Select Committee on Health Sixth Report


3. A new management and accountability structure

51. The Inquiry offered a total of 108 recommendations for change, 89 of which Lord Laming believed should be implemented within six months, as they "should be part of the lifeblood of organisations to behave in that way." We do not propose to scrutinise these individually, but to consider the totality of the recommendations and the overall model that they set out.

Development of recommendations

52. Lord Laming told us that he believed it was very important that the recommendations should not be based upon what happened to one child, or what happened in one part of North London. In his view, hard cases could make bad law. The Inquiry team decided to find a method that would enable them to test out the matters that had arisen during the first phase of the Inquiry with a much wider range of people. Five key themes were identified from Phase One (Discovery and inclusion; Identification; Determining requirements; Service provision and delivery; and Monitoring performance), and a series of five seminars was arranged around each of these. The participants for the seminars were invited to ensure a geographical spread, a range of political interests and varied experience. The seminars provided confirmation that many of the issues that had arisen in Victoria's case were indicative of issues causing general concern across the country.

53. We were somewhat surprised by the methodology adopted for the second phase of the Inquiry, which appeared to us to be a particularly selective model. It seems to us that a more broadly based investigative approach might have been of greater value. Lord Laming defended his choice of method on the basis of the need to "strike a balance between a reasonable examination of the issues and the amount of time and effort and expense that would be necessary to go down other routes."[36] In view of the arguably selective methodology used in developing the full recommendations from the Climbié Inquiry, we recommend that the Government should ensure the forthcoming Green Paper allows full consultation with the widest possible audience and stakeholders.

54. We recognise the difficult balance that needed to be maintained between further analysis and producing a timely and relevant report. However, we were especially struck by the absence of analysis of experience in other countries, which might have proved worthwhile. Lord Laming accepted that there could be arguments for looking at such experience, but contended that it was not possible to simply "pick up a system from one country and replicate it in another."[37] Moreover, because the Inquiry was already convinced from the first phase of its work that existing legislation provides a basically sound framework, but that the problems arose through the legislation being incorrectly interpreted and applied at local level, the essential challenge was to make the existing system work. As Lord Laming put it: "and because of that I thought, let's get on and do it."

55. However, not all other countries seem to have the same problems with child abuse as Britain does. The experience in Sweden, for example, which has long outlawed the physical punishment of children, is one in which child deaths from deliberate harm by adults are now unknown. What happened to Victoria involved the apparent escalation of discipline and punishment. Carl Manning told the Inquiry that the abuse had begun with little smacks. This raises the question of 'reasonable chastisement', and we are aware that this can be used as a defence in cases of child abuse, and often leads to the collapse of cases where real harm has taken place. Lord Laming's predecessor as Chief Inspector of Social Services (Sir William Utting) had argued that the reasonable chastisement defence should be removed in order to protect children from injury by parents or carers. Lord Laming did not address this particular issue in his Inquiry, although the implication of the recommendations and much of what he told us is that he recognises that a physical assault on a child must be treated with the same seriousness as an assault on an adult. Physical punishment of children is no longer permitted in schools, and the Government recently announced that new standards from September 2003 will outlaw childminders smacking children in their care. We urge the Government to use the opportunity of its forthcoming Green Paper on children at risk to remove the increasingly anomalous reasonable chastisement defence from parents and carers in order fully to protect children from injury and death.

The recommended new structure

56. While leaving the legislative framework intact, the Laming Inquiry recommended major structural changes, which are summarised in Figure 1 below. Lord Laming argued that the structures need to reflect new arrangements. For example, the proliferation of new organisational forms and boundaries creates major challenges to old structures such as the Area Child Protection Committee system established at a time when circumstances were different, and structures were less complex. As Lord Laming pointed out, there are now 30 Strategic Health Authorities, 43 police forces, 150 social services departments, 300 Primary Care Trusts and 355 housing authorities, which—he argued—constitute "a bureaucratic nightmare."[38] The system he was proposing was intended to create "less bureaucracy, greater focus and more certainty that things actually happen that can achieve outcomes for children."[39]

57. Lord Laming's Inquiry's recommendations were intended to ensure managerial accountability throughout the system. Lord Laming told us that there were three main weaknesses in the current system. First, there was no way of ensuring "that the will of Parliament is implemented." Second, there was no accountability through the system and Area Child Protection Committees have no statutory basis, but rather "depend solely on good will and best endeavours of local people." Third, there was no clear focus on ensuring a dedication to good outcomes for children.

58. The key changes proposed by the Laming Inquiry comprise the introduction of:

  • A Children and Families Board which should be established within government, chaired by a Minister of Cabinet rank, and having representation at ministerial level from each of the relevant government departments. The Board should be charged with ensuring that the impact of all initiatives with a bearing on the well-being of children and families is considered within the forum.
  • A National Agency for Children and Families where the Chief Executive will report to the Ministerial Children and Families Board. The Chief Executive should incorporate the responsibilities of a Children's Commissioner for England. The national agency should:
  • Assess and advise the ministerial Children and Families Board about the impact on children and families of proposed changes in policy
  • Scrutinise the new legislation and guidance issued for this purpose
  • Advise on the implementation of the UN convention on the Rights of the Child
  • Advise on setting nationally agreed outcomes for children and how they might best be achieved and monitored
  • Ensure that legislation and policy are implemented at local level and are monitored through its regional office network
  • Report annually to Parliament on the quality and effectiveness of services to children and families, in particular on the safety of children
  • Local Committees for Children and Families: each local authority with social services responsibilities should establish a Committee for Children and Families with lay members drawn from the management committees of each of the key services (local authority, police authority and health service boards and trusts). This Committee must ensure that services to children and families are properly co-ordinated and that the inter-agency dimension of this work is being managed effectively.
  • Management Boards for Services to Children and Families: the local authority Chief Executive should chair a Management Board for Services to Children and Families which will report to the Member Committee referred to above. The Management Board must include senior officers from each of the key agencies, and must also establish strong links with community-based organisations that make significant contributions to local services for children and families. The Board must ensure staff working in the key agencies are appropriately trained and are able to demonstrate competence in their respective tasks. It will be responsible for the work currently undertaken by the Area Child Protection Committee. The Management Board must appoint a Director responsible for ensuring that inter-agency arrangements are appropriate and effective, and for advising the Board on the development of services to meet local need.

59. The proposals are intended to "secure a clear line of accountability for the protection of children and for the well-being of families." It should ensure, the Report argued, that people in a senior position were no longer able to claim ignorance of what is happening on the ground, and to argue that this is not their responsibility. Instead, the arrangements would ensure that those who manage services for children and families are "held personally accountable for the effectiveness of these services, and for the arrangements their organisations put in place to ensure that all children are offered the best protection possible."

Figure 1: Recommended New Structure


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