practitioners, how far the work of each individual dovetails with the inputs of others and ultimately, who has overall responsibility.
approach of the social work led child protection system by making visible its inherent weaknesses, specifically in relation to child neglect, and will question both the feasibility and the advisability of giving social workers prime respon-sibility for assessing and intervening in these types of cases. On this basis, it will make a case for promoting interventions into child neglect by agencies and pro-fessionals who are working within a framework that is not necessarily statutory itself but is accountable to a statutory authority.
Potential for tense relationships between statutory child protection social workers and other professionals is particularly endemic, and strongly linked with issues such as power and obligation between on the one hand, the statu-tory social workers’ responsibility and on the other, their lack of influence over those professionals on whose co-operation they depend. Research has shown that certain professionals, such as teachers and social care workers, associate social workers’ responsibilities with power and can feel marginalized and excluded by the control that they seem to exert over the child protection process (Berry 2003; Buckley et al. 1997). In practice, however, as Lupton et al.
(2001) point out, social workers have had difficulty attaining full professional status and find it problematic to control their spheres of work, possibly because of its association with altruism rather than science. Research carried out on child protection practice in a statutory setting in Ireland has demonstrated the perception held by statutory social workers that they tended to be left with the difficult, confrontational elements of the work, and that other agencies wanted to do ‘therapy in isolation’, avoiding the ‘unpleasant, action taking bits’. The statutory social workers in this study resented the implication that ‘co-ordina-tion’ meant them taking on the ‘nasty’ bits to facilitate the treatment agencies doing the ‘nice’ work (Buckley 2003a). It is clear that social workers as case managers do not hold sufficient authority to compel a satisfactory level of co-operation and sharing of responsibility from other professionals, particu-larly those outside the statutory system. Normally, inter agency arrangements have to be negotiated by them within organisational contexts and cultures. Yet, despite their sense of powerlessness in the inter agency sphere, social workers in statutory settings do have a strong gate-keeping role that in many cases effectively determines children and families’ access to a range of services.
Where referrals are placed on waiting lists for assessment or fail to qualify for a service (a trend frequently associated with child neglect) this can impede or seriously delay their access to support or treatment. This could be seen as a negative use of power or control by statutory social workers.
One of the principal weaknesses of the type of statutory child protection system commonly operated in Ireland, the UK and elsewhere is the fact that child neglect has traditionally been accorded low priority in the continuum of child abuse. Despite what we know about the detrimental and long-term effects on children of failure to meet their basic needs for nutrition, supervision, emo-tional attachment and stability, research in England, Ireland, the USA and
Aus-tralia has substantially demonstrated that proportionately, the majority of refer-rals of suspected child abuse to statutory agencies concern neglect and that the majority of these are filtered out, often without a service, at an early stage (Berry 2003; Berry, Charlston and Dawson 2003; Buckley 2003a; Gibbons, Conroy and Bell 1995; Horwath and Bishop 2001; Sedlack and Broadhurst 1996). As Stevenson (1998a) has observed, ‘the nettle has not been grasped’ despite the acknowledged concern of professionals about the unsatisfactory response being made to reported child neglect. Its relegation to a lower priority is commonly explained as a consequence of the crisis-driven nature of child pro-tection social work, and the inevitable development of defensive practice despite the acknowledgement in child law and policy of the importance of early intervention and family support. Spratt (2001) argues that while statutory social workers express an attitudinal desire to adopt a welfare orientation, they experience constraint at an organizational level and still tend to prioritize the management of risk. As he points out, this trend has been underpinned by a realistically based fear that too wide a swing from child protection to child welfare may leave them open to criticism if child protection issues are seen to have been inadequately addressed. The refocusing debate in England was based on the notion that a less forensic approach to the problem of child neglect would yield more effective outcomes, but as others have argued (Parton 1996;
Parton, Thorpe and Wattam 1997) it would require more than a different mindset to achieve universal acceptance of a change of approach within a system that demands a high level of certainty and an elimination of risk.
The tendency of the child protection system to downgrade child neglect is also explained by Graham (1998) who suggests that the structures within which statutory social workers operate lack clear procedures and systems for dealing with neglect, unlike cases of physical and sexual abuse where causes and effects are easier to identify. Child sexual and physical abuses are crimes, thus, because of the structures set up to facilitate co-operation between the police and social workers, clearer channels exist for processing reported cases.
Clinical examinations and forensic interviewing may also provide corrobora-tive evidence of harm or injury and such procedures form a normal part of assessment. Interprofessional and inter agency work is easier to achieve in such circumstances, and multidisciplinary involvement is automatic.
However, under Irish child protection guidelines (Department of Health and Children (Ireland) 1999) child neglect (unless deemed ‘wilful’) is not reportable to the police as it does not involve law enforcement if it is deemed
‘unintentional’. As a type of child abuse, it is less likely than others to threaten a child’s immediate safety or cause a direct injury, and is therefore considered less dramatic and less urgent. Research has also shown that the low priority assigned to child neglect by statutory social workers is strongly linked to its complex nature and a combination of pessimism on the part of practitioners about the value of intervention together with ambivalence about the
bound-aries between poor quality and unacceptable care in a context of general adver-sity where an accusation of child abuse would further undermine the carers’
already stretched parenting capacities (Buckley 2003a; Stevenson 1998a;
Thorpe 1994). A much earlier study in the UK demonstrated that it was only when the boundary of ‘parental incorrigibility’ had been breached by some spectacularly and visibly harmful caregiver behaviour that the child protection system would assert itself in cases where parents were seen to be entrapped by social inequality and struggling against the odds (Dingwall, Eekelaar and Murray 1983, 1995).
Research on statutory child protection social work in Ireland, the UK and Australia has also demonstrated that, once thresholds for intervention have been breached, there can be a tendency for assessment of neglect to employ a kind of ‘sense-making’ which is based more on pragmatic rationalization than on any theoretical reasoning and focused more or less exclusively on caregiver performance and the extent to which they acknowledged culpability, in other words, their moral behaviour and attitude. There is less concentration on the physical, psychological or emotional needs of children, or evidence of knowl-edge about the specific impact of various factors such as parental alcohol problems or poverty on their development (Parton et al. 1997; Thorpe 1994).
Social workers can be somewhat shy about drawing explicitly on theory (Buckley 2003a; Howe 1996a; Stevenson 1989), unlike their counterparts in child health, psychology, clinical speech and language therapy and nursing who operate a more empiricist style of assessment by drawing on quantifiable evidence of delayed development or impaired well-being. Moves towards more needs-based assessments (Department of Health 2000) and the type of evidence-based practice advocated by Macdonald (2001 and Chapter Sixteen in this volume) and others should rationalize professional approaches to child neglect and by demonstrating convincing and systematically gathered data, validate its detrimental effect on children’s welfare and development. However, in the meantime, neglect suffers within the orthodox child protection system, which continues to give a higher profile and more urgent response to cases with more dramatic manifestations. The case example in Box 7.1, taken from a study of child protection practice in a statutory agency in Ireland in the mid 1990s (Buckley 2003a), demonstrates an approach adopted by statutory social workers that essentially ignored the contextual issues compounding the reported neglect.
The limited response to child neglect within the statutory social work system, and the potential for multidisciplinary involvement in treating it, are further undermined by a lack of confidence on the part of potential key refer-rers. Research carried out recently in Ireland and Australia has demonstrated the reluctance of community-based nurses to refer neglect cases to social work because of anticipated lack of response or feedback (Buckley 2002; Graham 1998; Horwath and Sanders 2003). Hanafin’s (1998) analysis of a high-profile
Box 7.1 Case example of the response of a statutory social work service to reported child neglect
This case was referred to the statutory child protection social work team by a member of the public who had been out canvassing for a forthcom-ing local election and had come across four children under ten in a house on their own at ten o’clock at night. This person had waited with the children for three hours until their parents’ return at which point she informed them that she would be reporting them to social services for child neglect. The parents (here called John and Mary) apparently dis-played distress at this and said it had never happened before.
However, the referrer, who was very concerned, had already spoken to neighbours who said that the children were frequently left alone at night and for periods during the day. The matter was reported to the duty social worker by telephone. When it was discussed at the weekly intake meeting with the social work team, it was decided to write to the parents and ask them to come to the office and discuss the complaint. One week later Mary came to see the duty social worker, partially in response to the letter, but principally looking for help. Mary explained that she and her husband were both problem drug users and had run up serious debts, they were on a waiting list for methadone treatment, they had been seeing people in different agencies in their (unsuccessful) efforts to get help.
They were about to be evicted from their rented accommodation and had lost their welfare allowances due to previous fraudulent claims. Neither parent had contact with their extended families and because of their tendency to move frequently and the isolation linked with their drug problem, they had virtually no connections with the local community.
Mary told the social worker that her objective in coming to social services was to find someone who would see the family’s difficulties as a
‘package’, not just separate bits, and who would give her some advice and advocate on her behalf. She expressed concern about the effect on the children of recent instability, poor diet, frequent moves, arguments between herself and her husband as well as both parents’ substance abuse.
The social worker brought up the matter of the children being left alone, and Mary explained it by saying that she worked late at night in a pub, and her husband got part-time work in the same place on occasions. She had claimed that the children were quite safe in bed at that time, but acknowledged, after talking to the social worker, that it was unacceptable to leave them alone.
The social worker made two telephone calls on her behalf, neither of which were successful, first to the welfare officer about a rent allowance
child abuse case in Ireland where a child had died of wilful neglect (Western Health Board 1996) and Nadya’s (2002) Australian study of community nurses’ reporting behaviours when they encounter child abuse both illustrate that nurses experience a sense that their opinions are neither valued nor taken seriously, and in the latter study, this acted to deter them from activating the child protection system. Faughey (1997) makes an argument based on her Irish study that although public health nurses share corporate responsibility under child care legislation, the high threshold of entry into the child protection system means that not only do families not get a service, but also public health nurses lose credibility in their eyes when their assessment of need does not result in an intervention. In areas where child protection social workers are the gate-keepers of family support services, this can be a crucial issue. Research in Ireland and the UK has also shown that the ambivalence felt by teachers in relation to the reporting of suspected child neglect is influenced by their sense that no response or feedback will be forthcoming, based on past experience (Baginsky 2000; Briggs 1997; Kelly 1997). A group of school principals inter-viewed by Berry (2003) were extremely vociferous in their expression of frus-tration at the poor communication from statutory child protection social work services in relation to children they had referred. In an earlier study on the role of secondary schools in supporting pupils who had been victims of child sexual abuse, Bradshaw (2000) points out that ‘teachers feel insignificant and under-valued by health board professionals’ (p.94), a factor that undermines their willingness to collaborate in child protection work.