Campaigning organisations are keen to collate advocacy research but professionals risk losing their positions of trust
According to Don Shenker of Alcohol Concern, social workers are “ideally placed to tell us more about how parental alcohol misuse affects families and children”.
I keep a bulging file of exhortations by similar authorities who consider that GPs are “ideally placed” to intervene in a wide range of social problems. This list includes alcohol and drug abuse, of course, but it also extends to gambling, diverse forms of domestic violence and problems of debt and teenage pregnancy.
It is a great relief to hear that social workers are being invited to share this burden of setting the world to rights.
The Alcohol Concern initiative, which has seen a questionnaire circulated to social workers asking them to report their perceptions of the extent to which alcohol is a factor in child abuse and domestic violence, raises a number of issues.
If social workers, who routinely visit families to provide help and support, are going to report to other authorities on intimate matters of those families’ lives, then they will – rightly – come to be regarded as spies and informers. Their perceptions, for example, about alcohol consumption, may be inaccurate or prejudiced.
Violation of confidentiality
Families will feel that observations are being made and notes taken that may be used against their interests. Taking advantage of professionals’ privileged access to clients’ personal lives for some ulterior purpose is a violation of confidentiality and destructive to any professional relationship.
The Alcohol Concern questionnaire is a good example of the sort of “advocacy research” conducted by such campaigning organisations. Even before the study is underway, the sponsors indicate that the results will be used to lobby for intervention in families affected by alcohol misuse. In other words, the object of the study is to provide data to back a conclusion that has already been drawn.
The recent NSPCC survey of teenagers’ sexual relationships provides another illustration of this approach. Like all NSPCC investigations, this starts from the assumption that there is an “appalling” and “shocking” level of “exploitation” and “violence” in intimate relationships. This is dramatically confirmed by the study, which provides statistical confirmation of these prejudices, leading to the demand that professionals, particularly teachers, “should check the safety of young people they have contact with”. The authors do not explain how this checking should be done, however.
For campaigners against social evils like alcohol abuse and domestic violence, the universal solution is: greater and more coercive state and professional intervention into personal and family life. These people are apparently oblivious to the absence of evidence about the effectiveness of such policies. The long history of prohibitionist measures against alcohol and drugs shows that these have little effect on consumption, but create socially destructive consequences that are even greater than the original problem.
At a time when professionals throughout the public sector are being pushed into adopting a more coercive approach, social workers, teachers and doctors are in an ideal position to reject this authoritarian role. We should insist that our first loyalty is to our clients, our students, our patients, and not to the state. The police and criminal justice system have an important place in society, but it is distinct from ours and we should not seek either to adopt it or usurp it.
What we are ideally placed to do is help individuals and families with their particular social, educational and medical problems. And we should not forget this.
Michael Fitzpatrick is a GP in Hackney and author of Defeating Autism: A Damaging Delusion
This article is published in the 17 September 2009 edition of Community Care magazine under the headline Just say no to spying on clients for dubious research projects