Stop meddling says GP

Shannon’s case sees police become social workers

Dr Michael Fitzpatrick laments the passing of the days when professionals understood that parents knew best and interventions were discreet

The police have received criticism in the press for taking more than three weeks to find Shannon Matthews, the nine-year-old discovered in the house of a member of her extended family, less than a mile from her home in Dewsbury.

Yet, there has been little criticism of the decision that she should be taken into care, with the implication that her immediate need was for therapeutic professional intervention rather than a return to her own family.

The fact police statements explaining that Shannon was receiving expert professional support met with widespread public approval reflects the consensus that parents lack the skills required to help their children, especially through periods of crisis. The prevailing view is that parents take second place to social workers, teachers – even doctors – in knowing what is best for their children.

Professional instruction

The notion that doctors should encourage parents to undergo professional instruction in parenting skills, in initiatives such as Sure Start, is now widely accepted. Yet it marks a dramatic reversal of what was traditionally regarded as good medical practice.

Donald Winnicott, the famous child psychotherapist who practised in my area of Hackney, and after whom the local child development centre was originally named, took a radically different view.

He insisted that “we must see that we never interfere with a home that is a going concern, not even for its own good”. He warned that “doctors are especially liable to get in the way between mothers and infants, or parents and children, always with the best intentions”.

Winnicott was acutely aware that intruding between children and parents, who he considered the most reliable guarantor of their interests, could have a destabilising effect.

In an essay entitled Advising Parents, he indicated that all his professional life he had “avoided giving advice” and that he aimed to discourage other doctors from doing so. He carefully distinguished legitimate medical treatment from giving “advice about life”, which was beyond doctors’ competence.

“Doctors and nurses should understand that they do not have to settle problems of living for their clients: men and women who are often more mature persons than the doctor or nurse who is advising.” According to Winnicott, for a doctor to advise people about such problems was not only impertinent but implicitly authoritarian.

Intimate experience

Expert intervention diminishes the value of parents’ intimate experience of dealing with their own children. The intrusion of an external source of authority into the family undermines not only confidence, but also accountability.

Any third-party intrusion between parents and children is likely to weaken their own capacities to work through and resolve conflicts. Though motivated by a desire to provide help and support to families in need or in crisis, parenting projects or specialist police family support workers are likely to weaken parental authority still further – to the detriment of both parents and children.

It is ironic that the best advice to the police in the search for Shannon came from her mother who told them publicly that her daughter was most likely to be found with somebody who knew her.

Now that the police have become social workers, social workers (and doctors) have taken over the tasks of parents, the only thing left for parents to do is to advise the police.

Dr Michael Fitzpatrick is a GP in the London Borough of Hackney



More from Community Care

Comments are closed.