Looked-after Children - Children, Schools and Families Committee Contents

Examination of Witnesses (Questions 240-246)


12 MAY 2008

  Q240  Chairman: Is that common practice?

  Jane Haywood: I do not know.

  Chairman: It sounded horrific to me.

  Steve Titcombe: Children's experience of being in care is not determined only by continuity of social worker. I had a recent all-staff conference up in Rochdale featuring all the staff employed by my service. We watched a fantastic DVD about three children in the same long-term care for four years. They were saying goodbye to their social worker, who had done a good job and they had already been introduced to their new social worker. They were not unhappy about this. The really important issues in those children's lives were related to the quality of care that they received from their long-term foster carers and their very positive contact with family, brothers and sisters. I just wanted to make that point.

  Q241  Chairman: Continuity is what we are all talking about though, is it not?

  Steve Titcombe: Yes. I entirely agree that the problems with the continuity of social workers can sometimes be a big problem for children.

  Celia Atherton: When you started on this particular line of questioning, you asked about whether we could not learn now. I would put that together with something that Jane said about the workforce being the beginning and the end of it. The bit of the jigsaw that we are missing is that we should ensure that the workforce are constant learners. I shall give two examples. Very recently, another Government report came out, on building brighter futures. Nothing in the body of the report mentioned the workforce being a learning workforce, the use of research or developing the ability to reflect on what they do. It is mentioned once in an annexe on the values of the children's workforce network. That is all. However, the document published on the same day about managing and leading children's services says a lot about reflective practice and using research evidence. It is as if, so long as people at the top know what the research evidence is, the workforce will follow. People at the top know that children want to know that the same person they saw last week will be there next week and in six months' time. But we have to get to a position where front-line workers are hungry to learn that for themselves—they should feel it for themselves instead of being asked to believe that other people know what they are doing and what is being put in place for them. It seems to me that unless we do that, we will not create people who are constantly reflecting and constantly learning and who are enabled to do some of those things that, as suggested, are not rocket science or terribly difficult, but quite straightforward.

  Professor Le Grand: Exactly. It is not rocket science, which makes one ask what is going on and what are the incentives in the system, which means that we do not have continuity. The reason why we do not have continuity is at least partly because of massive problems over recruitment and retention, as we heard. Social workers move on, and they do so very fast. There are reasons for that, which we have all articulated. I know that I am always banging on about incentives, but in some sense it is about getting the incentives right. It is not enough simply to say that it ought not to happen. We have to work out why it is happening or not happening, and how we can structure the incentives so that it works.

  Q242  Mr Chaytor: Scepticism about social work practices being the solution is based on the fact that the model on which they are based is that of GP practices. Over the past 60 years, they been very effective in building up practices and building up the status of doctors, but not terribly effective in doing anything about health inequalities, giving personalised service to patients or building a seamless approach to the rest of the national health service. That is what concerns some of us. The typical GP practice does not do anything of what we want from social work practices. Is there a model elsewhere, outside the UK, that gives a stronger evidence base for social work practices than the history of GP practices in the UK?

  Chairman: I think that one is for you, Julian.

  Professor Le Grand: We discuss international evidence at the back of the document, but there was not any. That is one reason why we want pilots—

  Q243  Mr Chaytor: You run pilots, but you are not allowing time to evaluate them before launching them nationwide.

  Professor Le Grand: Oh no.

  Q244  Mr Chaytor: What happens if the pilots prove to be totally disastrous?

  Professor Le Grand: We discuss the decom- missioning.

  Q245  Mr Chaytor: The legislation assumes that there will not be disasters and that you can quickly move from the completion of pilots to roll-out.

  Professor Le Grand: This is important: there is no presumption at all that this is a preliminary to rolling it out nationally. We try to make that clear. In fact, we discussed what happens if the pilots do not work. For instance, if some social workers in a social work practice have children being looked after by those social workers, how do we decommission the pilots effectively to return to the previous system? We talk about that quite a bit, which indicates that we really were not presuming that there will be an evaluation—simply nodding to the idea of evaluation and then rolling it out nationally. I am very keen, when talking to the relevant people, to impress it on them that that is not the idea. What you had to say about GPs was interesting. When people from abroad look at our GP service they think it is remarkable—for all the things you were saying that you did not think it did. They think it is extraordinary that it provides a personal service and that it acts as an integration device, because there is a central person who looks after the care of the patient. I suppose that it may be a glass that is half full or half empty. I would have said that GPs are remarkably effective in providing continuity—we have all these troubles and we know that there are to-ings and fro-ings on the hours and the rest of it, but when you look at it in the round and compare it internationally with the total absence of continuous primary care that seems to characterise most health systems, I believe that primary care is remarkable.

  Q246  Mr Chaytor: France?

  Professor Le Grand: You do not get continuity in France; you get people shifting very rapidly. The GPs get very upset about it—

  Mr Chaytor: That is the patient's choice, surely.

  Chairman: I am afraid that this is developing into a discussion that I am sure most of us would love to pursue, but we must get the second bank of witnesses in. I thank you all; Jane is staying with us. I am glad that Lancashire and Yorkshire did not come to blows. I was not prejudiced against you at all, Steve, even though Rochdale claims to have founded co-operatives in 1844. That is total nonsense, because they started in Huddersfield about 30 years previously. Apart from that, the evidence has been excellent all round. Will you maintain contact with us. We get best value out of you only if you come back to us and say, "There is something that never came up when we were discussing this." We write good reports not by making things up, but by listening to our evidence. We got a lot out of that. Thank you.

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