All entries for Sunday 16 November 2008

Child Protection: They're missing something, but what is it?

Writing about web page http://www.guardian.co.uk/society/2008/nov/15/baby-p-child-abuse

The Guardian’s front page, Saturday Nov. 15, reported “Eight in 10 seriously harmed children ‘missed’ by agencies. Government research reveals scale of gaps in child protection.” The reporter, Robert Booth, noted that our child protection register lists 29,200 children “known to be suffering harm”. But, of the “189 children whose death or serious injury prompted a local authority serious case review between 2005 and 2007,” no less than 156 were not on the register, according to an analysis of the most serious cases that ministers will receive in the New Year. Conclusion: “The research has raised concerns that, across the country, procedures that should result in children at risk being protected by the government’s flagship anti-child abuse system are not being followed, leading to deaths that could be avoided.”

Sounds bad for social workers, doesn’t it? And yes, it’s a possible conclusion. But it is not the only evaluation we could make. I’ll show that a completely different conclusion is also possible. The point is that, in order to evaluate social work intervention we have to look at what they did do, as well as what they didn’t do. And evaluating what they did do turns out to be surprisingly difficult, because it involves asking the question: “What would have happened in the absence of any social work intervention?”

The report states that, over the three years from 2005 to 2007, 33 of the 29,200 children registered as “known to be suffering harm” were killed or seriously injured—a rate of approximately 1 per 1,000. What would have happened to these children if social workers had not registered them and watched their welfare? There’s a clue: it lies in the 156 children killed or injured that were not registered. It is not completely clear what this means, however, in so far as we don’t appear to know the size of the total pool of children suffering harm that were never spotted in advance and so never registered.

Here are two possibilities.

• First, suppose the number at risk but unregistered was quite small, say, one tenth of those registered. In that case, the rate of death or injury among the unregistered children suffering harm must have been very high—156 divided by 2,920, or 54 per thousand. Apply this rate to all the children hypothetically suffering harm then, the 29,200 registered plus the 2,920 unregistered. That suggests, conditional on no social work intervention, more than 1,700 casualties. But in actual fact, there were “only” 189. On this scenario, by registering nearly all children at risk, our social workers reduced casualties by an order of magnitude; they deserve congratulations, not brickbats, for the successful protection of thousands of children.

• Alternatively, suppose the number at risk but unregistered was much larger, say, as many as the total number registered. In that case the rate of death or injury among the unregistered children at risk was much lower—156 divided by 29,200, or 5.4 per thousand. This time, applying 5.4 per thousand to all the 29,200×2 children hypothetically suffering harm, it appears that, without any social work intervention, there would have been some 315 casualties. In this scenario social work intervention would appear to be less effective. Social workers missed half the children at risk, and their efforts did not even halve the casualties. In their defence, however, a further point would then need to be made. This is that, with nearly 60,000 children suffering harm, and half of them undetected and entirely lacking the protection they need, abuse must be far more widespread in our country than has been assumed in resourcing our hard pressed family services. While there is less in this scenario for which social workers should be praised, the main lesson would be that society is in much worse shape than we thought, and criticism for not recognising this should be reserved for ministers and policy advisers.

Two possibilities; which is it? I’ve never worked in or on child protection (I’m just a parent). Like you, I rely on the experts to tell me. But if the experts don’t ask, we’ll stay in ignorance.

Mark Harrison : 16 Nov 2008 11:48 |  Tags: Social-Work Using-Data |  Comments (0) |  Close comments |  Report a problem