12 November 2008

On diminishing returns

Maria Colwell, Jasmine Beckford ... Victoria Climbie, baby P. Children who died at the hands of their carers over thirty-odd years. From what I hear on Newsnight, one still dies every week. But there are 50,000+ plus children on "at-risk" registers. In other words, one in a thousand dies each year, out of those already deemed to be at risk. In Maria Colwell's day, we didn't even know how many were at risk.

I used to teach social workers. In the discussion of the latest tragedy I was pleased to detect no sign of the strident blame which characterised previous cases. I was pleased to see that Herbert Laming is being commissioned not to review this particular case in the usual blaming exercise, but to look at overall nationwide strategies and procedures.

It's tragic. There is no acceptable level of child abuse, let alone murder. But there is a law of diminishing returns. The NSPCC has a Full Stop campaign against child abuse. And so they should. I've worked with NSPCC staff and I have enormous respect for their work (as well as some reservations about their care for their staff injured in the line of duty). But practitioners know that "Full Stop" is marketing bulls**t.

The danger is that defensive practice which is aimed more at forestalling criticism than working in the best interests of the child will inevitably create more problems than it solves. And I do mean "inevitably"; it is built into the nature of the system. I know that we can never be complacent, and that more can always be done, but there does come a point at which enormous amounts of time, resources and effort can be invested to no discernible advantage. After all, the measure of "improvement" is something which does not happen.

In the public services nowadays, in education and health care as well as social services, and as in the economy, the one taboo is the admission that we do not know what is going on and a fortiori that there is nothing we can do about it. Powerlessness is not an option, but as Taleb points out in that odd and infuriating book The Black Swan (2008) it may be a necessary admission.

Having said that, how did a paediatrician miss a broken spine, or two police investigations decide not to proceed, or sixty visits by professionals not notice what was going on? Perhaps this time all the inter-agency working led to a diffusion of responsibility, to no individual being prepared to take individual responsibility for launching that horrible juggernaut of care proceedings?

Indeed, is it just possible that it was the sheer level of resources and number of personnel involved which introduced those unintended consequences?

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