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UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 40-iii House of COMMONS MINUTES OF EVIDENCE TAKEN BEFORE Education and Skills Committee
Monday 20 DECember 2004 DAME GILL MORGAN, MR JOHN COUGHLAN, CLLR JAMES KEMPTON, MR DAVID HAWKER and CHIEF CONSTABLE TERRY GRANGE Evidence heard in Public Questions 153 - 198
USE OF THE TRANSCRIPT
Oral Evidence Taken before the Education and Skills Committee on Monday 20 December 2004 Members present Valerie Davey Jeff Ennis Paul Holmes Mr Kerry Pollard Jonathan Shaw
In the absence of the Chairman, Valerie Davey was called to the Chair ________________ Witness: Dame Gill Morgan, Chief Executive, NHS Confederation, Mr John Coughlan, Co-Chair, Children and Families Committee, Association of directors of Social Services, Cllr James Kempton, Vice-Chair, Children and Young People's Board, Local Government Association/Deputy Leader Islington Council, Mr David Hawker, Incoming Chair, Association of directors of Education and Children's Services and Director of Children Families & Schools, Brighton & Hove City Council, and Chief Constable Terry Grange, Lead on Child Protection, Association of Chief Police Officers, and Chief Constable of Dyfed-Powys Police, examined. Q153 Valerie Davey: I welcome you all, especially at what is, for everyone, a busy time. If we were not concerned for improving children's services before Christmas, then I cannot think whenever else we might. I should like to put on record the apologies of the Chair, who is out of the country, but will say that we are a smaller, but perhaps keener committee, with one other member hoping to join us fairly soon. We have looked on several occasions now, and taken evidence on several occasions on this very important subject of Every Child Matters. We reckon that amongst you, with your professional organisations behind you, you bring a particularly significant contribution to our deliberations. If each of you would like to say a word - and I mean a few words, but not many - as introduction, we would be very pleased before we start our questioning. Dame Gill Morgan: I am Gill Morgan, Chief Executive of the NHS Confederation. That is an organisation made up of NHS and statutory organisations. We currently have 92 per cent all NHS organisations in membership, and that includes primary care trusts as well as hospital trusts. Our other interest in this is that one of the things we have recently been involved in doing is negotiating the new GP contract, and we have a continuing responsibility for the maintenance of that contract. Mr Coughlan: I am John Coughlan, the Corporate Director for Social Care in Telford and Wrekin Council, and I am here as the Co-Chair of the Children and Families Committee of the Association of Directors of Social Services, the ADSS, a national body which accounts for its membership all the directors of social services in England and Wales, and acts as the professional representing their views, particularly in dialogue with government. Cllr Kempton: I am Councillor James Kempton, representing the Local Government Association. I am Vice-Chair of the Children and Young People's Board. In the LGA we have already re-organised around the theme of children and young people, as many authorities are doing at the moment. Aside from that, I am also the executive member for children and young people in Islington. Mr Hawker: I am David Hawker, Director of Children, Families & Schools for Brighton & Hove City Council, and I am Vice-Chair of the Association of Directors of Education and Children's Services, which represents directors of education for the 150 local education authorities and an increasing number of directors of children's services - about a third now out of the total. Chief Constable Grange: I am Terence Grange, Chief Constable of the Dyfed-Powys Police. I lead for the Association of Chief Police Officers on child protection, the management of sex offenders, and all things pertinent to private violence. There is another ACPO group, the Youth Issues Group, which deals with matters to do with children other than child protection. Q154 Valerie Davey: Thank you very much - a distinguished gathering! I wonder whether you often meet, but perhaps in the future under this remit of Every Child Matters you may indeed; but we are pleased to have you together. Although this is quite a large gathering, we will not expect each of you to answer every question. The theme clearly is collaboration of bringing together the different structures that you represent. How important do you see this to be. Terence, you have perhaps been less involved than the other groups. How important do you see this new approach? Chief Constable Grange: I think the Association of Chief Police Officers would argue that to date the police force have been, by mistake, peripheral to all discussions about children, particularly Every Child Matters. We would argue that if you look at the function of policing, a wider look, we are absolutely essential to any development in this area. We have done studies going back to 1997, where we looked at all the predictive causes of future difficulties with children, and police engagement in those areas; and we would say that we are absolutely crucial to these discussions. What surprises us is that we appear to be consultees of last resort. We would argue that we should be fully engaged at all times. Q155 Valerie Davey: Do you expect to be, as a result of the new structures which are proposed and do you think this will improve the situation for children, not just for police officers and the way they work, but for children concerned. Chief Constable Grange: We would hope to be. We do not expect to be because the evidence so far is that when the DfES and the Home Office have had their discussions, then they talk to us. We would expect that if we were engaged, there would be far better outcomes for children. Q156 Valerie Davey: David, does that provoke a comment? Mr Hawker: The general point is right. We need to do a lot of work at local level. Where I am, for example, we have the local chief of police on our chief officers' group for the children's trust, and that is an appropriate model I think in terms of engagement at the right level, not just as a consultee of last resort but as part and parcel of the strategic and management arrangements for the whole thing. It is particularly important in terms of child protection and also in terms of youth justice; but there are other dimensions to it as well in terms of the police involvement around school security, around behaviour management and around community safety, which also need to be part of the whole picture. I would certainly agree with ACPO that it is very important that at local level police are fully engaged in the development of children's services. What we do need are the right kinds of signals from the DfES and the Home Office to enable that to happen and to make it an expectation that it will happen at a local level. Q157 Valerie Davey: Gill, does health feel a little on the fringe of this as well, or do you feel you have been more integrated into the discussions and plans for the future? Dame Gill Morgan: In preparing for today we did a straw poll of members to answer that question. The view from PCTs is very positive. They feel that they have been actively involved at a local level, that they are in the heart of thinking about things. They see some practical problems but there are absolutely no complaints about engagement. I think we are downplaying the involvement of the police because in the overall children's agenda there are very many sub-components, and there are some excellent examples of the police being actively engaged in partnership: drug action teams; alcohol strategies; crime and disorder partnerships, which PCTs are statutory members of, and run by the police; youth offender teams, ACPCs, and many primary care organisations and strategic health authorities have very good information-sharing protocols with the police. Whilst I agree that the police need to be intimately involved, there is some very good practice to build on at the moment across the country. Q158 Valerie Davey: John, given that social services have always been central to this, do you see the extension of this work across so many different groupings being an improvement for children? Mr Coughlan: Yes, I do. I fully support what has been said about the crucial need to involve the police, and also about our own meeting as a group. There is a body called the inter-agency group, which has been running for two or three years, which has been crucial to the development of this agenda; and the police were founder members of that group. Outside of government dialogue the agencies are working very, very well together; and that was developed through the document Serving Children Well, which we think was a blueprint for Every Child Matters, some nine months before Every Child Matters was published. We do think there is a very positive framework at a national as well as a local level. As far as social services are concerned, we very much support the development of the integrated agenda as described in Every Child Matters. We have concerns about some of the structural prescription that has come through the legislation, but generally speaking we think that those concerns need to be put to one side, now that we are on the path we are on, because of the need to make the integrated agenda work. That has been a position that ADSS has taken obviously with some difficult self-examination because of the need for us to look at the roles of our membership and our services within what will be the new frameworks in local authorities. We are very, very pleased indeed that local authorities have been given the lead in this agenda, because we think that is where it should rightly sit. Q159 Jeff Ennis: Continuing on the theme of integrated working in practice, what are the key challenges that need to be overcome to achieve this Utopia, because I do not think it will be easy to achieve, certainly not in the short term. Cllr Kempton: Clearly, one of the challenges we are all responding to is the need for leadership in the area, both from government and national organisations but also for local government to respond to the leadership role which has been set out for it within the Children Act. That is a significant set of challenges for us, but one which local government feels ready to take up - and the evidence is that it is well able to do that. We have been running 35 pilots, which were started as children's trusts under the Serving Children Well banner, and they have been going for some time now. There is some really good evidence of progress in there from around the country. I can give you specific examples of where authorities like, for example, North Lincolnshire has established some very good practice, but which has been built around relationship-building rather than structural change. There is also good practice from places like Sheffield and Bolton, and I could go on. There is therefore quite a lot that we are looking to build on. One area that concerns us greatly in terms of integrated service is obviously the position of schools, where we seem to be arguing for services to come together with health and social services and the police, but where there are also other local authority services like housing, leisure, youth and childcare. There is widespread concern about the position of schools where there is no duty to co-operate laid down in legislation. I can not speak for everyone here, but there is concern about what that might mean in practice, particularly on the back of the rhetoric laid down even in the Children Act of schools becoming more autonomous and becoming masters of their own affairs. Whilst I think no-one has a problem with school autonomy as it stands at the moment, there is a concern about relying on the goodwill and spirit of individuals to see that the duty to collaborate is a kind of moral imperative as opposed to a legalistic duty that is being placed on everybody else. Q160 Jeff Ennis: You have just said that schools are not involved with a statutory duty to co‑operate; and obviously GPs are in a similar situation, James. Have you any comments to make, or have the health people any comment to make about the GPs not having the statutory duty to co-operate? Cllr Kempton: I would say it is a similar issue of concern with GPs. In the area of child protection, working with GPs is essential, and although there is very good evidence around of good working practice, we are concerned as to why some groups were left out and some were included, and what that might mean in practice. Q161 Dame Gill Morgan: This is one of the questions we asked the primary care trusts because if they are to make this deliver they will have to make sure that they can engage GPs at a local level. Primary care trusts regard it as a challenge to engage all GPs, and they are very keen to see some proper incentives in the system to enable them to do that. One of the issues that is not well formed enough - and this is an issue for us not for government - is that in framing the quality and outcome framework of the new GP contract, which tries to deliver general practice services against a set equality standard, is unique in the world. When we have gone back to look, in the light of the Children's Bill at the recommendations about what should be measured around the quality of children's services, we think it is very like. We do not think it is good or strong enough, and we would go back and think what we can do, in reviewing the quality and outcome framework, to be better. On the other hand, we know that if we look at the Royal College of GPs, they have some very clear statements of what a framework should look like, which seems to be very simple, very clear, and could be put into practice within general practice very easily, to put a set of standards that they could objectively measure themselves against. We know that the practices that are committed to the quality expected by the Royal College of General Practitioners all have a named doctor and a named nurse, so they are already well in train for the sort of principles that you would want. The biggest challenge, however, is that if you look at the number of individual GP practices, you have to have something that gets into every practice. That has to happen through primary care trusts and through training, development, and keeping people up to date. It will also have to happen through things like re-validation and through the quality and outcomes framework, because we know those are things that doctors inter-relate with quite intimately, because at the end of the day they affect pay; and something which affects pay is more likely to be a powerful driver of conformity than something that is enshrined in statute. We have some mechanisms for making sure that it does not become a problem around GPs, which are potentially easier to deal with than some of the concerns around schools. Q162 Jeff Ennis: James, you said that local authorities need to take the lead in Every Child Matters, which I do not dispute. How do the other agencies feel about local authorities taking the lead in this matter? Should we not just leave it to local authorities and have other agencies taking the lead more? Cllr Kempton: It is clear that the leadership role is a partnership one as well. I am not envisaging that local authorities work in isolation; and there is evidence of strong local partnerships already around the place. What might be new is making sure that those partnerships are focused around the five outcomes, and I think the leadership role of putting the outcomes at the centre. To give an example from my own authority, the very first thing we have done is to go out and talk to children, parents, and the professionals that support them, to agree a vision for the kind of services we want to see. We are now taking that vision around all the statutory and voluntary sector organisations in the area, getting people to sign up to that. That is what I mean by leadership. It is not a command and control relationship, but it is about getting people to buy and to putting those outcomes at the centre of what they do, and assessing themselves against the outcomes. I guess we will talk a little more about this when you ask questions on inspection; but that is the key first step that brings people together. It is no easy thing to reconfigure services around the child and its family. We all know that one of the reasons why we are discussing this today is because services have failed to do that in the past sufficiently well. Q163 Jeff Ennis: That is a good recovery, James, but I would still like to hear the other agencies' views on this. Chief Constable Grange: You will know that local crime and disorder partnerships are partnerships between the local chief executive and the local chief superintendent, and anybody else who should engage in statutory partnerships. Where you have children's services and outcomes for children across all the authorities, that kind of partnership is essential, and there has to be leadership. If you are going to have leadership that is locally managed, then the place where it seems to vest itself best is in local political authority, which would be the local authority with the other statutory agencies on board. Members of my authority constitute three parts, one of which is local political authority, and the chair of every local authority community safety arena is, by right, soon to be on a police authority. We would see it naturally vested there and would not have any difficulty with that. We would argue that given the links between local criminal justice boards, the local authority, the local children's safeguarding boards, it would be natural for those things to be linked. I doubt that there is a chief superintendent or chief police officer in the land that would disagree with that. We would not see ourselves leading on it. If I could briefly go back, there was discussion of children's trusts. In the police service we see huge overlaps between children's services and the Association of Chief Police Officers' youth strategy. What we do not see is integration between the two, and we think that with appropriate leadership locally and nationally there could be. On the children's trusts nationally, there is only one place, Braintree, where there is a police officer full-time engaged. It is early to be stating that that is successful, but the early indications are that it is not a bad approach and should be pursued. We would argue that you should explore these things far more. Dame Gill Morgan: If you would like me to comment from the health point of view, we are the bit of the system that does not have democracy involved in what we do. We are very happy with the concept that this is something where local government should take leadership. We think that there is responsibility at all sorts of levels. Clearly, in the Health Service individual professionals have very key personal responsibility to the children they look after, and that cannot be devolved or laid off to another organisation. Organisations themselves have individual responsibility for how they collectively provide services for children, and that has to be the responsibility of individual organisations. The fact that that should happen in the context where local government provides the leadership seems to us to be right, because children are children; children are fit and well; whereas the Health Service largely deals with children either to prevent them becoming unwell, but largely children have specific problems. We are therefore quite happy with a concept that is local government led. Q164 Jeff Ennis: Thinking about integrated working in practice, what do you think of the idea of co-location of staff, and to their co-location in extended schools and children's centres in particular? Mr Hawker: I think it is very important to co-locate staff wherever possible, if they are part of multi-disciplinary teams, and the heart of integration is single management and the professionals working together in their professional disciplines but as a team, and it is much easier to do that if they are co-located. Placing teams within schools is also a very good idea, and that raises a very important issue about the management of those teams and their relationship with the schools management. One of the issues we will need to tackle over the next few years is the nature of school leadership to be able to address safely the management of integrated teams within an extended school. That goes back to the issue of collaboration, duty to co-operate and so on. Our experience is that the majority of schools are keen to co‑operate. There is sometimes a knowledge gap in terms of what to co-operate on, and the particular relationships with the other agencies that will facilitate that - and clearly there is a development and training issue there. By and large, schools recognise that they are concerned with more than just educating a child that is when them from nine to three; they are concerned for the well-being of the whole child, and that is right. As an extension of that, they are keen to get involved in the wider aspects of this agenda, but they need to do this safely, and the issue of service integration raises the issue of professional supervision of specialist functions within an integrated framework. That means that effectively we have to look again at line management questions, the ways in which we can safely operate inter-disciplinary teams, and at the same time keep the professional supervision tight and of high quality so that people being part of those teams will continue to be professionally developed and continue to be able to practise their skills safely. Mr Coughlan: I support everything that David has said. There are some critical issues that we need to watch out for because there is a risk of "motherhood and apple pie" mentality around some of this, and if I am able to I would like to come back to your question about challenges as well. The point you raise about schools is an important one, but we have to remember as well that a significant proportion of children, including particularly more vulnerable younger children, who are nowhere near school yet. We have to look more broadly and more imaginatively than simply around schools, although schools critically have a significant part. Co-location should not be an end in itself. I have certainly worked in circumstances where co-location has been achieved, but the different agencies did not know where each other's door was and could not walk round and get to each other. We have to be realistic and work on some of the frameworks. Q165 Jeff Ennis: What would be your alternative then, in terms of an appropriate location, if it were not in the extended school setting? Mr Coughlan: Some of the early years settings, some of the health settings, but also making sure that we approach the position of co-location in the way we are trying to approach the themes of Every Child Matters - that we are looking for the outcomes, rather than some structural approach, and do not go for co-location for the sake of it, but make sure you have integrated systems where professionals are talking to each other - and if there is a natural progression to co-location which suits the environment and the locality, then pursue that. Q166 Jeff Ennis: It is not really the building that is important. Mr Coughlan: I do not think so, no. I really feel keenly about the point you made about some of the challenges - because I do think there is a risk in our support for this agenda, and we wholeheartedly support it - that that gets misinterpreted as saying "there is no problem with this then, is there?" I think there are five critical areas that we have to watch very closely. What we have been talking about I would characterise already as the issue of the competing agendas. Frankly, we are talking of the question of mainstream services for most children who do not require specialist input, and particularly attainment within education, versus the specialist needs of some children who require particularly intensive input. It is very positive to go for a universal approach under Every Child Matters but there is a potential tension in there as to how we make sure the right services get to the right children in the greatest need. That is the first area, which we have effectively been discussing already. As a local government officer, I have to raise the thorny issue of resources. We have constantly been making the claim that part of the difficulties we have been facing in children's services was a failure to fund the Children Act 1989, and we still think that failure is undermining much of our effort around children's services. One of the problems around the Climbié Inquiry was that unfortunately it pointed to a small group of authorities which apparently were under-funding their children's services, and I think this was used as a yardstick to say what local authorities are or are not doing for children's services. In fact the vast majority of local authorities are heavily funding their children's services, well beyond the formula spending assessment. That needs to be reflected through central government. There is also the cost of the change programme. Thirdly, there is a set of issues about how we develop a real consistent community voice into children's services. This will fail unless we are engaging children, their families and their communities; and we need to find ways which consistently are going imaginatively make people feel they are party to this agenda, and that it is not just an agenda that is being developed by the macro organisations. Fourthly, there is a set of issues around the fragility of safeguarding services for child protection concerns, and our concern would obviously be that the majority of authorities which are committed to this arena will work gainfully to protect their children, but there are inevitably going to be children who will slip through the net, and we have to give this agenda time to work forward, and support those authorities that may be struggling with their local competing forces. Finally, this hinges around information-sharing. We think there are still significant challenges around the information-sharing agenda; so I wanted to make sure we did not ignore the question about challenges, because we think they are significant and we do not want to pretend that they are not. Dame Gill Morgan: Coming back to the co-location issue, in general our view around issues like that is that they need to be identified as issues at a local level. There is a real danger of coming up with a one-size-fits-all; and what might be appropriate and applicable in Bradford might be completely the wrong solution for the wilds of Cornwall. There has to be a proper local joint needs assessment of what the issues are and what the opportunities are; and then co-location thought about in that context. It may or may not work out in individual communities. What we would resist is anything that is one-size-fits-all because the history of that is that we end up with worse services for the majority because we design things on the worst-case scenario. That might work in those places, but for the rest of it, it takes us backwards not forward. Chief Constable Grange: I am the Chief Constable of Dyfed-Powys, which is the largest geographical area in England and Wales for policing. Whilst co-location works in one part of the force, it emphatically cannot work in other parts to do with criminal justice, simply because the Crown Prosecution Service does not have enough agents to co-locate. We have seen successful co-location in youth offending teams across the country. We are seeing it in public protection units where the police and the probation services are co-located, to my knowledge, in 21 separate parts of the United Kingdom - and we are developing ever more physical or other forms of co-located working, by the use of buildings or IT. In child protection we have a violent and sex offenders database, which the police services will have in England and Wales by the end of March next year; and all the probation services by the end of the following year; and the prison service also. That works in that particular area; but co-location of itself is not the answer to the problem; as others have said, you need to think through the issues and the outcomes you intend. If co-location gets you there, fine, but for many organisations that will not be financially or geographically viable. Valerie Davey: We are now taking up the theme of professionals and their role within this. Q167 Jonathan Shaw: There is obviously this tension in terms of co-location. Gill Morgan, you said that one size does not fit all. I do not think anyone is saying that, but it is a general theme flowing from Lord Laming and the Minister for Children. Where local partnerships and agencies determine that co-location is appropriate, before that they have to agree how these teams will organise themselves. There are potential competing demands about different professionals and supervision. Would the panel like to talk us through those potential tensions, how they might work in practice, and what the potential hurdles are? I am asking you to paint a picture of how things may or may not work in practice within your areas of specialism. Gill Morgan, perhaps you can start by not having the one-size-fits-all! Dame Gill Morgan: Our anxiety, which I suspect is echoed by most people sitting this side of the panel, is that there is a very fine line from national flexibility getting interpreted into one-size-fits-all guidance when it comes and hits us, and that is what we would like to resist. We have to distinguish, for people working in children's services, between the things that they have to do and understand the same almost core professional standards of people who work with children. You may have different arrangements around those core sets of skills and specialisms, where people can share responsibility, and the things that people have to do as autonomous practitioners which are fundamentally different. Q168 Jonathan Shaw: Can you give us an example? Dame Gill Morgan: For example, as a health visitor working in a patch, you may, through sharing arrangements, take part with other professionals, and it would not matter which professional did it because you would use a common assessment framework to assess the needs of a particular child. That would be fine because you would be guided by those common standards and there would be a set of procedures. You need the same supervision as anyone else because you are applying one tool to everybody. On the other hand, if out of that comes a particular need for a child who has some rare genetic disorder but needs some sort of follow-up, the particular supervision you need for that is expert and specialist, and would probably not be provided within the team, but you would have to look for supervision elsewhere, because that is where you are specialist; you are highly trained; you are a nurse with extra training over and beyond it. I think you could begin to distinguish within teams which bit is general and would have a common supervision and support, and which bit we need to look to the broader church and the broader family to provide that additional expertise. That would be true for the majority of people working in the shared environment. Q169 Jonathan Shaw: What about when the lines are less clear? You are talking about a physical ailment, are you not, which is the medical profession? What about when there are mental health issues? You could have a CPA, a mental health social worker or a psychiatrist. Dame Gill Morgan: Yes. The way that has traditionally worked, and within proper team-based working is identifying the individual with the right combination of generalist skills, together with the additional specialist knowledge, and at many stages of a child's or adult's progression actually it does not matter the professional expertise is secondary to the general bit of handling a disturbed child. Within local teams and local professionals you would come up with agreement to guide that. This is not new; this is not part of the Bill; this is how many organisations and systems around children have been working since 1948 and before. If you look at some of the best child and adolescent mental health services, they do work in a multi-disciplinary way with shared responsibility, with a key worker who takes responsibility, and they take in the responsibility of pulling in those additional specialist services that are needed. Everybody does not have to know everything, but you have to know a man or even a woman who does, and be humble enough to know when you need those additional skills pulled in to the system. Q170 Jonathan Shaw: That all sounds very simple. John Coughlan, are you happy with that? Do you think it is all very simple, and we do not need to worry - that I need not ask these questions because you are going to get on with it? Mr Coughlan: I have said that it is an enormously challenging agenda. I think what will happen - I was interested listening to Gill because the models within my own authority follow some of that pattern. We have a community and schools clusters model, which has been developed and will go live in April. It will be working with children who are tiers 1 and 2 of need, so they are not in extreme need, not for example children looked after on the child protection register; but they are showing early signs of concern. They would have a concept of a team around the child, and the clusters team would be a multi-disciplinary team, but it is not a team that will necessarily disband existing core specialist teams, so we will still have a separate core cams team, although that team will be linked in to our community model. Where children require low levels of support, a lead professional from the clusters team will be nominated, and they will work with their partners in a collaborative way, identifying where particular skills are required to suit the needs of that child. Where more complex skills are required because the needs are extending, then the support for the more specialist services where there are professionally accountable lines of support will be called upon, whether calling in a child protection investigation from a classic social services model, or some more intensive consultant paediatric care from the health model. Q171 Jonathan Shaw: Cllr Kempton, you are sitting in your local authority, and the assembled professionals are providing you with this advice, saying of course the service is developing very well, and it is a great policy; but do you have any worries that whilst you are being told everything is fine, what is happening on the ground, from what your constituents are telling you, is quite different? Cllr Kempton: Everyone has made the point that it is an enormous change agenda. One thing I would say is that the change is going to take some time. The Government has identified that some of the structural changes need to be in place by 2006 or 2008, and what we want to argue very strongly for is that we need to take that time in order to get things in place. We know that we have crisis intervention services which are very good, but we want to improve them. We know that we have very good universal services that we want to improve as well. It seems to me that it is the area of prevention and getting the preventive services as good as the others, where I would want to ask some questions in my authority. It is the area of making sure that support is being provided to families where children are identified, or the family is identified as vulnerable in some way. Those are the sorts of areas where I would want to ask questions and would want to build up the services. That is an agenda not just for the statutory services but the voluntary and community sector as well, and that is one of the key leadership challenges that I have. No-one really wants to de-professionalise any of the people, and it is very important that we identify that we are bringing together groups of professionals from different disciplines because they add value by being together, and we do not want to create a structure that dissipates the expertise when it comes together. What we want to do is share some of the training - teachers that are training, and social workers might go on, identifying children in need and providing the sort of support they need. For example, we have seen through the Surestart programmes different professionals coming together and not losing their own identities but adding something by sharing their knowledge and approaches. Q172 Jonathan Shaw: David Hawker, it is not good everywhere, is it; otherwise we would not be having this inquiry, and Lord Laming would not have had to undergo his work? There are problems, and integration is the key word that has come from Lord Laming's inquiry. In the Green Paper there is a long list of members of multi-disciplinary teams, but it does not include teachers. You are services, and you are education: should it include teachers? Mr Hawker: Yes, it should include teachers and health professionals as well; and in many cases it does, depending on their particular area of work. If they are responsible for special educational needs or if they are the nominated to look after children, they will be part of a multi-disciplinary team which their school is linked with. The sort of service model that John has described is very similar to the service model that we are developing in our locality as well; and it is probably similar up and down the country. It is not one-size-fits-all, but there are some very clear service design principles that people are now working to up and down the land. In terms of making it work, we clearly need to have professionals who know when to stop, who know when they have reached the limit of their own expertise, and are therefore able to hand it over to somebody with the expertise that is needed. That is one of the important principles of multi-disciplinary working. In terms of teachers, clearly we need to look at how the school workforce reforms will be able to create enough time for teachers to engage in these important activities without them distracting from teaching, their core task. That is a challenge to us all, in terms of making the thing work in and around schools. In terms of other aspects of the requirements, we have clearly got to make progress on implementing a common assessment framework; we have to have good data information and sharing protocols. We need good referral systems and formal protocols for that. We would like to see some progress on pooling of budgets, but only when it is clear what the budgets are that we are pooling, what we are pooling them for and what the service specification is for pooling them. There have been some examples of pooled budgets before their time, which have not resulted in any service improvements. We would argue that the service specification, the review of the services - what James was saying in terms of looking at the middle part of that triangle, targeted services for children in need, needs to be got right; then you look at how you will pool the budgets to get the service into the shape you really wanted to serve the children better. This is a massive programme of change. It is clear that local authorities and their partners up and down the country are at very different stages in that process. Some are fairly well ahead, and others are only just starting to think about it. The head of steam that there is behind it now is such that it is pretty well on the way. We do have to watch out as we implement it that we do not fall into some of the elephant traps that are there, and it is very important that we move forward. Q173 Jonathan Shaw: What are the elephant traps? Mr Hawker: That people would move too fast and be too enthusiastic about doing change, and then fall over themselves. We could be putting children at risk if we are not careful, if we do not have the right kinds of safety mechanisms. It is important that as we manage change we are also improving services at the front line, or at least concentrating on not having services deteriorate and thus putting children at risk. It is important that we have a good view of the overall resource package that we need to work with. John raised the issue of concern, which many of us share, about the shortage of resources for managing this, which could jeopardise the whole exercise if we are not careful. Q174 Jonathan Shaw: What do you think it is going to cost? The figure of 20 million has been given so far. Mr Hawker: I think it will cost more than that. Our conservative estimate is that setting up the children's trust would probably cost around half a million pounds in back office costs, and that is leaving aside the workforce development issues and the management of change at the front line issues. Clearly, we are not going to be talking about adding all of that to existing projects. Q175 Jonathan Shaw: Any more money for training? Mr Hawker: Yes, we do need to put more money into training, workforce development, joint training of professionals. We need to do a lot around the information sharing and around child protection training. In our submission we have suggested we should be looking at an entitlement for every professional working in the field to have three days of training, which would enable them to take full part in the programme. Q176 Jonathan Shaw: Terry Grange, can you give your organisation's views of the information-sharing database that is being set up? Is that something that you have considered, or have you not been consulted on it? Chief Constable Grange: We know that there are attempts across the country to find out how information-sharing could be done. I do not believe that there is an information-sharing database being set up. I think we are in the throes of piloting in ten areas to find out what can be done. Information-sharing is absolutely essential, but you are back to the elephant factor; and there are cultural issues and professional issues about information sharing. The Soham Inquiry demonstrated only too clearly that people's professional cultures stopped them sharing information with others. Q177 Jonathan Shaw: What do we do about that, then? Chief Constable Grange: Training, cultural understanding - putting people in the same room tends to break down the cultural barriers which stop information-sharing. We have evidence in working with the probation service. As one of the two inquiries into the Soham incident showed - I think Sir Christopher Kelly's inquiry - there were police officers that would not share information with social services on principle, and vice versa. That will take a long time to break down. The idea that you can share information with 43 police forces - I do not know how many local authorities there are or how many primary care trusts in the country, but the idea that you are just going to create an IT package that will share information across them in short order is mythical. The first thing we would need to do as a police service, I would argue, is have one single child protection database nationally. Currently, we are working at trying to get the Home Office to fund that. If you said 20 million had been set aside, we could create a single child protection database for the English and Welsh police forces in about 24 months at round about £10 million, because we have evidence from doing it with the violent and sex offenders database. On top of that, you are talking about health and education circles, and you are talking about a very complicated thing that needs a great deal of thinking through. The same applies to the whole thing of working together in practice. The police view is that in terms of the role of professionals, our role in this has not yet been worked through properly at all. We would see that we have a major remit in such things as domestic violence, truancy or exclusion from schools, missing from home, criminal family members, where our role and that of children's services should be inextricably linked; but it has not yet been worked through. If things are to work, that has to be done. Q178 Jonathan Shaw: Mr Coughlan, from the social services point of view, what have you to say about databases? We have some pilots, and obviously we will wait for the outcome of those. The child protection end is one thing, but we will obviously be flagging up areas of concern or possible concern so that a picture emerges before a child protection conference is called. Is that right? Mr Coughlan: I think the picture is complex and mixed. I am not as pessimistic as some of the conclusions from the Soham inquiries would lead us to believe because most of us see on a very regular basis very high-quality joint working, on a day-to-day basis on the ground. One of the challenges of this process is to bottle that and get it consistently across the piece. I am not saying that there are not problems but I think front-line practitioners have developed great skills in identifying when they can and cannot share information. They do work within professional cultures where, for example, many of them have been trained about the sanctity of the information that they are holding; and then to work into a new environment where they are being told to break that sanctity is challenging for them. I think it can be achieved. The challenge is enormous, partly because of the systems issues that have just been described but also because of the professional cultural issues, and because we have to recognise that some of the families at the more extreme end of need are also extremely mobile. Some of them live beyond standard services. That is why keeping a track - and that is why it was called Identification, Referral and Tracking, originally - is critically important. We have been one of the authorities acting as an IRT trailblazer. We have made substantial progress. It has been very positive, encouraging work, but we still feel that we have a long way to go to be confident about an information-sharing database that is absolutely consistent. Q179 Jonathan Shaw: Can you tell us how it has been working, for example how would a teacher with a concern flag it? How would the GP know about that or how would Terry Grange, as a police officer, know about that? Mr Coughlan: The systems we are working with have recognised that the notion that you can effectively disband all the internal professional systems and create an all-singing, all-dancing children's database which covers all professional need is cloud-cuckoo land, and that will not happen, as far as we can see, in the future. We have developed a system that will talk, on a routine basis, to the existing professional systems within health, social services and the police. Finding the technical as well as professional solutions to achieve that have been complex. In an internal system, for example where there is a child database, if there is a way in which a school's concern can be noted on their database in a way that then gets swept up by the co-ordinating database or the integrated database, that becomes a simple model which does the very basics of what has been described in the consultation document so far. It expresses who the child is; the family; the address; where mainstream services are involved; and obviously the most complex issue is what specialist services have been involved, the parental permission for recording those specialist services or the case for recording that specialist involvement without parental permission. Q180 Jonathan Shaw: At the moment, in most local authority areas, if there were a referral to social services, whether from a school or neighbour, they would do that manually, would they not? Mr Coughlan: Yes. Q181 Jonathan Shaw: They would ring the police. They probably do that anyway. Mr Coughlan: Exactly. Q182 Jonathan Shaw: But in the first investigative level it may well be that they would check the database in the school to see whether there have been any concerns over the last two years. Is that right? Mr Coughlan: It is really crucial to recognise that this database does not become a proxy child-protection tool. Q183 Jonathan Shaw: Will this safeguard children better? That is what we all want to know. Mr Coughlan: It will assist with better preventative working, which will indirectly safeguard children better. If we use the database as a quasi child protection register, it will fail and will cause disaster. We have to make sure it is used as a communication tool where there is low level of concern. Where there is high level of concern, where there is concern that a child's safeguard is in jeopardy, then the existing child-protection mechanisms, or however they are going to develop out of the safeguarding process to follow, still need to b robust as far as we are concerned. Chief Constable Grange: I agree with what has been said. In West Yorkshire each of the agencies has its own IT system, and sat above that is another system called Liquid Logic. It takes the information, pools it and enables people to see that another organisation has just recorded a concern, be it an educational concern - about Terence Grange. It may be of no interest to the police service, but the education service may then notice that the police have just recorded a concern about the same Terence Grange. At some stage you have now got two or three concerns, and they are all clear to the group working together in West Yorkshire. The difficulty comes when Terence Grange moves to South Yorkshire, because it does not follow; and it is working out a system that enables you to track people across the country which will be the art; and that will take some doing. I would agree with the second part of what has been proposed. You do not want to create this system and turn it into just a child-protection issue, because that is one very small part of what is trying to be achieved. We are looking at the best possible outcomes for all children. If the police or the social services, or the police and social services together create the child-protection database that others can look at, subject to certain protocols, that might be a good idea; but we are here discussing something far wider than that. Q184 Jonathan Shaw: What about your GPs, Gill Morgan? Dame Gill Morgan: Can I distinguish between two sets of issues about sharing data? There is the sort of tracking system we are talking about, to allow organisations to share high-level information about contacts, which I think, if you look at some of the best examples of inter-agency sharing, there are many communities that have probably got agreements not far off allowing them to begin to implement this type of structure. The second issue is getting professionals to share the information and to be comfortable about sharing that information. That is a particular challenge for the Health Service, often because of the nature of that information. There are two sets of anxiety. One is about the nature of information on a medical condition that has major implications for the well-being of that child, for example a diagnosis of HIV, which is fundamentally important because of the associated stigma. How do you share that information? The guidance around that is that practitioners ought to share even that type of information if there is a risk either to the child or to other healthcare professionals by that information not being made available. One of the problems for the Health Service is not just persuading practitioners to share the information; it is the fact that you are in contact with all children, and that children currently admitted to different hospitals - and this is part of the Climbié stuff - will be given a different record in each of the individual hospitals. You have to set this concept of sharing information together with the reforms that are going on in the NHS, which is the National Programme for Information Technology, which is aiming to give every individual a single integrated patient focused record, which will be a very useful way of linking in a whole set of stories of an individual child, and that would avoid what happened with the Climbié child happening again. That record for that individual child - when the child goes into hospital - would say that this child has been in four A&E departments in different parts of the country over the last month. We are beginning to get at some of the backing to this support through other programmes within the NHS. The other thing that is really important is that the medical profession and the Health Service take confidentiality so seriously - and there are real ethical issues around the medical diagnosis. Some time ago a major review on confidentiality was done by Dame Fiona Caldecott, who was President of the Royal College of Psychiatrists. Every NHS organisation is obliged to have a Caldecott guardian who really works with professionals locally to agree the nature of information-sharing. It has been very interesting because many of the Caldecott guardians, who initially we believed would be a block to any information coming out, have been quite enabling because some of the professionals, when confronted in a local discussion and debate, realised that they are things that people hide behind, rather than realities, but you have to have that conversation in small areas where people understand and get to know each other. Some of the Caldecott agreements that have been reached with people have enabled far more sharing than people believed was possible. Mr Hawker: I endorse that view. Local authorities have to have Caldecott guardians as well. It is absolutely right that some of the barriers are more in people's minds and beliefs than they are in actuality, and you need to work them through. Then people find that they can share information better than they thought they could. The development of an all-child index to form the basis of data sharing spine on all children, and the kind of position that we want to get into eventually is a very complicated affair. It is proceeding and we would certainly like it to move faster, but there are many complicated issues surrounding it. I do not think we will ever be talking about a single database for all children which will serve every purpose; we are talking about a database which will form the heart of a range of linked databases in each individual service. Dame Gill Morgan: Despite a lot of misunderstanding, every doctor and every nurse is bound by an absolute responsibility to share information if they believe that a child is at risk, and that overrides any duty of confidentiality. That is sometimes misunderstood, but it can be difficult at the grey borderlines. Without doubt, that absolute responsibility stands. Q185 Jonathan Shaw: That is at the danger end, is it not? Dame Gill Morgan: Yes. Q186 Jonathan Shaw: When what we are actually talking about is broad areas of concern. Dame Gill Morgan: Indeed. Valerie Davey: As you were saying, we could stay with that for a long time, but I must move on to Paul. We are talking about different aspects of integration now, perhaps governance and accountability. Q187 Paul Holmes: In regard to the question of inter-agency governance, there are some requirements in the Children's Act which require the appointments of directors of children's services and lead members, and there are the proposed children's trust boards. There are various things in the pipeline to get agencies co-operating and working together, to make clear who is in charge; but then there are chunks of relevant people and organisations that fall outside these, like general practitioners, registered social landlords and schools. Are the inter-agency governance arrangements too limited? Cllr Kempton: There is certainly a challenge in your question, which is how we can use influence to get people to follow a particular set of policies which may be laid down by a children's trust. There is some scope, using the inspection framework, but I think local authorities would say that they have some anxieties about the assessment of their performance through corporate performance assessment, for example, against the performance effectively of other authorities with whom they have the ability to influence but not necessarily the ability to control. The issue of accountability of that authority is one of concern to us. We have certainly seen increasing fragmentation of services, in arm's length management organisations for local housing for example. That provides increasing challenges when the accommodation that families are in can often be a major determinant of the health of the children. You are right to identify this challenge that we are facing, and it is one of the issues we want to keep exploring with government. We are used in local government to working with a whole range of partners, and we are used to working in an area of accountability without authority, but that does not mean to say that that is necessarily the preferable place to be. However, in the real world I think we function reasonably well at the moment. We need to look at putting the outcomes at the centre of what we do, and that will help to focus people's minds on those areas. Equally, we need to explore some levers for accountability, not only with schools, which is probably the most obvious example, but other areas as well. Taking schools for example, there are concerns about admission arrangements and about schools excluding pupils and needing protocols across the authority to ensure that all schools participate in taking pupils that have been excluded from elsewhere. We are well placed to ensure that those protocols are drawn up and accepted. We feel that there are not necessarily the levers which would enable those protocols to be required of people, so there is an area of concern there. You may well be aware of the recent case of the Oratory School, which went to the High Court and has now secured the right to interview parents. Just when we thought we had got to the point where that was not going to be part of the agenda, we seem to have turned the clock back. While that is around, many people have real concerns about the ability of schools to float off and operate outside the family of the local education service. Q188 Paul Holmes: Anyone else? Gill, for example, in terms of GPs? Dame Gill Morgan: Yes. Can I get at it again in two ways, because there is the issue about how do NHS organisations - primary care trusts or hospitals - play into this? I suppose there are really three ways in which there is some sort of encouragement to work in a collaborative way. The first is the local agreements with your partners; and you should not downplay the importance of those good working relationships because we are intertwined, not just on children but on so many other things, that it is in our benefit as individual health organisations to work co‑operatively and collaboratively, otherwise all sorts of troubles can happen. The second thing we have is that every NHS organisation is inspected by the Healthcare Commission. This is over and above the joint area reviews. This is what they look at within health organisations. Getting those standards right and correct around children could be a major statement, because that is what determines your STAR status and it can impact on your money, it can impact on your future. That is a very powerful incentive. The third driver on NHS organisations is the performance management system exercised through the Strategic Heath Authority in the Department of Health. The issue about that, and it is a general question, is how important children genuinely are within all the priorities that come down the line. If the children's services for the Department of Health are not as high as a priority as some other things, for example waiting lists, then it is harder for NHS organisations to give the time that they may wish to give for the other reasons to the children's services. So that is three. If you look at individual GPs, they too have a multiplicity of control mechanisms that I think we forget about. The first is that they have to have professional standards. Many of them are members of colleges who put out best practices. The second thing is that they will have some form of revalidation. It is up for debate what that looks like, but it will be carried out by the GMC and that will look at competence to practice on a regular basis. The question at the moment is how much is in there and how we can influence to have children's issues as part of the revalidation for primary care. I think there is a lot to play for there. Ultimately, where practices fail, you have the input of the GMC. That is a more draconian bit of poor performance which you would not want to go for: you would want practices to be revalidated and demonstrating that they have high quality. You then have two other ways in, which I think we have to be much more canny about how we use. One is that the contractual framework and how we use the quality framework which gives 50 per cent of the income to practices comes through the quality standards. Again, influencing and changing that to have more focus on children seems to me to be a very useful measure of achieving some of the stuff we have talked about. Finally, as part of the new GP contract, there is the ability for a primary care trust to commission additional services from general practice which are over and above the core standards. For example, I am aware of primary care trusts which have commissioned services and then have a contractual basis of quality and therefore can build into the contracts some fairly clear things about the duty to collaborate, where primary care trusts have services specially developed for looked after children, where they have special services developed for refugees as a whole, including children, and in that we can include, with our partners, some very clear contractual requirements that could put some very clear focus around primary care and what it needs to deliver for some of the most disadvantaged children. I think we have to be really clever by thinking about all the levels of intervention and using them in a coherent way rather than actually focusing on any one component of what is an already complex system. Mr Hawker: I think governance is an interesting one in the context of inter‑agency working, because we are really talking about statutory agencies which are not relinquishing their statutory duties but are sharing, if you like, the overall accountability in their area; and that means that we are talking about partnership and, effectively, a voluntary arrangement for having a single set of decided outcomes, programmes, strategies, and so on. In that light it seems to me that the persuasion and canny approach incentivising partner organisations, schools GPs and one another and, indeed, the voluntary sector, which is clearly very important, is the right way forward. We will be looking at the governance arrangements which bring together the top decision‑making boards of the statutory partners in making joint decisions about key issues, and that is as far as it goes, effectively. Certainly where we are locally if the PCT Board and the council cannot agree on a particular decision, there is no tie‑breaker because we are entering into a voluntary partnership. We have to go back and think again and come to a decision where we will agree on a particular set of decisions, and holding the partnership together is as much a matter of establishing the same vision, the same set of objectives, agreements on how we are going to work together and then holding one another to account for that as about any kind of formal legal arrangement. I think there are some very powerful levers. The inspection lever is clearly one, and that applies across the board through the various inspectorates, and it is very important that the inspection frameworks should place the priority on meeting the five Every Child Matters outcomes wherever they are operating, and that that should then place a premium on the partnership working. Another of the levers, of course, is funding and commissioning, where we need to make sure that, as far as possible, the partnership governance arrangement is empowered to commission services and, if necessary, decommission services from partner organisations according to what the need is so that there is a lever there in terms of, if you like, prescribing what is needed locally to deliver the best outcomes for children. I think those two levers are quite powerful in the overall set of arrangements. Mr Coughlan: If I may come in, I would support what David has said. One of the reasons why we urge caution about the prescriptive approach to a structural solution and the development of a Director of Children's Services role is precisely because it was always going to be the case that, whatever sub‑structural solution you came to, there would be elements of children's services outside of the orbit of the Director of Children's Services; and there is an ambiguity about saying we will have a buck‑stopping approach which is clearly defined, but, alongside that, there is a set of brokered relationships and negotiated arrangements which are necessarily going to be part of the piece. That is why we felt that needed to be developed through local solution. I would add, just to follow up on what David has said, that I think joint commissioning is critical, and that is one of the few areas where my authority, for example, has gone into a pooled budget arrangement where we have got a very clearly defined set of relationships between the three major players ‑ education, health and social services ‑ about the ways in which services will be developed and delivered and also decommissioned, because that is critical also, and making sure that the children's strategic partnership is very close to the joint commissioning process so that all of the other agencies, including the police and the voluntary sector, are close to that decision‑making as well. It is critical. The role of the local strategic partnership is significant as well, because that is developing, in some areas, into a more fluent and authoritative body, and, particularly if local area agreements are to develop that function to a stronger level with resources attached, I think there is a stronger capacity there. The caution that I urge as well around the inspection lever, which I think is a very positive lever and can be brought to good effect, is that it has got a long lead into it, because I think it will take time for those standards to be developed, to be understood and, frankly, for agencies and individuals to recognise the damage to be done by not following the framework properly. It is going to take some years before we have got that clearly built into the system. Q189 Paul Holmes: David said earlier on not to rush into pooling budget arrangements until you were sure you were going, but you said your authority is already doing that? Mr Coughlan: No, I absolutely agree with David on that. I worry enormously about people seeing pooled budgets as a solution. It is a little bit like the co‑location argument. Put everything in and everything is fine. One of the risks around pooling budgets, for example, is that it is cynically potentially a mechanism whereby agencies can wash their hands of responsibility - "We have put our money in the pot and we are walking away now" - and that can be hugely damaging. I am sure that does not happen usually, but I think there is a risk there. We specifically went for a single pooled budget around joining our commissioning processes together, because we saw that as a critical lynch pin for joint working, and it is also an area where it is easier to negotiate what the level of the pot should be. For example, we are a long way short of some of the pressures that some authorities are going through to pool their budgets for external specialist placements because we think that is such a volatile budget. It is a much more stable arena where we knew exactly what we wanted to do. We were very clear about drawing together planning and strategic activity, less clear about defining commissioning, which is a different story altogether and which has been an interesting journey for us, but an area where it is easy to say that is our joint investment into what is a very specific function around analysing need, developing services, commissioning services and decommissioning them based upon, and in view of, that need, and that is working well on a very small local basis. Dame Gill Morgan: It is back to the heart of this is making sure that the tasks we set ourselves are based on the outcomes. The real danger is, if the task is defined as getting pooled budgets, getting pooled budgets becomes the task but it does not necessarily achieve the outcome for children, it always pushes back to the outcome, and allow flexibility for us to work out what is right. You have to remember that every organisation is starting this journey from a different place. Many places have excellence, but it may be isolated. Other people do not even have the relationships yet to get to base one. What works in your patch might be a complete disaster in another patch because there is not the trust, the history of joint working. In other places they have found more creative ways of doing things where they have never had to ask those questions because the rules were not there when they got into the long‑term partnerships. Cllr Kempton: It also presupposes there is a budget there to pool at the moment. For example, improving services for children with a disability might be an area where you would want to work together, possibly jointly commissioning, possibly with a view to pooling budgets in the future. Doing something about obesity, healthy eating and sport is clearly a key target both for local government and for the health service, but it is not necessarily going to be very easy to identify a budget within the NHS with which we could pool. Indeed, I think the evidence is clear; the interest is still largely focused on secondary services and the needs of trusts. Q190 Paul Holmes: We have already talked about the fact that GPs are outside the system - it was not on the face of the Act that they had to collaborate - and I think David and John and Gill all said that the role of PCTs will help them come out, especially the budgetary power. As we move to practice-led commissioning, is that not going to put more of the money into the GP's independence and less into the PCTs? Dame Gill Morgan: Yes, but practice-based commissioning has to happen within the context of both national and local priorities. It is not just handing over a blank cheque and saying, "Do what you want." Every primary care organisation has to have a local development plan, every local development plan has to take into context the local children's plan developed with local government, and practice-led commissioning ought to give you more flexibility as to how you achieve those outcomes. It should not - and the guidance is very clear - distort those priorities. Q191 Paul Holmes: So the PCT would still play a role with the others in setting the criteria? Dame Gill Morgan: Indeed, but what I think it is trying to do is free up the difference between "What do we want to achieve?", which is very much part of the goal of the primary care trust working with general practice and with other partners, from a "How do we do it?" Practices may have innovative ways of doing it that you may want to unleash and try, but it has to happen within a context that is taking you in the right direction. Mr Hawker: One of the things we need to guard against is money that is saved from the local commissioning arrangements at the practice level being reinvested in something else. We need to look at how it can be reinvested into better services for children, if that is how it is being used. There is a parallel here in terms of schools with passported budgets and the extent to which we allow or we encourage schools to set up foundation partnerships to deliver services on our behalf for children over a local area. The issue there, I think, is very similar in terms of how are you going to be able to monitor the fact that the money is being effectively used in the way that it is intended to be used for those children. We need to work with government on the mechanisms which will secure the right services for the children through those approaches, because, both with GPs and with schools, although you are setting out a performance framework and although you are saying, "We want to specify the services which you are going to deliver", we need to have the monitoring arrangements and, if you like, the accountability arrangements which will ensure that that does happen. Dame Gill Morgan: Just to clarify, savings have to be agreed by the Professional Executive Committee before they can be spent. I think one of the early tasks is making sure there are proper local agreements about how children's services are dealt with as part of the arrangement. Q192 Paul Holmes: On the pooling of budgets, the Audit Commission have pointed out that there are some practical problems - one organisation pays VAT, another does not - different budgetary cycles. The VAT one hit Connexions quite badly, for example. Are they minor issues that we can get round quite easily, or are they serious obstacles? Mr Coughlan: I think they are serious obstacles. Some of the bureaucracy around pooling budgets is part of the disincentive, and the work that is required to get through that bureaucracy, we certainly feel in the smaller authority, can be better invested in developing some of the cultural arrangements about joint working and look again, as Gill has said, about what were the outcomes that we were intending from the pool. We would enter into it very hesitantly, particularly around services. We can find very easy ways of making sure the shared money is getting to the service user without getting into complex bureaucratic arrangements which are not necessarily going to help, and I think the evidence-base for them is a bit weak. Dame Gill Morgan: I totally agree. On the issue about pooled budgets, there are barriers to making true pooled budgets work, stripping virtually all budgets, there are all sorts of ways, because at the end of the day, and it is not just children's services but across the board, it is the intent to work collaboratively that is the thing which creates collaborative working, and when you want it to succeed we have enough opportunities and rules to allow us to do it. The problem is not the people who want to make it succeed. My personal view is that sometimes a lot of these issues are used as barriers: because we do not want to do it therefore we will find 24 reasons why it is hard, rather than do what you are talking about, which is "Let's just make it work". In the best places that is what they do; they make it work. Mr Hawker: The point that I made earlier about the pooling of budgets is that the pooling of budgets follows the service specification, and, clearly, where you are talking about a service, for example, for mental and emotional health (which is CAMS), plus a whole range of other associated services, if you want to review and re-specify that whole range of services, you are looking at an entire service continuum and the budgets for that service continuum are held in a number of different places. Part of the service review is the identification of what money is being spent where and how within that whole thing and then reshaping it; and then, if you like, the outcome of the process could be either a virtual shared budget or an actual shared budget, but it would certainly be a budget which was seen as a whole, as a single entity delivering a good quality service across the board. Valerie Davey: I think you are touching on the last area of questioning we want to look at, which is how far is government thinking integrated? Mr Pollard: Can I apologise for being late. Sixteen ministers have signed up to the across departmental work on the Every Child Matters agenda. What is your view of existing levels of coordination within and between government departments as regards policies which affect our children? Q193 Jonathan Shaw: This is the moment we have been waiting for. Dame Gill Morgan: You have almost got to answer this in context, have you not? If you look at children and you compare the context of most of the stuff that we looked at for Joined Up Writing, this is an exemplar of good practice. There is much more to be done to make it truly joined up, to truly get the markers down that each department is looking at things which are the same from each system, and we are way off that, but, compared with most of the stuff we try to do in a joined up way, this is far better. Mr Coughlan: I think it is developing rapidly, thankfully. Certainly the level of engagement that we are experiencing as an inter‑agency group and through social services with the DfES and with DOH on this agenda is unprecedented, and I think officials and politician have to be applauded for that. The level of dialogue is extraordinary and very positive, I think. I would have to make one comment, though, on an area which we have not talked about. One of the things I do for ADSS and LGAs is Chair a body called the Youth Crime Group. We think it was an error to publish a separate agenda for young people who offend alongside Every Child Matters and we think the need to integrate and be very explicit and forward thinking from central government in the integration of the youth crime agenda with the children's agenda in a way which does not deflect from the obvious priorities around tackling and preventing youth crime, but recognises that children who commit offences, without excusing them or trying to defend them, are exactly the same constituency as children who get excluded from school, children who become in need of protection or have CAMS needs, and I think we need to make sure that we do not rehearse that separation in further working around this agenda. It has to be fully integrated across the piece. Chief Constable Grange: I would have to agree totally with what has just been said. Some years ago now, when I was based in Somerset, I was working with Taunton Deal Council. All the elements of Taunton Dean Council, the police and probation, pooled all the information they had on a geographic basis, and the brighter red the colour got the more of us were engaged with that address. The bright orange one turned out to be a community home where all the kids with problems had been placed and we all had an interest. Here we are now and the Home Office National Policing Plan does not mention child protection at all. The two words are not in there. Pages one and two talk about children and anti social behaviour orders and curfews. A colleague of mine suggested that we are demonising children and we should be asking ourselves what kind of adults we are creating. If the DfES are going to produce their document and the Home Office are going to produce their document, it would help if they would get together and ask the professionals who can advise them as to the best way to do this, jointly or together with them. We would argue from the police that Every Child Matters started off badly so far as we are concerned, because we were not consulted about it, but the last four months has seen a radical change. We have now sat down and had serious discussions with senior officials at the DfES. In terms of child protection, a senior official at the DfES attends my national child protection steering group, and so does Paul Clarke from the ADSS, so we are ever more closely working together but we are the ones creating that. It is not coming from a national leader at a political level because these things are being done in isolation by the political leadership, and we think that it could start there. They all sign something, but then the National Policing Plan did not mention child protection? Dame Gill Morgan: Could I mention something which is not about integration of the central bit, it is the fact that having refreshed my memory in preparing for today, there have been 52 different documents published in the last three years, of which 43 were this year, and there are a further 17 coming. When you read them you really have to challenge how much added value comes from document to document to document, and there is a real issue which is not perhaps about joining up, the bureaucracy is not just about demanding things from the people trying to implement, but it is giving so much guidance that nobody can read it. In many of our organisations there is the only one person dealing with the whole of the children's agenda, and I reckon they are fully occupied just trying to find the one nugget of wisdom in the very large document that is turned out. There is something about how, once you get some degree of integration - and we agree it could be better - that is then communicated, and it does appear to me that there is rather a growth industry, in terms of writing things, going on that I think is beginning to obfuscate the very simple messages rather than clarify them. Q194 Mr Pollard: Is that initiative overload? Dame Gill Morgan: It is not initiative overload, it is helpful guidance overload. Unfortunately, because they are not always written by people who have ever done anything, it is not necessarily desperately helpful. There are a lot of words. This is an edited selection I brought with me deliberately today. This is nowhere near a twentieth of what has already been published. It is enormous. By the kilogramme no child should ever have a problem, but the reality is that everyone who needs to know is too busy reading it to be doing the things that we all know, and have known for many years, should be done. Q195 Jonathan Shaw: Lots of witnesses come in front of us from professional backgrounds saying, "We are not getting enough guidance from government. We need more information." Chief Constable Grange: When I became a Chief Constable, which is under five years ago, there were two places in the Home Office that you went to for funding outside your general grant. There are now 29. We are drowning in parts of the Home Office, saying, "You can have this money if you do that", but they are not talking to the office next door, and that is just within the Home Office. If you then pass it to the other departments, there is an awful lot coming at us, and it does not stop. Cllr Kempton: The message you are getting from the different sectors and you are hearing together is a consistent one, because I think we all share the view about engagement across government in this agenda, and probably, compared to other areas, it has been a model of cross‑departmental working. However, there are major areas, and funding is the significant one, in relation to bringing together different funding streams within individual departments but also across government. There is a concern about Gershon efficiencies and how they are going to overlay what is a major change programme. I do not think any of us at the sharp end of that are very confident about delivering major change at the same time as a shrinking pool of funding. That is an area of concern in relation to putting money behind the National Service Framework for Children, which I think is a great document to have, but because we cannot see the funding streams which are going to support that, there are some major concerns across government to do with funding. There are also major concerns, as has already been highlighted, about where the Home Office sits in relation to this agenda. We are all saying that the Home Office needs to be drawn closer to this in the way that the Health Service is doing. The idea that the welfare aspect in the Criminal Justice Bill has been removed seems to me a flag of concern really, and, as you have already heard, the fact that the children are offending is, I think, a marker of other concerns which may be to do with schooling, which may be to do parenting or with social services. I would also like to flag up some concerns in relation to the DfES and joined up government. We probably have not talked enough about the role of school governors. They seem to be a forgotten group in this government's arrangements. There seems to be, on the one hand, a concern that school governors are being over laden with responsibility and, on the other hand, increasing the responsibility that the governors are going to have either within foundation schools or foundation partnerships. I think it is a concern about the inspection of schools and whether that is going to be sufficiently our message with the joint area review type inspection, and I think again, as I have highlighted before, a concern that within education, within schooling, there is a message coming out that schools are somehow going to become more separate from local authority services at the same time as we are talking about health and the police becoming more intimate partners. Mr Coughlan: I just want to come back on that point about witnesses who said they wanted more guidance, because I think I could speculate that that will be about two things. One is that the Children Act 1989 came with a welter of guidance, all of it excellent but extremely difficult and heavy‑going. Everything that has followed since has come with the ambition not of replacing existing guidance but as simply supplementing it. We are over laden, I think, with quite complex guidance, and it may be that what people are saying to you otherwise is, "We want to be pointed to the simplest, clearest direction." The second element to it is that one of the points within all of this that I worry enormously we are going to miss is about the pure skills of directly working with children, communicating with children and giving people the tools do that. I know the Government are very committed to developing a strong programme to develop the workforce. We entirely support that and are very keen that that should happen rapidly with investment, because we have got an army of children and staff who are very dedicated, very committed, but sometimes they feel under-skilled in doing basic direct work, and we have to remedy that very quickly, otherwise the referral process, the team processes, the assessment processes will not be addressing the problems of children and their families. Q196 Mr Pollard: Could I ask a specific question of David Hawker, please? If an individual school is performing well in terms of educational attainment in line with the five‑year schools strategy dealing with ADSS but badly in terms of social community inclusion - the concern of ECM - what should be done? Mr Hawker: Most schools that do one well do the other well as well. I think it is a false dichotomy to say that you either do achievement or you do inclusion ‑ that is the first point ‑ but there are schools who clearly strive for better achievement more than they strive for inclusion. I think we do need to be fairly rigorous with those schools in terms of their broader social responsibilities. They do have a responsibility to the community they serve, and they serve the community, and education is a means to an end; it is intended to get young people growing up as contributing citizens in society, and schools are not doing their job effectively unless they secure that, and that means effectively for all children within a local area. This is where the partnership comes in, of course, because this is where schools do not do it all alone, they do it in conjunction with other agencies, and there are clearly a number of children who, for one reason or another, need a lot of other support to do it, but schools doing their job properly will not opt out of that agenda. I think James made the point about the school inspection framework, that it is important that that inspection framework actually does highlight what success is in terms of children growing up and thriving in society, and that is not just about achievement. Achievement is one aspect of it, one dimension, and a very important dimension in some ways, for many children the most important dimension, but for other children you have to make sure that they are properly included and that they are helped to overcome their difficulties, and schools need to do both. I do not think a school can be truly successful unless it does genuinely address both aspects. Q197 Mr Pollard: One final question, Chair. All this is about risk. We have the cotton wool end of the spectrum or the laissez-faire end of the spectrum. Have we got it right yet? Mr Coughlan: I would argue that one of the concerns that we have with the change agenda, we support it we promote it, we work hard at it, but we must not fail to recognise how well some of the services have continued to work, despite some of the barriers that they face over the years. We have a very successful system of protecting children in this country. Regrettably and tragically, some children have slipped through the net previously. Regrettably and tragically, they are likely to do so again, however well this goes. Particularly for the sake of the workforce, we must not fail to recognise how well they go about their work on a day to day basis. I do not think we have got it right yet. As a child protection person, if you like, the one thing I have learnt through this process is that the day you think you have got it right it is going to bite you very badly. We must not have any complacency, we must have a culture of constant vigilance, but we must balance risk, because otherwise we will be too interventionist. Chief Constable Grange: May I come at it from a purely police perspective and agree with what has just been said. I do not think you will ever get it right. In my area I deal with child protection and the management of sex offenders, and there is an expectation in this country that we will produce a risk‑free environment for children. If you do, when they grow up they will get badly hurt. They have to go out and experience life and find out what the risks are. When we start managing sex offenders, we are managing an environment it which the risk is never going away, and everybody engaged in it knows it. What they also know is that on the day they fail, all the successes will be forgotten and everybody will turn their guns on the individuals who appear to have failed, and that is not a good way to manage anything? Dame Gill Morgan: I think it is even more complicated than that, because you can find in the newspapers the important commentators on health performance, in the same newspaper an article damning health care professionals for not intervening on a child who is damaged and the same article damning heath and social care professionals for taking children into care and actually pushing the boundary of risk too far. I think we have a real problem: that we do not actually know what we really want out of it. Here is an example today, just listening on the radio, this evening there is a programme about brittle bone disease saying that potentially 20 children each year may be misdiagnosed of child abuse whereas it is brittle bone disease. Just set that against the context of the children who are genuinely damaged. We are ambivalent. I think politicians have a key role to play in this. There needs to be a proper debate about the balance of risk, what can be expected and what you should expect from the professionals who work there, and what you will stand up and support for the professions of work, because when you are under those circumstances it can feel very unforgiving both ways. Q198 Valerie Davey: Thank you all. We were advised that this would be an important session, and it certainly has proved to be. It is hugely complicated. We are learning every time. We have learnt an enormous amount this afternoon from five highly committed people to an agenda that we have all signed into and from whom we have learned a great deal and from whom we also know there is a huge commitment in all the work you are doing. I want to personally say thank you very much indeed, not just for this afternoon, but for all you are doing, and just before you go, it has been an intense session, but is there anything any of you feel that you have not mentioned and wanted to say, either now or later? Is there anything any of you want to say immediately as a final comment? Can I ask each of you: is there anything you would like to add to the session today? Dame Gill Morgan: No, I have got my two tirades in, so I am happy now. Valerie Davey: I think you have all had the opportunity to come in, but let me say, as the Chairman would certainly say if he was sitting here: if on the way home, or tomorrow, or over Christmas you suddenly think, "Oh, that is important", please do let us have it, and please, later on, if there is anything that comes to your mind, send it in. We would be delighted to hear from any or all of you. It has been a useful session. Thank you very much indeed. |