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For Scotland's children report

Chapter 2 introduction/ background

Each of the 1 million children in Scotland is engaged on a journey from birth to adulthood. By its end the child should have realised his/her potential in terms of emotional and social maturity, be in good health, and have attained a level of academic achievement and other skills.

But every child in Scotland does not have the same starting point. It is suggested that fully one third of Scottish children begin in poverty, that 1 in 10 households is "multiply deprived" and 1 in 100 "seriously deprived". Of course, these circumstances are not evenly spread throughout Scotland: we refer to areas of deprivation or pockets of deprivation. We could say that the child from a background of poverty and deprivation has to emerge from a deep valley right at the start of the journey.

But a child is not on their own. The family is the principal guide to the child through the journey. Here again, there are major inequalities to take into account. The parents may have made an unsuccessful journey themselves, and not possess the maturity and skills to provide the support and guidance the child needs. The child may be a valued presence to parents who have a positive relationship within an encouraging extended family or, alternatively, may be part of an unpredictable and disorganised changing cast of uncommitted relationships with no identifiable stability. Some children, then, are placed by their family on a broad straight road, while others have to claw their way out of a steep-sided valley, sometimes with those around them pulling them back down. We, who provide services, need to be very clear that we are not organising our services in ways that push such children back into the valley from which they are attempting to emerge.

The family is not the only guide, though. For all children there are two others: the health service and education, the universal services. Some children - no one seems to know how many - start with some kind of impairment or disability and often require significant input from the NHS to help them in their journey. More than 2 in 100 have some level of learning disability, and 1 in 100 has extensive or complex needs which leads to them requiring help with ordinary daily living.

The health service is a guide not just to these children but to all children. This is clear in the early stages where developmental milestones are checked and progress noted. The precise nature of the responsibilities of different parts of the NHS - the GP, the health visitor, the community paediatrician - is sometimes less clear.

For most children, the health service is replaced by education as the main non-family guide. It is clear is that the NHS and education services do not always perceive themselves as having this key role with the child, since there is no handover of responsibility for the co-ordination of services from the NHS to education as a child enters formal education services. For some, this loss of continuity is critical. For all, there is the frustration of repeating information that has already been provided: a recurring theme on the journey.

For many teachers the term "education" comprises all of the elements of the child's task: achieving emotional and social maturity, good health and other skills, as well as academic achievement. This is also the ethos of New Community Schools and there are clearly steps being taken to win the hearts and minds, and thereby the commitment, of those staff who take a narrower view. We cannot yet claim that this holistic approach is working when 3 in 100 children are excluded from school. Again, there is not an even spread across Scotland and we can have no doubt that the clusters of exclusions are the same places as our pockets or areas of poverty and deprivation.

Some children lose their way on their journey. This may be because the child is a victim, or the child may have drawn attention to him or herself in some way. He/she may be struggling because of disability or illness (including, increasingly, psychiatric illness) or being a carer, or because the parents are unable to meet their responsibilities: increasingly commonly because they are drug-users.

They would not express it this way, but these children probably know that they have lost their way. But how do WE know and what do we DO about it? We should perhaps expect one of the two guides: health or education (the universal services) to identify such children and co-ordinate the further help they need. This does not always happen!

Instead, the child waits - sometimes escalating the problematic behaviour if that is their manifestation of "something wrong" - until there is some attention.

If it gets picked up at school there is a range of options: guidance, educational psychologist, social work, Reporter.

If in the community, another range, perhaps involving the police.

If in the family, yet another, perhaps including the GP and specialist medical services such as child and adolescent psychiatry.

The point is that the service the child ends up in is largely due to the accident of the point of entry to specialist services, rather than to any comprehensive appraisal of the optimum response to the assessed needs of the child.

How many children are we talking about? We have already noted 3 in 100 children excluded from school. More than 3 in 100 are referred to the Reporter and 1 in 100 becomes looked after by the local authority.

In Scotland today many children are losing their way. Are we properly organised to help guide them back and adequately support them on their journey?

We will describe later the long waiting lists, the unallocated cases, the disputes between agencies, the many changes of worker - even for the most disadvantaged children who have been accepted as having the greatest need. Some children start receiving the extra help of a special guide but then seem to be abandoned in the wilderness.

So is it a resource issue? Do we have sufficient guides, sufficient maps?

There are serious resource issues in some parts of our landscape of services, but since no one is able to say that we are using all resources as well as they could possibly be used within an integrated framework, we cannot conclude that there is an absolute shortfall.

The underlying principle in the work of the Action Team has been SOCIAL JUSTICE - how can we arrange children's services to reduce inequalities? Our task is to map the routes for all our children to successfully complete their journey.

The team examined children's services in Scotland by visiting a wide range of settings from South Uist in the North to Girvan in the South, to identify issues in current practice. Two, more extended, visits were joint exercises with the Child Health Support Group, charged with advising the health minister in relation to improving health services to children. The major element of the full range of visits conducted by the team was the emphasis on hearing the experience and views of service users i.e. children/families; and identifying examples of services working well which might be applied elsewhere. As well as visiting services, the team heard from a wide variety of organisations including the NHS (sessions with health boards, health trusts and local health care co-operatives), the Association of Directors of Social Work (ADSW), the Scottish Children's Reporters Administration, the Association of Directors of Education in Scotland (ADES) and the voluntary sector. The team also brought together contributors from a variety of settings for more thematic discussions e.g. social inclusion, drugs, criminal justice, mental health. In addition, specific events were arranged to hear directly from young people and from organisations representing parents. The team also received written submissions which often highlighted good practice.

The Scottish Executive arranged two national seminars in relation to the work of the team, at the first of which the Minister for Education, Jack McConnell, provided the key note address. In addition to this extensive range of direct activity, the team also had access to the full range of statistics in relation to children's services.

Why Now?

Previous Initiatives

The Scottish Executive has already put in place initiatives that promote a more integrated approach to providing services to children:

• Sure Start Scotland
• New Community Schools
• Social Inclusion Partnerships.

The experience of these initiatives plus a range of other, local projects, has confirmed that there is much to be gained from bringing services together to meet the needs of individual children and families.

Community Care

The Scottish Executive has recognised the need for more integrated approaches in a range of public services. Many of the agencies involved in providing children's services are already engaged in new measures to promote better-integrated services in the field of community care, particularly through the work of the Joint Futures Group. There is much that can be applied from community care to children's services, but it is recognised that there is also much that is different. There is a greater range of agencies and settings involved in children's services - particularly within the education sector, which does not have a central role in community care services.

Organisational Change

All of the main statutory agencies involved in children's services have been involved in major organisational change over the past 10 years.

Following local government reorganisation in 1996, financial pressures have led to further, internal, restructurings in many Scottish local authorities. Many of which have had an impact on housing, social work and education services.

The NHS moved to purchaser/provider split, had a major reconfiguration to NHS trusts and then a further reconfiguration of those trusts. It is now moving back to a more unified approach within the structure of unified health boards.

Despite the pace and volume of this change, some authorities have re-examined their structures from an ideological and service improvement perspective (rather than simply for reasons of financial expediency). They have promoted new children's services departments which have tended to bring together education and social work children and families services within one departmental organisation. Stirling and Perth & Kinross have taken this approach.

One council, Highland, has gone further and has fully engaged with its Highland Health Board partner to establish a joint service for children across the two public agencies. This has, however, been a change achieved through a joint "political" approach rather than through structural changes within the partner agencies.

The development of these innovative organisational arrangements has created more fertile ground for the consideration of more integrated approaches.

Best Value

The requirement to achieve best value in services is now applied to all public agencies. The Scottish Local Authority Management (SLAM) Centre at the University of Strathclyde has criticised any approach to best value that does not recognise the interdependence of agencies:

"Whether necessary or not, a function of fragmented organisational structures is often competition and protectionism in the allocation and use of resources, that contradicts concerns with best value. A head teacher's unwillingness to invest £40 per week in classroom assistance leads the social work department in the same council to spend £400 per week on an excluded child. Equally, it does not occur to social work managers to allocate £40 per week from their budgets to the head teacher.

Best value also has a longitudinal dimension: controlling costs now that result in far higher unnecessary expenditure later is equally not best value. The Head Teacher's £40 saving becomes thousands of pounds expenditure in the criminal-justice system as the impact of exclusion, labelling, and alienation kick-in. Put simply, "best-value" is an holistic concept incompatible with agency specific and time specific budget management interests."

- Colin Mair, Director, SLAM Centre

Rights of the Child

Children have always had a strong sense of what is right, of justice and of their frustration at not being heard. Where children and young people are offered opportunities to learn about their rights or to experience meaningful participation they are keen to engage. When children define what their rights should be they are often both a claim of right and an understanding of the social responsibilities we all share. For adults and adult-led agencies, however, a recognition of the rights of the child, an important cultural shift, can be challenging. Increasingly the child is being viewed as an active agent in his or her world. The right of the child to participate in decisions which are made which impact on their lives is being increasingly recognised and where decisions are made on behalf of children their best interests are being seen as paramount. The UK's commitment to implementation of the United Nations Convention on the Rights of Child should mean that a view of the child as a citizen with rights is being actively promoted and implemented by Government and by service providers across sectors. These issues will be returned to throughout the report on the Action Team process, and reflected in our findings and recommendations.

Service Improvement

While there is no doubt that a general consensus exists that better integrated children's services will be better children's services (i.e. more responsive services with better outcomes for children and families), the findings of the Action Team have demonstrated that current arrangements are failing some of our most disadvantaged children. The one option that is not available is to do nothing.

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