Author Archives: Sarah Phillimore

What if doctors don’t believe my child is really ill?

This is an issue that has provoked a lot of debate and comment; parents are concerned that they are being accused of hurting their children when in fact their children have serious medical conditions. Some parents feel that if they try to bring these conditions to their doctors’ attention, they run the risk they will be accused of ‘fabricating illness’.

We agree this area needs debate. Here is a piece from a parent who has been involved in this scenario. We would welcome any other contributions from people with knowledge of these issues.

You may also find this post useful – the social worker tells me my child has been hurt.

A medical condition – or a non accidential injury?

I have a concern around the subject of rare genetic connective tissue disorders such as Ehlers Danlos Syndrome and the high levels of non accident injury and Fabricated or Induced Illness (FII) accusations made against parents with children of this condition. A ruling was made last year and published in Family law week I believe, regarding non accidental injury and EDS.

Having spoken in large group settings organised at the Ehlers Danlos Support UK conferences, there seems to be a large number of Mothers who also have the same condition of FII. The numbers of parents reported to social services, that have gone on to be seen one particular doctor are out of proportion for one small group of the population, the last quote was 50-60%. I can provide contact details for this doctor if you want to verify the information. There is I gather debate if FII even exists, or if the symptoms are of a personality disorder. I am sure that there will be in the EDS community the same levels of FII/personality disorders as there is in the rest of the population.

So why do I think there are so many reports of this by professionals to social services?

Well there is a high proportion of Autistic diagnosis in the community apparently.

There have also been brain scans showing that the Amygdala works differently in hypermobile people, where as someone with antisocial personality disorder would have not much going on we seem to have far too much going on here.

We have issues with pain, and Anesthetic not working.

There is still so much to be found out, there is some interesting work done by Dr Driscoll. She has theories about mast cells and pressure levels in the brains of EDS people.

The parents will have not had their medical needs met and once they understand what has happened they will be keen for the children not to suffer also as they have. When you discover the complexity of what has been going on in your bodies and written off for so long, you go through all the stages of grief for yourself and for your children.

There are often undiagnosed secondary issues, for example it was only in November 2013 there was a proven link between sleep apnoea and EDS. There are complex GI issues and Neurological /cardiac issues from our autonomic system not functioning properly. These will interfere with the cognative ability of the parents and children. They will make them appear to have a primary mental health issue which is a secondary mental health condition, heal the physical cause and they will not have anxiety and depression. We look like there is nothing wrong with us, we don’t complain and we get on with things.

We are not helped by the fact there are two names for what is through to be the same condition, some doctors seem to have different ideas and the two charities not working together.

Right now I understand the department of Health, NHS national genetic EDS clinic think EDS and HMS (Hypermobility Syndrome) are to be treated as the same condition along with EDSUK, yet some other high profile NHS hospitals along with HMSA have other ideas.

Here are some links

http://www.hypermobility.org
www.ehlers-danlos.org

You can also visit the author’s Facebook page for more information about EDS and hyper mobility.

Case Law

We think these cases will be of interest

The case of Devon County Council v EB in 2013 where the Judge rejected the LA case that the parents were responsible for inflicting non accidental injuries – the mother had Ehlers Danlos syndrome and the father joint hyper mobility.

But see also Re J & R, decided shortly after Devon County Council v EB where the parents were not successful on similar arguments – the Judge stressed the importance of taking into account ALL the evidence and was not so impressed by the parents’ evidence in this case.

In Re B 2014 the parents were reunited with their child after the court found that he probably had EDS Type III which would have made him more vulnerable to subdural bleeding.

Words don’t come easy

This contribution is from a group of ‘birth’ and ‘adoptive’ parents who started discussing this issue on Twitter. What is the impact of the words we use to talk about people in the care and adoption process?

Do we need to be more considerate of or more challenging about the terms we use?

You may also be interested in this blog post from an adoptive parent.

Does the terminology associated with adoption need to be challenged?

The current adoption climate in the UK has seen the use of many terminologies being uttered that evoke negative emotions for all involved. Adoption in itself is very emotive for all involved especially where consent has been dispensed with. So can the use of some of these terms be considered as “hate speech”? Possibly, possibly not, but what is clear is that we need to remove the use of some of these terms as it builds an even greater divide between the “birth family” and the “adoptive family”.

Whichever side you find yourself on, it is the child at the end of the day that is most affected by whichever term is used. Some can denote that the one family is either lesser or even better than the other family, leaving the child in the middle feeling they are being torn in two having to choose sides. This has a devastating and lasting effect on the child’s identity, self worth, emotions and psychology not to mention a test on their loyalty to the families involved.

So let’s look at some of the terms and the emotive relationships associated to them:

Birth Parent

Person who gave birth is nothing more than a ‘surrogate’ or ‘breeder’. Denotes derogatory connotations. If an adopter has a blood child and an adopted child, it segregates the two making the adopted child always feel isolated.

Genetic Parent

Person is nothing more than a donor of an egg or sperm

First / Second Family

Renders the essence of a family unit moot. Undermines the role of permanence and stability. Suggests families can be discarded summarily and breeds lack of respect.

Forever Family

This is considered one of the most offensive terms in adoption. There is not such thing as a ‘forever family’ as the whole process of adoption contradicts the entire term. It is also suggestive to children in families who have not been separated by adoption, that their place in the family is temporary which has devastating consequences in terms of building trust, relationship alienation etc.

Natural Parent

Who will carry this term (adopter or other?) and is being a parent a ‘natural’ thing so that assistance is never required at any point? Everyone needs help and guidance as children do not come with manuals and no two children are alike. Whoever coins their family as ‘natural’ will them imply that the other family is ‘unnatural’.”

Real Mother/Father

Adopters are made to feel they are artificial parents

Mother/Father

The use of this term for adoptive parent dismisses the emotional and psychological link the ‘biological’ parent has and will always have, with a child who has been adopted.

Family

Many adopters feel they should have the use of this term as opposed to the inclusion of the ‘birth’ family within the term, but is a ‘family’ simply all who love and care for the child and can simply be seen as a ‘cohesive family’ ?

Adoptee

Denotes that the child is ‘different’ and unloved by those who gave birth to them. In the UK, this term is becoming synonymous with having come from an abusive home, hence they were removed for adoption. Not all children are removed from abusive or neglectful homes and parents who did not love them. Many parents who have lost their child to adoption will go to extra-ordinary lengths to fight for their child’s return. Another obvious observation is that if ‘birth’ parent is used does that make this child a ‘birth’ child?

Parent

Not everyone can parent. This applies to ‘birth’ parents as well as ‘adoptive’ parents. So do we keep the term parent for both?

The impact of terminology

The emotive responses can either have positive or negative connotations and more suitable terminology must begin to be accepted, especially amongst the legal fraternity and social care societies as it is from there that the initial steps can be introduced. So what do we use? There is much debate around this very subject with no definitive conclusion.

Do we start referring to “birth” parents as the “Alpha” parent/family while “Beta” is used for extended families, “Gamma” for Step families and “Delta” for the adoptive family? Does this make one again lesser than the other or is it simply a matter of numeric’s. After all, without the “birth” family coming first, there would be no adoption?

Literature and research accepts that the majority of ‘adoptees’ will at some point seek out their ‘birth’ family. How reunions turn out often depends on how the child, adopter and ‘birth parent’ have associated each other’s role based on the terminology that each has grown accustomed to or been offended by. If the reunion is a success, the adoptive family, especially the parent, will often feel sidelined and abandoned whilst the adoptee reconnects with the biological ties that will forever bind them to their ‘birth’ family.

We need to be realistic and frank if we are ever to get to the bottom of all this, despite everyone’s sensitivities. Adoption is nothing more than giving a child which is not your own, a potentially safe environment to grow up in, but how is this different to growing up with grandparents or extended families? Would you raise an eyebrow if a child referred to their grandparents as ‘my adoptive mom’? So is the use of Adopter still appropriate and should this term perhaps be replace with “Guardian”?

As adoption can be cross-cultural, do we also need to consider religion and culture in the terminology as translations can change an entire meaning? Or do we stick with the English speaking populous and leave the rest to be interpreted as each culture and religion sees fit?

Will changing the terminology go a long way to building a more constructive framework and solid foundation for the child involved and even possibly lead towards successful open adoptions?

What if we used similar words with similar meanings but either spelt or pronounced differently?

We call two grandmothers in a family different things so that we can distinguish them e.g. grandma, nan etc.., and one is not loved more or less than the other. The same can be done for mothers for example, so that the child knows the difference but the terminology would be different for every family.

Some possible suggestions are:

Female Carers: Mom, mommy, mother, mama, mammy, mum, ma, mummy, etc.

Male Carers: Dad, Father, Pops, pappy, daddy, papa, pa, etc.

It has to be argued that this has to be the better option for all involved but more so, for the child. If you accept that, then why not go the extra step when referring to ‘Birth’ and ‘Adoptive’ parents both as ‘Parents’? Similarly, both sides can be referred to as ‘Families’ because that is pure and simply what they are and will always be to the child.

Removing the adjectives and verbs will improve long term outcomes for the child and that dear reader, has to be what is in every child’s best interest.

How do child protection issues get reported?

From 2011 – 2012 over 600,000 children were referred to local authority children’s social care services because of concerns about their welfare. This number decreased by 1.9% for the year end 31st March 2013. See the most recent statistics from the Department of Education.

In this post we look at the routes of referral and what happens when a referral is made.

Structure of child protection in England

The Department of Education is the government department which is responsible for children’s welfare. It will consider what changes to the law and policy are needed and issue guidance for those agencies who deal with children such as schools and local authorities.

The Children Act 2004 set up Local Safeguarding Children Boards (LSCB) to ensure all the relevant agencies work together, such as local authorities, health authorities and the police. Each LSCB has to produce an annual report.

The key statutory agency involved in child protection is the local authority (LA). Each LA has a Director of Children’s Services (DCS) who has ultimate responsibility for the provision of local education and social services for children. An elected local councillor with be the ‘lead member’ and the DCS, the lead member and the LSCB work together to produce and implement child protection procedures.

The main policy guidance is Working Together to Safeguard Children which first came out in 1999. The main statutes are Part IV of the Children Act 1989 and the Children and Families Act 2014

Who reports concerns about child protection?

The public

By calling the child protection team of their Local Authority; the emergency team can be called out of hours. The telephone numbers should be easily available; or
If it is an emergency, call the police; or
telephone the NSPCC on 0808 800 5000 or email [email protected].T

There is a useful article from the Guardian, discussing what members of the public can do if they witness something that makes them worried about a child.

The police

The police have special powers to take a child into police protection for up to 72 hours without getting the court’s permission first. They should only exercise these powers in truly urgent and exceptional circumstances. They have the power to take a child to a place of safety – such as a hospital – or stop someone else trying to take the child away from a place of safety. You can find the police powers set out in section 46 of the Children Act 1989.

Schools and hospitals

All professionals who have regular contact with children ought to have clear procedures in place for how they will respond to any worries about a child they see. There should be someone who is clearly identified as the designated child protection teacher or nurse/doctor who will deal with the concern when it is first reported.

There is at the current time no legal requirement to report suspected child abuse. There are many who believe that this should change – see for example the campaign following the death of Daniel Pelka.

Here is a useful article from the Patient.co.uk website for doctors which discusses how to recognise abuse or a child at risk.

Risk assessments by Cafcass

Under section 16A of the Children Act 1989, if you are involved in ‘private law’ proceedings – i.e. you are asking the court to help resolve a dispute between parents about their children – an officer of Cafcass may have to carry out a risk assessment if he or she has cause to believe a child is at risk of harm and may have to then refer the matter on to Children’s Services.

What happens when the referral is made to the SW Team?

The team must decide quickly what action to take; they have one working day. If the team decides it needs more information to make a decision it will start a process of further assessment.

The initial assessment should be done within 10 working days of the referral. If this assessment indicates serious concerns then a strategy discussion takes place to decide whether or not to start an inquiry under section 47 of the Children Act 1989. Usually a ‘core assessment’ should take place to gather the relevant information from the parents, the child (if old enough) and other professionals. Core Assessments should be finished within 35 working days of the referral.

If the section 47 enquiry shows there are serious worries about the child, the LA then has decide what to do to protect the child. The more serious and urgent concerns should mean that the LA make an application to the court for a care or supervision order. Other concerns may mean that the LA write out a ‘child protection plan’ so that everyone knows what they need to do to keep an eye on the situation or to take active steps to stop it getting any worse.

If the situation is VERY urgent, the LA can apply to the court for an Emergency Protection Order under section 44 of the Children Act which gives the LA permission to remove a child from home for up to 8 days. Another emergency option is to apply to the court under section 38A of the Children Act for an exclusion order to ban someone from remaining in or coming to the family home. Or the LA could ask the police for help, as the police could use their special powers to remove a child for 72 hours.

Have a look at this ‘map’ of the child protection system from the Children’s Legal Centre.

Child protection conferences and plans

If the outcome of the section 47 investigation confirms that the situation is worrying enough to need continued LA involvement, then a child protection conference must be held within 15 working days of the last strategy discussion. The family, and all the relevant professionals will be invited to this meeting, as well as the child if he is old enough to understand what is going on.

Those at the conference will need to decide whether a child protection plan is needed. These plans replaced the child protection register in April 2008, but the criteria for inclusion remains the same.

Plans should be agreed by everyone where possible and set out

the intended short and long term outcomes are for the child
how children’s services will monitor the child’s welfare
what needs to change to reduce the risk of harm to the child; and
what support will be offered to the family.

The child protection plan should be regularly reviewed; the first review should happen within 3 months and then at six monthly intervals after that.

What happens if the situation doesn’t get better?

Then the LA will need to seriously think about asking the court to make a care or supervision order, which could mean that the child is taken away from the family. If the LA decide that things are so serious that they need to go to court, they should start the ‘Pre-Proceedings Procedure’ and they will explain to the parents in a letter why they are so concerned.

This information from the Government explains the pre-proceedings procedure and what parents need to do.

If the situation suddenly gets very bad then the LA may decide it needs to act very quickly and may apply for an Emergency Protection Order, as explained above.

See further our post about Care and Supervision orders and Interim Care orders.

So you want to be a Social Worker?

An interesting perspective on the job of social worker can be found in Hilary Searing’s blog The Barefoot Social Worker, written from a radical and libertarian perspective.

She comments in her post So You Want to be a Social Worker?

Politicians, policy-makers and many middle class professionals are confused about the social work role. They seem ambivalent about the social worker’s use of authority and presume that all social work is simply ‘social care’, which is misleading. They choose to depict social work as a helping profession and as the answer to many social problems – including those that are an inherent part of the socio-economic system and require political action. Working class people, on the other hand, know that the provision of social services is closely linked with systems for monitoring, surveillance and control and are in no doubt about the social control function of social work.

…

Social work is not an easy job but there are many rewards for those who never lose touch with what is important – to understand and respect the life experience of clients and never forget the social and political context in which their problems arise. At the heart of social work is the task of alleviating the stress of clients living in poverty and in impoverished communities, where divisions arising out of class, ethnicity and religion are sometimes entrenched. Poverty and inequality are often at the root of many social problems and social work must recognise the part that class plays in perpetuating these problems.

She also poses the question – what has gone wrong with Child Protection?

Read the post here

She concludes:

My argument is that there needs to be a clearer focus on the acute end of the spectrum of children’s services. There is plenty of positive work going on but it does not get the support it deserves. The work is both challenging and rewarding and the existence of stable and supportive teams is crucial to the development of good practice. We desperately need strong, imaginative and constructive social work if Children’s Services are to improve their reliability in making the best possible decisions about seemingly intractable situations.

Response to Commentators #3

A question from one of our readers ‘Justice for children’.

How are you going to prevent paedophiles from working in your new and improved organization?

All traditional insitutions are already tainted and they have lost credability in the public’s eye. It’s safer to keep children at home so that parents can be assured of their children’s lives not being destroyed, hence they demand actions instead of words.

How do you guarantee that you don’t have rotten apples inside your organization who get free access to vulnerable children?

Our reply

We don’t have any access to any children. This is a site set up to offer information about the child protection system.

Nor do we accept that it is always ‘safer’ to keep children at home. Most young children who are killed, are killed at the hands of their parents or carers. At home.

We do want to have a debate. But we are clear that we don’t accept the majority of the conspiracy theories and it sounds like you might be a proponent of one.

@justiceforchildren

How are you preventing paedophiles to work in school and nurseries?
Not possible. Therefore… Are you keeping children at home all time?

Second question:
How are you preventing parent to abuse children?
Not possible…..

I think you asked a very silly question in your post. Sorry but there is not any intelligent answer to that.

Edit

A child’s perspective – Tammy’s story

Thanks to the TaKen UK website for letting us share this. Obviously, we don’t know all the details of what happened to Tammy’s family – the fact that care proceedings lasted from 1989 – 1992 suggests that the case was about more than just one accident in the kitchen.

But whatever happened in this case, her perspective on her pain and hurt about what she believes happened to her and her family emphasises the emotional cost of decisions in the family courts; something we should not lose sight of.

Tammy’s story – told in 2006

“In the best interest of the child” that’s what the professional’s state, but even the professionals and the family courts can be wrong as they were in my case.

Let me explain about my birth family, and myself. I am a young adopted adult; I was taken from my mum nearly 17 years ago on a false allegation, I was seven months old and sitting in my bouncing chair, my mum had gone into the kitchen to make me a night feed. I was happily playing with an activity toy, which I dropped on the floor; I leant forward to reach the toy but the chair followed me arid tipped forward falling on top of me. I sustained a bruise on my cheek. And that’s where my life was changed forever.

My case was heard within the family court in the years 1989 which lasted all the way to 1992. I was placed with a set of foster carers whom I stayed with for 13 months.

Then one-day social services accused the foster carers of suffering from depression and removed me from their care! I was then placed with three lots of emergency foster carers before being placed with my pre adopters, who then became my parents.

While this was happening to me my mum gave birth to my brother Cameron. One minute after his birth social services (a male) walked into the labour suite and tried to hand a place and safety order in writing to my mum who was laid on the bed with no clothes on and she had not even delivered the placenta. Medical staff asked the social worker to leave on three occasions eventually the social worker left the labour suite, leaving my mum very distressed and losing all her dignity.

My mum and Cameron went home to my grandparents where they resided until the 28th of December 1990. My mum then went to the family court as social services were trying for an interim care order to remove my brother from her care. My mum fought and won full parental rights of Cameron and no further action was taken.

All my mum wanted was to fight for me, she attended many family courts, which were held in secret and she was not allowed to talk about our case or me to anyone.

Time passed and Cameron reached the age of 21 months old, when the social services actually reached a date for my freeing order, which was in the year of 1992; there were no concerns to Cameron’s welfare. She was an excellent mother to him.

The judge who heard my case made his decision on the basis that social services had delayed my case for over two and a half years. On reading his decision to my mum (he stated) “Miss Coulter if I return your daughter home to you, you will be a stranger to her” and on that decision I was freed for adoption and my whole future was completely changed.

Finding out that you are adopted is one of the worst feelings in the world because you feel that all your identity you have known of yourself is a lie; for example your whole childhood and personality.

I found out through photos that my brother was still with my mum and is one and a half years younger than me. This was very upsetting and left me wondering why my mum wanted my brother and not me.

Left with these unanswered questions and feeling very confused; like I did not belong anywhere I wanted to find the truth, and the answers to my questions, the only person who could answer them was my mum.

My decision to find my birth family was not supported in the way in which I would have liked from my adoptive parents. I went about looking for my mum by first of all ringing support after adoption that told me I must wait until I am 18 years of age and would not offer me any help or advice. Which left me more confused and very upset?

In January this year on a Thursday night I received a phone call from my best friend. She told me to go over to her house, as it was very important. I had no idea of what I was to be told. Her laptop was placed on her bed and she told me to read the posting. I was ecstatic as I read the information, which confirmed that my mum was looking for me as much as I was looking for her.

My friend who knew as much as I did about my adoption found the posting when secretly putting my name on GENES REUNITED. I found myself emailing her my mobile number as I knew the same information which was written in her posting; which included information that nobody would have known about me.

I waited three and a half hours for the phone call which would change my whole life, and answer all the unanswered questions which had been tormenting me since the age of about 11 when I moved to Comprehensive School where I met many other adopted and fostered children.

Waiting for the phone call was the most exciting and precious time of my life, the hours seemed like weeks. In the next breath I was actually talking to my mum on the phone, we spoke for an hour about everything that we could. We put the phone down and later that evening I rang my mum back and told her I know it was short notice but could we please meet the following morning and she agreed to.

Our meeting was very emotional for the both of us, neither of us spoke we just put our arms around each other and cried together, we held each other very tight and I cant explain how happy I was feeling.

After many secret meetings I decided to tell my adoptive parents about my news, I did not tell them for about two months because I knew what their reaction would be. When I told my mum, as my dad was at work she cried and turned her back on me making me feel very isolated as if I had done something wrong. They never did understand why it was important that I find my birth family nor did they support me at the emotional time. I was keeping in contact via the Internet with my birth family as my mobile phone was confiscated; however they also stopped me from using the Internet to stop any contact, which I was having with my birth family. During this time I was studying for my AS levels which I failed due to all the stress and confusion.

The way my adoptive parents were towards my other life caused a huge conflict in the house making life unbearable at home and at school. I was eventually turned away from my home due to arguments other than my birth parents; this is when I phoned my birth mum, as I had nowhere else to turn. It was too late when I was asked to return to the house I did not want to be treated like a child nor did I want to my feelings to be ignored any longer, so I decided to move in with my birth family.

This brings me to why I am here today, I was a child who was wrongfully removed from the care of my mother and most of all I have had the rights taken away from me to have enjoyed the right to a family life with my natural family.

I would like to say I have had a good upbringing by my adoptive parents and I love them very much, however the complication of my adoption also ruined my relationship with my adoptive parents, as I only wanted to find the truth about my life.

I am publicly speaking today on behalf of children and parents who have also been through the secrecy of family courts and the injustices that have taken place and do still take place and the devastation of what one decision that determines the future of a child can cause to a whole family.

Since I have moved in with my birth family I see the relationship between my mother, brother and sister and cannot help feeling like I have missed out no matter how much I fit in now. We have all bonded very well, I now feel as if I fit in somewhere and feel I can be myself as I have found out who I really am and that my mum never did anything wrong. Over the years Yvonne has been fighting to prove her innocence and that an injustice has taken place. I am very angry and also upset that my mum was treated like a criminal and punished for life on something that she never did, and she had the right to a family life taken away.

Let me explain to you how I am feeling:

• Confused
• Hurt
• Stripped of my identity
• I missed out on a relationship with my brothers and sisters, mum and dad and other close relations
• Exhausted through lies

• I know I am not the only person to have gone through the hell of secrecy in family courts and hope to have expressed the way in which they will feel and are feeling at my age.

Changes that I would like to see happen.

1) For medical evidence used in the courts to not be based on probabilities when determining a child’s future, it must be fact.

2) To stop social services making medical diagnoses when not qualified to do so.

3) For social services when conducting assessments to be thorough and not based on self-opinions but facts.

4) For an independent body who is impartial to social services to be brought in when social services are assessing a family and to check they are following all guide lines of social work.

5) More support for families with whatever reason; a low IQ, a mother whom has depression, a parent that has suffered domestic violence and also a parent whom has a disability. More outside agencies should be involved to help put support packages in place to help families stay together and have the right to a family life.

6) Slow integration of a child back with its natural family should be paramount and decisions to take away the child should be the last resort. For example my mum was told she would be a stranger to me if I were returned home to her however my foster parents and my adoptive parents were also strangers.

7) The most important factor of us all being here today is about the secrecy surrounding the family courts and why they should be opened, you have all listened to my story and many of you would have read similar stories to mine in the media. I am of age where I can talk about the detrimental effects that the secrecy of the family courts has caused to me.

Many of the children who have been taken in the past and are still being taken do not have a voice.

The opening of the family courts would make it a fairer, non judgmental and a more impartial system which would help children that are left in the hands of abuser’s and would also work by stopping children from being wrongfully removed and injustices from taking place.

So please when considering the opening of the family courts take into account that we are all human and we have feelings and the way in which the courts have been working up to this day has been inhumane in many cases and human rights have been exploited.

The detrimental emotional effects and the separation, has on children torn apart from their birth families, lasts a life time.

How is the system doing?

Key points from recent discussion from the Guardian Social Care Network about the child protection system and how it is faring. Some examples of what said are below:

Misrepresentation of Social Work

Andrew Webb, president of the Association of Directors of Children’s Services: “I agree entirely with the comments about us needing to understand and promote sucess in working with children at risk of harm. But I still get very frustrated by the lack of sustained access for the sector to promote this in the face of all the presumptions about how our systems are failing so many children.”

Building trust between families and the authorities

Cathy Ashley, Chief Executive of the Family Rights Group: “What can make a difference is access to specialist independent advice and advocacy – with advisers who can assist families to navigate the system and consider what is in the child’s interests and what would work, without fear that that the adviser will judge them or has power over them.”

Improving liaison between different organisations

June Thoburn, professor of social work, University of East Anglia: “Working across agencies and professions works best when a ‘team around the family’ approach is used, and that works best when child and family social work teams combine family support and child protection work and are locality based.”

David Niven, of David Niven Associates: “All serious case reviews talk about failures in communication between agencies – this is true but I believe it’s compounded by massive restructuring in most organisations, partly due to the austerity measures, and so the people in different agencies that are meant to liaise with each other now frequently have never met so there is no relationship to built on.”

Carol Long: “Some local authorities already have a multi-agency safeguarding hub or similar which, if they are working effectively, show great promise in identifying cases where children may be at risk. ”

Sue Woolmore, chair, Association of Independent LSCB Chairs: “Local safeguarding children boards have a role to play in creating a culture of information sharing which puts the needs of the child at the centre, rather than allowing workers to feel inhibited by threats of legal action/data protection/confidentiality. This is no easy task and is a real test of how child-centred the system is willing to be.”

Medical Doctors – Basic principles of child protection and reviews of evidence

The British Medical Association Child Protection Tool Kit.

The British Medical Association (BMA) have an excellent resource called the Child Protection Toolkit which distills essential principles of child protection practice for doctors. This is now hosted on on Paediatric Care Online – an online decision support tool for all frontline practitioners in contact with infants, children and young people.

The BMA set out the basic Principles on ‘card 2’

Basic Principles of Child Protection for Doctors

In child protection cases, a doctor’s primary responsibility is to the well being of the child or children concerned. Where a child is at risk of serious harm, the interests of the child override those of parents or carers. Never delay taking emergency action (card 7).

All doctors working with children, parents and other adults in contact with children should be able to recognise, and know how to act upon, signs that a child may be at risk of abuse or neglect, both in a home environment and in residential and other institutions (cards 5 and 6).

Any doctor seeing a child who raises concerns must ensure follow-on care. In particular, children must not be discharged from hospital without a full examination (cards 13 and 14).

Efforts should be made to include children and young people in decisions which closely affect them. The views and wishes of children should therefore be listened to and respected according to their competence and the level of their understanding. In some cases translation services suitable for young people may be needed (card 8).

Wherever possible, the involvement and support of those who have parental responsibility for, or regular care of, a child should be encouraged, in so far as this is in keeping with promoting the best interests of the child or children concerned. Older children and young people may have their own views about parental involvement (card 11).

When concerns about deliberate harm to children or young people have been raised, doctors must keep clear, accurate, comprehensive and contemporaneous notes. This must include a future care plan and identify the individual with lead responsibility (card 12).

All doctors working with children, parents and other adults in contact with children must be familiar with relevant local child protection procedures, and must know how to deal promptly and professionally with any child protection concerns raised during their practice (card 7).

All doctors working directly with children should ensure that safeguarding and promoting their welfare forms an integral part of all stages of the care they offer. Where doctors have patients who are parents or carers, they must also consider the potential impact of health conditions in those adults on the children in their care (card 7).

Wherever a doctor sees a child who may be at risk, he or she must ensure that systems are in place to ensure follow-up care (cards 1 and 3).

As full a picture as possible of the circumstances of a child at risk must be drawn up (cards 13 and 14)

Where a child presents at hospital, inquiries must be made about any previous admissions (cards 14 and 15).

Where a child is admitted to hospital, a named consultant must be given overall responsibility for the child protection aspects of the case (cards 14 and 15).

Any child admitted to hospital about whom there are concerns about deliberate harm must receive a thorough examination within 24 hours unless it would compromise the child’s care or wellbeing (cards 14 and 15).

Where a child at risk is to be discharged from hospital, a documented plan for the future care of the child must be drawn up (cards 14 and 15).

A child at risk must not be discharged from hospital without being registered at an identified GP (cards 14 and 15).

All professionals must be clear about their own responsibilities, and which professional has overall responsibility for the child- protection aspects of a child’s care.

Key advice: Royal College of General Practitioners; Safeguarding Children and Young People

Key review findings from systematic reviews

These inform clinical best practice in the Child Protection Companion. All reviews can be downloaded from the Royal College of Paediatrics. As of 2018, 7new studies have been included in this update. Two studies reported on fractures indicative of abuse, two studies described the evidence for radiological dating of fractures in children and three studies discussed which radiological investigations should be performed to identify fractures in suspected child abuse.

Response to Commentators #2

You are apologists for a multi billion pound industry

This is a response by Sarah Phillimore, a family law barrister

I confess that I did not think the post Establishing Good Relationships would provoke much by way of comment either good or bad. But ‘Outraged’ lived up to his or her name.

Outraged said:

This doesn’t mean that either the parent or the social worker has to be 100% well behaved 100% of the time; this probably isn’t possible.” Twaddle…absolute twaddle…a social worker is supposed to be a “professional”, they have standards and codes of practice to adhere to, which includes the social worker being professional, not being “well behaved” completely contravenes that. In that instance any social worker who does not behave well 100% for 100% of the time is in contravention of their professional ethics. Hence they should be hauled in front of the HCPC “fitness to practice” hearing and if serious enough prosecuted for Misconduct or Misfeasance in Public Office. The fact that this is happening, Social workers ARE being struck off and being prosecuted undermines the whole toadying drivel written on this website.

The point of this post was NOT to suggest that we ought to expect social workers to behave badly to the point that they fail to adhere to professional standards and ethical codes. The point being made was that the social work/parent relationship is one between two humans, working in often stressful and difficult situations.

It is not difficult to see how both participants in that relationship might at times be guilty of failing to listen carefully or failing to respond authentically. What is important is that people can recognize when they are behaving in ways that don’t promote healthy working relationships and take active steps to improve the situation.

I accept that I probably need to change the wording of this post because if anyone is reading thinks we advocate anything less than professionalism from social workers, this is not our intent at all and I am sorry if my post was clumsily worded.

The simple point I was trying to make is that social workers are human too. And respect and good working relationships are a two way street. But of course if you think you have been badly treated or a social worker has acted unprofessionally you must complain and take action as this is not acceptable.

The issue of standards of professional conduct and proper routes of complaint is an important one and hopefully we will soon be able to provide more detailed information about this in another post. [Edit – this has now been done, see our post on making a complaint]

For now I will edit the Relationships post to reflect Outrage’s concern.

Anyone who thinks this site is ‘toadying drivel’ either hasn’t read it or has a very different definition of ‘toadying drivel’ than most.

This site should be taken down instantly, you are disinformation agents, there is a mass of evidence out there for the abuse of parents and children by the social services of this country, illegal actions by social workers, solicitors, the courts. There are no conspiracy theories here, the Social Services are stealing children, it is a multi-billion pound industry that cares little for child protection and is focused on profits.

Again, a comment that refers to the ‘mass of evidence out there’ but strangely, refers or links to none of it. We would particularly like to see evidence that the child protection system is a ‘multi billion pound industry’ that is ‘focused on profits’. The evidence we have found – see our Mythbusters section – does not support this assertion.

What I feel is irrelevant, as clearly shown in your response, what would be interesting is for you to actually respond to the points raised…do you seriously believe it is ok for Social workers not to be “well-behaved” 100% of the time?

I think I have answered that point above. Of course professonals with professional training should reflect that in their behavior and dealings with others. But it is also important to recognize that social workers are still humans and if their clients are persistently rude or aggressive, then it may be that the social worker responds in a less than patient and calm manner

Do you deny that the Child protection fiction is a multi-billion pound industry?

I am not sure what is meant by this. Do I agree that vast sums of money are spent in investigating harm done to children? In trying to work to keep families together? To pay for experts and foster care and lawyers at final hearings? Well yes of course.

But do I agree that it is an ‘industry’ make ‘mulit-billion’ pounds worth of profits? Absolutely not. I would like to see some evidence about this. I have been asking for a number of years now and I am still waiting. But of course it is easier to make astonishing claims than it is to prove them.

Have no social workers been struck off, prosecuted or had their fitness to practice questioned? How does your line “This doesn’t mean that either the parent or the social worker has to be 100% well behaved 100% of the time; this probably isn’t possible.” fit in with the codes of conduct and professionalism social workers have to adhere to?

Yes social workers have been struck off for misconduct. So too have barristers, doctors, solicitors – in fact any professional body that operates according to a code of conduct will have had to act against some of its members some of the time.

If you are genuinely anything other than a disinformation agent would you have not entered into the debate rather than simply telling me to take my leave? I don’t wish to take my leave as I would happily enjoy commenting on every aspect of the disinformation you have all over this site and provide evidence that contradicts your fairy tale of social services in this country. Of course I know that would not happen as you “moderate” ie censor comments and replies to your site, not something that an objective, balanced and genuinely “resource” site would have to do. The site reads like propaganda, and clearly comes from an “authority” perspective. It’s not a resource site, it is a poorly hidden agent for the child stealers.

I hope that by entering into the debate I can reassure ‘Outraged’ that we are not ‘disinformation agents’ and nor do we censor or moderate with a heavy hand.

But to enter into and continue a debate requires that the participants are prepared to treat each other and their arguments with a basic level of courtesy and respect and to keep the number of sensationalized and unsupported allegations to a minimum.

If Outraged truly believes we are a ‘poorly hidden agent for child stealers’ then by this comment alone he/she puts himself very firmly in the Conspiracy Theory camp and I doubt that any further engagement is going to produce anything positive.

But as ever, I will be delighted to be proved wrong.

Lawyers need to see it through the parents’ eyes

This is a guest post from Jacque Courtnage founder of the TaKen UK website. She has the perspective of not only being a parent who went through the system but she is also a lay advisor to other parents in family proceedings.

Here she describes some of the frustrations and difficulties she has encountered concerning the parent/lawyer relationship. We agree that it is important for professionals to always be aware of how confusing proceedings can seem to their lay clients and just how anxious and afraid their clients can be.

The importance of clear explanations

One of the problems we are finding is that some of the legal aid solicitors appear to only be going through the motions and tend to forget they are dealing with people who do not know their rights, the legal system or the practices and expectations of social care. I have taken on cases where some of the basics of the legal process is little, if not at all understood. From many of those whom I have assisted, they have often come back saying to me “why did my lawyer not tell me that” or “if only someone had explained that to me”. Whilst an explanation of lack of time, high case loads and resources can often be blamed, an excuse already used by social care, it is but yet just another nail in the coffin of the family facing forced permanent separation.

Some of the lawyers I have spoken to about this have admitted they tend to forget they are dealing with laymen not to mention most of these families are traumatised and can barely see the wood for the trees.

So how do you fix this? I do not know, but what I can say is the role I often fulfil in these cases, is acting as an intermediate between client and solicitor. Whilst this is unique and I do not know how many do what I do, it works and alleviates the solicitor having to deal with incessant queries. To make the relationship work, there has to be a good understanding and working relationship between myself and the solicitor. We each know each other’s boundaries and we keep each other in check whilst the client benefits knowing that all areas are covered and their best interests are always put first. Whether this can be allowed as an extension of the role of a Mackenzie Friend is something only the relevant law firm and courts can consider.

The benefits of working with a lay advisor

There are many benefits in pursuing this course of action. Just some pluses is that not only does the MF learn more about the system the correct way to help those who cannot afford representation, but the solicitor gets a different set of eyes as well as the benefit of having someone help weed out the irrelevant and highlight pertinent stuff that may otherwise be missed or dismissed by the carer.

Whilst many solicitors will cringe at the very thought of the aforementioned suggestion, it must be remembered that whilst solicitors have long fought for individuals in court, the majority will never have had the experience of being the subject to care proceedings and all that that entails, whilst many MF on the other hand have and can be considered experts in their own rights. Please do not mistake this for plugging MF’s but would it not be beneficial to gain access to ALL experts in the field to help your client case? I am by no means challenging the role of solicitors, what I am challenging is the very real perception of an invisible insurmountable wall between client and their family law solicitors.

Simple things like, open communication, access to information or at least be informed that there is information and support out there and where to find it.

The biggest of them all is building a trusting relationship with their client because let’s face it, whilst many consider this as just their job and yet another case, for the client it is their worst nightmare come true and they are terrified.

Access to counselling

All I can further add is that it would be very helpful to families who are the subjects of care proceedings to ensure they have access to counselling as PTSD is very seldom considered, if at all. All we are asking from solicitors is for just a few minutes to consider what they would want if they found themselves in unfamiliar surrounding fighting for their and their families lives and then use that list to help their clients.