The high rate of parental substance misuse is a cause for concern for child protection practitioners in Scotland. But how should services respond, asks Gordon Carson
If the release of the Lockerbie bomber was the subject of the most highly charged debate in Scottish politics so far this year, the fallout from the death of Dundee toddler Brandon Muir, following injuries caused by his mother’s partner, has been a strong contender for second place.
A significant case review published in August found child protection agencies in Dundee could not have predicted Brandon’s death in March 2008, aged 23 months, after he suffered a ruptured intestine caused by a heavy blow inflicted by Robert Cunningham.
However, social workers were unaware that Brandon’s mother, Heather Boyd, was using heroin with Cunningham and involved in prostitution, and the review said poor information-sharing and recording had undermined the ability of agencies to investigate concerns.
The minority Scottish National Party government responded to the review by backing the right of child protection professionals to determine the best action in each case, but opposition members of the Scottish parliament have called for far-reaching reforms to change the balance of the system.
Labour’s Iain Gray, responding to the Brandon Muir case and that of Baby Peter in the London Borough of Haringey, has demanded a national inquiry into child protection and a policy shift towards removing children from their parents more quickly if required. Meanwhile, Scottish Conservatives leader Annabel Goldie asked if there should be a “shift in onus so that parents must prove they are fit and proper, rather than on the state to prove they are not”.
But there is little appetite in Scottish social work for an inquiry. Ruth Stark (right), professional officer at the British Association of Social Workers, says: “We know what the issues are, we’ve had enough inquiries, and we have enough information about the problems we face.”
Tom Roberts, head of public affairs at charity Children 1st, agrees: “We know what works: early intervention, long-term support and joined-up working. We don’t need another inquiry to tell us that. We need to make the resources available to enable social workers to do their job.”
Parental drugs and alcohol misuse
At the heart of the huge problems facing vulnerable children in Scotland is parental drugs and alcohol misuse. The Scottish government estimates that up to 20,000 children are living with parents addicted to drugs, while the Labour Party claims the parents of up to 100,000 children are addicted to alcohol.
Social workers also report that the pattern of drug-taking is changing. Addicts are becoming more promiscuous in their misuse, mixing several drugs including heroin, marijuana, cocaine and methamphetamine, and many are also drinking heavily.
Official figures do not suggest that social workers in Scotland are reluctant to instigate care proceedings. Nationally, the number of looked-after children hit a 25-year high of almost 15,000 in 2008, up from 11,400 five years earlier.
Glasgow Council, Scotland’s biggest local authority, was looking after more than 3,200 children in August 2009, compared with 2,900 in June 2006, and 63% of those had a parent or parents with current or previous substance misuse issues.
Meanwhile, a study of children in Edinburgh subject to child protection orders in 2006-7, published by the Scottish Children’s Reporter Administration, found that almost 80% had a parent who was misusing drugs. In addition, the review into Brandon Muir’s death was published only a week after the revelation that drug-related deaths in Scotland hit an all-time high of 574 in 2008, up by 119 on 2007.
As a result of these shocking statistics, the task facing social workers is massive. Stark says a good start would be to redirect resources to the frontline. She estimates social workers spend only 12% of their working hours in direct contact with clients because of the huge volume of paperwork they are required to complete.
“Some young parents can kick drugs and become good parents,” she says. “It isn’t all doom and gloom. But we have to have skilled people who can help them overcome their addictions.”
Roberts says much of the paperwork was devised following child protection inquiries, and there is a “valid place for making sure information is shared”. But it shouldn’t be to the detriment of frontline work.
He also says there is “no way” the state can take all children with substance-misusing parents into care, and advocates more early intervention. “The priority is to keep children in families where it’s safe to do so but also to have a system that can spot things early on,” he says.
‘Expand the role of health visitors’
One of the solutions offered by the Scottish Conservatives is to expand the role of health visitors to offer more home visits, so they can “spot many dangers before they escalate”.
Shadow children’s minister Elizabeth Smith says a Conservative Scottish government would invest £20m to fund this extension of health visiting. She also advocates placing more emphasis on voluntary services providing support to parents at a local level.
One charity has been doing just this in Glasgow for decades, albeit on a small scale. Aberlour runs two residential centres that provide intensive support to substance-misusing mothers and their children for up to six months at a time. But the centres only offer 12 places in total so are only “skimming the surface”, says Bruce Thomson, Aberlour’s assistant regional director for the West of Scotland.
To access the service, mothers must be able to show “evidence of motivation”, Thomson says. Over the course of their stay, mothers will receive treatment for their addictions as well as help with parenting skills. Aberlour’s outreach service assesses parents before they are admitted to the centres and supports them for up to six months after they leave.
Aberlour did run a similar residential service in Edinburgh, but it closed last year. However, it continues to offer an outreach service in the capital, as well as in Dundee and now in Dumfries.
Health authorities are also taking their own steps to improve early intervention, particularly through the Vulnerable Pathways Project launched in May by NHS Quality Improvement Scotland. This 18-month project aims to ensure that vulnerable women and children aged up to three receive evidence-based care in all parts of Scotland.
The project will help maternity and early years services to support potentially vulnerable families and, where required, refer them for appropriate support or intervention. It will also develop a common approach to assessment across different agencies.
In an era of increased budgetary pressures and threats of cuts to public spending, any short-term improvements are likely to come from this approach of refocusing resources.
But, for longer term improvements, a major financial injection is required, particularly when there are no signs of Scotland’s substance misuse problems easing. As BASW’s Ruth Stark says: “Until we really get our heads around the resources we need to tackle those problems, we are only putting on a band aid.”
“It comes down to what society wants,” adds one frontline social worker says, who does not wish to be named. “Social workers and health visitors want to do better. But it won’t happen unless we are prepared to put in more funding and widen support.”
Brandon died on 16 March 2008, aged 23 months, after suffering more than 40 injuries, including a ruptured intestine and four broken ribs.
The injuries happened in the last three weeks of Brandon’s life, after he and his mother, Heather Boyd, started living with Robert Cunningham on 26 February 2008.
Brandon’s grandparents raised concerns with social workers about Boyd’s parenting skills and her relationship with Cunningham, who they had seen being violent to a previous partner.
A child protection staff case conference was scheduled for 18 March, but Brandon died before it took place.
Boyd had prostituted herself for heroin on the night before her son died, and he was left in the care of Cunningham, who had convictions for housebreaking and domestic abuse.
Cunningham was found guilty of the culpable homicide of Brandon and jailed for 10 years. Boyd was cleared of the charge of the culpable homicide by failing to get him medical help.
Reviews by former Fife police chief constable Peter Wilson and social work consultant Jimmy Hawthorn made a number of recommendations, including improvements to the recording and sharing of information between agencies. They also proposed that full background checks should be carried out on all household members in child protection cases.
Published in Community Care, 24 September 2009, under headline ‘Where drugs rule, children suffer’