One of the heatbreaking picture of baby P shortly before he died.

I am off work today- a return of an old problem with cluster headaches. Dreadful things- a conveyor belt of Migraines. I think I am over it, and then the vision goes, the sickness and nausea kick in, and the head starts to split…

In between, I am functioning, but not very well.

Almost by way of penance, I have been catching up with some information about the dreadful story of baby P, whose tragic death at the hands of his mother and mother’ boyfriend has been all over the news these past couple of weeks.

I am a social worker, and once again I find that my whole profession appears to be on trial by media and politicians.

There seems no doubt that something went badly wrong with the plan to support and protect this little boy. His body bore the marks and scars of a dreadful litany of injuries. Faced with this information, it seems so simple- he should have been rescued much earlier- at one of the many point of contact. Here is a list of contacts with services;

78 contacts with health workers, doctors, social workers and police
2 health visitors
3 doctors
1 mental health worker
1 policewoman
4 social workers
1 family friend;
1 childminder
10 hospital visits (to at least 3 hospitals)
4 visits to clinic
5 parenting classes (the last two weeks before his death)
Seen by GP 14 times
Seen by health visitor 7 times
Mother seen by mental health worker 4 times

(figures taken from Times online- see detailed breakdown of these visits- here.)

The fact is, society needs someone to blame. Despite all the different agencies involved- and despite the fact that all child protection decisions in England are taken by multi-disciplinary conferences, the finger of blame has fallen on social workers. All the other contacts listed above count for little…

Large numbers of us, in the face of this shock, have mutated into mere gobs on legs, iterating and reiterating the last plausible prejudice that sat on us. A terrible thing has happened, it’s all down to X (fill in the prejudice) and someone’s head should bump bloodily down the steps of the Temple of the Sun, to save us from the wrath of the gods.

(David Aaronovitch column, also in the Times- check out the full thing here.)

This is the second tragic death in the Haringey area of London to make news. The last one sparked a public inquiry (Victoria Climbie- details here.) The shocking failings of services in that case reverberated around the social care world. An inexperienced social worker who appeared to be totally out of her depth was hounded by the press in this case.

I have been a social worker since 1990. Like many of my colleagues, I chose social work as a career because I wanted to make a difference. I wanted to work for something that mattered- and as far as I understood what my faith called me to, what mattered most were those at the broken edges of society- those who are in the most need.

For most of my career I have worked with adults who have mental health problems, but in this capacity have worked with many many family situations where kids were at risk. The simple truth is that outcomes (measured in terms of self esteem, education and vocational acheivement, and later experience of life problems/mental illness) for kids who grow up in troubled situations is not good. Add mental illness, and parental addiction to substances into this mix, and damage is likely to be more severe.

However, if you REMOVE kids from home in the UK and place them in foster care or in group living environments, then outcomes are even worse.

I worked in a childrens home for a while back in 1989, and it nearly broke me. It was a violent, oppressive place, with a high octane mixture of very damaged kids ranging from 7 years old to 17. All of these kids were there because foster placements were either impossible to find, or had broken down because of the extremes of behaviour exhibited by the kids. Thankfully this place has now closed, but the issue of how best to support the most vulnerable kids within our society remains the same.

Most social work departments use a sliding scale of interventions, based on a multidisciplinary assessment. So typically, things will start with a discussion between health, education and social workers, and a plan might involve extra childcare, or home support for parents. Child psychology or family therapy is extremely difficult to access, and often the system is forced to focus on kids in the most need, and to offer supervision, but few solutions. The removal of children from home is always seen as a very last resort.

These are complex issues, that depend on highly complex systems, riddled with bureaucracy and regulation. After each scandal, we kid ourselves that there is a regulatory solution- a way of organising the risk of a further failure away. Whatever the failings in this current case, the simple truth is that kids will continue to be born to dysfunctional and damaged parents, and attempts to protect and support these kids will sometimes succeed, and sometimes fail.

Sometimes they will fail badly, and the results will be tragic.

There are so many variables- team dynamics (within departments and across disciplines), available resources, work loads, culture of the organisations, etc.

Here are some very perceptive comments made by Rob Williams in The Inependent;

Our process presumes that it is normally better for a child to stay with the family, even in a household which falls far below the ideal, and social workers who go to their managers with a recommendation to commence care proceedings know that they will have to put up a very strong case.

When you consider the outcomes of the 60,000 looked-after children in our care, this is hardly surprising. Almost threequarters of them will leave care with no formal qualifications. Only one per cent will go on to enter any kind of university education. One fifth of looked-after children are homeless two years after leaving care; 25 per cent of our prison population has been through the care system. Things have to be really bad at home before care looks like a better option.

Yet in other countries the picture is very different. In Germany looked-after children do extremely well, with 95 per cent of children in the German care system going on to vocational education. Crime committed by looked-after children in Germany runs at 5 per cent of the rate of crime committed by those in our care.

Money is important. In Germany most looked-after children live in small community homes, with fewer than 16 residents. By contrast, more than two-thirds of our looked-after children are placed in foster families which cost less than a quarter of a residential placement in Germany.

Money also hangs in the air at case management meetings, and sets up serious conflicts of interest. It is the local authority managers who decide whether to go for care proceedings. They are also the people who will have to find the money to pay for care.

When budgets are tight, the best interests of the child are not always aligned with the best interests of the local authority. In fact the two can often be contradictory. And in those crucial meetings the social worker, the main advocate for the child’s welfare, is often the most junior person in the room.

As a society we need to look again at our priorities. Unsurprisingly, the current social work witch hunt following baby P’s death has already seen a rise in the numbers of kids being removed form parents. Practitioners will almost certainly take less collective risks. Given the pressures on the systems looking after kids in care, this may well be unsustainable.

Is this what we want?

I think the focus on BLAME masks a societal failure to put the needs of kids first. But given the current financial crisis, I fear that finding a scapegoat or two will be the preferred option…

As for me, I will say a prayer for this baby, and his parents. And for the imperfect workers (like me) who work in an imperfect system, and hope that we can make things better.