April 11, 2011

Miscarriages of Justice in Contemporary Child Protection:a brief history and proposals for change Dr Lynne Wrennall

Miscarriages of Justice in Contemporary Child Protection:a brief history and proposals for changeÓPresentation by Dr Lynne Wrennall to the All Party Group on Abuse InvestigationsAttlee Suite, Portcullis House2.12.2004Dedication
I dedicate this paper to Victoria Climbie, to the children we have failed and to the process of becoming civilized. By civilization, I mean the process of getting things done without harming people.
I would like to acknowledge the considerable advice and guidance I received in preparing this paper. Many people contributed directly, indirectly and through the literature. I would also like to acknowledge all the sources cited in the Joint Statement.
Systemic Reform
This paper addresses the questions: what is wrong with the Child Protection system? What are the indicators of the need for change? Which changes will solve the problem?
In this paper, I intend to argue that the Child Protection system is harming children, families and communities. The failure to appropriately act on genuine reports of abuse and the pursuit of false allegations, are seen as two sides of the same coin. This is the problem of too many false positives and false negatives. The causes are inter-related and the solutions must focus on both sides of the problem.
The rapid expansion of the Child Protection discourse has resulted in a loss of focus. Too many normal, trivial and misinterpreted factors are accounted into Child Protection investigations. The general public quite rightly expects Child Protection to focus on genuine cases of child abuse and neglect, not to be involved in general issues in child rearing, health and social care. That Child Protection has been unable to retain the focus on abuse and neglect is the source of the crisis of credibility that the discourse now experiences.
This loss of focus is also linked to adverse health and social impacts. Too many families feel terrorized out of accessing services for their children and for themselves. Social exclusion is the consequence.
The misdiagnosis of abuse also means that children do not receive the appropriate health and social care to which they are legally entitled. In some cases, the result is that children are dying. Professionals are increasingly aware that referring children to Social Services may result in children and families being harmed rather than helped.
Unexplained health problems have been interpreted as abuse and the burden of proof has been reversed. Families rather than doctors have been forced to try to explain why their child was unwell. Unexplained infant death has become an area prone to miscarriages of Justice. As the number of infant and child deaths declines, the proportionate significance of commercially, financially and politically sensitive deaths is likely to increase. This matter must be squarely addressed. There is a very real danger that undisclosed and undisclosable causes of illness and death lead to miscarriages of justice involving wrongful conviction and removal of children from their families.
Wildly inaccurate markers of abuse, draw families into the Child Protection net. Yet cases of serious reported abuse are ignored. Families claim that the potential for Child Protection powers to be mis-used leaves their children unprotected against harm and exploitation. The context is one in which unvalidated models, frameworks, theories, techniques and tests are generating serious adverse health and social impacts. Within this context, Child Protection powers are detoured into purposes which are unconnected with the needs of children. A pattern of discredited approaches linked to inaccurate targeting and pervasive miscarriages of justice legitimates the claim that systemic reform is required.
Some diagnoses and tests have become almost emblematic of the distortions and distractions that have blighted Child Protection. Munchausen Syndrome by Proxy/Fabricated or Induced Illness (MSbP/FII) has attained a particular status as a grab bag of myths, mystifications and superstitions. This diagnosis is particularly available for mis-use because it’s markers fall within the broad range of normalacy. Almost anyone could be conceptualized as falling within the diagnostic criteria. MSbP/FII is believed to be associated with large scale miscarriages of justice because the allegation is located in narrative spin and requires no actual evidence of abuse. It joins the long line of discredited approaches to Child Protection, though it’s ambit may be greater than all the other categories of misdiagnosis.
As a closed system, Child Protection has not been able to hear and to respond adequately, to the feedback which has been aroused over more than two decades of criticism. Violation of the privacy of service users co-exists with secrecy over the everyday practices of the discourse. There is grave concern that the secrecy of the Child Protection discourse has concealed and encouraged malpractice by professionals. There is a body of evidence demonstrating that secrecy has concealed child endangerment within the Child Protection system. So deep is the loss of trust now experienced towards the Child Protection discourse that the aphorism, everybody makes mistakes, but doctors bury theirs is increasingly being replaced with, everybody makes mistakes but fostering and adoption conceal the evidence.
The current model of Child Protection in Britain asks professionals to talk amongst themselves but has silenced service users.  This model became an article of faith in UK Child Protection though, like other features of the system, it is without an evidence base. Service users are unable to directly communicate the harm which is done, because to do so would be to risk further punitive action. The direct feedback received by the system thereby understates the harm that is occurring. Social Workers are aware that the Child Protection system is doing harm, but they do not receive the evidence of the full extent of the harm which is occurring. Service Users eventually broke the silence.
Let’s take an example of a service: Alcoholics Anonymous. It’s called Alcoholics ANONYMOUS for very good reason, because if people’s anonymity and confidentiality is not guaranteed, many people will not access the service. In Britain, the problem is that people are afraid that if they access services they will have their children taken from them. If they don’t get the help they need then social problems are not solved and we are all the poorer for that.
However, to know what is wrong with Child Protection, we must know why and I am indebted to Eileen Munro for focusing me on this. Why does the system entertain false allegations and fail to protect children who are genuinely being abused and neglected? Harker and Kendall from the Institute of Public Policy Research have acknowledged a truth that Britain has taken a long time to accept, that the role expectations of forensic investigator and social worker are mutually contradictory. Combining these roles has meant that neither is done well.
The role of forensic investigator and gatherer of intelligence has eclipsed the role of social worker to such a high degree that little actual social work takes place. British children and families have tended to receive police work performed by social workers rather than social work, recognizable by any international standards.
Britain is almost alone in adopting a model of Child Welfare in which these roles are combined. It is not the only country, but one of the few. Social workers have long been aware of the tensions and contradictions between the roles of carer and controller. The dictum, “we sometimes control because we care,” quoted in the literature, was meant to resolve the contradiction. But putting words together in the same sentence is not the same as resolving the problem of irreconcilable role expectations.
The countries which have combined the roles of forensic investigator and social worker in the same personnel, in the same agencies are the countries whose Child Protection systems face the greatest crises of credibility. In Britain, the emphasis has been on proof rather than prevention, such an emphasis is not likely to engender support for the system.
Blending of the care and control functions is also known as linking social control and service provision. Service provision has suffered in the bargain. Large expenditure on intelligence gathering, assessment and surveillance has concealed the impoverishment of expenditure on genuine service provision. Service users and social workers alike, lament the lack of investment in genuine services for families. For fundholders though, something I have termed “nombyism,” the Not On My Budget phenomena takes over. “The service is great idea, but not on my budget.” [A phenomena similar to “Nimbyism,” Not In My Back Yard.]
Forgive me for turning to accountancy, but the Child Protection discourse is strongly dominated by the disciplines of accountancy and law. It makes short term financial sense for fundholders to opt for rapid forced closed adoption, rather than to invest in supplementary services to families in difficulty and in universal provision of preventative services. Rapid forcible closed adoption is an example of financial short termism. However, a full health and social audit would probably demonstrate false economy. Cost cutting on one budget, creates expense on another. Rapid closed forced adoption is probably an example of those small rationalities that together, work against the larger rationality. Similarly, undereducated and untrained staff offered short term budgetary relief. It is time we started to count the cost.
Authoritarian practices in Child Protection centred on control, surveillance, issuing of threats and orders, and severing children’s contact with their families of origin have been counter-productive to the best interests of children. Some of the most vulnerable children of all, are double orphans and to deprive children of their families of origin, de facto creates these children as double orphans. This is what the Children’s Act 1989 aimed to prevent, but the Act has been widely subverted, due to financial conflicts of interest.
A small minority of children removed from their families of origin find loving adopting parents, but fully one quarter of adopted children are returned to the Local Authority. Many children in the “Care” system are under protected against iatrogenic abuse and suffer very adverse outcomes. False allegations of child abuse and authoritarian approaches to families harm children.
We need to face some uncomfortable truths. We need to acknowledge that the Child Protection agenda has been hijacked by interests entirely unconnected with the best interests of children. We need to acknowledge that Child Protection has become a battleground in which the professions fight for their own interests. The bodies and lives of children and families have become the terrain in which they fight their small wars out.
The claim that “the interests of the child are paramount” has become a euphemism for ulterior motives and unacknowledged sectional interests. When strategies which mis-use Child Protection powers for ulterior motives become destructive to children and families, remedy and reform are appropriately sought.
Summary: What is Wrong?Irreconcilable and unclear role expectations.Nombyism.Inaccurate markers of abuse and neglect.Unexplained health problems assumed to be evidence of abuse.Reversal of the burden of proof.Emphasis on proof rather than prevention.Children not actually receiving social work.Financial short-termism.Absence of a true health and social audit.Mis-use of powers due to conflicts of interest.
Summary: Adverse Health and Social ImpactsHealth and social consequences from mis-diagnosis; children not receiving appropriate assessment, treatment and support.Parents and carers being intimidated out of accessing necessary services.Diversion of resources from genuine life-saving courses of action.Families suffering health and social consequences from the trauma of inappropriate assessment, false allegations and false inferences.Children suffering in the “Care” system.
Systemic Reform: Out of the Silence
There is substantial support for the view that reform of the Child Protection system is necessary. The indicators of the need for reform are expressed in parliamentary debate, judicial decisions, research findings, media reports, incorporation as themes in artistic and dramatic works, discussion in professional newsletters and email lists, discussion in cyberspace and in complaints to members of parliament, professional bodies, Health Authorities, Local Authorities and Local Government Ombudsmen. The indicators may be measured numerically and in terms of population diversity.
In the Service Users’ Joint Statement, some 47 research studies were coordinated together with comment and guidance from 50 or so constituencies of children and families, service providers, academics, consultants and other colleagues as part of a research project to determine what reforms in Child Protect were necessary. The reform agenda is underpinned by that research and by an extensive body of critical literature.
Some eighty or so Child Protection service user websites are now in existence addressing the problem of miscarriages of justice in Child Protection.  It should be pointed out that the majority of Child Protection service users are the falsely accused and falsely suspected and their children.
Media reports on miscarriages of justice in Child Protection are probably in the thousands. Approximately seventy families have allegedly complained to the GMC about so called expert witnesses. The number of complaints to other agencies is not currently known, but is believed to be widespread.
Over four hundred Child Protection miscarriages of justice have been identified in the public arena in Britain and America. Yet how many of the 52,00-78,000 British “looked after children” were obtained through miscarriages of justice is not yet known. More than thirty preventable deaths have occurred among children administered by Child Protection. The implications of more than eleven legal precedents are yet be to cascaded down through the system.
Summary: Indicators of the Need for Reform
Miscarriages of Justice. Preventable injury and deaths. Under servicing. Poor outcomes in “Care”Complaints to M.P.’s.Complaints to professional bodies, Health authorities, Local Authorities and the Local government Ombudsman.Legal precedents.Research studies.Media reports: articles in broadsheets and tabloids, letters to the editor, radio & TV news.Documentaries.Internet activity: number of websites, hit rate, participants in chat rooms.Demonstrations.Discussion in professional newsletters and email lists.Artistic and dramatic expression.
Systemic Reform: Listening to Feedback
When perceived needs for reform graduate to the status of expressed needs and are reproduced on a large scale by diverse populations in diverse settings, a political claim may be regarded as having been intensively and extensively made out. Taken together, the indicators of the need for reform are strong and pervasive. The reform agenda has thereby achieved the critical mass necessary to legitimately assert that reform of the Child Protection system is essential.
In speaking to the reform agenda, I wish to stress the importance of consulting health and social care service users and listening to the insights their perspectives generate. The reform agenda has developed from consultation with children and families and those who share their perspectives.
Recommendations for change include the need for the social policing and surveillance functions which characterize Child Protection to be separated from the service provision functions which enhance the lives of children and their families. Under the current British system, contradictory role expectations result in conflicts of interests which undermine the roles that professionals are expected to perform. Families feel intimidated out of accessing services by the presence of draconian Child Protection functions. If they are to be able to access the preventative and therapeutic services which enhance the lives of children and families, then Child Protection must be quarantined, only to be called in where there is genuine evidence of abuse and neglect. To hamper service provision to children and families with destructive and failing Child Protection practices is to fail to meet the needs of children and families.
Summary: The Reform AgendaPlace the needs of children and families at the heart of policy development.Create opportunities for children and families to exert influence at all levels.Use honest language: poisoning is poisoning, suffocation is suffocation.Create role clarity:  police do police work, social workers do social work. Reconceptualise the role of Social Worker to bring it into line with international standards and requirements.Remove conflicts of interest.Locate Social Workers in an independent location to allow them to use child centred and family centred practice and to exercise professional judgment.Favour universally available services over targeted services, as this reduces stigmatisation and traumatic assessment. Divert resources wasted on assessment into service provision.The principle of self-referral to replace coercion.Respect privacy and confidentiality so that people are able to access therapeutic and preventative services.Create transparency and respond appropriately to feedback.Implement the real intention of the 1989 Children’s Act. Reform legislation and policies which are in conflict with the Act.Shared Care: adopt the principle that a child cannot be loved too much. (Abandon closed adoption).Cascade down the implications of International Law on Human Rights.
Placing Children and Families at the Heart of Public Policy
I would like to return to where we started. To Victoria Climbie and to the children we have failed, to those we have failed utterly and completely. I would like to repeat, the question Charles Pragnell asked, “What would Victoria have wanted to happen?” I think it is unlikely that she would have repeated the refrain which has been offered after every Child Protection Inquiry into a Child death that “more communication among professionals is required.”
Victoria would not have wanted us to talk more, but to listen more. Not to speak about her, but to speak to her. She may have wanted to return to the care of her parents. She may have wanted to attend Boarding School. She would have had a special and intimate knowledge of her own needs. We shall never know exactly what that knowledge was, because no one asked. We must now clear away the conflicts of interest so that children can be seen and heard, unequivocally.


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