Plenty to take on trust

With so many players involved in providing services,
children’s trusts might find it a struggle to form the
relationships necessary for success, writes Bob Hudson.

In June the Commons health select committee response to the
Laming report had this to say about children’s trusts: “We
are concerned the model is too vague, and there is a danger of new
structures and mechanisms running ahead of any coherent strategy.
We recommend that the forthcoming green paper should provide
further clarification on the contribution that might be expected of
children’s trusts, and the nature of the preferred model.”
Now at last the green paper is out, how closer are we to a better
understanding?

The proposals have created more clarity about some issues. The
vision and remit of children’s trusts have been fleshed out,
with more emphasis given to the need to integrate key services
around the needs of children, in particular education, social care,
health, youth justice and Connexions.

All local authorities will be required to appoint a director of
children’s services who will be accountable for education and
social services and for overseeing services for children delegated
to the local authority by other services. Current legislation
requiring the appointment of a chief education officer and director
of social services will be amended to reflect this. The green paper
(paragraph 5.8) notes that “we expect that in time this will lead
to a single children’s department in most authorities,
although we will not require it.”

There is also some more detail about what will be required, and
what will be discretionary. Paragraph 5.14 confirms that three key
services should be within children’s trusts – education,
children’s social services and community and acute health
services, but beyond this there is flexibility in relation to the
range of partners, the focus of activity and the extent to which
services will be integrated.

We know a little more about how children’s trusts are
likely to be rolled out. Earlier guidance emphasised that the
government did not see them as the preserve of “better” partnership
localities. Instead, children’s trust status would be open to
all – a different approach from care trusts and foundation trusts.
On the back of this – and without waiting for the results of local
or national evaluation of the 35 Pathfinder projects – paragraph
5.12 of the green paper states that most areas should have trusts
by 2006.

As paragraph 5.18 notes: “The move to children’s trusts is
an ambitious agenda… the pace of change will need to vary
according to local circumstances.” This caveat on the nature and
scale of extending the model is wise, particularly since several
issues still appear rather murky.

In particular there are major question marks hanging over the
way the partnerships on which children’s trusts depend are to
be forged. The first of these problems concerns those public sector
agencies which will remain outside of children’s trusts.
These include the police, learning and skills councils and some
health functions. Others are expected to participate but since they
do not fall within the remit of the children’s minister at
DfES, there is bound to be a question mark over their full
involvement. The most prominent of these is youth justice, which
remains at the Home Office. The green paper fails to address this
tension within government about the relationship between
children’s services and youth services.

Even more worrying is the questionable leverage the new
directors of children’s services might have in relation to
the core partners in the children’s trust. The smallest and
most pliable is children’s social services, but health
services and education are very different animals. In the case of
health services, paragraph 5.19 states that, at a minimum, primary
care trusts will be asked to ensure that the relevant sections of
their delivery plans in relation to children are agreed with the
director of children’s services, but delegation of
commissioning and the transfer of budgets is said to be the
preferred model. Furthermore, partnership working on
children’s services will, it is said, be viewed as an
integral part of the agreement that PCTs reach with their strategic
health authority as part of the performance management system. The
value of this leverage remains to be seen, but it is difficult to
envisage a children’s director having much clout over a PCT
fixated with meeting key NHS targets on waiting lists and waiting
times.

A similar situation applies to the world of education. Extended
schools constitute one of the key planks for delivering integrated
provision in universal settings, but the commitment of autonomous
individual schools to the green paper vision simply cannot be taken
for granted. In particular, it is not easy to see how it can be
squared with a policy that has hitherto emphasised competition
between schools. Many head teachers feel that their schools, by
being made accountable through crude league tables, have been
driven into putting their own interests before those of the
community they serve. And it is worth remembering that in the
furore earlier this year about teacher redundancies and school
funding education secretary Charles Clarke could not even find out
which schools were under-funded or why.

Another complication will be the way children’s trusts
relate to existing partnerships because as the new kids on the
block they will be moving into a crowded partnership arena. New and
unclear relationships will have to be formed with existing
children’s strategic partnerships, Connexions partnerships,
children’s fund partnerships and residual adult social
services, among others. Only in the case of Connexions partnerships
does the green paper give a clear steer, stating that from 2005
they will be expected to use children’s trusts as their local
management committees, and that Connexions business plans will need
to be signed off by local children’s trusts before ministers
will agree them. There remains a need for greater clarity about the
co-ordination of a multiplicity of local partnerships.

Overall, the green paper still leaves the children’s trust
model shrouded in some uncertainty. Indeed, it remains the case
that willing local partners across social services, education and
health, could already have achieved much of the green paper vision
by maximising local use of the section 31 Health Act Flexibilities.
However, the reality is that education services, in particular,
were reluctant partners in this respect, and the impetus provided
through children’s trust status allied to the new directors
of children’s services might well make a difference.

There seems to be little disagreement with the vision laid out
in the green paper for the integration of local services; what
remains to be accomplished is effective implementation of the
vision. The scale of ambition is high, and much faith is placed in
a partnership model of limited proven effectiveness. It would be
churlish not to give the green paper in general, and the
children’s trust model in particular, two cheers out of
three. However, partnership working has no qualities of spontaneous
growth or self-perpetuation, and effective integration of
children’s services will require greater clarity from the
centre, and hitherto unparalleled skill and commitment within
localities.

Bob Hudson is senior associate at the University of
Birmingham’s Health Services Management Centre.