Reach for the high lands

The Scottish executive is backing plans to
integrate children’s services in a drive to turn around the
country’s high rates of child poverty. Natalie Valios reports.

Scotland has some of the highest rates of
relative child poverty in the developed world. Of one million
Scottish children, about 100,000 live with domestic violence, up to
9,000 run away every year, and 80 become homeless every day. More
than 11,000 are looked after.¹

There are no easy solutions, and although
there are similar scenarios in England and Northern Ireland, an
action team set up by the Scottish executive has come up with a
plan to address the specific problems in Scotland.

After devolution the Scottish executive
identified integrated services for children and young people as a
priority issue. A children and young people’s group was set up
within the education department. The executive also took on and
revised the Scottish Office’s child strategy statement, designed to
ensure that all parts of the Scottish Office took account of the
effects on children when developing policy.

Policy in England is running in a similar
vein. In July 2000 Prime Minister Tony Blair announced government
structures to ensure better co-ordination of policies and services
for children. He set up a Cabinet committee to look at services for
children and young people, and created the post of minister for
young people, held by John Denham. A children and young people’s
unit was also created. Its task is to develop an overarching
strategy for all children up to 19 and to administer the £450m
children’s fund.

Back in Scotland, money from the modernising
government fund was used to bring key people together to form a new
action team within the Scottish executive. This team came from
children and families backgrounds across a range of disciplines:
social work, education, health, voluntary sector, and corporate
planning. Their remit was to come up with practical recommendations
for better integrated children’s services.

The resulting report from the action team
published last October describes Scotland’s current system for
children as “chaotic” and “close to crisis”.² The report
paints a picture of a system where some children are “invisible” to
services, where services and needs assessment are often poorly
co-ordinated and often exclude the most vulnerable; where a skills
shortage impacts on work with families, and where information
sharing between agencies often falls down.

The action team’s key recommendation is
radical – that all services to children should be integrated. The
action team drew up a six-point action plan, which states that
agencies working with children should:

– Consider children’s services as a single
service system.

– Establish a joint children’s service
plan.

– Ensure inclusive access to universal
services.

– Co-ordinate needs assessment.

– Co-ordinate intervention.

– Target services.

A ministerial task force has been set up to
drive forward progress on the plan. And accompanying the launch of
the report was an announcement that £63.5m of the new changing
children’s services fund will be used to deliver better outcomes
for vulnerable and deprived children by supporting sustainable
solutions. The remaining £18m of the fund is being used to
develop and extend anti-drugs programmes for children and young
people.

Andrea Batchelor, head of integrated lifelong
learning at South Lanarkshire Council, is a member of the action
team. She acknowledges that the concept of a single system will
require leadership, particularly political leadership, and a
willingness to make cultural changes.

“You need a system that will begin at the top
with a vision of the way forward from partner agencies, plans for
that in a joint way by bringing everyone on board, sets in place
arrangements that will deliver it, and then monitors and evaluates
it,” she says.

Although the Scottish executive is stressing
the importance of a single service system, it is not making it
mandatory. Could this be a flaw in the plan? Apparently not. The
money from the changing children’s services fund is firmly tied to
local areas delivering on the action plan. Local authorities have
until April 2002 to put forward proposals to revise their
children’s services plans to ensure an integrated service with
their partners, says Batchelor.

The fund’s first phase finishes in 2004, and
Batchelor says that progress will have to be evaluated by the
Scottish executive to decide whether ongoing funding is
worthwhile.

The agencies involved in setting up integrated
children’s services are at varying stages of implementation. The
action team wants to see the Scottish executive set up a change
support agency to help them through the process. “The willingness
and commitment is there, but people aren’t always sure how to get
from that to the outcome,” says Batchelor.

Willingness and commitment appear to be
available at the top, too. Batchelor is impressed by the decision
that minister for education and young people Cathy Jamieson will
pass her schools remit to her deputy to enable her to concentrate
on better integrated children’s services.

Much to the delight of Hugh Mackintosh,
director of Barnardo’s Scotland, the importance of voluntary
organisations as key partners in children’s services planning is
emphasised by one of the recommendations.

For a start, they already have good experience
of integrated work and of bringing various departments together in
local authorities, he says. Batchelor agrees: “Many people see
voluntary organisations as a source of good services, as
non-stigmatising and easy to access. But in many instances in the
planning process they are a bit of a last thought. We wanted to see
them considered early on, so they can play as full a part as
possible.”

Mackintosh strongly supports the plan to use
the changing children’s services fund for core services: “Lots of
money is put into new initiatives, but that leads to a major
twofold problem: they are often funded only short term, and key
staff are removed from core work to pilot them.”

And he suggests that although these
short-term, intensive initiatives can have impressive outcomes for
children and families, the results can disappear after a couple of
years. “There’s an issue of sustainability,” he says. “Some
children will need continuous support. It’s a waste if all that
work is thrown away because of a lack of this. Some of the better
methods of achieving best outcomes are not necessarily going to be
cheaper.”

Any local authorities with reservations about
the feasibility of an integrated children’s service need only look
at Highland Council for confirmation that it can work.

Highland is well ahead of the game. A joint
committee for children and young people was set up two years ago,
bringing together not only the council’s services, but the NHS
Highland services, police, children’s reporter, Who Cares? Scotland
and other key agencies working for children and young people.

The joint committee takes an overview of
development, strategy and implementation of policy and practice.
“We are endeavouring to provide a seamless service as envisaged in
the report,” says Bill Alexander, head of service (children, young
people and families) at NHS Highland and Highland Council.

Behind its success is a significant political
drive within the council and health service. It was agreed early on
that a post at directorate level covering social work, education
and health was necessary and Alexander’s post was created. Until
recently it was the only one of its kind in Scotland, but a couple
of months ago another broad spanning post was created – head of
integrated community care, NHS Highland and Highland Council.

Alexander’s post means agencies can work
together quickly at a political and strategic level. All areas,
such as youth justice or substance misuse, are now viewed as
multi-agency agendas. In the child and adolescent mental health
service, for example, primary mental health workers spend some of
their time working alongside teachers and social workers.

Alexander is rightly pleased with the fact
that the six-point action plan is already explicitly policy in
Highland. To bring about a single service system, Highland was
divided into eight areas. The three local managers for social work,
education and the primary care trust were brought together to
collaboratively plan children and families services.

And the fact that he regularly meets every
primary care, social work and education manager to discuss
strategy, policy and practice at the same time in the same room,
reflects the priority given to these services in Highland, he
adds.

Given that Highland comprises one third of
Scotland’s land mass Alexander is justifiably proud of the
achievement. “If you can do that in the largest authority in
Scotland, it can be done anywhere, frankly,” he says.

¹ For Scotland’s
Children, Scottish executive, 2001

² As above