Archived Transcript for 12 April 2002: Pages 1 to 50


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1 Friday, 12th April 2002

2 (10.00 am)

3 THE CHAIRMAN: Good morning ladies and gentlemen, my name is

4 Herbert Laming. I am very pleased indeed to welcome you

5 to this seminar. Apologies to those who have their

6 backs to me. It will not last very long, so it will not

7 be a problem. I wanted to begin by formally welcoming

8 you all to this third seminar in our series of seminars

9 which constitute Phase II of the Victoria Climbie

10 Inquiry.

11 You recall that our terms of reference, and you all

12 have those in your pack, include, and here I quote, that

13 the Inquiry is to reach conclusions as to the

14 circumstances leading to Victoria Climbie's death and to

15 make recommendations to the Secretary of State for

16 Health and to the Secretary of State for the Home

17 Department as to how such an event may as far as

18 possible be avoided in the future. It is that latter

19 section about how such events can as far as possible be

20 avoided in the future that this series of seminars is

21 designed to address.

22 I and my colleagues are extremely grateful to you

23 for the interest that you have shown in this part of our

24 work and in particular the thought that you have already

25 given to the papers that you have sent us and which

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1 issues are to be discussed today. We have no doubt that

2 the Inquiry will be much better informed by the

3 contributions which you are to make.

4 I am most grateful to Counsel to the Inquiry who is

5 Mr Neil Garnham who is sitting on my left in the middle,

6 Neil Garnham QC, for his willingness to chair each of

7 these seminars.

8 Before I hand over to Mr Garnham, I would like to

9 introduce formally my four colleagues who are sitting

10 with me to observe the seminar. They are on my

11 immediate right Dr Adjaye, who is a Consultant

12 Paediatrician with a special interest in community child

13 health, currently working for the Maidstone and

14 Tunbridge Wells NHS Trust. On Dr Adjaye's right is

15 Mr Fox who is a Detective Superintendent with the

16 Hampshire Constabulary, who has played a significant

17 part in not only investigating child protection matters

18 but in working in both the Home Office and with the

19 Department of Health on matters relating to the care and

20 protection of children.

21 On my left is Mrs Kinnair, who is a qualified nurse

22 and health visitor, and more recently a Senior Nurse

23 Manager for the Lambeth, Southwark and Lewisham Health

24 Authorities' Children Services. She has considerable

25 practical and managerial experience in the child

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1 protection services. On her left is Mr Richardson, the

2 Assistant Director, Children and Family Services, for

3 the North Lincolnshire Council and Vice Chairman of the

4 local Area Protection Committee. Like all of my

5 colleagues they have all played a major part, not only

6 in the local services but on the national scene, and

7 I have to say that having worked with them in what now

8 seems to be a rather long time, I could not be blessed

9 with a better team of colleagues, both because of their

10 skills and knowledge but also because of their support.

11 Inevitably an inquiry of this kind attracts a wide

12 range of responses, all no doubt very important of

13 themselves, but not all relevant to our terms of

14 reference. For reasons that you will fully understand,

15 we have to keep constantly before us the terms of

16 reference that we have been given and issues which are

17 beyond the scope of the Inquiry, however important they

18 may be, cannot be considered.

19 As I said on 16th January, I will be identifying the

20 contributions which we have received which seem to me to

21 be both relevant and of value to the Inquiry. Those

22 contributions which I determine are relevant and of

23 value to the Inquiry will be treated as evidence to the

24 Inquiry and published on the Inquiry's website. Others

25 will not be regarded as evidence to the Inquiry.

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1 I should add now that I and my colleagues very much

2 look forward to joining you during the breaks and at

3 lunchtime but I must make it clear that evidence to the

4 Inquiry must be in public and properly recorded in

5 public, so it is better that we do not discuss with you

6 any matters which you wish to put before the Inquiry or

7 which would be subject to the debate during the seminars

8 whilst we are having the informal breaks.

9 That said, it is clear that this series of seminars

10 is of great importance to the work of the Inquiry.

11 Neither I nor my colleagues that are sitting with me

12 will comment as the seminar progresses. However,

13 towards the end of the afternoon some time will be set

14 aside so that any one of us will be free to ask

15 questions of clarification.

16 In the light of experience I would be very grateful

17 if everybody in the room would now make sure that their

18 mobile telephones, pagers and any other forms of

19 communication that they might be carrying with them are

20 switched off. It is incredibly distracting when someone

21 is trying to make a point to hear some piece of music.

22 I was hesitating about mentioning the music. However,

23 you know what I mean.

24 So, ladies and gentlemen, I think that we can now

25 progress and I will hand over to Mr Garnham who is going

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1 to chair the seminar.

2 MR GARNHAM: Thank you Chairman. Can I add my welcome to

3 Lord Laming's. All of us involved in this Inquiry are

4 enormously grateful to the many busy and distinguished

5 people who have given up their time to be here today.

6 Thank you very much for coming.

7 Can I too begin with some introductions. I am

8 Neil Garnham, I am Counsel to this Inquiry. To my left

9 is Neil Sheldon who has worked as Junior Counsel to the

10 Inquiry. To my right sit Dr Valerie Brass and

11 Dr Susan Shepherd who have been advising the Inquiry on

12 social care and health matters respectively. To my far

13 left is Mandy Jacklin the Inquiry Secretary and to my

14 far right sits our stenographer who will be keeping

15 a record of what you will say during the course of the

16 day.

17 First, a few housekeeping points. We will break for

18 coffee at about 11.15 and lunch at about one o'clock.

19 Both will be served in the room where coffee was served

20 when you arrived. There is a gents lavatory next to the

21 lift on this floor and a ladies on the floor below. We

22 will aim to finish the seminar by about four o'clock pm

23 so that we aim to get through the programme of

24 discussion by about then.

25 Unfortunately, two of the delegates who we hoped to

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1 have here today are unable to be with us. Yoni Ejo and

2 David Jones have both indicated very late on that they

3 were unable to be present and we have one, Mr Bowman,

4 who is likely to be somewhat late.

5 I wonder if I can begin by going around the table

6 and asking each of you to introduce yourselves. We have

7 circulated brief biographical notes in the packs which

8 you have all received but perhaps you could tell us the

9 name by which you would like to be called during the

10 course of the seminar and something of the nature of

11 your work.

12 MR EVANS: My name is Dave Evans. Currently employed as

13 a child protection coordinator in Swindon Borough

14 Council. My job means I chair child protection

15 conferences. I act as a consultant in child protection

16 issues to all agencies within Swindon, and I have

17 significant input into training with child protection

18 issues.

19 MR WEBSTER: I am David Webster, current Principal

20 Educational Psychologist and Head of Special Educational

21 Needs for Lancashire County Council and Vice President

22 of the Association of Educational Psychologists.

23 MR BEGLEY: Peter Begley, an IT consultant, particularly

24 interested in developing the art of the possible for the

25 social care department and health and I particularly

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1 work on the health and social care interface.

2 MR BUTLER: Chris Butler, Acting Chief Executive of the

3 South West London and St George's Mental Health Trust.

4 I am the Trust's Chief Nurse, and within the Trust I am

5 the Executive Lead on child and adolescent mental health

6 services.

7 MR JONES: Richard Jones, I am a qualified social worker

8 with 18 years' experience working in local authority

9 social services departments. For the last year I have

10 now worked for the Department of Health and Social

11 Services Inspectorate, managing the SSI in the north

12 west, whose function is to inspect performance, assess

13 and contribute to the overall performance improvement of

14 local authority social services departments.

15 MS HELD: I am Jane Held, Director of Social Services at the

16 London Borough of Camden, also the Co-Chair of the

17 Association of Directors of Social Services Children and

18 Families Committee. My background is 24 years in social

19 work, primarily in Children's Services and I worked in

20 children's homes for the first 14 years.

21 MR DAVIES: I am Owen Davies from the public sector union

22 Unison. I qualified as a social worker in 1972 and

23 worked for six years in social work but for the last

24 20-something years I have been working in various jobs

25 within the trade unions, but for the last two and a half

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1 years I have been Unison's lead officer on social

2 services matters.

3 PROFESSOR TUNSTILL: I am Jane Tunstill, I have the chair of

4 social work at Royal Holloway London University, which

5 means that my job is a mix of doing childcare research

6 for a variety of commissioners and running qualifying

7 and post qualifying social work courses.

8 MS DAVIES: I am Rhian Davies, Assistant Commissioner for

9 children for Wales. My responsibility is in relation to

10 policy analysis and review of all regulated services

11 provided to children and young people within Wales.

12 MR ANDERSON: I am Bill Anderson, Assistant Director with

13 Kent Social Services. I manage the eastern part of

14 Kent. I am qualified as a social worker and I have

15 probably spent about 12 years specialising in childcare.

16 MS HENDRY: My name is Enid Hendry, Head of Child Protection

17 Training for the NSPCC. I am also here as one of the

18 founder members of PIAT which is a partnership promoting

19 interagency training, and I am also independent chair of

20 two ACPCs and my background is in social work.

21 PROFESSOR THORPE: I am David Thorpe, Professor of Applied

22 Social Science at Lancaster University. I chair the

23 Lakes and West Pennines post-qualifying social work

24 consortium as well as the Lancaster Diploma in Social

25 Work Program. My research interests are in social work

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1 practice. Some years ago I directed the international

2 study of outcomes in child protection in Australia.

3 Subsequently I have undertaken research in child

4 protection as part of a European Union group as well as

5 15 local authorities.

6 My major interest is in the application of systems

7 theory to social work practices.

8 THE CHAIRMAN: Can I ask people to aim a little closer to

9 the microphone. We are just about picking up what

10 people say.

11 MS ATKINSON: I am Issy Atkinson, Senior Practitioner with

12 Peterborough City Council Education and Children's

13 Department, in the Intake and Assessment Team.

14 PROFESSOR LYNCH: Margaret Lynch, Professor of Community

15 Paediatrics at Guy's, King's and St Thomas' Medical

16 School. I have worked as a community paediatrician in

17 South East London since 1979. I actually saw my first

18 cases of child abuse in Newcastle upon Tyne 35 years ago

19 and have been working with the topic ever since. I have

20 been very involved with child protection both in this

21 country and internationally. I recently chaired the

22 Royal College of Paediatrics Committee on child

23 protection.

24 MR HAMPSON: Peter Hampson, Chief Constable of West Mercia

25 Constabulary, which means I have responsibility for all

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1 aspects of policing in the counties of Herefordshire,

2 Shropshire, Worcester, Telford and Rekin. I am also the

3 Chair of the ACPO, Association of Chief Police Officers

4 Group, and it was called the crime committee, it is now

5 known as the crime business area, which includes some

6 aspects of child protection as well and child issues.

7 I also a little over three years ago led a team which

8 prepared the HMIC thematic inspection on child

9 protection.

10 MR GARNHAM: Mr Bowman has timed his arrival to perfection.

11 Good morning.

12 MR BOWMAN: Good morning. I am Alan Bowman, Director of

13 Social Care and Health with Brighton and Hove City

14 Council and have been Chair of the Area Child Protection

15 Committee there for the last four years.

16 My main interest in coming here today relates to

17 work I carried out in Fife region in Scotland with the

18 development of joint police social services

19 investigation teams, and that is the basis of the paper

20 I have submitted.

21 DR COOKEY: Nnenna Cookey, Consultant Paediatrician. I have

22 over 20 years' experience in paediatrics and child

23 health, employed by North Durham Trust. I am

24 a designated doctor to North Durham ACPC and the named

25 doctor for my Trust for child protection. I am involved

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1 not just in the assessment of children who may have been

2 abused, but in training also colleagues in Health,

3 Social Services and police. In addition I am a forensic

4 medical examiner for children.

5 MR BASKER: I am Dave Basker, Principal Child Care Manager,

6 North Lincolnshire Council. I have overall

7 responsibility for fieldwork services, which includes

8 the whole assessment and planning for children in need.

9 I have 18 years' experience as a social worker, as child

10 protection coordinator and a senior manager.

11 MR RUNDLE: My name is Mike Rundle, Director of Social

12 Services for Wandsworth Council in south London. I have

13 been Director there for 13 years and throughout that

14 13 years I have chaired the Area Child Protection

15 Committee. My background is not in social work but

16 I have spent most of my career since the 1971 reforms in

17 social services departments in one form or another,

18 interspersed with other local authority services and one

19 short spell with the police.

20 MS RYAN: My name is Hilary Ryan. I am the Team Manager,

21 Assessment Team Childcare, Wellingborough East, North

22 Hants. I manage and supervise a team of assessment

23 intake workers, and I have been a social worker since

24 1984.

25 MR SPICER: My name is David Spicer. I am a member of the

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1 Bar. I am a past Chair and Honorary Secretary of

2 BASPCAN, British Association for the Study and

3 Prevention of Child Abuse and Neglect, and my day job is

4 Assistant Head of Legal Services at Nottinghamshire

5 County Council, where I manage legal staff concerned

6 with the public law applications on behalf of the local

7 authority. I have been a legal adviser to area review

8 committees and area child protection committees for

9 approximately 27 years and I have been concerned with

10 inquiries following the deaths of children in relation

11 to approximately 70 children.

12 MR BANKS: My name is Richard Banks. I work for TOPSS

13 England, the national training organisation for social

14 care, which is an organisation responsible for the

15 education and training strategy for the sector; the

16 sector which incidentally is one and a quarter million

17 people in England. That is an employment led

18 organisation, not a Government agency. My particular

19 job is I am responsible for the overall development of

20 national occupational standards and the qualification

21 framework based on those standards. My particular

22 interest here today I think is around the integration of

23 service management and performance with the competence

24 of the workforce. I started in social work in 1971 in

25 a children's home when I was 19.

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1 MR MARLOW: I am Kerry Marlow, a Detective Inspector from

2 South Wales Police. I have been in charge of child

3 protection for the east side of South Wales Police since

4 1999. I have been a training officer in charge of child

5 protection since 1989 and for the last six years I have

6 researched the investigation of child abuse. I sit on

7 four ACPCs and the South Wales Child Protection Forum.

8 I am a member of the writing group for the All Wales

9 Child Protection Procedures and I am currently

10 researching other areas of child protection,

11 particularly information sharing.

12 MR GARNHAM: Thank you very much, you are all will most

13 welcome. Before we begin I want to say a little about

14 the purpose of these seminars and the way that we

15 propose that they will operate. First the purpose. It

16 became apparent from an early reading of the documents

17 generated by Victoria's case that Lord Laming was likely

18 to have to consider making recommendations of two rather

19 different types. The first type would be addressed to

20 the particular circumstances of Victoria's case and to

21 the events that had occurred in Ealing, Brent and

22 Haringey whilst Victoria lived there. Many of these

23 would be directed at particular organisations, the

24 police, social services and health bodies who had been

25 involved with Victoria. But we also recognise that

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1 there might need to be recommendations of rather wider

2 potential impact, recommendations that might affect the

3 relevant agencies right across the country.

4 Lord Laming is not charged with conducting a review

5 of the entire child protection system in this country

6 but his brief is to make recommendations as he said this

7 morning as to how a tragedy such as Victoria's might as

8 far as possible be avoided in the future. That

9 direction recognises the impossibility of guaranteeing

10 that there will never be another Victoria but it plainly

11 requires us to consider the need for change beyond the

12 borders of the London borough where she happened to

13 live. That might well involve changes to

14 well-established practices, perhaps changes in the

15 advice that Government departments give to local

16 authorities, perhaps changes in legislation.

17 Inevitably some of these recommendations are likely

18 to be to the effect that certain new steps should be

19 considered, rather than the immediate changes be put

20 into effect, but it can be dangerous, even in those

21 circumstances, to proceed from the particular to the

22 general. In the course of Phase I of this Inquiry we

23 have become familiar with practice and procedures in

24 certain parts of London but it would be an obvious

25 mistake to assume that the same practices and procedures

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1 are necessarily followed elsewhere in the country.

2 Phase II of this Inquiry, therefore, has been

3 designed as a vehicle for exploring those wider concerns

4 and for generating and testing amongst a wider

5 constituency ideas that might serve to improve child

6 protection arrangements in this country generally.

7 As Lord Laming has explained, there are two elements

8 to Phase II, two means of trying to understand where

9 change is necessary in child protection practice. The

10 first is by inviting written submissions from the public

11 and Lord Laming has explained how we will consider that

12 material. These seminars constitute the second element.

13 Next a word about the way in which this seminar will

14 operate. We are grateful for the written papers that

15 have been produced by the participants in this and all

16 the other seminars and by many others. All of them we

17 have read and inwardly digested. As will readily become

18 apparent, they have served as a prompt for many of the

19 issues on which I am going to invite discussion today.

20 Together with those of the public submissions that are

21 chosen by Lord Laming, they will be treated as evidence

22 to this Inquiry and posted on our website once today's

23 proceedings are over.

24 I will be happy to receive suggestions for further

25 topics for discussion from members of the public who are

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1 present here today although I do not guarantee we will

2 deal with every one of them. There are supplied

3 pro formas somewhere around the room which can be

4 completed by anyone who would like a question

5 considered. If you would place them in the baskets

6 beside the pillar in the middle of the room they will be

7 gathered up by Inquiry staff and given to me.

8 As I have said, what is said during the course of

9 this seminar will be treated as evidence to the Inquiry.

10 The verbatim note prepared by our stenographer will

11 enable Lord Laming and his assessors to reflect further

12 on what you tell us after today's proceedings are over.

13 But that I hope and predict will not inhibit the free

14 exchange of ideas at least once we get going. What we

15 want is your honest views based on your knowledge and

16 experience about how the child protection system in this

17 country might be improved.

18 In order to approach our work systematically we have

19 attempted to break down the processes by which children

20 are protected into their constituent elements. This is

21 the third of five seminars, each one focused on

22 a different stage in the provision of services to

23 children in need. We recognise that these divisions are

24 somewhat artificial and that some of the issues that we

25 will discuss today will have implications relevant to

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1 other seminars.

2 I do not want to inhibit the full and thorough

3 consideration of those matters by sticking too

4 dogmatically to the issues identified in the preliminary

5 discussion paper we circulated in advance of today, but

6 given the limited time at our disposal, I am sure you

7 will forgive me if from time to time I try and bring us

8 back to the central issues that we have to deal with

9 today.

10 Our last seminar, the second of the series,

11 considered the identification of children potentially in

12 need of services. In this seminar we are to look at the

13 assessment of need. That issue gives rise to a series

14 of questions which for convenience we have set out on

15 a single sheet of paper that you will find on your

16 desks.

17 It seems to us that good quality assessment is the

18 foundation for the proper delivery of services. This

19 seminar is aimed at identifying the essential elements

20 of good assessment and considering the mechanism by

21 which that can best be achieved.

22 I would like to begin therefore by trying to

23 identify what the essential elements of good assessment

24 are and what inhibits good assessment. For the present

25 can we consider assessments as a generality and we will

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1 come on to look at the assessment framework a little

2 later.

3 Can I begin with this. Issy Atkinson, are we

4 content, are you content that when a professional sits

5 down to commence an assessment on a child, he or she

6 knows exactly what he is attempting to achieve?

7 MS ATKINSON: I am speaking as a social worker and not

8 a representative of the whole profession. I would think

9 it was vital that anybody undertaking assessment was

10 aware of the purpose of that assessment. However,

11 assessment is ongoing and dynamic, so it is not

12 something tangible we can touch, and it will change and

13 it will depend on what we are assessing at that time.

14 So at the initial stages we are going on the information

15 we have available. That is very likely either in need

16 or in need of protection to change as the information

17 comes in. I would like to say yes, we do know what the

18 purpose of assessment is.

19 MR GARNHAM: What would you say it is?

20 MS ATKINSON: I would say it is looking to ensure that

21 children are going to achieve or are achieving their

22 full potential. So in terms of my practice, I would be

23 looking at better outcomes, if that was appropriate, so

24 what if any intervention is required? If it is, that

25 would feed on to the next level of assessment.

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1 MR GARNHAM: Thank you. Should an assessment, whoever

2 conducts it, be a response to need or a response to

3 risk? David Thorpe, you might have something to say on

4 that.

5 PROFESSOR THORPE: Yes, I think the risks simulacrum in a

6 sense, and by simulacrum I mean a kind of calculation of

7 odds is extremely problematic in children and family

8 social work. For example, a social worker might visit

9 a family in the morning where there is a sober mother

10 and the children may be comfortable, well dressed and so

11 on. Later in the afternoon the mother might be drunk

12 and neglecting the child. So the difficulty is that

13 when you start to used word risk you have to think of

14 real calculable issues.

15 It seems to me they can only exist where there has

16 been a history of harm or injury to a child, deliberate

17 harm or injury or deliberate neglect. The rest, clearly

18 there is a lot of speculation: is this a normal family

19 with a normal mother and so on and so forth. The

20 difficulty is that the whole working together network as

21 well as social workers themselves have had this word

22 risk used constantly in a very loose and free way, so

23 you can pin this on almost any situation.

24 Listening to the recorded telephone calls when we

25 have had permission from callers, talking about not

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1 members of the public, the police officers, health

2 visitors, education and social workers and so on, they

3 seem to press the risk button because they believe that

4 if they use that word there will be some kind of

5 intervention and some action in the situation where

6 there are genuine concerns about children, and at that

7 level, once you use the word risk the social worker will

8 go into a situation and try and make a speculative

9 calculation. In the absence of harm or injury it is

10 actually virtually impossible to do that but this word

11 is used constantly almost as sort of an advertising

12 slogan, the word child abuse itself.

13 MR GARNHAM: I want to discuss later the way in which other

14 agencies present their cases to social services because

15 I am sure you are right that that is important, but at

16 a theoretical level, David Thorpe, would you say that we

17 ought to be aiming at assessing need or assessing risk

18 even if the latter were possible?

19 PROFESSOR THORPE: We ought to be aiming at assessing need

20 and I do not think that is a difficult task to do and

21 I think the national framework is a significant and

22 important start in doing that. I think it does provide

23 a mechanism through which people can stand back and look

24 very carefully at a child's situation and work out what

25 kinds of interventions can be provided to improve the

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1 situation.

2 MR GARNHAM: One of the most interesting parts of my job is

3 finding where everybody is sitting. I have lost

4 Jane Held. Where is she? Yes. Jane Held, what do

5 social services see as the essential qualities of a good

6 assessment?

7 MS HELD: The essential qualities of a good assessment

8 include taking time to actually sit down and understand

9 the case, gathering rigorously evidence from a wide

10 range of people, listening to the child involved and

11 actually using good technology and good understanding as

12 well as good skills in listening with that child and

13 indeed listening to the family and the extended family.

14 The gathering of information in a systematic way, so

15 including things like chronologies, understanding of

16 relationships within the system and all of those

17 matters. Then the application of professional and

18 theoretical and research knowledge to the findings to

19 arrive at a conclusion which can then be tested in

20 discussion with others can be checked against evidence

21 and good practice knowledge and then will lead to

22 a discussion about the right sorts of ways forward.

23 MR GARNHAM: That is extremely helpful, thank you. Reading

24 some of the submissions we have had for the purposes of

25 this seminar, there appears to be something of

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1 a tension, some competing considerations in this sense.

2 On the one hand there seems to be a desire to make

3 assessments relatively simple and straightforward so

4 they can be done quickly by whoever is called upon to do

5 them, and on the other there is said to be the need for

6 the sort of thoroughness, Jane Held, that you have been

7 talking about. One option might be a tick box style

8 assessment. Bill Anderson, why not a tick box form of

9 assessment to make it easier?

10 MR ANDERSON: I think when we talk about assessments there

11 is a danger in social work that we believe that if only

12 we get enough information, somehow all will be revealed,

13 and so often social workers spend a lot of time trying

14 to get as much information rather than understanding the

15 information they have. I think to create a tick box

16 will encourage people to believe that what is

17 significant is the amount of information you have rather

18 than the capacity to analyse it. It is not about how

19 many questions you ask, it is about asking the right

20 questions in the right context at the right time.

21 As David said, you may go to a family one day and

22 ask one question and another day you might ask an

23 entirely different question. One of the problems with

24 becoming so procedurally driven is we believe if we

25 follow procedures we will get it right when what we need

23



1 to do is sharpen our capacity to analyse the information

2 that is already before us. Often we can actually come

3 up with a very good analysis and a very good hypothesis

4 that allows us to actually move forward with very little

5 information. So just having a tick box is not going to

6 make people's critical faculties more acute. It is not

7 going to make people go out and ask the right questions,

8 it will just satisfy procedures.

9 MR GARNHAM: Before I was involved in this Inquiry I had

10 never heard the expression "time for reflection".

11 Lawyers do not tend to waste a lot of time reflecting,

12 probably to their considerable detriment, but in social

13 work it is regarded as important that there is time for

14 reflection, is it not?

15 MR ANDERSON: I would not call it reflection, I would call

16 it analysis really, and I think that when you analyse

17 situations you analyse them as they are happening. One

18 of the purposes of supervision, one of the purposes of

19 teams is to go back and through supervision, through

20 your team to test out your analysis, to test out the

21 assumptions you are making, to actually get somebody

22 with a different perspective: "have you looked at it

23 like that?"

24 So I think reflection sounds quite passive, sitting

25 in a dark corner waiting for some insight. I think

24



1 really what you should be doing is challenging the

2 knowledge you have, challenging the analysis you have

3 and doing that in a very active way. It is not time for

4 reflection, it is time to be challenged on the way you

5 are seeing things.

6 MR GARNHAM: It might be said that that is all very well if

7 a social worker has an abundance of time in which to do

8 that sort of exercise. It might be said that for others

9 who come into contact with children there is seldom

10 going to be that sort of time to carry out that sort of

11 assessment. Professor Lynch, what about a busy

12 community paediatrician, somebody of that sort, what

13 sort of level of assessment might we expect from them?

14 PROFESSOR LYNCH: Are you assuming that they are the first

15 to see a child?

16 MR GARNHAM: Yes, let us take that.

17 PROFESSOR LYNCH: I think they need to be looking to see

18 whether that child has any unmet health needs and

19 I think that would also go for the child that maybe the

20 social worker has concern about, and that we must not

21 forget that many of these children do have unmet health

22 needs because they are in the kind of families that may

23 be have not been able or willing to seek medical help

24 for their child, and that a lot of difference can be

25 made, coming back to the point about outcomes, if one

25



1 actually identifies health problems and developmental

2 problems in the children and suggests ways in which they

3 can be either treated if it is a medical problem or the

4 kind of extra input they want if it is a developmental

5 problem.

6 I think that is one of the functions of a community

7 paediatrician, to be providing that kind of assessment,

8 in partnership with social services, with the families

9 who are already known or identifying the child that

10 comes to them with a medical problem or a developmental

11 problem as having other needs where they need to refer

12 to social services for them to do their part of the

13 assessment. I think with all children we are talking

14 about multidisciplinary assessment and there are

15 important health contributions to that. I think the

16 community paediatrician, the health visitor are in

17 a position to provide a facet of the assessment in

18 cooperation with the social worker.

19 I have greater concerns I think about the general

20 practitioner or the busy consultant paediatrician in the

21 hospital who may only have 10 minutes with the child or

22 20 minutes with the child in an out-patient setting,

23 whether they are going to be able to in that short time

24 do anything more than look at the medical problem in

25 front of them.

26



1 MR GARNHAM: Nnenna Cookey.

2 DR COOKEY: I agree entirely with that. My job involves

3 both acute and community paediatrics, and there is no

4 doubt whatsoever that children in situations as we are

5 describing do need a holistic approach.

6 MR GARNHAM: Does a busy paediatrician consultant or junior

7 doctor have time to do more than address clinical needs?

8 PROFESSOR LYNCH: Yes and no. It depends on the pressure,

9 it depends on the situation. Sometimes when you are

10 extremely busy and you cannot do things you want to do

11 them with such thoroughness -- so it is possible.

12 MR GARNHAM: So what happens?

13 DR COOKEY: Say within the community situation what

14 Margaret Lynch describes is what should happen.

15 Appropriate adequate time should be given to assessing

16 the child's needs, not just medical needs as they are

17 presented to you; the child's development, everything in

18 total, identify these needs, deal with them, pass on for

19 further assessment to other agencies, including child

20 and adolescent mental health services.

21 Within the acute setting it is a bit more difficult,

22 particularly if you are in an on call situation, an

23 emergency on-call situation, where you are dealing with

24 other acute work, and you are presented with a situation

25 where you have to assess a child and maybe at the same

27



1 time an acutely ill child who may be in a position that

2 needs transferring or might die. In that situation you

3 have to take a step back and deal with emergency first

4 and this child who is presented to you may not be "an

5 emergency". In that situation you have not as much time

6 to deal with it and it can be a problem.

7 The same applies in the out-patient situation, where

8 a child is brought to you, you have a clinic load of

9 children waiting to be seen. It is very difficult in

10 that situation to give as comprehensive an assessment as

11 required. Quite often consultants, busy in that

12 situation, will probably deal with the immediate medical

13 needs, I hope, with an intention to deal with the rest

14 later, but it is often very, very difficult.

15 MR GARNHAM: Yes. What about the police? Kerry Marlow, you

16 are a specialist with great experience in child

17 protection work but many officers out there on the beat

18 are not. They might well come across a child wandering

19 around a shopping centre at 11 o'clock when they should

20 be at school. What level of assessment realistically

21 can we expect of them?

22 MR MARLOW: It would be a very limited assessment based on

23 what is presented to them. As they see it there and

24 then, what we teach them to do is if they have

25 a concern, whatever that concern is, to report it to the

28



1 necessary authorities, so it would either be reported to

2 social services or would be reported to our child

3 protection teams and if it was of great concern we would

4 take the child into our care. It does concern me in

5 certain areas where police officers work according to

6 the environment. If they work in a very poor area where

7 generally housing conditions are generally poor and the

8 state of homes are generally poor, the threshold tends

9 to be a bit higher and they perhaps do not consider the

10 concern as much as if they went to a middle class area.

11 MR GARNHAM: Yes. Can we move on to another aspect of

12 assessment in the round. Presumably it is difficult to

13 decide at the time of this sort of initial assessment

14 that we are talking about whether a child is in need of

15 welfare services or in need of some more active form of

16 protection. Is there a danger, do we think, of placing

17 a child too rigidly in one category or another at this

18 early stage? Jane Held, you nod which you will find out

19 soon is a fairly fatal step.

20 MS HELD: I think it is dangerous to get into that sort of

21 rigid categorisation. You need to consider children in

22 the context of their families, their communities and

23 actually take into account a lot of the information

24 around that and see it on the continuum. Different

25 things at different times in children's lives will

29



1 affect them differently. Different situations will

2 affect them differently.

3 I think the initial task of all of us, whichever

4 discipline or profession we come from, is to actually

5 take into account what we see and think about how that

6 will impact on the well-being, the emotional, physical

7 and all other parts of the child's well-being, and then

8 have the kit bag really in our professional training to

9 decide which tools or which routes or which solutions

10 will work in that situation. If you try and put people

11 into boxes there are always gaps between boxes and they

12 fall out.

13 MR GARNHAM: This question of categorisation for the agency

14 generally is quite an important one, is it not? It

15 picks up something I think David Thorpe was saying

16 earlier about the best way to get a response out of

17 social services is to pick the description that pushes

18 the red button fastest.

19 PROFESSOR THORPE: I think you have to understand that the

20 child protection orthodoxy, to use an academic term,

21 which reduces the complexities of the lifeworld to the

22 expressions physical abuse, emotional abuse, sexual

23 abuse, neglect at risk, which are in fact boxes that you

24 tick, actually censors out a huge amount of things about

25 what goes on in families. The difficulty is that within

30



1 that school of thought, within much of the literature,

2 first of all it deals primarily with children who are

3 significantly harmed, we are talking about those

4 children who show up in accident and emergency

5 departments, those children tragically who are killed,

6 and yet the bulk of what is referred in fact is not

7 around children who are harmed or injured but children

8 about whom there are "concerns".

9 The difficulty is that once you have been trained in

10 the narrow aspect of what we might call abuse, the tick

11 box way of classifying or categorising the life world,

12 it becomes a much easier way of proceeding and that is

13 mercifully to a certain extent undermined by the needs

14 assessment framework, but primarily in observing,

15 particularly videotaping referral-taking in offices,

16 what social workers do is move straight to the kind of

17 defensive, cautious view of their work and say our job

18 is really to look for evidence of abuse. In other

19 words, they look for harm or injury or actions which

20 could cause it, and afterwards they will sit back and

21 think maybe there are other factors here to do with

22 single parenthood, poor housing, educational

23 retardation, usually very, very stressed mothers.

24 Half of what is coming into the system are single

25 female parents who do not harm or injure their children,

31



1 and secondly, roughly two-thirds of those referred

2 matters are already known to the agency, a third of them

3 are current open cases to a social worker, a third are

4 previous investigation or assessment. So these cases

5 are being recycled all the time anyway.

6 It seems to me that in a sense it is helpful, you

7 have to actually say if we have some form of

8 categorisation fairly early on it will help reduce

9 uncertainty about why you are actually there, and the

10 difficulty is that if you kind of speak of continuum and

11 referring to what you said is that the whole thing gets

12 modelled and confused, and I think that you stop looking

13 for evidence, you might do something else, you actually

14 begin to lay child protection on top of needs

15 assessment, and it becomes very difficult to untangle

16 the thing.

17 I think fairly early on you have to establish do we

18 need to look for evidence, is there a case to be made

19 for a search for evidence, perhaps because of a criminal

20 prosecution that we might have to make or because of

21 care proceedings or whatever. What are the evidential

22 requirements of child protection? I think you have to

23 make that decision fairly quickly and early on. What

24 I must say is you must never do nothing.

25 MR GARNHAM: The "you" in that sentence is social services,

32



1 is it?

2 PROFESSOR THORPE: Yes, I think just as the police officer

3 asks the question, "is there a crime here?", in other

4 words what is the role of police, the social worker has

5 to ask either is there some form of action here which

6 will harm a child or has the child been non-accidentally

7 harmed or injured or is it something different? Is it

8 something else we are looking at because the way that

9 the life world is presented by the referrer is usually

10 a catalogue, a jumbled up catalogue of complaints about

11 the moral character of carers. They take drugs, drink

12 too much, neglect their children, and it is all jumbled

13 up together and it all has to be somehow distilled and

14 sorted out.

15 This is the reflection process that was being

16 referred to earlier. It is not as simple, we are

17 looking at moral character, it is not as simple as the

18 neat descriptions of a criminal act where the law is

19 specific about what the behaviour is or indeed the

20 technical scientific descriptions attached to a medical

21 condition. We are looking at a moral category which is

22 created by virtue of moral reasoning in social settings.

23 MR GARNHAM: Can I ask what the practical experience of

24 practitioners is about the ups and downs of putting

25 a label, a categorisation when you are making a referral

33



1 to social services? Kerry Marlow, do you find you get

2 a different response from social services if you

3 describe a case as being a welfare case as opposed to

4 a case where a child is at risk of physical harm?

5 MR MARLOW: Yes, they will make an assessment on that

6 because they have priorities to set themselves as we all

7 have priorities.

8 MR GARNHAM: Who is "they"?

9 MR MARLOW: Social services. They are limited with staff

10 like everybody else and how you present information to

11 them will -- they will assess it on what they see, so if

12 we play it down there is likelihood there will not be

13 any intervention or very little intervention.

14 MR GARNHAM: Does that mean there is a temptation to play it

15 up to encourage social services?

16 MR MARLOW: I take David Thorpe's view there. When you get

17 families who present drug abuse, alcohol abuse and those

18 kind of issues, people see it as a social problem. What

19 they do not realise is that if you have families on low

20 income and they are abusing through alcohol or drugs,

21 they have to get money to fuel that abuse, so how are

22 they getting that money and where are they when they are

23 doing that? Where are the children when they are doing

24 that? I think it is role perception really, police

25 officers look at things from a different perception and

34



1 social workers look at things from a different

2 perception and they come to a decision based on their

3 perception. We tend to create a case hypothesis, as

4 a police officer will assume --

5 MR GARNHAM: That is at a fairly early stage?

6 MR MARLOW: At a very early stage they assume a case

7 hypothesis and they will follow the case hypothesis

8 rather than looking at and evaluating the evidence.

9 MR GARNHAM: Chris Butler, what about your staff? Do they

10 believe they get a different response from social

11 services depending on what label they give a case?

12 MR BUTLER: It normally works the other way around from my

13 experience. If you take most local child and adolescent

14 mental health services, they are from my experience all

15 under quite extreme pressure. In my locality, the local

16 service which I work with, for example, has had to work

17 extremely hard by getting down waiting lists for routine

18 consultations and the experience to date is that the

19 harder they work and that the more people they push

20 through the system, the more people are still coming in

21 and referrals being received, linked in part to poorly

22 developed services further back into the system, say

23 around primary care in dealing with emotional and mental

24 health problems on the part of children and young

25 people.

35



1 So the point about if you like an escalated story

2 prompting a more immediate response really strikes

3 a chord with me, because myself as a manager of the

4 Trust where I work, linked to national priorities,

5 pressing people quite hard locally in terms of actually

6 getting through what they have already got on their desk

7 as quickly and as efficiently as they can and of course

8 as managers and also with colleagues with social

9 services helping people with that in terms of resources

10 and so on, but in terms of the getting a quicker

11 response, describing a bleaker situation will inevitably

12 escalate something to the point where people respond

13 more quickly.

14 But a more generalised point if I may, there is

15 something linked to how we can join up learning from

16 inquiries such as this to the results of inquiries

17 concerning homicides committed by adults with mental

18 health problems and certainly one of the lessons for me

19 is about helping people not to eliminate risk but to

20 manage it and to actually mitigate it where possible

21 rather than pretend. If you like, in enabling society

22 to have a fantasy that we are all going to magic this

23 away is not reality.

24 MR GARNHAM: No. Richard Jones.

25 MR JONES: I think that what I want to say is that when we

36



1 talk about racking up the risk elements, that is often

2 within a system where you are seeing children and

3 families pass in a fragmented way from one bit of the

4 overall health, social care, education, police system to

5 another bit, outside of a clear understanding within

6 that system about what is it we want to achieve for

7 children, what outcomes are we looking to achieve and

8 how are we integrating the way in which we work together

9 to actually achieve those.

10 So I think it is not all doom and gloom. You can

11 look at some systems that have identified a model of how

12 they are going to respond to children and families at

13 a strategic level in terms of how the organisations work

14 together, that then is mapped into how individual

15 practitioners work, which guards to some extent from

16 "This is not mine, I am passing it to somebody else".

17 It moves to a situation of "Right, this is my assessment

18 of what we have here". It fits into our overall

19 assessment and strategic position in terms of that has

20 got something to do with us and probably something to do

21 with social services and it leads to a more integrated

22 approach rather than this "Hang on, I have got

23 a concern, where am I going to put it?"

24 If you take some of the experience certainly of

25 joint reviews and social service inspections then

37



1 I would flag an authority like Bolton for instance who

2 have a cause for concern model that is understood

3 through the system as a whole, not just in terms of

4 a bit of paper but in the minds of thinking of

5 practitioners which enable them and hopefully the

6 experience of families to be a little more integrated in

7 terms of how we respond. So not all doom and gloom but

8 it will only happen when we are clear about what we want

9 to achieve for children and what our relative

10 responsibilities are.

11 MR GARNHAM: How close are we getting to that sort of ideal,

12 if that is the ideal amongst the social services

13 departments who are represented here? David Evans what

14 about Swindon?

15 MR EVANS: I think assessment is running the risk of

16 becoming the sort of the mountain we all need to climb

17 and if we had a service user here talking about

18 assessment we might be having a different conversation.

19 I think our clients come to us in two major ways. One,

20 they want a service, and secondly, they are being

21 investigated because of concerns about their children.

22 I very much take Bill's point that what I am looking for

23 when working in child protection cases is not

24 necessarily a great deal of information, what I am

25 looking for is some analysis of that information and

38



1 I think families are looking for services.

2 I think in Swindon we are getting better at talking

3 to each other, we are better at passing information.

4 But in my role as a consultant I am often seen as

5 a second bite of the cherry. If an agency tries to make

6 a referral to a childcare intake team and that referral

7 is batted away, if they come to a child protection

8 coordinator they think they can slip it in through that

9 door and obtain a service at that point, so I think

10 agencies do use social services as a dumping ground for

11 some of their concerns. I think social services spend

12 a lot of time reassessing those and that is to the

13 detriment of our clients.

14 MR GARNHAM: Thank you. David Thorpe, as I understand your

15 paper you would say that a prioritisation by social

16 services of child protection cases is something of

17 a false economy anyway.

18 PROFESSOR THORPE: Yes, it is. In fact, when you research

19 those agencies, issue the prioritisations system, half

20 of them eventually work out to be wrong. Things that

21 were urgent were not seen to be urgent and things which

22 were not urgent were seen to be urgent.

23 Secondly, the actual process of playing up and

24 playing down, which is a word Kerry introduced. Our

25 first encounter on the first videotape we shot, a call

39



1 came in anonymously from a member of public complaining

2 about a woman's care of children. As the social worker

3 began to press him over the phone about the specific

4 complaint, the man just said "Well, you do your job,

5 I have done mine" and put the phone down. At that stage

6 I said to the social worker, "What are you going to do

7 next?" and he said, "I am going to fill the form in

8 because my duty period ends at 5 o'clock and I will pass

9 it to the senior" and I said, "And how are you going to

10 fill the form in?" He said, "I can play it up or play

11 it down".

12 In other words, the very process within the offices

13 themselves, obviously we have a situation of an

14 anonymous caller giving very little information anyway

15 but that was fairly typical of what we began to see

16 happening, that even within the work settings themselves

17 that take these calls there are some key absences of

18 reflection and so on which means that things get on

19 paper, they do not represent real events and the world

20 gets constructed in different ways.

21 MR GARNHAM: Mike Rundle does any of this sound familiar?

22 MR RUNDLE: Very, very familiar. I would like to take us

23 back to this point of a continuum. This is the reality,

24 two-thirds of the children in the families that we are

25 working with certainly in social services under the

40



1 child protection label are families that were known to

2 the agencies either immediately before or at some time

3 before, and it does seem to me that there is a danger of

4 viewing the point at which risk becomes the predominant

5 concern as a point which takes the work into a separate

6 category somewhere, and I say that because of two

7 points, the first being continuity.

8 If there has been a lot of preceding work with

9 a family and with a child it is very important to build

10 on that when the prime concern becomes one of risk and

11 not suddenly to have a break point where something else

12 starts and you perhaps lose what has gone before. The

13 other end of the process is also important, that when we

14 finish very often working with a child or family through

15 the Child Protection Procedures, they do not suddenly

16 require no support and no services at all. They will

17 remain somewhere in the child in need framework and the

18 continuity point remains important in terms of

19 continuing to provide the support that is necessary to

20 ensure that risk does not again become the overriding

21 concern for that particular child.

22 So I have the point of continuity in mind when

23 I worry about a separate process or a separate box and

24 lastly I have a point of focus in mind because we know

25 from lots of research that by playing up situations and

41



1 as it were sucking more children and families into the

2 child protection process, that does not necessarily

3 provide the best outcome for those particular children

4 and families. So I think we must guard against any sort

5 of tinkering with our existing models which might lead

6 to that sub-optimal outcome.

7 MR GARNHAM: Owen Davies, given your background, how do you

8 see these ideas playing out in practice?

9 MR DAVIES: Well, I would really like to comment, the way

10 that assessment is being talked about here quite

11 appropriately is as a mechanism for moving people

12 towards the right part of the service spectrum that is

13 available but I think the reality for the people who

14 have been talking to me over the last three months --

15 and I have been talking to a lot of social workers who

16 have been involved both in this case and related

17 cases -- is that actually assessment is about rationing,

18 it is not about service delivery on a theoretical model

19 about appropriateness, it is about rationing and that is

20 why the playing up/playing down syndrome comes in

21 because we have a lot of workers who are deeply

22 committed to trying to move people into the bits of

23 service that they say as appropriate for their needs but

24 they know very well that all of them, police, health,

25 education, are all working on a rationing model and so

42



1 assessment has become a tool for rationing.

2 Once the rationing mentality is behind it then the

3 logical measured reflective analytic way of dealing with

4 needs becomes very difficult to manage. I am perhaps

5 not in the right place but that is what leads to the

6 despair and demoralisation, the manifestation of it that

7 comes to us because of my particular role in this.

8 MR GARNHAM: We heard a good deal in Phase I about

9 eligibility criteria and social services departments

10 raising eligibility criteria as a response to increasing

11 demand on services and restriction on funds, resources.

12 Jane Held, is this entirely foreign to you?

13 MS HELD: Of course it is not entirely foreign and it will

14 not be entirely foreign to anyone around this table. It

15 is a pragmatic reality of the lives we all live and it

16 is not entirely foreign to any profession around this

17 table as well as just social services departments.

18 I think I would like to take us back to the issue of

19 having common agreements about what are the outcomes we

20 want to achieve for kids. How do we go about achieving

21 them commonly? How do we share responsibility and how

22 do we manage what resources we have wisely?

23 I think one of the problems we have at the moment is

24 that absence of common understanding and the kind of

25 siege mentality that a very rigid classification, very

43



1 rigid single agency approaches create take us away from

2 shared agreement about the type of criteria that will

3 apply. We are always going to have to have criteria.

4 MR GARNHAM: Do you mean common criteria, shared criteria

5 across geographical barriers or amongst professions or

6 both?

7 MS HELD: I mean both. Local agreement about what are the

8 outcomes we want, how do we know we have them, but then

9 what do we have to do to get them and what are the ways

10 in which we are going to do it together and share

11 responsibility together and how do we then actually

12 balance assessment need, what comes -- assessment of

13 that need and the right routing of that need into

14 services. Let us not forget that a large percentage of

15 services day in day out, prejudice day in day out are

16 managed through the provision of services either quickly

17 or routing people through to the right place and having

18 common agreements about our roles in that our

19 accountability in that will make that better, and less

20 we have to rack it up to get someone to listen or we

21 have to pass it on because I cannot deal with it because

22 I am too busy.

23 MR GARNHAM: It sounds as if there are two possible

24 circumstances in which there is this temptation to rack

25 up: one external, referrers who want a faster response,

44



1 and one internal, staff who are trying to manage limited

2 resources. Jane Tunstill, do you see a tension there

3 between those drivers on the one hand and the sort of

4 optimum approach to assessment that we have been talking

5 about?

6 PROFESSOR TUNSTILL: I am so relieved we have started

7 talking services because I do not think you can possibly

8 consider the task of assessment outside of the reality

9 of what is available, and if we are expecting assessment

10 in the round we have to be prepared to look at social

11 workers' actions in the round and directors of social

12 services around this table will know very well that

13 social workers will not be welcomed by pushing people

14 through for services that either do not exist or I would

15 have to say at the moment are being actively dismantled.

16 Can I say I think it is terribly sad that in spite

17 of the huge amount of public money that has been spent

18 predominantly by the Department of Health on research

19 studies which have said everything around this table

20 over and over and over again, we have not acted on them,

21 so I think there is a real issue about accountability

22 for public money.

23 If people are going to do research studies which

24 show authoritatively on the basis of real life social

25 services departments what is happening, there has to be

45



1 something like this before we can talk about it and if

2 you like reinvent the wheel.

3 MR GARNHAM: How do we go from discovering --

4 PROFESSOR TUNSTILL: I do not want to get sidetracked into

5 talking about how you disseminate research finding for

6 practitioners in an accessible way, although I know

7 a lot about it because we do a lot about it in my

8 particular university in partnership with many of the

9 agencies around this table. Things like making research

10 count, things like research into practice and let us

11 hope that Sky is going to make a difference, so I think

12 that is a bigger topic I can to come back to.

13 Just to refer quickly to one of my studies, the

14 current one, just coming to the end of a national DH

15 funded study on 500 Family Centres, you might naively

16 suppose that Family Centres represent a constellation of

17 all the services that round this table we might like to

18 make available to families. They are being shut at the

19 rate of knots. In the three years this study has been

20 up and running, we have had to redo the national survey

21 to take account of all of those that have been closed so

22 that the relatively easy or more open access to services

23 has been eroded even in the period that we are talking

24 about.

25 The last point, because I can see from how these

46



1 seminars run there is no guarantee that you come back to

2 any of us, is that I do not think we should lose sight

3 of the link between what a system looks like and the

4 readiness, indeed desperate anxiety of parents to refer

5 themselves. The last study I did for the DA showed that

6 two-thirds of the sample of nearly 100 of quite complex

7 cases we looked at involved self referrals.

8 Predominantly the families in that category had already

9 been through something to do with the child protection

10 service, they were not just straightforward, uncomplex

11 cases. They thought highly enough of the service that

12 they had been able to get from social services

13 departments to go back voluntarily and ask for a bit

14 more, because at that point they knew they were in

15 difficulties and unless they got the risk label, all the

16 things David has been saying very convincingly, they

17 have not got a hope in hell of getting anything.

18 That will not necessarily help you with people like

19 Victoria but there is an awful lot of families out there

20 who are not moral cases, that are desperate, because

21 99 per cent of them are living in absolute poverty, to

22 get their hands on services and I do not think we can

23 take out the service dimension from this more

24 theoretical professional debate.

25 MR GARNHAM: I am sure that is right and I was conscious,

47



1 when I was introducing this seminar and talking about

2 the fact that there is something artificial about the

3 divides we put in place to structure these seminars,

4 that that was one aspect of it, because I read your

5 paper and it was helpful on that. There is I think, is

6 there not, tell me if I am wrong about this, a value in

7 trying to make sure we understand the best way in which

8 assessment should be conducted as a precursor to

9 ensuring proper service delivery, is that right?

10 PROFESSOR TUNSTILL: I think that is true. I think in lower

11 slopes of assessment what you want is a light touch.

12 You cannot have a light touch unless you have some --

13 I know I sound like I am bloody minded and I am not, but

14 you cannot have a light touch unless the front line

15 worker, be it a health visitor, a social worker, a GP or

16 whoever it is, or a policeman or woman has some

17 confidence that services are there to be accessed

18 because if they do not have that sense, if they do not

19 carry around -- Jane mentioned the word kit bag, you

20 want a kit bag of professional charms but also where

21 would you be as a doctor if you were looking at health

22 cases secure in the knowledge that there were no

23 clinical services behind you, that you would not be able

24 to write a prescription if that was the answer because

25 these services did not exist unless the child was in the

48



1 last stages of terminal cancer?

2 You could forget all your professional training

3 because it would make a mockery of talking about

4 assessment. I think that you are only going to get that

5 phased light touch working on to something more

6 intrusive where you then begin to unearth the more

7 worrying bits of information and then you are finally

8 into a much more comprehensive assessment.

9 MR GARNHAM: You only do that if the services are there

10 behind it.

11 PROFESSOR TUNSTILL: I think so. Maybe I was a funny sort

12 of social worker but I think it is true for all

13 professionals, you can only make a reasoned assessment

14 if you think there is something you can do. If you know

15 that there is not then -- anyway, I do not know whether

16 other people think that is completely barmy.

17 MR JONES: I think that is right. I think as Jane suggests,

18 that is how everybody operates, irrespective of their

19 professional base, you are making assessments in the

20 light of what you know is available and out there.

21 There is a question though about what it is that we know

22 is available and there has been a debate in previous

23 seminars in relation to community resources themselves,

24 which increasingly I think we are out of touch with.

25 MR GARNHAM: I want to come on to Peter Hampton on this

49



1 subject in a moment. Can I first ask Dave Basker how

2 does it work in North Lincolnshire?

3 MR BASKER: I was going to say I take the point about

4 resources and services and I think one of the things

5 I would say is we have neglected the fact that some of

6 the most valuable resources are human resources, the

7 role of the health visitor, the role of the Home Start,

8 the voluntary worker and to make it that assessment is

9 everybody's business. I see these scenarios of pressing

10 the trigger of it is risk, it is risk, it is risk and

11 certainly five years ago I was working in a system where

12 that was the case. After a lot of hard working, looking

13 at what we mean by assessment, what does concern mean,

14 what does it mean to the Home Start worker, voluntary

15 worker, the social worker, the police officer, trying to

16 get a common language, trying to get a common knowledge

17 base if you like about what it is. I do not think that

18 has to be very complex and very time-consuming.

19 For someone to actually have -- in North

20 Lincolnshire we have developed a common assessment tool

21 which I think you heard about in the last seminar and

22 I am confident that whether it is a voluntary worker

23 with the family using that lighter touch by just

24 following some of the simple prompts in that assessment,

25 they can come to a conclusion themselves that it may be

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1 something they can offer by talking, listening,

2 solution, focus work with the family in a very, very

3 basic way.

4 MR GARNHAM: Without it being referred on to social

5 services?

6 MR BASKER: Absolutely and we have had many examples where

7 for example a non-teaching assistant has been working

8 with a mother complaining about a little boy who is

9 soiling and is presenting challenging behaviour. We

10 have a system where there is a lot of dialogue and a lot

11 of discussion and the teaching assistant rang our common

12 assessment coordinator and talked it through, talked to

13 the Duty Team social worker about it, trusting that no

14 big juggernaut would get into operation and take it away

15 from them.

16 There were issues in the family about contact and

17 custody disputes, the parents were separated and the

18 non-teaching assistant was able to unravel that,

19 discover it and work in conjunction with the school

20 nurse to provide a service to this family.

21 MR GARNHAM: And the key to that was this relatively simple

22 common assessment tool, was it?

23 MR BASKER: I think it is the shared notion that assessment

24 is everybody's business. We do not have to throw them

25 into the system somewhere and we have recently completed