Examination of Witnesses (Questions 20-39)
MS NAOMI
EISENSTADT, MS
SUE HACKMAN
AND DR
SHEILA SHRIBMAN
19 APRIL 2006
Q20 Dr Blackman-Woods: I have some
general questions about where we are with the implication of the
Every Child Matters agenda. Can you give us your view of
where you think areas are with the development of children's trusts?
What proportion do you think are quite advanced and what proportion
are behind? Is it more or less where you expected it to be or
not?
Ms Eisenstadt: In terms of what
we have expected, it is better than we expected. All local authorities
will have directors of children's services by 2008. At the moment
142 local authorities have directors of local services. All local
authorities except the excellent authorities are required to do
a children and young people's plan. Our evidence is that even
excellent authorities are doing children and young people's plans
because they want to, because they find it is such a useful tool.
We are finding an incredible enthusiasm out there for the key
principles. Where we are now is from design to delivery to real
implementation, and a lot of the changes so far have been structural
changes that were required to set the scene for the real changes
at the front line. In terms of which ones are good and which ones
are bad, some are very, very good.
Q21 Dr Blackman-Woods: It was proportions
I was asking about. Where are we in terms of overall areas? Have
you got a feel for where we are?
Ms Eisenstadt: On the children's
trusts side, overall I would say that a good two-thirds are making
real progress towards children's trusts arrangements in terms
of joining up and there are very few where we feel they are very,
very far behind. So it is better than we would have expected at
this stage. Our evidence for that is the things I have just said
but also things like engagement in extended schools. The Training
and Development Agency has doubled the requests from schools that
they were expecting. They were expecting around 2,000 and they
have got over 4,000 schools who want the development training
on becoming an extended school.
Ms Hackman: The annual performance
assessment is a new procedure from Ofsted which replaces old inspection
procedures where the educational and social inspections take place
jointly. They reported in December on the state of play and they
gave local authorities four scores: one was for their social care,
one was for their educational opportunities, one was for both
and the other was for their capacity to improve. We thought, bearing
in mind the early stages, the results of that were very good.
They found that three-quarters of local authorities consistently
are well above the minimum requirements that they expected. With
regard to just social care, they said 60% were consistently above
the minimum and that is up 50% since the previous year, which
must have been 2004. They said—and this was particularly
pleasing—that a very high proportion had good or excellent
capacity to improve and I think that is important because at an
early stage the capacity to improve is a very significant score
because some are just simply further along the road because they
have been Pathfinders. I think that small authorities are well
advanced and particularly well developed and that is just because
they are small. A unitary authority is by nature already unified
and had that flying start and I think they have found it easier
for their staff to be together and to talk together. They have
already developed some of the systems that are just still ambitions
for large authorities and which are genuinely and practically
much more difficult in larger authorities to establish. In the
beginning that was a very good report. However, they did have
some concerns, of which the first and most important one was the
position of looked after children. I think we have to bear the
criticism that with looked after children our performance just
is not good enough. They pointed to attendance, attainment and
the need for stable care for those pupils as really still terribly
important. They reckoned about 50% of local authorities were doing
a good job, were getting a good performance out of those children
and looking after them well, but they said that 50% still had
some way to go and amongst those some were better than others,
obviously. I think we have got to pay big attention to that. In
my own area of responsibility, for example looked after children,
in the very best cases the difference in achievement between themselves
and their peers at the end of primary school is as much as a 20%
gap and in the worst cases it is 50%. We have to take the rap.
We must try harder on looked after children and we are going to
do so.
Dr Shribman: We are seeing increasing
notifications of pooled budget arrangements which does show evidence
of collaboration in children's trust partnerships. We have heard
of examples of £9 million and £700,000 from different
individual areas and a total of over £90 million and rising
for these pooled budget arrangements which I think shows the contribution
people are jointly making with half of the money coming from PCTs
and NHS trusts and half from partners to take initiatives forward.
I think that is an indicator of progress again along the line
of working more closely together.
Ms Eisenstadt: And increasing
numbers of joint posts across the PCT and the local authority.
Q22 Dr Blackman-Woods: You are painting
a picture of really quite widespread engagement with the agenda.
Would that be fair?
Ms Hackman: I think that is fair.
I speak to headteachers every week and in a year I will get round
half of the secondary headteachers and very many primary teachers
and I have yet to hear anyone say they disagree with the policy.
No-one is opposed to children being safe, valued, attaining well
and enjoying school. It is a very popular policy. I think they
also feel well supported financially with the money that is coming
in via personalisation, extended schools and so on. If we hear
anything negative, it is not about their willingness or their
commitment, it is about having time. On that initial stage of
the implementation of the policy, I think one has to say it takes
time to change a system. It takes strength and energy to set up
new teams and to make new ways of working and to establish new
team spirit. We believe and they believe that the long-term benefits
outweigh the short-term challenges.
Q23 Dr Blackman-Woods: What proportion
of areas currently have functioning local safeguarding children's
boards?
Ms Eisenstadt: They all do.
Q24 Dr Blackman-Woods: Do you think
any of them are not up to speed, and what advice are you giving
to the Secretary of State about that?
Ms Eisenstadt: I cannot say. It
would be inappropriate for me to say. It would be very difficult
to stand in front of this Committee and say they are all functioning
perfectly because this is a very new arrangement. What I think
we can say is that the changes in the arrangements in that they
are statutory gives a much stronger lever to the quality of their
operations because ACPCs (Area Child Protection Committees) were
not statutory. I feel that great progress is being made, but it
will be different from authority to authority and that is why
processes like the APA and the joint area reviews are so important.
Given that they had to be in place from 1 April, they have been
functioning for 19 days, it would be inappropriate for me to say
which ones were functioning well and which were not.
Q25 Dr Blackman-Woods: Can you remind
us of what you said about the children and young people's plans?
Ms Eisenstadt: Virtually every
single authority has their plan posted on their website. The plans
do demonstrate very close joint working across the services. The
really good news on the plans—and I am actually a non-executive
director on a local Primary Care Trust so I was involved in my
local plan as well—is the extent to which they work very,
very hard to engage both with children and young people, local
parents and the local voluntary sector in developing the plan
so that the plan is not planned just by the public sector services,
it is planned by the constituency that is interested in children's
services. I think that the plans are a very good tool, they are
a very good first step, but it is also about making the plan a
living document that is then used. In my locality my criticism
of my plan was that in some areas the targets were very clearly
identified in terms of where we are now and where we need to get
to, but in other areas it was just profit in without setting out
where we are now. I think for the plans to really work they need
to be done in the way that education plans were because the data
in education is much better than our data in wider children's
services. To make all this work we have to get better at data
collection, we have to understand what the data means and we have
to make sure that the kind of rigour that we have developed for
education in schools over the last 10 years really is now applied
in a similar way to children's services because we just have not
had the capacity for that kind of rigour.
Q26 Dr Blackman-Woods: We have talked
a lot about planning and changing structures. Has this been getting
in the way of or facilitating delivering on the outcomes, particularly
this narrowing of the gap? Is all of this getting in the way of
the focus on the outcomes or is it really turning the ship?
Ms Eisenstadt: I just do not think
you could do it without those structural changes. That always
makes it slower. It was a very interesting discussion that we
had with Home Office people on respect, about the need for speed
and then the need to make sure that you have all the key partners
on board. To get all the key partners on board takes time because
of cultural differences, language differences and all of that.
On the other hand, we need to see some real results because local
people will become very disenchanted if they do not see their
services improve. Where we see the real results is on extended
schools and children's centres and integrated youth support. We
now have pilots on targeted integrated youth support for the most
disaffected young people. Across the piece, which I always say
is minus nine months to 19 years, through extended schools, through
children's centres and integrated youth support, we are seeing
real changes in communities, but I think for that to be universally
applied we need the structure and the systems to change and for
that to happen in parallel. We have not had the luxury of doing
these things in sequence.
Q27 Dr Blackman-Woods: Can I come
back to this issue about outcomes and narrowing the gap because
we had a very long discussion on the Childcare Bill about the
importance of reducing childhood inequalities and because of the
way in which the legislation is structured it means the children
at the bottom have got to achieve faster if we are going to narrow
the gap because all outcomes for all children have got to be improved.
I think it is fair to say that we had real difficulty convincing
the Conservative opposition that that was something that should
be aimed for. Can you tell us from your experience why narrowing
the gap is so important for children, and do you see the Every
Child Matters agenda really gearing itself to delivering on
reducing inequality?
Ms Eisenstadt: I sat in on the
committee debate when that clause was debated so I know there
is real difficulty in convincing people of the importance of narrowing
the gap. The point of narrowing the gap is about equity and opportunity
because basically if children are going to have an equal chance
at good employment and at good opportunities as adults then they
have to be able to compete with their better off peers. Right
now who you are born to determines your future in a way that is
fundamentally inequitable. The principle behind it in terms of
what our ministers want, in terms of what I know Beverley Hughes
wants, is to make it fairer in terms of children's outcomes and
in terms of where you are born and who you are born to not necessarily
determining where you wind up as an adult. That is why narrowing
the gap is very important. In terms of the policies and how they
will contribute to narrowing the gap, my best area of expertise
is early years. We have very, very good evidence on the difference
that quality early education can make. One of the pieces of evidence
that is quite interesting on it is that the effective provision
of pre-school education, the research on which this is based,
is we are still getting good educational outcomes up to age eight.
Children's advancement at any level at school is highly dependent
on their performance at a previous level, which sounds quite basic
but that is a very, very important principle. So if you do not
do well at Key Stage 1 your likelihood of doing well at Key Stage
2 is significantly reduced. What good quality early education
does is it lifts the children in the poorest areas above the line
at Key Stage 1, so their chances of then having a successful educational
career are greatly enhanced because they are above that line,
but below that you are less likely to do well through the rest
of your educational career. How do we do that in terms of narrowing
the gap? If we did that for all children then all the children
would go up together. I think the key to narrowing the gap is
the engagement with parents because that is where you get the
biggest difference in terms of what Sue was saying about it being
quite basic, we know it already. We know that babies that are
read to, sung to and held and cuddled learn to speak quicker and
better. We know what developmental opportunities are needed in
under 3s, but how to get parents to do it in terms of the poorest
communities I think has a lot to do with the Sure Start approach
on addressing the other issues in families' lives. So if people
are in poor health their ability to do that is much less. If people
cannot give their children a decent diet their ability to do that
is much less. The way in which we are working jointly with the
New Deal for communities to address the wider issues of housing,
environment and of parents' ability to do these things with their
very young children I think will eventually narrow the gap. I
know it is a great aspiration but we have to believe it and we
have to keep the evidence flowing and the only way is to keep
measuring whether we are doing it.
Ms Hackman: It is early days for
seeing the results and some of it is faith, but we did have 14
Pathfinders to learn from. The 14 Pathfinder authorities did not
cover the whole gamut of Every Child Matters policy. Some
of them concentrated on particular aspects such as disability.
Some of them concentrated on a certain number of schools rather
than all of them. The results there are very optimistic. For example,
in Hertfordshire, where they integrated their preventative services
around probation and they ran that around 15 schools, the results
that came out of that, not just on the services they were addressing
but on the exam results of the pupils and reductions in truancy,
were very noticeable, they were certainly statistically significant.
For example, they did 3% better at GCSE and that was a better
improvement than other local schools. Similarly, at Key Stage
2 results went up by 6.5% which is well above national and local
averages, their permanent exclusions went down by 25% and their
fixed term exclusions went down by 28%. Those kinds of figures
I could cite to you from Portsmouth, for example, or West Sussex
similarly on individual children. We do run a target setting process.
We are asking schools and local authorities to look ahead and
say, in the light of everything you know, what is your best expectation
for how pupils will perform next year? The whole country is very
optimistic and predicts rising results next year. To me that speaks
of a certain amount of confidence amongst schools that not only
do they support the policy but they do expect it to feed through
into results. It takes 16 years to brew a child educationally
up to GCSE and we will have to come back in 12 years and see if
we were right! I think we are going to give it our best shot.
Dr Shribman: There is a very large
programme to tackle health inequalities across the board. Our
infant mortality rate is improving but again there is an inequalities
gap. We have an opportunity over our forward programme this year
where we will be looking at the child health promotion programmes.
That is part of the national service framework for children. We
will have an opportunity to look again at how we implement that
in practice, and Naomi is going to join me on our group looking
at this and it will give us a further chance to look at engaging
families in all of those areas that Naomi referred to, in early
language development for example. There is an opportunity there
to get to the very early years where I think we feel it is a very
important time.
Chairman: Stephen, you have been very
patient.
Q28 Stephen Williams: We have talked
so far about the relationship between different services for children,
putting together education and social care, and so on. I want
to talk a little bit about the relationship between children's
services and adult services and in particular the danger that
some people might fall in between the two. First of all, perhaps
for Naomi, what guidance is the Department giving to authorities
to make sure that people successfully transfer from being an adolescent
to being a young adult?
Ms Eisenstadt: Interestingly enough,
we issued some joint guidance through the National Service Framework
because we have a lot in the National Service Framework for children
on particular issues. First of all, there is the transfer between
child and adolescent mental health services and making less rigid
the age at which children would move from a child and adolescent
mental health service to an adult mental health service, giving
more flexibility at local level to decide when it is appropriate
for a child to move because it can be very difficult and in my
own area we have problems with this. There is also the issue which
I think is as important, and again we picked it up in the NSF
on things like adult mental health services and parenting, on
services for adults with drug and alcohol difficulties and parenting,
on domestic violence and parenting, and all of these are whole
family approaches where the joint working on NSF, and also particularly
with the Home Office, are enormously important. So we work very
closely with the Home Office on issues of domestic violence and
then what happens with the children. We work very closely with
the Department of Health on issues of drugs and alcohol and what
happens with the children. It has been an uphill battle but, again,
I feel from my local experience we are making real progress on
getting the adult psychiatric services to pay more attention to
the adult patients' responsibility as parents in terms of treatment
methodologies. So the kind of guidance that would come from DoH
would be influenced by us and we would in the DfES have a chance
to look at it and to comment on it before it goes out.
Dr Shribman: Just to tell you
about a recent publication and initiative. We have been looking
particularly at the transition and, as Naomi said, a referral
letter from a children's service to an adult service is not always
good enough. We have to look at a process for young people to
transfer from children's services to adult services at the right
time. We have held a major international conference on that recently
and published Transition: Getting it Right, so we recognise
through the National Service Framework that this is an area where
more work is needed, and I am pleased to be able to say we have
a lot of buy into this. The Medical Royal Colleges, for example,
are very interested in improving this area of care for young people
and they recognise that there is more to do as many young people
are now growing up into adulthood with some of the rarer conditions
where children used not to survive. There is quite a lot of medical,
clinical and health care engagement that is needed with this as
well as our partners, as Naomi has outlined already.
Q29 Stephen Williams: Can I ask a
supplementary question on the whole family approach that Naomi
mentioned. I had a good experience recently in my constituency
of a meeting with a group of young carers aged from about nine
to 13. It was probably the most impressive group of people I have
met in the endless rounds of meetings that I have had as a constituency
MP. Some of them supported a single parent with a disability,
anything from MS to a physical handicap. Others looked after siblings
with different disabilities or who were somewhere on the autism
spectrum, and they did a wonderful job, but they definitely had
practical problems with their educational experience and the lack
of support, as they saw it, from social services. So what guidance
does the Department give to children's services trusts to have
joint assessments of families where there is a child who has a
caring responsibility either for a fellow child or for their parent?
Ms Eisenstadt: Young carers have
been of interest to us for quite some time, and it was certainly
an interest of mine when I was in the voluntary sector as the
voluntary organisation I worked for did a lot of work with young
carers. I would expect that a common assessment framework for
the young carer would be in place for the kind of support they
need, not just in terms of the adult's health but in terms of
respite. The interesting experience I had when we worked with
young carers is that they did not want permission to come to school
late; they wanted taxi fares so they did not have to be late,
and of course through pooled budgets we have a better ability
to be able to offer that kind of support. Interestingly enough,
in terms of the charity I worked for at the time the local authority
gave the charity the money because the local authority could not
give the children the money itself. However, at least the local
authority was recognising that it was very, very important to
engage with these young people themselves about what they thought
they wanted, not what we thought was important. So there had been
historically particular projects and a lot of work. I suppose
what we want through Every Child Matters is to make sure
that it is not patchy so that if you happen to live in this area
where this charity operates you might get a good service. That
is precisely what we are trying to do with Every Child Matters,
to use those voluntary organisations, not to cut them out but
to make sure that there is some standard level of service across
the country. We would include young carers in that. In terms of
specific guidance, the answer is I do not know but in terms of
the discussions and the way we would want to make sure this policy
process is about all children and all children's needs being dealt
with as individuals, of course it would fit in perfectly.
Dr Shribman: Just to add to that,
the recent health White Paper Our Health, Our Care, Our Say
has a lot to say about carers and the importance of carers, so
there is more work to do to support carers in general. Of course,
that does include children who are carers. I agree with you, I
have seen a number of children in these circumstances and they
are a particular potentially vulnerable group, and although many
of them are, as you say, extremely able and capable, we do need
to provide that appropriate support but it does depend on the
assessment of the individual situation. I do think that is particularly
important for these young people; what is right for them and what
they would like to have in order to improve their life situation
is critical.
Q30 Stephen Williams: We heard earlier
from both Naomi and Sue about the whole system "supporting
attainment", which was the phrase that Naomi used, and Sue
talked about barriers to achievement as well. Young carers, it
seems to me, have these practical barriers in front of them so
what processes are in place within schools to identify that there
are young carers amongst the school population and what practical
measures should a school then have in place to make sure that
child is supported? You mentioned taxi fares. There were other
things as well that were mentioned to me like use of the telephone
or not being told to turn off their mobile phones and there is
also the aspect of truancy as well. Some young people felt that
they were being treated as truants if they were late or had to
go home in the afternoon.
Ms Hackman: I certainly think
with regard to truancy in the last two or three years we have
shifted the emphasis away from simply finding truancy and punishing
it to looking into the reasons why people truant and trying to
resolve them, to take a more proactive approach. I think in that
situation it is a good example of where joint services working
together would find that child and not perceive it as a problem
of just "truancy" as such but as a greater need that
child has. So I think we are much more likely to pick up such
issues. Is that what you were asking?
Q31 Stephen Williams: We have talked
about looked after children and we know that there is a big gap
in achievement there, but in children who look after there must
be an under-achievement gap there as well. I just wondered whether
the Department monitors that as carefully as it monitors other
groups.
Ms Eisenstadt: We can check that
for you.
Q32 Stephen Williams: That is two
"don't knows" so far.
Ms Eisenstadt: I think this is
a very interesting issue on young carers because my experience
with them is that they really want to do it, and they are magnificent
children because they want to do it, but the demands of doing
it can prevent them from achieving at school, can prevent them
from fulfilling their potential in terms of their own lives as
adults, and of course can prevent them from the normal social
life that children and young people enjoy. I think there is a
very, very delicate balance here between children's wishes and
children's rights and a future about what is good for those children
and what is best for them and how that interacts with what their
parents want for them. What I have just said is my own views on
how I think we need to address the issue but in terms of how as
a Department we are addressing the issue, I will have to find
out and let you know.
Ms Hackman: It has been useful
to have that raised.
Q33 Chairman: We like it when witnesses
say they do not know.
Ms Eisenstadt: It is better to
be honest.
Chairman: We welcome the honesty. There
are some people we get as witnesses who know the answer to everything
and we do not always believe that. We have got to move on because
we are enjoying this too much and we have got to make progress.
Helen is going take us through the management of the Children's
Trust.
Q34 Helen Jones: The Committee has
previously expressed some concern that most of the directors of
children's services who were being appointed seem to be from an
educational background. Do you have the data for what is happening
now? Is that still the case? What proportion are from education
and what proportion are from other areas, do you know?
Ms Eisenstadt: 98 have an educational
background, 41 have a social services background and one has a
private sector background.
Q35 Helen Jones: Does that bother
you?
Ms Eisenstadt: No, it does not.
It does not bother me because I think that the ones that I know,
and of course like Sue I meet with them quite frequently, have
taken on the wider agenda in a very, very serious way and understand
it and are using their social care colleagues for the specific
expertise. We were talking about it before we arrived in terms
of the three of us before we came to you that at the end of the
day no matter who does it someone has to do it and someone has
to have some sort of background. The important thing is the leadership
qualities to understand what you do not know—it is really
exactly what you were saying, Chairman—and the leadership
qualities to build the team around you to make sure that you have
the particular expertise. I see great evidence of that, I really
do, so it does not bother me.
Q36 Helen Jones: You do not think
that many local authorities are still seeing this whole area of
children's services/children's trusts as being simply an educational
issue or an extension of education and therefore that affects
who they appoint?
Ms Eisenstadt: In some sense the
good news is that you get the rows on both sides so we must be
doing something right because the education people think it is
a social care takeover and the social care people think it is
an education takeover. That is what happens when you bring stuff
together. That is what people are going to think and that is why
we have to bring it together because we have to break down that
silo mentality if we can.
Q37 Helen Jones: Can we have a look
at the management then. If we are, as we are doing, trying to
bring together all these different areas of expertise, how in
your opinion are directors of children's services able to manage
that? If they are expected to co-ordinate people who are employed
by other agencies—schools for instance or GPs (which is
an area that we have looked at in the past here) how is that working
on the ground? Are those agencies co-operating with this agenda
in reality as opposed to saying, "Of course we want it and
we co-operate with it", and what are the barriers in the
way of doing that?
Ms Eisenstadt: I think the key
question is what are the levers that the director of children's
services and indeed the lead member, because of course there is
a democratic accountability in this—
Q38 Helen Jones: —who is also
often from education.
Ms Eisenstadt: —what are
the levers that they have at their disposal. There are some quite
strong levers like duty to co-operate and some levers that they
do not have. At the end of the day what we were trying to fix
was that there was no clear accountability for children in a locality
and the idea you have one person, shared with the lead member—the
executive member and the political member—who has accountability
for what happens to children in the locality, in my view, has
to be right. I think it is the right thing to do. Then does that
person have the authority and the power to bend the services in
the way you are describing? In some cases, yes, in some cases,
no, and in some cases it is about influence and knowledge and
working together and building the capacity and the partnership,
and in some cases it is "I'm sorry, mate, you have to do
this". So on local safeguarding boards it is, "I'm sorry,
mate, you have to do this". On extended schools it is, "This
would be a really good idea. Wouldn't you like to do it?"
and, lo and behold, lots and lots do. So I think that balance
between the "must dos" and the bringing people on board
because they feel a shared commitment is quite important, and
I think it is psychologically important because the must dos only
get you so far in real changes on the ground and the "must
dos" do not let you feel like "this is something I really
want to happen in my locality". I think that mix—and
I read it in your report from last year—where you draw the
line on the "everybody must do" and where you draw the
line on "at local level decisions should be made" or
where you draw the line on "at school level or neighbourhood
level decisions must be made" will always be an issue for
debate. Have we got it right? I do not know.
Q39 Helen Jones: Before I come back
to schools I wonder if Sheila would like to comment on how GPs
are working with this process because that is much more your area
of expertise. What are you finding on the ground?
Dr Shribman: If I could start
with primary care trusts in general because I think that is important
in terms of the framework and then move on to GPs specifically.
Obviously you will be aware that primary care trusts have a duty
to co-operate in the new arrangements and they have to discharge
their functions particularly in relation to safeguarding, so there
are the specific and there are the general collaborative duties.
Within a PCT's remit is of course the entire primary health care
team in which GPs play an important part, as I am sure you would
all agree, but not the sole part, so I think it is very important
to focus on the whole of the team as well as GPs. From my point
of view, I think this whole agenda has brought primary care in
general into the co-operative arena in a more effective way than
previously. I guess the worries that you have expressed and that
people do express about GPs is how far are they engaged particularly
in the specifics around safeguarding. It would help me to know
what your particular concerns were around GPs.
| 
