies being shaken in Northern Ireland. Irrespective of the outcome of the Office of Law Reform Consultation on 'Physical Punishment in the Home', [vi] measures should be adopted to promote awareness of the dangers of smacking and shaking babies. 34. DHSSPS in conjunction with ACPCs should commission training programmes for professionals on identifying shaken baby syndrome. 5.2 Accident and Emergency Procedures 35. Comprehensive mandatory training in child protection for medical staff in casualty departments. 36. Better guidance and protocols on the detection of child abuse and neglect for medical staff, and the use of one regionally agreed set of procedures by A and E staff which should be published by the medical side of the Department in conjunction with ACPCs. 5.3 Use of the Child Protection Register 31. The DHSSPS in conjunction with ACPCs should carry out an audit of the current location, structure, usage and access to Child Protection Registers and examine any issues that arise regarding their effectiveness. 32. The DHSSPS with the Board should examine the feasibility of using computer technology to maintain a central, regionally analysed Child Protection Register. 5.4 Criminal Justice Issues 33. Systems should be put in place to provide accurate data on children giving evidence in all Courts in Northern Ireland. 34. NIO should move to follow the Home Office in implementing new special measures under the Criminal Evidence (NI) Order 1999. 35. Plea and directions should be introduced. 36. Training and accreditation should be introduced for judges and lawyers in cases involving offences against children where there are young witnesses. 37. There should be increased availability of post-abuse therapeutic services. 38. DHSSPS should review the role of social services in cases involving young Witnesses. 39. The voluntary sector should be represented on the Criminal Justice Issues Group. 5.5 Child Protection and the media 40. Child Protection organisations should review their media relations and ensure that at both local and regional levels staff are encouraged to work with the media. 41. A sub-group representing ACPCs and involving membership of the NISOSMC/ PECS Awareness and the Department's Child Protection Review Group should seek to develop a proactive media strategy on child protection in Northern Ireland. 5.6 Recording practices 42. The Social Services Inspectorate in conjunction with the four Boards and the Trust, should consider the introduction of regionally agreed standards for recording and the layout and structure of files. 1. Introduction NSPCC Northern Ireland is grateful to the Assembly Health, Social Services and Public Safety Committee for its invitation to present written evidence to its Inquiry into Child Protection Services in Northern Ireland. The UK is a signatory to the UN Convention on the Rights of the Child and there are responsibilities on the Executive of the Northern Ireland Assembly to implement the requirements of the Convention. Articles 3 and 19 of the Convention require that State Parties undertake to ensure the child receives such protection and care as is necessary for his or her wellbeing and to take all appropriate legislative, administrative, social and educational measures to protect children from all forms of abuse. It is a standard which must be achieved. It is hoped that the Inquiry will play an important role in highlighting areas where Northern Ireland has met or fallen short of this standard, as well as offering solutions based on children's rights. It will also facilitate the examination of a new radical approach to how we might better protect children. 2. NSPCC Northern Ireland The NSPCC's FULL STOP campaign aims to end child cruelty, and to create a society in which children are valued, respected and able to fulfil their potential. The NSPCC aims to: n Help protect children who have suffered abuse overcome the effects of such harm; n Prevent children from suffering abuse; and n Help children who are at risk of harm. In Northern Ireland the NSPCC employs 130 staff in a range of projects and services. The Society has statutory powers under the Children (NI) Order 1995 and provides a range of services throughout the region in conjunction with partner organisations including: - n Child protection teams in Foyle, Belfast and Craigavon that specialise in treatment and recovery work with children who have been abused. n Family Support teams in Belfast, Ballymena and Foyle which specialise in a range of family support services to parents and their children. n The lead role in one Sure Start project and a partner in a number of others. n A Young Witness Support Scheme which is being extended to all Crown Courts- this enables children and young people giving evidence as victims to understand more about the court procedure and process. n Two Schools Counselling Schemes in Western Education & Library Board (WELB) and Southern Education & Library Board (SEELB) areas, providing a range of independent counselling services to young people in 17 primary and post-primary schools. n A 24-hr telephone helpline and There4me our new UK online counselling service, which has one of its 3 centres based in Belfast. n A dedicated Policy Unit. n A Child Protection in Sport Unit. n A service for young people who sexually harm. n Child Protection Consultancy and Training. n Training and Safeguarding work and public education campaigns on a wide range of child protection issues. NSPCC in Northern Ireland is also represented on all Area Child Protection Committees (ACPCs) in Northern Ireland, on most Trust Child Protection Panels and on the Northern Ireland Sex Offender Strategic Management Committee. Much of NSPCC's strategic direction originates from the conclusion of the National Commission of Inquiry into the Prevention of Child Abuse that "child abuse and neglect can almost always be prevented - provided the will to do so is there". The Commission's Report Childhood Matters [vii] was published in 1996 and contains 85 wide-ranging recommendations. Many of these recommendations are of relevance to the Health Committee Inquiry and have been influential in moving on the debate about how best to protect children in the UK. Aspects of Childhood Matters and its recommendations will be referred to during specific parts of this submission. Our report outlines the key recommendations, which the NSPCC believes must be undertaken to improve the protection of children in Northern Ireland. It is however by no means the definitive or comprehensive analysis of all the improvements that need to take place to protect children in Northern Ireland. Other statutory and voluntary organisations will make other valid and important suggestions. It does, however, represent a synopsis of the key matters, which the NSPCC considers crucial to improving the protection of children in Northern Ireland. 3. Child Abuse in Northern Ireland: statistical
context Research by NSPCC published in Child Maltreatment UK, [viii] the most comprehensive report ever completed into the likely prevalence levels of child abuse [as opposed to what is reported] estimated that: n 7% of children suffered serious physical abuse as children at the hands of their parents; n 6% suffered serious neglect; n 6% suffered multiple attacks on their emotive well-being; and n 1% suffered sexual abuse by a parent with a further 3% suffering sex abuse at the hands of a relative or someone known to them. The research also demonstrated that much of this abuse went unreported, undetected and hence unrecorded. The research shows that children are much more likely to be physically or emotionally abused within the family and where sexual abuse occurs, it is more likely to be at the hands of someone known to and trusted by the child. In Northern Ireland the best available data on 'reported' cases of abuse, is contained in the DHSSPS document Key Indicators. [ix] Table 1 and 2 report two important measures: Table 1 - Reported offences against children to Police Service Northern Ireland (PSNI) in 2000/1
Table 2 - Child Protection Registration
figures per 10,000 children for NI with England comparison 1997-2001
The provision of key child protection data and trends is essential to the planning of services and the measurement of successful outcomes. It is not something that Northern Ireland has been traditionally good at but it needs to be a feature of all work in this field. There are, however, significant gaps in a number of key areas, which need to be addressed. These include: n Criminal conviction rates for criminal offences against children - this is not clear and each of the agencies appear to gather different information in different ways. n Offences reported to PSNI against children under 18 - current information is only collated up to age 17. n Through research carried out by the Department of Education Northern Ireland (DENI) it has been shown that children in care are 10 times more likely to be excluded from school yet we do not systematically gather this key information. n Measurement of unmet need across Trusts in Northern Ireland within agreed definitions of children in need. n Wide variations between Trusts on key child protection data, which call into question the use of established definitions and thresholds and is unhelpful in relation to the planning and allocation of resources. There is urgent need for a comprehensive incidence study of child maltreatment in Northern Ireland and in all other UK jurisdictions to ensure that services which are informed by children's experience are developed. We would also like to see Child Well-Being Indicators [x] which are produced by many governments in other parts of the world being adopted for use here. These are designed to: n Describe the condition of children; n Help monitor or track child outcomes; n Set future policy goals. Such indices would help measure over time improvements and outcomes in not just child protection in the strictest terms but wider measures of welfare. Child Well-Being Indicators (see Appendix 2) may include, for example, reductions in low birth weight babies in Sure Start areas, reduction in hospital rates as a result of serious injury, improvement in the education attainment of looked after children, etc. NSPCC recommends that: n The Department, the Northern Ireland Executive and the Northern Ireland Office should collaborate in providing good baseline data on child abuse and child protection including a comprehensive incidence study of child maltreatment. n Consideration should be given to the creation of Child Well-Being Indicators that would assist in setting future policy goals and track outcomes for children. n Social Services Inspectorate (SSI), in conjunction with the Northern Ireland Statistics and Research Agency, should carry out an audit of Trust child protection data to ensure consistency of approach and application of common definitions across Northern Ireland. 4. A Stronger Child Protection System 4.1 The Department of Health, Social Services and Public Safety The Department of Health and its Child and Community Directorate play an important lead role in government on child protection. However there are a number of structural and historic problems associated with direct rule, which have tended to work against this: There are no clear policy objectives on child protection from the Department and/or the Executive. From the 'Programme for Government', through 'Priorities for Action' [xi] and publications such as 'Well into 2000', 'Investing for Health' [xii] the protection of children and related issues receive scant attention; or are referred to in a piecemeal fashion. n The dominance of the acute hospital agenda. Child protection receives much less attention than health issues by the Department. Often we see child protection issues sandwiched between health and acute hospital provision and this is matched by poor resource allocation. n The structure of and the relationships between the Department, the Boards and the HPSS Trusts. The very complicated HPSS arrangements create difficulties over accountability, tracking of expenditure and ringfencing of funding. In the past funding allocated by the Department to the Boards for family and childcare has been diverted into the acute hospital sector. n The resourcing of the Child and Community Care Directorate. The Child and Community Care Directorate and in particular the Child Care Unit are understaffed and under resource. They are not adequately equipped to tackle the key child protection issues they must address. The expertise of staff in the Department needs to be complemented imaginatively with skills and knowledge from outside agencies. The NSPCC welcomes recent indications from the Minister that her Department is developing a 'Strategy for Children's Social Services' as well as working with the Children and Young People's Unit at the Office of the First Minister and Deputy First Minister (OFMDFM) on the Executive's cross-cutting children's strategy. NSPCC believes that this should be a continuous process and not simply a one-off consultation. There should be a strategic plan for child protection across Government. There should be a three-yearly planning cycle, accompanied by a yearly report by the Department on their assessment of progress against objectives and outcomes. This strategic plan should both inform and be informed by Children's Services Planning and the work of ACPCs. 4.2 The Child Protection Review Group (CPRG) The Department should seek to use the Child Protection Review Group (CPRG) in Northern Ireland to create a stronger regional focus for issues relating to safeguarding children, and provide a coherent framework for the work of local agencies. The CPRG would develop an overarching strategy for safeguarding children that would include a regional framework for the prevention of and effective response to child maltreatment. The framework would be based on an evidence-based understanding of the extent of the problem of maltreatment, including data on the incidence of abuse and regular prevalence research. The CPRG would oversee the development and implementation of both the existing guidance, which relates to safeguarding children, and any new guidance developed to correspond with the new team structures and strengthened ACPC model. The NSPCC proposes that the CPRG should have the following roles and responsibilities: 4.2.1 Standards The CPRG would advise the Minister for Health & Social Services & Public Safety on the framework standards for the prevention and response to maltreatment. This would include standards for the operational delivery of the safeguarding teams and the work of the ACPCs. The CPRG would issue guidance on: a) Standards for the work of CSTs including establishing the teams (team building and training programmes) and protocols for intervention, investigation and assessment. b) Disclosure of information between the agencies and issues relating to the Data Protection Act and the Human Rights Act. c) The work of ACPCs. 4.2.2 Evaluation and monitoring The CPRG would monitor and evaluate the systems and services for safeguarding children. This would include the following: a) Setting and evaluating the overarching strategy for safeguarding children, to include a framework for the prevention and response to maltreatment. b) Specifying outcomes for ACPCs and overseeing their business/strategic plans on an annual basis to ensure they include; details of how outcomes will be met and how they will monitor rates of child maltreatment at a local level; c) Evaluating the effectiveness of the CSTs by monitoring and evaluating outcomes for children in receipt of their services; d) Producing a regional evaluation report to disseminate good practice and generate learning; e) Overseeing the serious case review process, producing an annual report and disseminating common themes and trends from serious case review reports. The NSPCC recommends that: n The DHSSPS should establish a clear strategic plan for children's protection and welfare, which sets out the responsibilities for child protection of other Government Departments. n The Minister for Health, Social Services and Public Safety should consider innovative ways of complementing the resources and expertise in the Department with those from the statutory and voluntary sectors, such as the use of secondments, placements, joint working arrangements. n The Assembly should ensure that the Child Protection Review Group established by the Department, provides a strong focus through its new role for issues relating to the welfare and protection of children. 4.3 Implementation of the Children (NI) Order and Funding The Children (NI) Order 1995 implemented on 4 November 1996 was the most radical piece of childcare legislation in the 20th century and introduced a new series of responsibilities for staff in the HPSS system and new approaches to the protection of children. At the time of the implementation of the Children (NI) Order 1995, the then DHSS very conservatively estimated the costs of funding the requirements of the legislation. In December 2000 a paper produced by the 4 Boards [xiii] estimated that while approximately Ł17 million additional funding had been allocated by the Department for implementation of the Order, this still fell Ł17 million short of what the Boards felt was necessary. It was also the case that the Boards themselves under-estimated what was actually required in the implementation of the Children (NI) Order 1995. While the total additional amount of extra funding made available to the Boards since implementation of the Children (NI) Order 1995 is in the region of Ł30.3 million recurring and Ł3.5 million non-recurring, [xiv] it is important to document the wider context to this underfunding and to examine pressures on the system: n Re-direction of resources to the acute hospital sector and action by Boards to transfer funding originally for family and childcare within the system. Departmental bids to the Public Expenditure Survey under the Children (NI) Order 1995 excluded costs associated with Child Protection, Family Placements, Residential Care medical costs and significant legal costs. [This latter point needs to be seen in the increasing time both public and private family proceedings cases are requiring with significant resource implication in terms of representation for Trusts and the time involved for staff. Disposal times have increased from and average of 9.7 weeks (public) and 8.9 weeks (private) [xv] to 18.98 and 19.92 weeks respectively [xvi] ]. n Subsequent policy initiatives and developments some of which have been very resource intensive. These include: - New Children's Services Planning legislation and processes; - Juvenile Justice responsibilities through the Juvenile Justice (Children) Order 1999 with increased emphasis on working with young people who offend in community settings; - The Sex Offenders Act 1997 and subsequent new multi-agency procedures developed under the Northern Ireland Sex Offender Strategic Management Committee and the 6 local committees; - SSI Reports and new systems relating to Looked After Children such as LAC forms and Care Planning etc; - The NI Children's Strategy 'Children First' and the pre-school expansion programme; - Introduction of the principles of the Framework for the Assessment of Children in Need and their Families. In England and Wales since 1997 there has been considerable investment in family and childcare services. 'In 1998/9 while there was Ł158.60 per capita spend in Northern Ireland [with variation in Trusts from Ł241 N&W Belfast to Ł96.80 Craigavon and Banbridge]. The average in England Ł248.20. Compared to England and Wales there is therefore a considerable shortfall on family and childcare spending in Northern Ireland resulting in under-funding of the implementation of the Children (NI) Order 1995. Information obtained from the DHSSPS would indicate that best 'guestimates' of per capita expenditure demonstrates Ł70 less is being spent per child in Northern Ireland, than in England. Under funding also needs to be seen in the context of a raft of policy initiatives that have emanated from Westminster, many of which have either not been introduced in NI or not at the same level of investment: a) The Quality Protects initiative Ł885 million into family and childcare services in England for 5 years from 1999/00. No NI equivalent. b) Sure Start Ł449m over 3 years which works out as an average of Ł63 per child under 4. In Northern Ireland equivalent figures are Ł7.8m over 2 years or Ł41 per child. c) Supporting Families Green Paper - No NI equivalent. d) Connexions, On Track, Sure Start Extra - No NI equivalent. The NSPCC welcomes the Children Matter Task Force and the additional funding that has been made available to develop residential services and places. Such is the interconnectiveness of the child protection system that improvements in resourcing one aspect, in this case placements for children in residential and secure accommodation, will have benefits in relieving pressures in other parts of the childcare system. Lack of adequate investment in family and childcare is having a serious impact on the provision of services. Specifically: n The statutory sector has had to focus on meeting largely statutory provisions under the Children (NI) Order 1995 at the expense of moving resources into preventative services. n Growing demands, expectations and pressure on workforce and significant workforce problems. NSPCC recommends that: n The Department, in conjunction with the Boards, should review the adequacy of funding for family and childcare services in Northern Ireland. n The Department should develop, as part of its Strategy for Children's Social Services, ways to improve investment levels in child protection, family support and childcare. 4.4 Structural Arrangements for the Delivery of Child Protection Services Northern Ireland's integrated health and social services model of child protection has strengths and weaknesses, some of which are outlined in other parts of this submission. Safeguarding children is also governed by the Children (NI) Order 1995 (NI) Order 1995 and its accompanying volumes of guidance and regulations which map out a clear direction for multi-agency working and communication. In England and Wales during the 1980s and 90s the repeated failures of professionals to work together and communicate with each other were highlighted in many Inquires into child abuse. [xvii] Recent submissions to the Climbié Inquiry by NSPCC and others have highlighted the need for structural reform and systems, which promote multi- agency relationships and working. However though the Northern Ireland integrated model of services, is often seen as an improvement on the structural arrangements in England and Wales. There are still a number of factors that militate against effective working relationships: n While the integrated model has health visitors and social workers working in the same Trust, they often have different management and reporting lines and compete in terms of role and resources and this can work against effective communication. n Article 46 of the Children (NI) Order 1995 requires agencies to co-operate with the Trusts' in fulfilling their responsibilities under the legislation It does not mention GPs or the police and there are effective exemption clauses for agencies who should be complying with requirements e.g. if it is compatible with that body's own statutory or other duties and obligations and does not unduly prejudice the discharge of any of its functions The legislation is also weak in that it contains no sanction for failure to comply with a request. n The system has polarised children as falling into 'children in need' under Article 17 or into 'child protection under Article 66'. We have seen above how little the 'children in need' requirements of the Order have been resourced. There has also been a less than wholehearted endorsement by the Department of the Framework for Assessment of Children in Need and their Families [xviii] leading to differing models being developed by different Boards. n The role of GPs as independent contractors and the difficulties this may cause in strengthening their role in the child protection system. Research has shown that junior doctors tend to receive relatively little child protection training and local audits have highlighted poor attendance by GPs at case conferences. 4.4.1 Child Safeguarding Teams We recommend that multi-agency Child Safeguarding Teams should be established in Northern Ireland to bring together all relevant local agencies responsible for the assessment of, and investigation into, children's welfare. The teams would be responsible for commissioning or referring children and families on to the necessary family support and therapeutic services, and for providing strong links with other mainstream services such as health visitors. CSTs would provide the basis for an integrated approach to children, ensuring that a child's needs for support and protection were assessed simultaneously. There must be recognition that a child's circumstances can change, and that just as protection issues can quickly arise in a family support case, support is vital for children and families where there are protection issues. At operational level, the NSPCC propose that the teams should include social workers, education and health staff and police officers, but they could also involve individuals from other agencies and organisations, including the voluntary sector. These proposals for CSTs are intended to bring together existing staff, services and the ACPCs on a more effective inter-agency basis, we do not propose that ACPCs have operational responsibility for the teams. However, the two would need to develop a close relationship. In multi-agency teams, education representatives could perform a liaison role and ensure that schools pass on relevant information, receive feedback and know what their responsibilities in the investigation and planning process are. They would also be able to provide expertise where there are significant education issues or where the school is a vital part of the protection plan. Similarly, the presence of health representatives on the teams would provide a vital link with mainstream health services, leading to an improved understanding of roles, responsibilities and systems, particularly in relation to paediatricians, health visiting services and psychiatry. A multi-agency structure would enhance the strengths of the different agencies. In certain circumstances, such as when a crime has been committed, the police could take the lead. Another case may benefit from a joint social work/health approach. Effective joint working is already in place, but practices could be improved through this new structure. The teams would counter the 'inward looking' nature of agencies and the preoccupation with an individual agency's agenda and core responsibilities. A multi-agency team approach is not a new idea and there are many examples of where this works well. This is the right time to develop and formalise the approach in relation to safeguarding children, the way to create a seamless and effective response to promoting their welfare and ensuring that protecting them from abuse remains a high priority. NSPCC recommends that: n The Boards, in conjunction with Trusts, should review current arrangements for the provision of child protection services. In particular, they should consider establishing inter - disciplinary, multi-agency 'Child Safeguarding Teams' to bring together all the relevant local agencies responsible for the assessment and investigation into children's welfare. These teams should be piloted and evaluated. n The Assembly Health, Social Services and Public Safety Committee should consider how it might amend Article 46 of the Children (NI) Order 1995 in order to strengthen multi-agency co-operation in child protection. n The Department should review the role of GPs as independent contractors in order to encourage their more effective involvement in the child protection system. 4.5 Family Support and Prevention Prevention and family support are an integral part of the child protection process and much valuable and innovative work has been carried out by Boards, Trusts and the voluntary and community sectors through Children's Services Planning. A result of under-investment outlined previously has been a focus on statutory child protection work at the expense of prevention. Prevention and family support need to be seen as part of a seamless continuum of service delivery, which ranges from universal support through services to children in need, to the core business of child protection agencies in the identification of children suffering significant harm. It is not an 'either/or' choice. There is no comprehensive child protection strategy in Northern Ireland which has inhibited the development of prevention and welfare services in Northern Ireland. This problem has been compounded, by the lack of direct application of initiatives within England and Wales such as the: n Quality Protects Initiative [xix] which establishes National Government Objectives for children's services with achievable targets and outcomes. n Supporting Families Green Paper [xx] which introduced a range of policy initiatives related to financial support and promotion of parenting. 'Children First [xxi] ' provided some support for parents such as establishing Sure Start in Northern Ireland. However fell short of providing an overall childcare strategy. Even within the Programme for Government and the Department's Priorities for Action [xxii] there is disappointingly little recognition of the need for prevention. Staff working in preventative services need tools and an agreed theoretical framework in which to work. The multi-agency nature of the Health and Social Services in Northern Ireland creates opportunities for a broad spectrum of professionals to work with families and this needs to take place in the context of a common understanding of assessments and thresholds. This must include a common understanding of risk assessments and NSPCC commends the work of the 4 ACPCs in taking forward an agreed model for Northern Ireland. There needs also to be a fresh look at our current structures and their ability to deliver preventative services, particularly with the creation of new Health and Social Care Partnerships. NSPCC recommends that: n The DHSSPS should establish a Departmental Taskforce with the Boards to set in place a comprehensive, coherent and properly funded regional strategy on prevention and family support to: - Consider the adequacy of current structures to deliver preventative services, and develop a multi-agency threshold model for the delivery of these services. - Establish systems to ensure better Department and Board expenditure and funding for prevention. - Ensure the development of agreed regional policies and subsequent procedures to allow for the standardised assessment of need. 4.6 Giving Children Someone to Turn to Research has shown that the majority of children are unwilling to discuss problems with professionals. [xxiii] [xxiv] One of the major disincentives for children to confide problems, especially with professionals, is their fear of confidentiality being broken. [xxv] Research indicates that children have good reason to suspect that the disclosure of abuse will be problematic for them. Several studies have shown that, on the whole, children find child protection processes very distressing and in some cases more traumatic than the abuse itself. [xxvi] Therapeutic services, when used, are highly valued by children, but the process of investigation can be distressing for children who feel uninformed and that the process is out of their control. In addition, many victims of abuse never disclose and it is unusual for a child to disclose to a professional. [xxvii] This unwillingness of children to engage with the child protection system indicates the need to create systems that have their confidence in and which they value and trust. It is vital that children have access to a range of innovative services for advice and protection. They need someone they can trust, to have control over the process and space to work through their problems without being catapulted unwillingly into the child protection system. The UN Convention sets out the right of children to participate in decision-making that affects their lives. The need to develop preventative services is a major feature of this report and in the development of new services. NSPCC recommends that: n In the development of the Department's Children's Strategy for Social Services priority should be given to innovative ways of helping children protect themselves through access to independent counselling in schools, peer support, and independent advocacy for all children in receipt of social services. The development of adequate independent visiting schemes to help to safeguard the interests of these vulnerable young people should be seen as a major priority. 4.7 ACPCs and Case Management Reviews NSPCC believes that strengthening ACPCs is vital to improve the child protection system in Northern Ireland. We support MLA, Patricia Lewsley's Private Member's Bill on ACPCs. ACPCs are the multi-agency child protection forums whose function is to develop a strategic approach to child protection. They have existed in each Health & Social Services Board area in Northern Ireland since 1990. Although social services have statutory responsibility for child protection, ACPCs are intended to ensure that the exercise of this responsibility is carried out on an interagency and inter-disciplinary basis. The 4 ACPCs are constituted in accordance with the guidance 'Co-operating to Protect Children' issued by the Department of Health, Social Services and Public Safety. ACPCs are normally chaired by Assistant Directors of Social Services and comprise membership from a range of other organisations and professional bodies with an interest in child protection, including the NSPCC. Established under each ACPC are Trust Child Protection Panels (CPPs), tasked with the local implementation of ACPC policies. Although ACPCs occupy a pivotal position in relation to the protection of children, they are not statutory. This leads to a number of drawbacks: n The lack of a specific statutory remit. The present constitution of ACPCs encourages a view that child protection is only a matter for social services. In the recently published 'Learning from Past Experience - A Review of Serious Cases', the Department of Health stated, 'that while ACPCs reflect the multi-agency nature of child protection services and the responsibility of all agencies for safeguarding children, the fact that the social services department is seen as the lead agency does have implications for the way in which that responsibility is perceived and monitored'. Non-social services agencies feel their child protection role to be rather marginal and secondary to legislative and other core duties imposed on them. n The lack of specific funding for ACPCs means the Committees are totally dependent on resources from other budgets and limits the development of effective and sustained strategic approaches to child protection. n Some of the functions of ACPCs, particularly around the handling of case management reviews, remain uncertain. n Despite inquiries and high profile cases involving child abuse, both here and in other parts of the UK, there are no clear mechanisms in place to ensure that recommendations and lessons learned are applied in a sustained and consistent manner. The need to place ACPCs on a statutory basis has been recognised in England where the Victoria Climbié Inquiry, in particular, has highlighted the weaknesses of ACPC powers and functions. A 10-Minute Rule Bill supported by the NSPCC to strengthen the role of ACPCs gained considerable support in the UK Parliament. In Northern Ireland a recent high profile case involving the death of a child has been the subject of an independent inquiry instigated by the DHSSPS. Although the report of the inquiry has yet to be completed, it is possible it will draw attention to the need for an enhanced role for ACPCs in ensuring collaboration between agencies and professionals on child protection The Bill is intended to build upon the functions and remit of ACPCs as set out in the draft 'Co-operating to Safeguard Children' and in particular to: n create a statutory duty on Boards to establish ACPCs; n provide for chairing arrangements; n require participation by senior members of organisations; n require the Department to provide funding for ACPCs; n establish rules on the conduct of case management reviews; and n require the DHSSPS to commission and publish Overview Reports of case management reviews. The draft Bill has received widespread endorsement and the NSPCC believes that this Bill will considerably improve and strengthen the role of these important child protection forums. 4.7.1 Case Management Reviews One of the most important proposed functions of ACPCs in the draft guidance 'Co-operating to Safeguard Children' is the responsibility to commission case management reviews. Case management reviews are an important way in which to learn from both good and bad practice. However, there have been difficulties in the way in which they have operated in Northern Ireland. These include: n Inadequate dissemination of reports. Under the DHSSPS current guidance 'Co-operating to Protect Children' and the draft guidance 'Co-operating to Safeguard Children', there is no requirement to disseminate these reports and their findings. This is in contrast to the guidance from the Department of Heath [xxviii] in London which sets out very clear processes for the local and national dissemination of case management reviews and the recommendations they contain. Despite anecdotal evidence that approximately 2-3 are completed each year in Northern Ireland, the Department itself until recently was not compiling a database of completed reports. Nor are case management reviews routinely shared between ACPCs. The culture of secrecy around case management reviews in Northern Ireland has resulted in lost opportunities improve practice. n Negative view of case management reviews. There is an unfortunate perception that case management reviews are only carried out to find staff culpable of mistakes. The recent Briggs case in the Southern Health and Social Services Board (SHSSB) has underlined this perception. The ACPC Bill is intended to deal with these weaknesses by requiring the DHSSPS to establish arrangements for the consideration of case management review reports, the wider dissemination of key findings and the publication of annual 'Overview Reports.' NSPCC welcomes the Department's proposed creation of a high level Child Protection Review Group whose function would be to learn the lessons, disseminate information and take action arising from case management reviews. NSPCC recommends that: n ACPCs should be placed on a statutory footing to require all the agencies named in the Children's (NI) Order 1995 and giving each a statutory responsibility to provide representatives and resources enabling them to have a much stronger, clearer and extended function. This would improve outcomes for children and play a key role in the prevention of, and response to maltreatment. n There should be a statutory duty on the Department to complete 'Overview Reports' annually which complement recent proposals on the creation of a Child Protection Review Group. 4.8 Child Death Review Teams (CDRTs) Case management reviews are held in certain circumstances and they occur in small numbers and only when abuse has been 'suspected' or 'identified' as being a factor in a child's injury or death. However there is a very different problem with babies whose death is unexplained. ACPC case management reviews are held in these circumstances. The main function of the review is to look at the actions of the agencies involved. Recently research on babies, has shown: n Increasing numbers of child deaths diagnosed as Sudden Infant Deaths (SIDS) when they were in fact related to abuse and neglect. Hobbs et al 1995 [xxix] reported in a retrospective study of infant deaths that there were many discrepancies in accounts surrounding the deaths of children, and that 27 of the 37 cases of unexpected infant deaths studied featured abuse or neglect. The Confidential Enquiry into Still Births and Deaths in Infancy (CESDI) Studies (Johnston et al [xxx] ) found that many deaths originally classified as SIDS were later thought to be suspicious following detailed discussion of family histories. n NSPCC examined the issue of child deaths in the UK in its publication 'Out of Sight [xxxi] ' and concluded that infant and child homicide rates in the UK have remained stable over the last 20 years .One of the key recommendations from this study was the need to create Child Death Review Teams in the UK. 4.8.1 Child Death Review Teams and developments in Northern Ireland One way in which other countries have begun to deal with the unexplained children's deaths, diagnosis, and the relationship to possible abuse is through the creation of child death review teams and related processes. Different models have developed in different parts of the world but common features are the multi-disciplinary exchange of information between agencies, formal protocols governing procedures and processes designed to help distinguish unnatural and natural deaths of children and to build up a better picture of these deaths. For example, in the US, [xxxii] Child Death Review Teams (CDRTs) have developed in many states, which review the deaths of all children. They have a number of roles, which include: n accurate identification and documentation of the cause of all child fatalities; n interagency co-operation; n identification of potentially preventable child deaths; n improvement in the identification and prosecution of maltreatment deaths; and n development and use of inter-agency policies for investigating certain categories of child fatality. In the UK there have been, similar developments such as the Sussex Joint Agency Protocol for Unexplained Deaths [xxxiii] which establishes the principles and processes for the investigation and management of unexplained children's deaths on an inter-agency basis. This procedure facilitates a multi-agency discussion in order to pull together all the information about a child's death from a wide range of sources including the Coroners Office. Discussions the NSPCC has had with medical staff in Northern Ireland indicate that the Coroners' process operates largely in isolation from health and social services. Indeed, it is illustrative of this point, that the terms of reference of the DHSSPS independent Inquiry into the Briggs case do not include the role of State Pathology and the Coroners Office. While the numbers of unexplained children's deaths are relatively small, we believe that there should be a formal Child Death Review Process that incorporates components of best national and international practice. The NSPCC proposes that independent, multi-disciplinary child death review teams should be established on a statutory basis. These would provide consistent, regular and thorough analysis of the deaths of all children under 18. The primary concern of the NSPCC is to reduce deaths following abuse or neglect. The means to this - the CDRT - must become "part of what we do" in Northern Ireland when a child or young person dies, as it is in parts of the USA, and Australia. It must not be stigmatising. It must help us learn about "preventable" deaths - accidents, suicides and other forms of death that we currently do not understand, as well as those in which maltreatment is a contributory factor. There are current moves in the SHSSB area under the auspices of the ACPC to establish a Child Death Review Team and development of inter-agency protocols and processes. An initial discussion has taken place involving medical staff, representatives of the Coroners Office, GPs, the NSPCC, and social services and it is hoped that this will lead to a pilot CDRT NSPCC recommends that: n DHSSPS should establish a Child Death Review Team in the Southern Health & Social Services Board (SHSSB) area and ensure a common approach to child deaths is developed in conjunction with other government departments throughout Northern Ireland. 4.9 North-South Issues The Border presents a challenge to effective child protection because of the considerable cross-border movement of population which takes place and the different legal and social welfare systems. There is a need to find better ways of protecting children on an all-Island basis as strengths in one jurisdiction can be undermined by weaknesses in the other. For example, the Assembly is currently debating the Protection of Children and Vulnerable Adults Bill, which will do much to improve the system of vetting those who seek work with children. While the Minister has announced that organisations in the South can access the Department's Pre-Employment Consultancy Service (PECS) list for staff who have worked or been domiciled in Northern Ireland, there is no equivalent system in the Republic of Ireland. In response to a written Dail Question [xxxiv] to the then Minister for Children Ms Hanafin did acknowledge the creation of a Garda Central Vetting Unit. However, this service is only available to organisations in the statutory sector and there is no equivalent to the DHSSPS current Consultancy Register or any proposals - to match the improved system that will be introduced in Northern Ireland. This means that individuals from the Republic of Ireland working with children in Northern Ireland are vetted to a much lower standard because of the different systems in the two parts of the island. The Irish government has recently enacted its Sex Offenders Act bringing policy and practice more in line with the UK 1997 Sex Offenders Act [xxxv] . There are however significant differences between the different pieces of legislation, such as: n Supervision and assessment and post-release arrangements; n Registration periods; n Convictions outside the jurisdictions and their effect; and n Registration requirements on moving from one jurisdiction to the other. The danger of different standards on the vetting of sex offenders is that loopholes will be exploited to avoid detection and will put children at risk The lead on child protection in the North-South Ministerial Council has been taken by education through the auspices of the North-South Child Protection Working Group. NSPCC, while welcoming this all-island structure, is concerned about its composition, transparency, and working processes. Its remit, current agenda, composition, and even frequency of meeting are unclear. NSPCC recommends that: n The North-South Child Protection Working Group should establish structures to include the statutory and voluntary sectors and develop an agenda and transparency which meets the need for child protection on a cross-border basis. 4.10 The Commissioner for Children and Young People NSPCC welcomes the all-party support for a Commissioner for Children and Young People and the current Bill which is entering its Assembly Committee Stage. We regard the Commissioner for Children and Young People as one of the key structural changes that will help protect children in Northern Ireland in a range of ways. Not least in acting as a driver for change, underpinning a rights-based approach using the UNCRC and acting as an authoritative voice with the media on children's issues. Some of the proposed powers of the Commissioner contained in the Bill will be influential in relation to child protection issues. NSPCC has a number of concerns about expectations placed on the Children's Commissioner and the ability of this Office to deliver better protection for children. The Office is only one among other measures that should be in place; having a Children's Commissioner will not in isolation deliver better child protection in Northern Ireland. Such is the enormity of the agenda that needs to be addressed many other key players have important roles including the SSI, the DHSSPS, other government departments, and the statutory and voluntary sectors. 4.11 Child Protection Training and Development Issues 4.11.1 NSPCC's role in child protection training The NSPCC has a long tradition of providing child protection training, consultancy and research to a range of agencies and organisations. In Northern Ireland this has included the statutory, voluntary, community and private sectors. The NSPCC is currently involved in child protection training for a wide range of organisations such as the Police Service of NI, Health Boards, sporting organisations and community groups. We have also developed a range of child protection training materials and packs, the most recent was targeted at protecting babies and was for a range of health professionals. 4.11.2 A skilled, experienced child protection workforce NSPCC believes that all those working with children must have the necessary skills, knowledge, support and experience to undertake this important role. All child death inquiry reports have invariably recommended improved training for key staff working in child protection. These have naturally concentrated on what went wrong and how children were not protected. However it is important that any training curriculum presents a balanced approach of 'what works' in child protection, using evidence-based practice and current research. It is important that staff receive training on identifying signs of abuse and neglect and know how to act to protect the child. Professionals making inquiries, assessments and decisions about children for whom there is concern must be highly skilled and child focussed. Childcare staff must be able to communicate with children of different ages, abilities and social and cultural backgrounds. In particular, they should be equipped to assess child development and identify reasons for concern. Their training should also prepare them to work effectively in partnership with parents /carers, (even when they are uncooperative), and other key professionals. The NSPCC believe that there should be a co-ordinated, government-funded child protection training strategy for Northern Ireland. Currently a range of training planners and providers, including the four individual ACPCs determine current training needs. The strategy should also inform the Northern Ireland Social Care Council's (NISCC), training strategy - TOPSS (NI) 2000. [xxxvi] At present in Northern Ireland child protection training is not mandatory for some key staff groups who work with children. Also a number of key disciplines such as teachers receive very minimal training, perhaps a few hours in a three or four year qualifying course. We are aware that in NI some community groups receive more child protection training than key professionals in the statutory health care sector do. For all those in contact with children, a core curriculum, supported by approved teaching materials and trainers, should form part of the qualifying and post-qualifying training for all relevant professionals. Minimum standards should be set for training and requirements determined for further practice development and training, reflecting the staff member's role in the child protection process. Refresher training for experienced staff is also important. This would ensure that new evidence-based practice developments and research, as well as lessons from inquiries would be disseminated as soon as possible. All opportunities for inter-agency and multi-disciplinary training should be developed and promoted at both qualifying and post-qualifying levels. In the past this type of training has been limited because of resource and logistical difficulties. Any training strategy should take cognisance of new technologies and distance-learning resources, 'going on a course' is not the only avenue for professional development. 4.11.3 Social work qualifying and post-qualifying training: In October 2001 the DHSSPS announced a package of reforms to social work training at qualifying and post-qualifying levels. NSPCC would like to see the re-design of qualifying training to a standardised child protection module on the course. The new qualification provides the potential for 'specialisms' in years three and four in child care work. This would be a recognition of the 'specialist' nature and complexity of child protection work. It is debatable if a 'generic' social work qualifying course could prepare new social workers for their role in child protection work. In addition the NSPCC thinks that action should be taken to resolve current problems with practice placements in social work training. The DHSSPS, relevant Training Partnerships and the NISCC should contact with all agencies and provide resources to ensure that the necessary range of childcare placements is provided. At present some newly qualified staff will be working in the child protection arena without having any practice experience during their professional training. 4.11.4 Post-qualifying: Childcare staff need the time and resources to continue their professional development. Too often in the past there has been no workload easement or available relief staff to facilitate opportunities such as the new Post Qualifying Child Care Award. The Northern Ireland Social Care Council (NISCC) should set mandatory practice development and training targets for all social care staff to ensure continued registration to practice. This should of course include child protection training updates and refresher courses. 4.11.5 Managers' Training: Training for managers supervising child protection work should also become mandatory. This is particularly relevant for first line managers because of their key role in co-ordinating the process and in making decisions around child protection thresholds. This training could of course involve staff from other key disciplines. Consideration should be given to the use of experienced 'child protection consultants', who could assist in providing independent advice and support in complex cases. At present most experienced practitioners move into management positions and their expertise may be lost from the 'front line'. NSPCC recognises from experience that staff training and development have a key role to play in the development and maintenance of an effective child protection system. A co-ordinated, child protection training strategy needs proper resourcing and quality assurance. NSPCC recommends that: n All staff who work with children should receive training on identifying indicators of abuse and neglect and know how to protect the child. There should be a co-ordinated, government-funded child protection training strategy for Northern Ireland. n Child protection training should be mandatory for key professionals who work in children's services, including health and education. n Child protection should be multi-disciplinary and interagency in its delivery. n All current child protection training should be reviewed and a quality assurance system established. n The new social work qualification should recognise the specialist nature of child protection work and this should be reflected in a core curriculum and adequate practice opportunities. n NISCC should monitor social care registration requirements against key post-qualifying training areas, including child protection. n All training content should reflect lessons from inquiries balanced with evidence-based practice and 'what works' in child protection. n The use of experienced child protection consultants should be considered to assist with professional development for front line staff. 4.11.6 Recruitment and Retention A skilled, experienced workforce is essential if Northern Ireland is to have an effective, safe child protection system. Historically, the management of child protection cases is the most complex and demanding task in the field of social care. Crucial decisions in childcare are often made in difficult circumstances requiring fine judgements about the weight and significance of limited information. There may be personal risks to professionals in the field and they often have limited opportunity for reflection and access to specialist advice and consultation. High caseloads and staff turnover, combined with a negative public relations profile have done little to attract new staff or retain experienced staff in child protection work. Due to the personal impact of this type of work, many new social workers will not contemplate childcare work when posts with other client groups are available on the same salary scales. Not surprisingly the NSPCC, like many employers have struggled to fill practitioner and management posts in our children's services. The recruitment position seems to have got particularly difficult in the past two years and this may reflect other socio-demographic changes eg posts available in the Republic of Ireland. The outlook in relation to the supply and demand of social workers in Northern Ireland, as outlined in the NISCC document ' Workforce Planning for Social Work', (2002), [xxxvii] predicts further difficulties and a supply shortfall. The NSPCC is currently undertaking a workforce planning process to address some of our difficulties across all three nations. NSPCC has realised that the provision of practice placements, competitive advertising and enhanced allowances, still doesn't provide us with enough suitable new or experienced staff. A 'grow your own' approach has been adopted in some of our English divisions, with some current staff bridging from NVQ to Dip. SW courses. In Northern Ireland we have availed, in a limited sense, of the Dip SW (employment based route). In the short term the crisis within family and childcare services in Northern Ireland will not be resolved without an increase in the number of newly qualified social workers. The recruitment campaign by the NISCC had limited success. It must be remembered that castigation of the social work profession in court cases and on the media sustains the negative image that many young people have of it. To prevent the large turnover of existing staff the government should urgently conclude its review of current pay scales for social work staff and consider special provision for staff working in child protection services. NSPCC recommends that: n NISCC and the DHSSPS should continue to monitor of the supply and demand situation in relation to social workers in NI. n Organisations should be encouraged and supported in undertaking effective workforce planning. n An urgent review of pay and condition of existing staff and if necessary, n Special provision made for staff that work in child protection services. n The public education/ recruitment programme, targeted at young people, should be continued with renewed vigour. n The new social work qualification in NI should be readily accessible and have flexible routes to qualification. 5. Policy and Practice Areas 5.1 Shaken Baby Syndrome A recent Inquiry by the Health Committee was initiated following the death of a baby in Down Lisburn Trust where the child had demonstrated symptoms of being shaken. There have been other significant deaths of young babies in Northern Ireland and statistically those under 12 months are 4 times more likely to be murdered than any other age group of children [xxxviii] . In children less than 1-year old, non-accidental injury is the commonest cause of serious head injury, much of it as a result of shaking [xxxix] . Young babies are also more vulnerable from abuse with children under 1 year being about 3 times more likely to be placed on the Child Protection Register than children of any other age. There are many complex reasons
why young babies are shaken: n Lack of support to new parents. There have been growing pressures on health visitors and a reduction in home visits. The lack of funding and emphasis on prevention services within social services is highly significant. n Demands on new parents and in particular the stresses caused by inconsolable crying. Papousek and von Hofacker [xl] stated that chronic stress caused by inconsolable crying and sleep deprivation typically drains parental resources, may cause or deteriorate maternal stresses of postpartum depression, anxiety, or guilt. n Lack of education and understanding about the vulnerability of young babies. Studies such as Jayawant et al [xli] have suggested that the predominance of male shaken babies may be due to stereotypical beliefs by parents that male babies can withstand rougher handling than girls or that cultural expectation is such that boys should cry less than girls. n Smacking babies in the context of a culture where smacking and hitting children is seen as normal and acceptable. One study reported that 75% of parents start smacking before their child's first birthday [xlii] while another found that 52% of one-year-old children were hit weekly or more often by their parents [xliii] . NSPCC feels that the issue of shaken babies is such an important one that it needs urgent Executive attention and in particular the establishment of an ACPC/ Department of Health group to examine this complex problem. The problem of shaken babies has multiple causes and requires a multi-agency solution to tackle it. NSPCC recommends that: n The DHSSPS with ACPCs should establish a multi-agency forum or task group to examine the specific issue of how to protect young babies in Northern Ireland. The DHSSPS should
seek to develop a strategic crosscutting government approach to quantifying,
analysing the causes and preventing babies being shaken in Northern Ireland.
Irrespective of the outcome of the Office of Law Reform Consultation on 'Physical
Punishment in the Home',
[xliv]
measures should be adopted to promote awareness of the dangers
of smacking and shaking babies. n DHSSPS in conjunction with ACPCs should commission training programmes for professionals on identifying shaken baby syndrome. 5.2 Accident and Emergency Procedures Accident and Emergency Departments in hospitals in Northern Ireland are the main way through which injured children enter the hospital system. Research completed for the DHSSPS [xlv] indicated that there were in the region of 55,000 A and E attendances by children under the age of 16 and it is estimated that 30,000 children per annum attended the Royal Belfast Hospital for Sick Children (RBHSC) in the years 1999-2001. The difficulties over diagnosis of child abuse and neglect in a hospital context have been widely documented in the literature [see Benger and McCabe (2002) [xlvi] and Jayawant et al [xlvii] ] and this was one of the reasons why Barnardos and NSPCC, in the Children's Manifesto, [xlviii] called for: 'Regionally agreed guidelines to ensure consistent procedures in casualty departments to detect non-accidental injuries as soon as they occur. This should include full multi-agency investigations of all cases where babies are shaken' In Northern Ireland we have seen a number of very tragic deaths of children that have involved A and E Departments. Barnardos, the NSPCC and the DHSSPS have recently carried out a survey of child protection practices in A and E Departments based on a survey conducted with lead consultants and nursing sisters. NSPCC recommends: n Comprehensive mandatory training in child protection for medical staff in casualty departments; n Better guidance and protocols on the detection of child abuse and neglect for medical staff, and the use of one regionally agreed set of procedures by A and E staff which should be published by the medical side of the Department in conjunction with ACPCs. 5.3 Use of the Child Protection Register The Child Protection Register forms an important part of child protection. Its main purposes are to [xlix] : n Provide a record of all children in the area who are at risk of harm and who are the subject of an interagency child protection plans. n Ensure that plans are formally reviewed every 6 months. n Provide a central point of enquiry for professional staff worried about a child. n Provide important useful information for the child protection agencies and for the ACPC. The Register and its use raise a number of concerns. Trend data outlined in Section 3 Table 2 has shown a year on year increase in registration rates in Northern Ireland from 1997/98. NSPCC believes that this trend indicates a connection with the under-funding of family and childcare services compared to England. There is considerable disparity in registration rates and other statistics associated with child protection. While some of this is a reflection of operation of local procedures, social economic factors and the exercise of professional judgement, such variations cause concern. It is important to go beyond registrations rates and look at processes operating behind them. Anecdotal evidence through the work being completed on A and E procedures suggests that there is remarkably little use of the register by professionals other than in social services. Indeed, the structure of the Child Protection Register and its location in Northern Ireland is far from clear. Registers, in the main, tend to be held on a consortium Board area basis but this is not universal practice. It would seem that there might be problems associated with: n access to the Registers; n compatibility of information technology systems; n boundary issues where it is unclear in which HSS Board a child may be resident; and n processes to track inquiries from professionals. It must be remembered that the Child Protection Register is not a static tool and involves a process of assessment, deliberation and review in the content of a multi- agency protection plan for children who have been abused or who are at risk of abuse. It sits within the wider context of the case planning process established under each Board's Children (NI) Order 1995 procedures to ensure that children in need and by definition children who have been abused or who are at risk of abuse receive planned services. We do not know how valuable the Child Protection register is because there is no consistent evaluation of the statistics. NSPCC recommends that: n The DHSSPS in conjunction with ACPCs should carry out an audit of the current location, structure, usage and access to the Child Protection Registers and examine the issues that arise. n The DHSSPS with the Board should examine the feasibility of using computer technology and maintaining a central, regional Child Protection Register. 5.4 Criminal Justice Issues Key issues for NSPCC relate to how children are treated in the investigative and prosecution process. Principal concerns relate to the effects of stress on children's testimony and the risk of secondary victimisation through the criminal justice process, particularly when appearing as a witness at court. The provision of the Young Witness Support Services goes some way to reducing stress and preventing secondary victimisation. However, good outcomes for children in terms of experience of the process (irrespective of any verdict) depend on all the key agencies working together (Police, Social Services, DPP, Court Service, Victim Support and NSPCC). This reinforces the 'working together' messages from child protection guidance and inquiries. The criminal justice agencies have a poor record of sharing information, which contributes to delay and the inability to provide a coherent statistical picture across the criminal justice system. The proposed Department of Justice may help in this regard. NSPCC welcomes the Causeway Programme. This initiative is a joint enterprise by the criminal justice organisations in Northern Ireland (Criminal Justice Directorate of the Northern Ireland Office, Department of the Director of Public Prosecutions for Northern Ireland, Police Service of Northern Ireland, Northern Ireland Court Service Probation Service for Northern Ireland, Northern Ireland Prison Service and Forensic Service Northern Ireland) which aims to improve their performance by sharing information electronically. The work of the programme will be firstly, to design new business processes based on the electronic sharing of information and secondly, to build business applications and a common data store, that will support these processes. The key factors for initiating this programme are the need to reduce delay in processing criminal cases, the Review of the Criminal Justice System in Northern Ireland, Modernising Government and the need to improve efficiency. Systems should be put in place to count accurately the number of children (under 18 years) appearing as witnesses in all courts in NI (Crown, Magistrates', Youth, Coroners' and Court-Martial). Statistical analysis should indicate age, gender, special needs, length of time to process case, whether the child is the injured party or appearing for the prosecution or the defence, the nature of the offences, any special measures used, the outcome of the case and if a plea of guilt was entered and at what stage this took place. The NIO needs to demonstrate greater urgency in implementing special measures provisions under the Criminal Evidence (NI) Order 1999. The NIO's position has been to follow implementation of the same measures under the Youth Justice and Criminal Evidence Act in England and Wales. From the 24 July 2002 the use of screens, TV links, giving evidence in private, the removal of wigs and gowns, and the use of video recorded interviews as evidence-in-chief will be available to all young witnesses in cases involving offences against children in Crown, Magistrates' and Youth Courts in England and Wales. There is no reason why the NIO could not act with similar speed to confirm these special measures provisions in Northern Ireland. The opportunity to pilot the other special measures in Northern Ireland has been missed (video-recorded cross-examination, communication through intermediaries and the use of special communication aids or techniques) given that we are a small, self-contained and separate jurisdiction, which is generally better equipped. Less than a quarter of the children referred to the Young Witness Service made a video-recorded interview despite the fact that three-quarters of the young witnesses referred were the injured parties in cases involving a sexual assault. We hope that recent training initiatives between the PSNI and the Boards will result in greater numbers of video interviews being produced. There is still a significant delay in the system. This was highlighted by young witnesses and their parents at a NSPCC/Childline seminar in February 2002 as part of the Justice for Children Campaign. It appears that delay is worse in Northern Ireland than in the rest of the UK. The NSPCC strongly supports the introduction of plea and direction hearings to better manage court business along with pre-trial checklists for cases involving young witnesses. There is a need for the judiciary to manage court business more robustly and for the defence to be more accountable for delay. The language used in courts and the manner in which children are questioned presents an enormous barrier to obtaining clear and coherent testimony from children. This is often the aspect that children report as being as abusive as the offence. There is a need for training and accreditation for all judges and lawyers involved in such cases. The better practice in meeting the needs of young defendants' needs to be similarly available to young witnesses. There is a serious lack of post-abuse therapeutic services for children. Children should have the opportunity to receive pre-trial therapeutic services in accordance with established guidelines. Our experience in Northern Ireland is that, where there is not an ongoing child protection concern, social services usually closes the case, with the result that there is no a referral to a therapeutic service. It is clear from the evidence to the Children's Seminar that young witnesses and their families are very unhappy with this. NSPCC recommends that: n The voluntary sector should be represented on the Criminal Justice Issues Group. n Systems should be put in place to provide accurate data on children giving evidence in all Courts in Northern Ireland. n NIO should move to follow the Home Office in implementing new special measures under the Criminal Evidence (NI) Order 1999. n Plea and directions should be introduced. n Training and accreditation should be introduced for judges and lawyers in cases involving offences against children where there are young witnesses. n There should be increased availability of post-abuse therapeutic services. n DHSSPS should review the role of social services in cases involving young Witnesses. 5.5 Child Protection and the media The media plays an extremely important role in the reporting of child abuse and in raising public awareness of the many complex issues relating to child protection. Sections of the media have helped to create a positive climate in which victims of child abuse are able to disclose their abuse and seek help and in doing so assisting with wider public education and debate on abuse. However there are a number of ways in which the reporting of child abuse and neglect is affected by wider issues, and some of these are highlighted in Childhood Matters [l] : In 'Childhood Matters' the National Commission of Inquiry into Prevention of Child Abuse made 6 specific recommendations in relation to the media reporting of child abuse including: n Key professionals within social services and social work departments should be trained in media relations. n A public education campaign should be developed and aimed at awareness of the needs of children in general; including the nature of child abuse and of the appropriate action to take when concerned about a child There are a number of important child protection groups and bodies in Northern Ireland who have regular contact with the media. These include ACPCs, the Northern Ireland Sex Offender Strategic Management Committee [NISOSMC], the PECS Awareness Group and the proposed Child Protection Review Group at DHSSPS. There is a need for more effective co-ordination of media activities in order to set the agenda in terms on child protection. Agencies should recognise and work with the media to get child protection issues across to the public. NSPCC recommends that: n Child Protection organisations should review their media relations and ensure that at both local and regional levels staff are encouraged to work with the media. n A sub-group representing ACPCs and involving membership of the NISOSMC/ PECS Awareness and the Department's Child Protection Review Group should seek to develop a proactive media strategy on child protection in Northern Ireland. 5.5 Recording practices Child protection agencies can very quickly become overloaded with a large volume of information, reports, assessments, correspondence and documentation. It is of the utmost importance that material is comprehensively and systematically recorded and filed: n to enable easier accessibility to historical information to understand patterns and trends; n to ensure evidenced based and informed decision making; n to facilitate retrieval of relevant information; and n to enable efficient transfer of material between Trusts when families or children move home. Case recording takes time and requires skill. There have been important developments which have improved consistency of recording examples, for example referral forms, case management pro-forma, and Joint Protocol forms. However, this does not extend to recording contacts, significant incidents, case file summaries and file structure/layout. There is no consistent regional approach to this issue resulting in differing standards, formats and styles within the Trusts. The NSPCC welcomes the attempts in the SHSSB to standardise recording using an agreed system and commends the regional approach taken by the SSI in relation to the Looked After Children forms. The issue of recording and file structure has been addressed by the SSI in a number of recent inspections in areas related to child protection. Planning to Care [li] which looked at care planning for children in public care stated: 'The structure of case files and filing of information require to be addressed to ensure that information is readily accessible and up-to-date' The inspection report, 'Adopting Best Case an Inspection of Statutory Adoption Services' [lii] highlighted the significant variation in the standard of children's case files. The inspectors pointed out that file structure and contents needed to be easily accessible and made a number of suggestions relating to the use of fronting sheets, indexing systems and file layout. NSPCC uses a standardised procedure for content and structure of case files, their administration, retention and eventual disposal. Performance Indicators set out national and minimum standards of recording, lists documentation to be used by staff and explains expectations of how this should be completed. Experience from our staff, internal audits and the National Inspection Unit has confirmed the benefits of this system in maintaining standards of recording. NSPCC fully appreciates the demands on statutory sector staff in terms of many aspects of their practice. NSPCC recommends that: n The Social Services Inspectorate in conjunction with the four Boards and the Trusts, should consider the introduction of regionally agreed standards for recording and the layout and structure of files. 6. Conclusion Children have the right to be protected from abuse and the state has a responsibility to take measures to protect them and promote their welfare. There are significant problems in the child protection system in Northern Ireland. The devolved government must now grasp the opportunity to address them. The NSPCC recommends that: n The strengthening of the CPRG in NI to create a stronger regional focus for issues relating to the safeguarding of children. n Good baseline data is established on child abuse and child protection and adequate statistical information is gathered to inform our understanding of what is working effectively. n Comprehensive investment by government and a clear strategy to prioritise children's protection and welfare. n The creation of new multi-agency Child Safeguarding Teams to ensure child protection professionals work together more effectively. n The need for stronger, statutory ACPCs to oversee child protection and establish mechanisms to improve the understanding of the lessons from Case Management Reviews. n The establishment of independent, muti-disciplinary Child Death Review Teams to provide consistent, regular and thorough analysis of the deaths of children aged between 0-17 years (inclusive). n Services which encourage children to seek help and give them 'someone to turn to'. n Improved North-South child protection co-operation and policy development. n Skilled experienced workforce supported through effective training. There are challenging priorities ahead but with commitment from the Executive, the Department and partnership from the statutory and voluntary sectors, we can map out a clear vision for ending the abuse of children in Northern Ireland. Appendix 1 Terms
of Reference of the Assembly Health Social Services and Public Safety Inquiry
into Child Protection Services in Northern Ireland The Committee for Health, Social Services and Public Safety has agreed: "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: n Role and responsibilities of the Department of Health, Social Services and Public Safety, other relevant Departments, and statutory and voluntary agencies, including area child protection committees and child protection panels. n Role of the Commissioner for Children. n Role and use of the child protection register. n Legislative context within which child protection services operate. n Resources available for those services. n Current guidance. In addressing the terms of reference the Inquiry will examine the effectiveness of current arrangements and the extent to which those arrangements ensure compliance with statutory requirements and meet the needs of corporate governance. Particular regard will be paid to: n Case recording, professional judgement, and the assessment and analysis of information. n Communication and liaison between involved parties eg social worker, health visitor, GP and police) and between agencies. n Linkages with children, parents/carers and local communities and their access to information. n Workforce issues, with reference to training, supervision and pressures on staff. n Lessons learnt from relevant previous case management reviews/inquiries/ reports into child protection. The Inquiry will consider the quality of and resources allocated to child protection services in Northern Ireland with reference to the provision of similar services in Great Britain and other selected countries. The Committee will report to the Minister of Health, Social Services and Public Safety and the Northern Ireland Assembly on the Inquiry's findings and conclusions, and make recommendations for improvements as necessary. WRITTEN SUBMISSION BY: 9 August 2002 Parents Advice Centre
welcomes the opportunity to comment to the Committee for Health, Social Services
and Public Safety. PAC provides a service for
parents with any type of family difficulty. The service is operated by trained
volunteers and over the past 23 years has expanded in response to demand,
and now has branches in the 4 Health and Social Services Board areas. In addition,
PAC runs The Men's Project, The Parenting Forum NI, Parents' Reference Groups
and Parenting Education Courses. In the course of
the work PAC would be involved in child protection cases. In some instances
the organisation would be the first to bring Social Services attention to child
protection issues. In other cases PAC would support a family where Social Services
are already involved. Our experience has
brought the following points to our attention which I hope may be useful. Clearly the nature
of child protection requires communication to be effective between all those
involved. PAC feels it would be in the interests of the child if there were
established linkages between recognised agencies. Presently, working boundaries
seem to be limited to statutory agencies. If PAC is excluded
from having meaningful dialogues about individual cases with Social Services
this may impact on Social Services' approach to the child protection issue.
PAC fully acknowledges that there may be some reluctance on the part of statutory
agencies to share information for reasons of confidentiality. However, gaps
in information where there is a child protection issue leaves PAC less well
equipped to provide appropriate support for the family, which compliments that
of statutory agencies. PAC is of the opinion that more clearly defined lines
of communication would be in the best interests of the child and to the benefit
of the family. PAC would like to see greater
emphasis given to situations where children are exposed to emotional abuse
or neglect. We are all aware that this type of abuse is less easy to
identify though that fact should not diminish our efforts to keep it on everyone's
agenda and regarding it as potentially harmful as other types of abuse. Parents'
attitudes and beliefs about discipline, punishment and lack of knowledge about
child development are often major contributory factors. Parenting courses
are an important means of enlightenment for parents which have very positive
outcomes. PAC experience leads
us to believe that assumptions are made about the social background of families
with the belief that the materially "better off" are less prone to abuse/neglect.
While recognising the additional pressures on families living in poverty or
facing disadvantages PAC is of the view that attitudes which support this assumption
should be revisited as child protection issues can, and do occur in any family. Sometimes cases which
we have regarded as being urgent have not had what we consider an urgent response
from Social Services. PAC has had cases where there have been days before any
contact is made with the family and we have had to ring Social Services to
try to ascertain what is happening. PAC fully realises that we can only go
on the facts as presented to us by the caller but we feel we are well experienced
in identifying cases which need further investigation and we would not make
a referral lightly. However, the speed of response by Social Services does
not seem to us to be commensurate with the apparent gravity of the case. Inevitably,
this brings into question the length of time a potential child protection case
is left uninvestigated. Furthermore, we may have spent some time trying to
get parents to agree to a referral and give us their identity and location
(we offer to talk to parents anonymously if they prefer). When there is undue
delay the parent can change their attitude about the referral and feel less
confident about Social Services. PAC appreciates that
Social Services need to prioritise their workload. Nevertheless, unless there
are adequate resources to respond to potential child protection cases we run
the risk of children being left in harmful situations unnecessarily. PAC would like to see training
on child protection being truly multidisciplinary and not only opened across
disciplines for special or occasional events. This would then reflect the reality
that child protection and the aspiration to identify it swiftly, is
everyone's business. We would then become more familiar with each other's codes
of practice, remit and standards. There is a real need to have much fuller
understanding of how agencies work so that when it comes to child protection
we can all have a shared confidence between relevant organisations. The importance of
early identification and intervention in a non-stigmatising way is central
to the whole area of prevention. Child protection tends to be seen as children
"at risk" or "at potential risk". The range of family
support services play a pivotal role in prevention. Currently, the provision
is limited and underfunded, in spite of research and policy advocating further
implementation. In NI we have many
highly regarded family support services which continue to struggle annually
to sustain their financial
viability. This prohibits longer term planning, creates uncertainty, and most
importantly impacts on families. PAC would like to
see full recognition given, backed by strategic planning to ensure that family
support services are universally available to empower parents to meet the needs
of their children more appropriately thus reducing the numbers of children
at risk of significant harm. Until family support
services are widespread and accessible we will continue to need to spend significant
revenue on responding to the result of lack of early identification and intervention.
PIP JAFFA OBE [i] I. Butler and H. Williamson (1994) Children Speak. Children, Trauma and Social Work, London: NSPCC/ Longman.
[ii] R. Fuller, C. Hallett, C. Murray and S. Punch (2000) Young People and Welfare: Negotiating Pathways, End of Award Report to the ESRC/University of Sterling.
[iii] OLR (Opinion Leader Research) (1999) Consultation with Children: Report to the NSPCC, Unpublished Report.
[iv] C. Wattam (1997) 'Is the criminalisation of child harm and injury in the interests of the child?' Children and Society, Vol 11/2: 97-107.
[v] P. Cawson et al., op.cit.
[vi] Physical punishment in the home- thinking about the issues, looking at the evidence Office of Law Reform Department of Finance and Personnel 2001.
[vii] Childhood Matters Report of the National Commission of Inquiry into the Prevention of Child Abuse 1996 The Stationary Office London.
[viii] NSPCC 2000 Child Maltreatment in the UK London. The research was published after a random survey across the UK of 2,869 18-24 year olds which examined in detail their experiences of childhood.
[ix] Key Indicators of Personal Social Services and Related Statistics 2001 DHSSPS.
[x] NSPCC 2000 Monitoring improvements in outcomes for children: Developing Child Well-Being Indicators.
[xi] Priorities for Action 2002/3 DHSSPS
[xii] Investing for Health DHSSPS March 2002
[xiii] Family and Childcare Services in Northern Ireland in 2000 A Four-Board Perspective.
[xiv] In correspondence between DHSSPS and NSPCC Northern Ireland.
[xv] Page 45 Table 4 First Annual Report The Children (NI) Order 1995 Advisory Committee 1998 DHSS and NI Courts Service The Stationary Office Belfast.
[xvi] See Table 4.3 page 55 The Children (NI) Order 1995 Advisory Committee Second Report 2001.
[xvii] DHSS (1991) Child Abuse; A study of Inquiry Reports 1980-1989, London HMSO
[xviii] Department of Health, Department for Education and Employment, Home Office (2000) Framework for the Assessment of Children in Need and Their Families, London: The Stationary Office.
[xix] Modernising Social Services - Promoting independence, Improving protection, Raising standards
[xx] Supporting Families : A consultation document 1998
[xxi] Children First The Northern Ireland Childcare Strategy A Policy Statement DHSSPS, T&EA and DENI 1999
[xxii] Priorities for Action Op. Cit.
[xxiii] Butler, I., Williamson,H. (1994) Children Speak Children, Trauma and Social Work, London NSPCC/Longman
[xxiv] Fuller,R., Hallet,C., Murray,C. and Punch. S.(2000) Young People and Welfare: Negotiating Pathways, End of Award Report to the ESRC/ University of Sterling.
[xxv] Wattam, C. (1999) Confidentiality and the social organisation of telling, in Parton N. and Wattam, C. (eds) Child Sexual abuse. Responding to the Experiences of Children, Chichester: John Wiley and Sons.
[xxvi] Green.R., Katz.I.(1999) Support for Child Witnesses in Hampshire: Final Report, NSPCC Practice Development Unit NSPCC London.
[xxvii] Cawson et al., op. cit.
[xxviii] Working Together to Safeguard Children Department of Health London 1999.
[xxix] Hobbs, C .J., Wynne, J.M. and Gellerlie, R. (1995) 'Leeds Inquiry into Infant Deaths: the importance of abuse and neglect in sudden infant death' Child Abuse Review, 4, pp329-339.
[xxx] Fleming, P. Blair., C. Bacon and Berry, J. (eds) (2000) Sudden unexplained Deaths in Infancy: The Confidential Enquiry for Stillbirths & Deaths in Infancy (CESDI) Sudden Unexplained Deaths in Infancy (SUDI) studies 1993-1996 (London: The Stationary Office).
[xxxi] Out of Sight NSPCC Report on Child Deaths from Abuse Second Edition January 2001 London.
[xxxii] see Appendix (ii) Out of Sight op cit.
[xxxiii] see Page 86 Out of Sight op cit.
[xxxiv] Question 320 ref 10217/02 addressed to the Minister for State at the Department of Health and Children Ms Hanafin by Deputy Nora Owen on 26/03/2002.
[xxxv] Sex Offenders Act Number 18 2001.
[xxxvi] TOPSS (NI) 2000, PSS Training Strategy : A first Class Service 2000 -2003
[xxxvii] Northern Ireland Social Care Council 2002
[xxxviii] Criminal Statistics 1998 for England and Wales The Stationary Office 2000.
[xxxix] Billmire M.E., and Myers, P.A. Serious head injury in infants: accident or abuse? Paediatrics 1985; 75:340-2.
[xl] Papousek, M., von Hofscker, N. Persistent crying in early infancy: a non-trivial condition of risk for the developing mother-infant relationship. ChildCare, Health and Development Vol. 24. No5 1998.
[xli] Jayawant, S., Rawlinson, A., Gibbon, F., Price, J., Schulte, J,. Sharpes, P., Sibert, J.R., and Kemp, A.M. Subdural haemorrhages in infants: population based study BMJ 1998; 317:1558-1561.
[xlii] Smith et al. Parental Control within the Family: The Nature and Extent of Parental Violence to Children. Child Protection Messages from Research. DoH. 1995.
[xliii] Nobes, G. and Smith M. Physical Punishment of Children in Two Parent Families. Clinical Child Psychology and Psychiatry, 2:2 April 1997.
[xliv] Physical punishment in the home- thinking about the issues, looking at the evidence Office of Law Reform Department of Finance and Personnel 2001.
[xlv] DHSSPS Accident and Emergency Survey Summary Report Price Waterhouse Coopers 2002.
[xlvi] Benger, J.R. and McCabe, S.E. (2001) Burns and scalds in pre-school children attending accident and emergency departments: accident or abuse? Emerg Med J;18: 172-174.
[xlvii] Jayawant et al. Op Cit.
[xlviii] Our Children their future. A Manifesto of Children in Northern Ireland published by Barnardos, NSPCC [NI] and CPAG May 2001
[xlix] See Southern ACPC procedures Para 9.2.
[l] Childhood Matters op cit.
[li] Planning to Care: An overview report of care planning for children subject to statutory intervention in Northern Ireland SSI DHSS 1999.
[lii] Adopting Best Care Inspection of Statutory Adoption Services in Northern Ireland Social Service Inspectorate DHSSPS May 2002.
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