Child protection

Breaking the distrust

Catchy titles are not something I’m good at, so I thought I would keep it simple.

 

Everyone knows there are 2 sides to every story and that those on opposing sides often think they know best. The question nobody seems to ask is, is that the best’s opinion to have and am I really right?

 

There are people that do not trust child protection officers and there are people who think they are brilliant. At the same time you get people like me who are always on the side of the child which means I am often against both sides. You would think that would be the best place to be, but in reality it is a rather uncomfortable and at times upsetting place to be because I see both sides go at it, often like they were possessed, and I see the child stuck in the middle. I know of people who have been saved because of child protection workers and I know of others that have had their life ruined by child protection workers.

 

Having never done an article like this before, I thought it would be easier to play devils advocate for both sides. I am hopping that by putting both sides in the same article along with some solutions I think would help, at least some of those on the opposing armies will have a truce and do what is best for the child, that is stop thinking they are always right, get rid of their ego and start talking to each other.

 

Why the distrust?

There are various reasons why the public distrust paediatricians who work in child protection and other child protection workers. They operate in a world more secret than the security services, they are perceived to assume they are always right, the court hearings are among the most secret anywhere in the world meaning there is little or no transparency, they rely on things that are virtually impossible to defend against and they are often seen as being able to do what ever they want.

 

Despite all these concerns (I’m sure there are more), child protection officers still can’t seem to understand why they get such a hard time.

 

Whilst child protection workers do need to have some powers to act in the child’s best interest, is it right for them to have so much power whilst working under such secrecy? Some of the concerns might be unfounded, but the perception of child protection workers is important, simply thinking or saying it is not right misses the point and fails to address the concerns raised.

 

There is an argument that these levels of powers, secrecy and lower standards of proof are all needed to protect the child, but do they hold water and who is benefiting the most, the child or the profession?

 

Secrecy

Whilst there is an obvious need to protect the child’s privacy, is this done to an extent that goes far beyond what is needed and worse still, does this level of secrecy mean the child’s right, both under the human rights act and the Convention on the Rights of the Child are breached? After all, does the child not have a right to a family? How many times have we read/heard about the rape/sexual assault of women and even children in the news without them being identified? Whilst it would be far easier to work out the identity of the child if the identity of those involved were released, is it impossible to release any information without revealing their identity?

 

Some time ago there was a TV programme about the way the family courts work. In part of the programme it was reported that they were not allowed to say if 3 ‘experts’ talked to the parents before deciding if they harmed the child. Would the reporting of such a crucial thing really risk the child’s right to privacy? Would revealing the ‘experts’ did not talk to the parents show that there was a serious flaw in the evidence?

 

These courts are so secretive that reporters are not allowed in the court room, yet reporters are allowed in courts that involve serious sexual offences. What is the difference?

 

Burden of proof

This is a very touchy subject in fact even suggesting the burden of proof is to low can get you in trouble with some people.

 

Whilst the burden of proof does need to be lower, especially for those that can not give evidence, does it need to be so low?

 

It is well known that what would be thrown out of court, can be used to have children taken into care and child protection workers see themselves as being better than anyone else. Some stories that have been reported simply go to show how dangerous it is to have such a low level of proof, especially in courts that are so secretive. I took just 10 min to find a few examples, given an hour or so the list could be longer even with the secrecy surrounding child protection.

 

Experience

Have you ever noticed how young some child protection experts and social workers are? Granted some are getting on in years, but others look as if they are not long out of school or worse still, should still be in school. Can someone who has never had to raise a family and has had very little life experience be expected to know what’s best? If their background has been both parents, well off, private school and brought up in a nice area, can that really prepare them for dealing with a single mum/dad from a poor family staying in a housing estate in Glasgow where you don’t go out after dark? Are they really going to know what’s best simply because of their training? Are their personal experiences going to have an influence on what they think is best for the child?

 

Granted, not every child protection expert or social worker should have had a crap upbringing and be old enough to get a free bus pass, but should there be a balance of backgrounds and age in cases involving child protection?

 

Combination of things

The combination of the low standards of proof, the attitude of child protection workers and the secrecy surrounding what happens only makes things much worse, yet very little, if anything, is done to change this. This leaves us asking the question, why?

 

The ‘experts’ side

I write this not based on much experience (although I do have some), so others might think I am wrong on what I have to say.

 

Protecting a child is one of the most important things anyone can do and saving a child from abuse or neglect has got to be one of the greatest things anyone can do.

 

There is nothing more upsetting than thinking a child is at risk and not being able to do anything about it, I should know, I have been in that position. If you thought a child was at risk, how far would you go to protect them? That is an important question, because thinking of an answer might give you an insight into how child protection workers might feel.

 

Child protection workers have one aim, protect the child. They are often stuck between a rock and a hard place. If they get it wrong and the child is harmed, the press complain about them and if they take a child away when they should not have, the press complain about them and parent groups get vocal.

 

There is also the amount of work involved to be considered. Back in 2005 social workers took to picket lines over their casework load. Putting aside the details of the Victoria Climbie case (one often sited by government as a example of how we need more and more intrusion into private life’s), this was a tragic example of excessive work loads. It was reported back in 2001 that the case worker involved was overworked and not properly supervised. Instead of having to deal with her target of 12 caseloads, she was reported to have had 18. This not only shows what harm can come to a child by workload overload, but it also raises the question about the workload of other social workers etc. If you have a workload far in excessive of what you can cope with mistakes will happen, children will not only be harmed, but children might be taken away without good reason. The latter of these is crucial when thinking about some social workers and child protection workers. Whilst there is no doubt there will be people determined to get children away from parents regardless of what everyone else thinks because they think they know better or they simply don’t like the parents lifestyle, but does this extra workload mean some child protection workers are overly keen to get things done and dusted, something that could be causing them to get it wrong?

 

Is it right to target a group of workers who are often overworked and often stressed? I am not saying it justifies what they do, but it can help understand why they work the way they do.

 

There is also the fear of getting it wrong. If you get it wrong and the child is taken away you might get the odd slap on the wrist, but who else will know? The secrecy surrounding the system is so tight, will anyone else ever know? Public criticisms of such people rarely make the headlines and when they do, other child protection workers often come to the rescue. You only have to look at the case involving Prof Southall to see how this can happen. Putting aside whether or not he should have been allowed to keep doing the work, it is not only an example of how no matter how bad you get it, people will protect you, it is also a excellent example of how the press and family groups will go for your throat. On the other hand if you get it wrong and harm comes to the child, you can start emptying your desk because when the shit hits the fan, the fan is usually held by your boss and politicians who aim it at you. You only have to look at what the social worker involved with Victoria Climbie went through to see how people can be used as an escape goat. Faced with those options, can anyone say that this has no effect on judgment?

 

There are also those dreaded targets that have to be met. I am not saying children should be taken away to meet targets, anyone who thinks that quite clear should not be working in child protection. What I mean by this is there are targets to be meet and people get in trouble for not meeting targets. If this is having an affect on the amount of children taken into care, then would it not be better for both sides to work together to get rid of these targets?

 

The combination of workload, targets, stress, fear of getting it wrong and a lack of life experience could be having an affect. That does not make the person evil or even just not a nice person, it means they are human beings working under extreme pressure yet they are often viewed as hostile and the enemy.

 

Improvements?

Whilst being the first to admit to not being a child protection expert, I fail to see why giving people a massive workload is better than taken on more staff to allow more contact time for staff and helping to reduce stress levels.

 

The stress levels is something I think is crucial. Can someone under extreme stress be expected to get it right every time? Allowing child protection workers uninhibited direct access to a specialist counselling service without their boss knowing (unless they were thought to be a risk) and decreasing workloads could do far more than simply collecting data in ways that have now been described as ‘data rape’. Does anyone know the amount of social workers and child protection workers that suffer from stress? If not, some really needs to do an anonymous survey because that is crucial.

 

To use a specific example, I will use MSBP. For things like MSBP should there be more places/spaces where children can be looked after with only parental supervision? That would allow the child to be safe whilst allowing the parents to see the child on a regular basis meaning if the parent is found not to be harming the child, the bond is not broken. If used in conjunction with more after birth health care for both parents, the parents could get help if they have emotional problems. Having supervised access could also allow parents to eventually take their children home with them if they get better. This would cost a lot of money but considering the £12 billion spent on the NHS database, £300 million spent on the child index and lots of other things, would it not be worthwhile spending something that could keep families together?

 

If you are a parent and you think your child is ill and get help only to find out nothing is wrong, will you ever take him/her back to hospital if you are worried about being called a liar who is making it up simply to subject your child to medical test?

 

All those involved in child protection and other social care work, need to sit back and ask the question, “Are we doing more harm than good”? This might seem like a stupid question, but with the way things are run and the way the government is planning on invading the privacy of parents and children. This is not such a stupid question.

 

Parent groups also need to sit back and think about what they are doing. If you push people, they push back, if you annoy them, they are not going to be all that nice to you ether. Sit back and think of ways to work with child protection workers, you might find you have common ground.

 

Consequences

With the way information, including sensitive information, is set to be shared with more and more people, will this see parents and children withholding information from others and not seeking help sooner for fear of losing their child or future children? It is easy to say they should, but why should the parents or the child not be allowed to get help in confidence? From where I am standing, it makes better sense to increase the ways people can obtain help and make it easier for them to get access. Why spend Billions on spying, when we could spend less on allowing people to get help far easier with not having to worry about the police, employers, insurance companies, social services and others finding out? There will always be people who refuse to get help and others who are determined to harm their child, but are the current systems and the proposed increase on data sharing going to help? I doubt it simply because you can only share data you have and if parents and children do not share info out of fear, nether can you.

 

What also seems to have been ignored are the consequences of collecting so much information when it comes to workload. The child index/database/contact point (its name has been changed a few times) is set to increase the amount of information in a way that there will be very few families not in contact with social services, yet has the government decided to increase the amount of social workers and other child protection workers to match the workload? Will 16 case loads soon be the norm?

 

The system needs to be changed to the point where social workers etc are seen as people you go to for help rather than people who come to your door at 6 in the morning to take your child away. For that to happen, everyone needs to stop viewing the army on the other side of the battle line as if they were in the trenches in World War One because at the end of the day both sides want what is best for the child, a family and to be safe.

 

There are some key question government and child protection workers need to address:

 

1. If a child protection worker thinks someone is withholding information will they jump top the conclusion that the child is at risk?
2. Should we as citizens in a free country have to worry about who will know if we have a drink or gambling problem?
3. Would it be better if we could get help without others knowing or should be denied help if we are not prepared to tell social workers, schools, police etc?
4. What is best for the child, being allowed to get help without others knowing or simply not getting help?
5. Is it better to have more child protection and social workers to lessen their workload to allow them to make a more involved judgment or better to simply invade the privacy of families?
6. Is it best to have more places where families can get help or is it best to simply build databases to collect info about them?
7. Will the way more and more info is accessed and shared mean there will be an increased workload and if so, will this make matters worse?

 

 

There is a balance to be struck between protecting children, protecting child protection officers and protecting privacy. So long as child protection workers use outdated laws to prevent the public knowing what they do, so long as they intrude more and more into the life’s of families and are seen to be protecting each other, the public will have no trust in child protection workers and that will see children harmed. Simply saying you are an expert and expecting people to believe you and making no apology for getting it wrong is not good enough. On the other hand, so long as family pressure groups see child protection workers as the enemy and treat them with disgust, nothing will change and families will be torn apart and worse, children will die.

 

My experience of dealing with child protection workers is not a direct one but I have had close friends who have had direct experience in the past, including a 12 year old girl who was failed because of the way the system worked then (might be different now). That 12 year old was to become the best friend I have ever had, but because of the system in place at the time and not being able to get help when she needed it, she committed suicide at the age of 19, an experience that has stayed with me all these years. On the other hand my experience of being ‘harmed’ because of the way data is shared is something I have a lot of.

http://www.telegraph.co.uk/news/uknews/1468412/Children-are-taken-away-andndash-but-the-system-can’t-admit-it’s-wrong.html?pageNum=3

 

http://www.computeractive.co.uk/computeractive/news/2224775/child-database-hit-fresh

 

http://www.fipr.org/childrens_databases.pdf

http://www.rcpsg.ac.uk/Education/Documents/Good%20Doctors%20Safer%20Patients.pdf

 

http://www.computerweekly.com/blogs/tony_collins/2008/02/police-will-be-allowed-searche.html

 

http://www.guardian.co.uk/society/2006/sep/08/childrensservices.politics

 

http://www.justice.gov.uk/docs/National-Society-for-Prevention-of-Cruelty-to-Children-Data-Sharing-Response.pdf

 

http://www.justice.gov.uk/docs/Childrens-Rights-Alliance-for-England-Data-Sharing-Response.pdf

 

http://www.everychildmatters.gov.uk/deliveringservices/contactpoint/

 

http://www.wilson-nesbitt.com/articles/858/14072008/family_court_concerns_revealed.html

 

http://www.communitycare.co.uk/Articles/2007/03/27/103929/family-court-used-flawed-medical-advice-to-wrongly-remove-child-from-parents.html

 

http://www.hmcourts-service.gov.uk/infoabout/children/famcourt/index.htm

 

http://news.bbc.co.uk/1/low/uk/1115166.stm

 

http://www.opsi.gov.uk/ACTS/acts1998/ukpga_19980042_en_1

 

http://www.unhchr.ch/html/menu3/b/k2crc.htm

 

http://www.timesonline.co.uk/tol/comment/columnists/camilla_cavendish/article4288255.ece

 

http://news.bbc.co.uk/1/hi/scotland/5272092.stm

 

http://www.communitycare.co.uk/Articles/2007/09/14/105785/tape-interviews-in-child-protection-cases.html

 

http://www.dailymail.co.uk/news/article-1064930/8-000-couple-baby-wrongly-taken-away-social-workers.html

 

http://business.timesonline.co.uk/tol/business/law/article2317284.ece

 

http://www.guardian.co.uk/society/2005/jan/11/politics.tradeunions

 

http://www.timesonline.co.uk/tol/news/politics/article2332307.ece

 

Types of people who ‘protect’ data

When it comes to medical privacy there is often a lot of talk from those who want to share/access identifiable data about how data will be protected and they can control access. Unfortunatley these are often grouped into 3 different groups.

1. There are those who have a low standard of protection. An example of this would be most GPs. GPs often tell patients that what they learn in the course of their work will go no further and their records are protected, yet a lot will often start telling people about tye patient so the information can get into the patients records, as one of my ex GPs said “doctors do not do notes, that is someone elses job”. In other words, the min the patient leaves, the GOP will tell someone else. I have also found that most calldicott Gaurdians come under this group. As with GPs, their standard of aproprate sharing of data is often far lower than what patients think and when it comes to privacy, they rarely, if ever, will hear both sides of any complaint, usually deciding to side with their friends who also have a low standard. This is further complicated in that they are often paid by the people they are overseeing even though this creates a conflict of interest. Who have to ask whos interest they have at heart, their own or that of the patient? Unfortunatly I have found they have the interest of their own at heart and most would rather protect the reputation of health workers and the NHS than tell the truth. This group of people are the low of the low as far as I am concerned. they lie to patients to obtain data/carry out examinations and when patients do get told they ether attempt to make the patient think it is for their own good and those patients that see past this Bull are given 2 simple choices, ’share or die’. This group will also often share data so that it can be passed to others for targets or payments. In some cases it will be identifiable but even if it is not, the people accessing the records to get it will have access to the identity of the patient.
2. There are those who think they have a high standard by are not aware of what is being shared. An example of this are some Calldicott Gaurdians and some health workers (not all are scum, just most). Some will tell you that when it comes to the police and social services they will tell them to ‘get stuffed’. Whilst this seems good, they are often unaware of data sharing. for example data from the new Summary Care Record in the NHS in England will be copied in a way that police and social services have access. This means that when they tell the police or SS to ‘get stuffed’, the police and SS will simply access the data from somewhere else (such as SUS) or they will alreday have the information anyway. At the same time anti-privacy laws/legislation in the UK is being introduced faster, meaning any promise about privacy is no protection. Other groups of people that come under this are those who work in Sexual Health Clinics. These people are often unaware that identifiable data can be shared with researchers, but I have to say that some will know but simply not tell the patient
3. The last, and by far the smallest group, are those who do protect data. These people are far and few between. they will store data in a way that others can not access and they will stand up to those who demand it. Some will even not record data. An example of this are some therapist. If you wanted some therapy, you can often tell the person you are seeing that you do not want anyone else to know what you are there for. Whilst some will refuse to see you unless you ‘consent’ to notes being kept others will agree not to keep notes (the disadvatage of keeping notes is that they can be accessed under some UK laws by others. Although this does not happen often, it is staill a risk). Some of those that demand they make notes willl often make them very brief and a broad outline.

Example 3

A man is arrested for sexual abusing children, or ay other crime. The man is arrested and then questioned at which time he admits the crime. The only evidence the police have is the mans confession. The man is then charged and brought before the courts. At this point it is discovered that the man had not been read his rights after being arrested and had not been told he was under caution. He had also been lead to believe that what he had said before being arrested would ‘go no further’. Because his rights were breached, what he had said in the past could not be used as evidence, he then walks free.A patient. tells a doctor/nurse something under the impression that nobody else will know and unaware of the fact that the data would be used by others, such as for insurance or to determine if the idividual broke the law. The patient then finds out data latter date about this and the doctor then simply tells the patient this is the case and the patient can do nothing to stop it. If that means the patients would not have disclosed data or be examined, then that is tough luck, the patient has fewer rights than the criminal. If the patient happened to be a victim of the above crime and had sought help due to this, then that raises one big question. Why is it the patient has less rights? Their attacker walks free for not being told the truth, the patient simply has this back dated to allow data to be shared and accessed.I for one find that imoral, yet it gets done almost every day in the health profession.

Example 4

If I was to lead someone to believe that I was a doctor so that I could carry out an intimate examination on them, would it be an assault/ sexual assualt even if they agree to me touching them? I would say yes.If a patient was to allow a doctor to carry out an intimate examination because of they thought tht only the GP would know why they were there and what was wrong with them but the info was then known by others (ether from reading the info or from thr doctor dictating the info to them), would that be a assault/sexual assualt? Again I would say yes.A lie to touch is still alie no matter what your profession. This sort of assualt goes on almost everyday in the health profession, yet it goes un-punished

Example 5

If someone was to put a gun to someones head and demand sex, would that be rape? I think it would be even if the victim was to say yes, as saying no could result in their harm. If the gun was hidden away, but the patient knew it was there, would that still be rape? I would say yes. This is an implied threat by the attacker.Currently, in most practices, unless a patient agrees to data sharing (I have been in practices, such as Gilbert Road in Bucksburn, Aberdeen) where all doctors/nurses have full access to GP files, such as asthma clincs knowing if patients have ever been raped and in these pracices even admin staff are allowed to know which patient is on Viagra or been abused etc), the patient is not allowed access to health care even where this causes discomfort or even their death unless they ‘consent’ to data sharing. With the threat of discomfort or even death for saying no (said or implied), can the patient saying yes be of their own freewill? I for one say no as to be consentioanl you must be able to say no without it causing any side effects, and to me discomfort/death is a side effect. NHS Grampian and other NHS trust (even government ministers) seem to view the patients discomfort/death as a viable option for the patient.