Express yourself

Barry Raynes is the executive director of Reconstruct.
He has worked extensively with many area child protection
committees as a consultant on child protection issues. He is
researching his doctorate into common language in child
protection.   

Since the 1970s virtually all reviews of fatal child abuse cases
in the United Kingdom report that there was evidence of
communication failures between professionals.¹

Forthcoming government changes hinge on three initiatives designed
to improve the protection of children: children’s trusts, a common
assessment framework and a common language.

It seems obvious that these are “good things”. After all, people
from different agencies working together as colleagues, working to
the same format, speaking a language they all understand, will
ensure that the poor communication caused by cross boundary working
and different thresholds will disappear. However the inquiry into
the death of Victoria Climbie, work by Peter Reder and Sylvia
Duncan at North Lincolnshire area child protection committee and my
own research tell a different story.

The Laming report into the death of Victoria Climbie is littered
with references about failures to:

• Share and record concerns.
• Communicate with Victoria.
• Listen to the concerns of junior or non-professional
  people.
• Hear the concerns of a doctor.
• Follow a plan developed in a strategy meeting.
• Question the use of jargon.
• Question the diagnosis of someone senior.
• Use interpreters.

What we see in the list is not a need to restructure or the need
for yet another form, but a need to re-establish the
inquisitiveness and moral responsibility that social work used to
take for granted. As Reder and Duncan point out, the call for
reorganisation fundamentally misses the point about the psychology
of communication.²

Social workers need to be encouraged to enter into dialogue with
other professionals. To debate and question their views, to be not
put off by different thresholds or different attitudes, to be
neither arrogant nor submissive but to work hard at understanding
what the other professional is trying to convey. In short, they
should not be “telephone answering machines”, merely recording what
is being said.

The Laming report cited the following quote from a social worker
describing a conversation with a doctor: “It was not really a
discussionÉ it was one-way.”³ This demonstrates
that the telephone answering machine way of working was present in
Victoria’s case.

Dialogue and analysis come easily to some social workers, but not
others. All social workers talk about needing to feel confident in
their role and on top of their job. Few of them feel that they
achieve this for much of the time. They talk about needing to be
supported and having time to reflect. With the requirements to fill
in forms and comply with timescales, it is perhaps unsurprising
they rarely feel that they have time for reflection.

Few social services departments have dealt with the complications
of successful communication. One three-star local authority
continues to strive for a common language in an increasing complex
environment. Here, social workers are encouraged to remember that
social inequality is at the heart of their work, that success is
based upon making a real change in a child’s life rather than
filling out a form on time and that professionals from other
agencies are collaborators in the protection of children, not
people putting up obstacles to getting the “real” job done.

Many managers from other departments have visited to find out how
this works. It has been achieved because a small, committed,
creative group of managers decided to put into practice theoretical
concepts of the importance of metaphor in understanding the world
and how we communicate. This work has been a hard slog of eight
years continual improvement with still much to learn and do. This
is explained to the visitors. The visitors get excited. At the end
they say, “can you show us the forms?” and that is what they go
away with. Weeks later they say: “It can’t work here.”

How have we got here? Where the problems of understanding the
complexity of organisations and human behaviour is projected onto
“getting the form right”, “getting the structure sorted”, ensuring
that communication follows a “common language”? Depressing isn’t
it?

Government’s reliance on the incorrect usage of performance
indicators, a blame culture and an emphasis on compliance at the
expense of quality makes it unsurprising that local managers
believe successful change can be achieved through a “new form”.
After all, it demonstrates that things are happening.

We are told to identify a common language. Yet the vast majority of
child abuse investigations are carried out in a common language –
English. Even those that are not will be conducted in a language
known to all participants. So, we don’t need a “common language,”
we need to learn to use the one we have better. Even the emphasis
on the phrase “common language” implies that the skill is in the
talking, but inquiry reports and research demonstrate that, to the
contrary, the skill is in the listening.

The government has produced a Children Bill which will become the
Children Act 2004. The act introduces a children’s commissioner,
merges children’s social services sections with education, suggests
the concept of a national database for flagging concerns about
children and changes the name of area child protection committees
to local safeguarding children’s boards. Would these changes have
saved Victoria Climbie? The answer is short: “No”.

The issue of status will remain whether staff are part of the same,
or in different, organisations. In the Victoria Climbie case, there
were several doctors, lower in the hierarchy, who disagreed with
the consultant paediatrician’s “scabies” diagnosis, but they did
not speak up.

Children’s trusts will not, in themselves, make the situation
worse. Perhaps a little better – after all, the inter-disciplinary
teams work reasonably well in youth justice. But another
restructuring, another set of government initiatives, and another
assessment system takes the attention away from what really
matters: developing better communication and relationships.

Abstract 

This article questions the emphasis that the government is
placing on children’s trusts, a common assessment framework and a
common language. It argues that this needlessly diverts attention
away from ways of working that really would protect children and
that the changes proposed would not have saved the life of Victoria
Climbie.

References   

^{1, 2} P Reder, S Duncan,
“Understanding communication in child protection networks”,
Child Abuse Review, Vol 12, pp82-100, 2003  

³ Lord Laming, Inquiry
into the Death of Victoria Climbie, 2002

Further information   

• M Payne, Teamwork in Multi-Professional Care,
  Palgrave, 2000   
• P Reder, S Duncan, MGray, Beyond Blame: Child Abuse
  Tragedies Revisited,   Routledge, 1993 
• R Sinclair, R Bullock, Learning from Past Experience: A
  Review of Serious Case Reviews, Department of Health,
  2002 
• O Stevenson, Child Abuse: Public Policy and Professional
  Practice, Harvester Wheatsheaf, 1989

Contact details

Barry Raynes welcomes contact by e-mail, barry@reconstruct.co.uk
or telephone 01225 787031. He will  be speaking at the forthcoming
“Small Voices, Loud Noises” conference in London on 2 December.
Please e-mail conference@reconstruct.co.uk
for further details.