The dangers of information sharing.Abstract Both the New Zealand New Zealand (zē`lənd), island country (2005 est. pop. 4,035,000), 104,454 sq mi (270,534 sq km), in the S Pacific Ocean, over 1,000 mi (1,600 km) SE of Australia. The capital is Wellington; the largest city and leading port is Auckland. and British governments For pre-1721 elected parliaments see List of Parliaments of England. Party Prime Minister(s) Date Notes Whig Robert Walpole 1721-1742 generally regarded as being the first Prime Minister of Great Britain Whig The Earl of Wilmington 1742-1743 want to improve children's welfare and are seeking ways of improving preventative and early intervention ear·ly intervention n. Abbr. EI A process of assessment and therapy provided to children, especially those younger than age 6, to facilitate normal cognitive and emotional development and to prevent developmental disability or delay. services. This article critiques the policy being implemented in England with a particular focus on the role given to professionals collecting and sharing information about families as a means of screening children and deciding which ones to target. It is argued that this policy undermines parents and overestimates professionals' ability to predict future outcomes. INTRODUCTION Good information sharing See data conferencing. is the key to successful collaborative working and early intervention to help children and young people at risk of poor outcomes. (DfES 2006:1) The belief that more data or information automatically leads to better decisions is probably one of the most unfortunate mistakes of the information society. (Woods and Hollnagel 2006) These two conflicting views on the value of sharing information, the first by the UK department responsible for children's services in England (2) and the second by two eminent researchers in cognitive systems engineering, illustrate an important and highly topical debate. Governments in both the United Kingdom and New Zealand have the excellent ambition of improving the welfare and safety of their children and both are considering how to provide more timely and effective services to families. This article reviews the UK government's policy "Every Child Matters" (HM Treasury 2003) and, in particular, the central role it ascribes to increased information gathering and sharing by professionals as the way to decide which families need additional help (for full details of all the proposed and actual databases, see FIPR FIPR Foundation for Information Policy Research FIPR Florida Institute of Phosphate Research FIPR Fellow of the Institute of Public Relations FIPR Flash, Immediate, Priority, Routine (US military message precedence) FIPR Fault Isolation Process Routine 2006). Developments in information and communication technology (ICT (1) (Information and Communications Technology) An umbrella term for the information technology field. See IT. (2) (International Computers and Tabulators) See ICL. 1. (testing) ICT - In Circuit Test. ) have transformed our ability to record, analyse and transmit data. It is now technically possible to collect comprehensive data on all children within a country and for that data to be dispersed dis·perse v. dis·persed, dis·pers·ing, dis·pers·es v.tr. 1. a. To drive off or scatter in different directions: The police dispersed the crowd. b. around the various departments and agencies that have some role in children's lives. However, although it is possible, we need to ask whether it is the right thing to do, "right" in both its practical and ethical meanings. The proposals on the use of ICT are not just small, innocuous in·noc·u·ous adj. Having no adverse effect; harmless. innocuous (i·näˈ·kyōō· , administrative changes in services but are a central part of a new approach to working with families. The UK policy of "Every Child Matters" entails a transformation of the relationship between the State and families. The policy sets out the government's targets and performance indicators for children's development; it ascribes responsibility for achieving the targets not to parents but to professionals working in children's services; and it sets out a scheme for monitoring, screening, and intervening in the lives of children in order to improve attainment of the targets. While the underlying motivation contains a strong and genuine concern for children's welfare, this is tempered by a definition of welfare that is linked to the needs of the State and a failure to acknowledge that the concept itself is contested; children and parents do not always agree with politicians or professionals on what is best for a particular child at a particular point in their lives, nor is there universal consensus on what a "good" adult looks like. Even within professional groups, there is a lack of consensus: social workers in a Scottish study failed to agree on the significance of a child's attachment to a carer carer Noun a person who looks after someone who is ill or old, often a relative: the group offers support for the carers of those with dementia carer n → or whether harm arose from physical neglect alone (Daniel 1999). This article takes the subdued sub·due tr.v. sub·dued, sub·du·ing, sub·dues 1. To conquer and subjugate; vanquish. See Synonyms at defeat. 2. To quiet or bring under control by physical force or persuasion; make tractable. 3. view of the value of data sharing The ability to share the same data resource with multiple applications or users. It implies that the data are stored in one or more servers in the network and that there is some software locking mechanism that prevents the same set of data from being changed by two people at the same time. captured in the second quote. While there is evidence that professional sharing of information is necessary to uncover concealed cases of abuse and neglect, there is no empirical evidence to support the claim that extensive cross-sectoral data sharing is required to identify other problems experienced by children and parents (Brown and White 2006:3). It will be argued that the proposed network of professional data sharing in the UK is not a significant part of the solution for improving children's welfare and, indeed, may have unanticipated adverse effects. An alternative approach in situations not involving child safety issues is to continue to place parents at the heart of decision-making about children's needs and to focus more on listening to parents and children than on monitoring and making professional judgements about them. The article will draw on the debates and the experiences in England, where the policy is being implemented to bring out the arguments for and against the role of data sharing. WHAT PROBLEMS ARE WE TRYING TO SOLVE? Before judging the merits of a proposal or policy we need to be clear about what problems it is intended to help to solve. In both countries, the ambitions for children's welfare are high. In the UK, the government wants "to ensure every child has the chance to fulfil their potential" (The Treasury 2003:6). Societies' concern for children's welfare has often had a dual motivation of altruism altruism (ăl`tr ĭz`əm), concept in philosophy and psychology that holds that the interests of others, rather than of the self, can motivate an individual. and self-interest (Parton par·ton n. Any of the point particles believed to be a constituent of hadrons, now known as quarks. No longer in technical use. [part(icle) + -on1.] 2006). In the UK, altruism is certainly a motivating force but the urgency of the issue is strengthened by the economic needs arising from the increasingly competitive global market and demographic changes: We all stand to share the benefits of an economy and society with less educational failure, higher skills, less crime, and better health. (The Treasury 2003:5) The link between children's outcomes and economic factors is also recognised by New Zealand's Children's Commissioner Children's Commissioner could refer to:
An ageing population structure, with increasing economic dependency and caregiver ratios, means that the future productivity of every child and young person is important. (Children's Commissioner 2006) Within the overall aim of all children fulfilling their potential, the UK government has identified priority aims: To reduce the numbers of children who experience educational failure, engage in offending or anti-social behaviour, suffer from ill health, or become teenage parents. (The Treasury 2003:5) Although the policy change was introduced to the public as a response to the report into the tragic death of Victoria Climbie, a child abused, neglected, and then killed by her great-aunt and partner (Laming 2003), it has a longer genealogy genealogy (jē'nēŏl`əjē, –ăl`–, jĕ–), the study of family lineage. Genealogies have existed since ancient times. , stemming from New Labour deliberations in the 1990s about improving education and reducing delinquency (Parton 2006). Its origins within the criminal justice system are apparent in its emphasis on policing children's behaviour and developmental progress; the original version of the electronic system was called "Identification, Referral and Tracking" (IRT IRT Item Response Theory IRT In Regard To IRT Incident Response Team IRT In Reference To IRT In Regards To IRT Icing Research Tunnel (wind tunnel) IRT Interborough Rapid Transit ) which has strong associations with criminal investigations. Before looking at the contribution that more intensive data collecting and sharing could have in achieving these aims, it is helpful to analyse further the key elements in implementing the policy. Firstly, we need to be able to identify who needs help. Secondly, professionals need the knowledge and skills to offer help that puts the children on a more beneficial developmental path. Thirdly, they need the resources to provide that help. All three elements present difficulties but what contribution, if any, can data sharing make? WHO NEEDS HELP? A key aim in the new English New English n. See Modern English. policy is to increase preventative and early intervention services. This has compelling arguments in its favour: it could reduce the amount of distress and harm experienced by children; it is likely to be easier to solve problems when they are at an early stage; it might lead to more effective solutions that reduce the number of children who enter adulthood with significant problems that are costly to society, i.e. of becoming what Feinstein and Sabates (2006:1) have termed "high-cost, high-harm adults". Preventative services can operate at different points in the aetiology aetiology see etiology. (causation causation Relation that holds between two temporally simultaneous or successive events when the first event (the cause) brings about the other (the effect). According to David Hume, when we say of two types of object or event that “X causes Y” (e.g. ) of a social problem. Primary prevention seeks to ameliorate a·mel·io·rate tr. & intr.v. a·me·lio·rat·ed, a·me·lio·rat·ing, a·me·lio·rates To make or become better; improve. See Synonyms at improve. [Alteration of meliorate. the conditions that create the problem in the first place. Secondary prevention aims to respond quickly when low level problems arise and prevent them getting worse. Tertiary prevention tertiary prevention Medtalk Treatment that alters the course of clinical disease--eg, with CABG or PCTA. See Percutaneous transluminal coronary angioplasty Psychiatry Measures to reduce impairment or disability following a disorder–eg, through rehabilitation. involves responding when the problem has become serious. With social and psychological problems, as with health, the ideal is to have a successful primary prevention policy that eliminates the problem. The United Nations Convention on the Rights of the Child The United Nations Convention on the Rights of the Child, often referred to as CRC or UNCRC, is an international convention setting out the civil, political, economic, social and cultural rights of children. (UNCROC UNCROC United Nations Convention on the Rights of the Child ) provides an internationally agreed set of basic needs of children. Both New Zealand and the UK have seen impressive improvements in meeting the basic social needs of the population in the past 50 years. The universal services of health, education, housing and income support are designed to support and complement parenting, maximising the number of children who develop satisfactorily. In addition to fully universal services, some services in England are specific to areas of extreme deprivation but are then universally available within that area, e.g. the early Sure Start schemes. However, for some families, universal services are not enough. It is here that the shift in emphasis in the new UK policy is apparent. Historically, in both the UK and New Zealand, children's services have become significantly skewed skewed curve of a usually unimodal distribution with one tail drawn out more than the other and the median will lie above or below the mean. skewed Epidemiology adjective Referring to an asymmetrical distribution of a population or of data towards tertiary prevention, specifically in relation to serious cases of child abuse and neglect (Department of Health 1995, Mansell 2006). Lower levels of abuse and other problems have received less professional attention, despite a continuing policy commitment to secondary prevention. This shortfall in services has been felt in particular by families whose children have physical disabilities or learning difficulties who consequently have suffered considerable stress and family breakdown (Every Disabled Child Matters 2006). It has also been experienced by those families where there are low-level concerns about abuse and neglect. This, too, has been a long-standing source of frustration to those working in the child protection services. Workers meet families whose problems are now severe and hard to tackle but who had clearly shown low level signs of difficulty in the past when the problems would have been significantly easier to remedy. However, due to the high threshold for receiving a service implicit in Adj. 1. implicit in - in the nature of something though not readily apparent; "shortcomings inherent in our approach"; "an underlying meaning" underlying, inherent a tertiary prevention service, they were not able to access help at that stage, even though many would have welcomed it. In contrast, the goals of prevention in the new English policy are twofold: firstly, to use risk factor research to identify children who are at higher than average risk of having an adverse outcome; secondly, to collate col·late tr.v. col·lat·ed, col·lat·ing, col·lates 1. To examine and compare carefully in order to note points of disagreement. 2. To assemble in proper numerical or logical sequence. 3. evidence of low level problems and offer swift intervention to prevent escalation es·ca·late v. es·ca·lat·ed, es·ca·lat·ing, es·ca·lates v.tr. To increase, enlarge, or intensify: escalated the hostilities in the Persian Gulf. v.intr. . To achieve these goals, the emphasis is on professionals collectively making judgments about children's needs with the voices of parents and children themselves playing a much lesser role. That is why the collection and sharing of data between professionals is given such a central role in the identification of members of the target groups. THE RESEARCH BASE How much can research help professionals to identify which children are vulnerable to poor outcomes? There is a well-established set of factors that are known to contribute to creating an environment in which children tend to fare badly. The UK policy document summarises these factors (HM Treasury 2003:17): * low income and parental unemployment * homelessness * poor parenting * poor schooling * postnatal depression Postnatal depression is a form of clinical depression which can affect women, and less frequently men, after childbirth. It is widely considered to be treatable. Studies report prevalence rates from 5% to 25%, but methodological differences among the studies make the actual amongst mothers * low birth weight * parental substance misuse * individual characteristics such as intelligence * community factors, such as living in a disadvantaged neighbourhood. It is noticeable that, to a great extent, these endorse the set of needs enshrined in UNCROC that are formulated as "rights" that a society should secure for all children, not just those selected by the State. However, what is also noticeable about these factors is that we do not need to collect extensive personal data about children in order to identify where they exist. Data on the existence of many of the factors is already available, such as disadvantaged neighbourhoods, unemployment and low income. Even where more personal data is required, it is mainly in relation to the parents not the child, e.g. postnatal depression and substance misuse. Besides the more general research on adverse factors in childhood, there are sets of research examining the aetiology of specific social problems, the ones that will be discussed here are the risk factors for child abuse and neglect, delinquency, and social exclusion social exclusion Noun Sociol the failure of society to provide certain people with those rights normally available to its members, such as employment, health care, education, etc. . Child abuse and neglect are areas where there have been persistent research efforts to identify which parents are at high risk of becoming abusive. However, screening instruments have, to date, had an unacceptably high level of inaccuracies (Peters and Barlow bar·low n. An inexpensive, one- or two-bladed pocketknife. [After Barlow, the family name of its makers, two brothers in Sheffield, England.] 2003, Lyons et al. 1996). A federal US review of the available evidence concluded: That there was insufficient evidence to recommend for or against the use of specific screening instruments to detect family violence for children. (U.S. Preventive Services Task Force 2004:2) In contrast, in relation to predicting delinquency and anti-social behaviour, the UK government has made strong claims that: There is now a wealth of empirical data to analyse. The purport of it is clear. You can detect and predict the children and families likely to go wrong. (Blair 2006b) On the strength of this claim about the research, the government is proposing that midwives carry out a risk assessment and identify which newly born, or unborn children, are likely to grow up to be "a future menace to society" (Blair 2006a). The two main sets of research that the government website references in relation to this policy are on crime and anti-social behaviour (summarized for them by Farrington 2006), and on the prediction of which children will become high-cost/high-harm individuals in adult life (summarized for them by Feinstein and Sabates 2006). Neither of these sets of research provide the evidence to support the political claims that antenatal an·te·na·tal adj. See prenatal. antenatal before parturition. Called also prenatal, antepartal. and post-birth screening and prediction is feasible unless we are willing to tolerate a high level of mis-labelling with all the harm that the label "future menace" (Blair 2006a) will cause to innocent babies. In relation to criminality, the possibility of accurate prediction is consistently dismissed by academics: Any notion that better screening can enable policy makers to identify young children destined to join the 5 per cent of offenders responsible for 50-60 per cent of crime is fanciful. Even if there were no ethical objections to putting "potential delinquent" labels round the necks of young children, there would continue to be statistical barriers. Research into the continuity of anti-social behaviour shows substantial flows out of- as well as in to-the pool of children who develop chronic conduct problems. This demonstrates the dangers of assuming that anti-social five-year-olds are the criminals or drug abusers of tomorrow. (Sutton et al. 2005) In relation to "high-cost/high-harm" outcomes, Feinstein and Sabates (2006) come to a slightly more optimistic op·ti·mist n. 1. One who usually expects a favorable outcome. 2. A believer in philosophical optimism. op judgment but it has to be remembered that they are considering a wide range of adverse adult outcomes where the base rate is far higher than for serious criminality, e.g. obesity, smoking, and being depressed. Their judgment is also tempered by the warning that children's risk levels change over time: Children move in and out of risk in terms of their own development and their levels of contextual risk. Therefore, it is important that the policy mechanisms allocating interventions and support to children and families are flexible and able to track and monitor levels of risk, not always intervening at the first sign of risk but equally able to provide early interventions that may reduce the need for more substantive and costly later interventions. This requires a considerable degree of local practitioner skill. (2006:35) Politicians are not unusual in being overconfident o·ver·con·fi·dent adj. Excessively confident; presumptuous. o ver·con about the
ability of professionals to predict adverse outcomes. People are
notoriously bad at intuitive estimates of probability (Gigerenzer 2002).
The problem is that they are beguiled be·guile tr.v. be·guiled, be·guil·ing, be·guiles 1. To deceive by guile; delude. See Synonyms at deceive. 2. by the observation that, when you look into the history of adults with problematic behaviour you often see a record of adverse experiences and problems that now look like early signs of trouble. Where intuition intuition, in philosophy, way of knowing directly; immediate apprehension. The Greeks understood intuition to be the grasp of universal principles by the intelligence (nous), as distinguished from the fleeting impressions of the senses. falters, however, is in thinking about how many children had those similar adverse experiences and did not become problematic in their behaviour. Without including the base rate of the factor, it is impossible to calculate its predictive value pre·dic·tive value n. The likelihood that a positive test result indicates disease or that a negative test result excludes disease. predictive value a measure used by clinicians to interpret diagnostic test results. ; it is the relative incidence of the factor in the subgroup sub·group n. 1. A distinct group within a group; a subdivision of a group. 2. A subordinate group. 3. Mathematics A group that is a subset of a group. tr.v. with the problem as compared to the general population and that determines the predictive strength of that factor (Gigernezer 2002, Munro 2004). Hence, poverty is predictive of serious criminality but it is still true that the large majority of poor people do not become serious criminals. Having discussed the obstacles to accurate primary prediction, let us now consider issues related to prediction at the secondary prevention level: of identifying low level problems and deciding which ones should have professional intervention. The key problem here is illustrated by politicians' frequent use of the phrase "early signs". The issue is that most low level problems get resolved, with or without professional help, and it is only with hindsight hind·sight n. 1. Perception of the significance and nature of events after they have occurred. 2. The rear sight of a firearm. that we can look back and say "that low level problem was an early sign of the current serious problem". The development of secondary preventative services has always been bedevilled by the level of need. While tertiary services respond to the relatively small group who become seriously problematic, secondary services also need to offer help to the much larger group who have low level problems. Many of these will not escalate es·ca·late v. es·ca·lat·ed, es·ca·lat·ing, es·ca·lates v.tr. To increase, enlarge, or intensify: escalated the hostilities in the Persian Gulf. v.intr. but we are unable to identify accurately which ones will. This leads to a resource problem that is discussed in a later section. DO WE HAVE THE KNOWLEDGE TO SOLVE THE PROBLEMS IN CHILD DEVELOPMENT? Primary Prevention In terms of tackling the factors that have been identified as contributing towards creating an adverse environment for raising children, government policies can play at least as big a role as the efforts of individual families. Many of the factors lie outside of the capacity of parents to influence them: they cannot readily alter the quality of the local school or neighbourhood or the level of benefit for the unemployed; homelessness may be a problem they are anxious to solve but are restricted by availability. Many of the factors are associated with social inequalities and, in the UK and New Zealand, social inequalities have been increasing despite the respective governments' explicit policy aims of reducing them. The UK target of halving child poverty by 2010 is likely to be missed. After initial progress lifted 600,000 out of poverty, the number has started to rise again by 200,000 so that 3.8 million children (about one in three) is living in relative poverty (below 60% of the median income) (Department of Work and Pensions 2007). In New Zealand, the proportion of children living in families with low living standards living standards npl → nivel msg de vida living standards living npl → niveau m de vie living standards living npl increased from 36% to 38% between 2000 and 2004 (MSD (MicroSoft Diagnostics) A utility that accompanied Windows 3.1 and DOS 6 that reported on the internal configuration of the PC. A variety of information on disks, video, drivers, IRQs and port addresses was provided. 2006:65). A UNICEF UNICEF (y `nĭsĕf'), the United Nations Children's Fund, an affiliated agency of the United Nations. review of child
wellbeing in rich countries placed the UK at the bottom of the league
overall (UNICEF 2007). There was insufficient data for New Zealand to be
placed but it scored 7th highest out of the 24 rich countries when it
came to the percentage of children (16%) living in relative income
poverty (p.6).
An interesting example of the impact of economic factors on social problems is provided by a review by the Prime Minister's Strategy Unit The Prime Minister's Strategy Unit (now known simply as The Strategy Unit) provides the UK Prime Minister with in-depth strategy advice and policy analysis on his key priorities. It has three primary roles. on why the UK has seen a steady drop in the crime rate since the mid 1990s. It concluded that 80% of the fall was attributable to economic factors--this conclusion was deleted from the version placed on their website but the original is discussed in Solomon et al. (2007:14). Secondary and Tertiary Prevention The new UK policy is, in the main, directed at secondary and tertiary prevention--at responding when children show signs of harm arising from their adverse environmental conditions. It is in this context that collecting and sharing data is considered to play a major role in facilitating the identification of problematic children. Currently, identification of need is mainly done by children and parents themselves, or by professionals in contact with them, rather than by an external screening process. Given the myriad of physical, cognitive, emotional and behavioural Adj. 1. behavioural - of or relating to behavior; "behavioral sciences" behavioral problems that children may have there can be no definitive judgment on the effectiveness of interventions. However, evidence on effectiveness allows us at most to make modest claims about the ability of professionals to solve different childhood problems (McDonald 2001). This does not imply the gloomy gloom·y adj. gloom·i·er, gloom·i·est 1. Partially or totally dark, especially dismal and dreary: a damp, gloomy day. 2. conclusion that most problems are insoluble insoluble /in·sol·u·ble/ (in-sol´u-b'l) not susceptible of being dissolved. in·sol·u·ble adj. Not soluble. : many are sorted out with or without professional interventions as demonstrated by random controlled trials random controlled trial, n a study plan for a proposed new treatment in which subjects are assigned on a random basis to participate in either an experimental group receiving the new treatment or a control group that does not. . However, for those kinds of problems where there is demonstrated effectiveness, success is nothing like 100%. A New Zealand academic reviewing the effectiveness of a range of interventions designed to reduce delinquency concluded that the success rate ranged between 5% and 50% (McLaren 2000:9). Even though the success rates may be modest, in terms of human wellbeing they are significant and to be valued. ARE THE REQUIRED RESOURCES AVAILABLE? For primary prevention, providing the resources needed involves the funding of universal services to a level that ensures all children receive adequate basic care. The political will in both countries to provide such funding is mixed. The basic values of left-wing governments predispose pre·dis·pose v. To make susceptible, as to a disease. them to wanting to offer all children a decent chance in life but these values are undermined by pressures originating in neo-liberal economics that try to drive down public spending in order to maximise the freedom of the market and so stimulate the economy. Consequently, politicians are in an uncomfortable position. Both the New Zealand and the UK governments can be seen to have done much to reverse the impacts of spending cuts Noun 1. spending cut - the act of reducing spending cut - the act of reducing the amount or number; "the mayor proposed extensive cuts in the city budget" in the 1980s and 1990s but the scale of the problem is immense. For example, it has been estimated that to meet the UK target of halving child poverty by 2010, the government needs to spend an extra 3.8 billion [pounds sterling] (Barnardo's 2007). This is a dauntingly daunt tr.v. daunt·ed, daunt·ing, daunts To abate the courage of; discourage. See Synonyms at dismay. [Middle English daunten, from Old French danter, from Latin large amount though, as the children's charity Barnardo's points out, it can be contrasted with the 9 billion [pounds sterling] that is being spent on hosting the Olympics. Political decisions on spending reflect choices about priorities and it is questionable whether there is sufficient political will to provide the help that families might benefit from. In terms of secondary and tertiary services, the main, current problem for families and professionals is that there are insufficient secondary level services (Social Services social services Noun, pl welfare services provided by local authorities or a state agency for people with particular social needs social services npl → servicios mpl sociales Inspectorate in·spec·tor·ate n. 1. The office or duties of an inspector. 2. A staff of inspectors. 3. An inspector's district. inspectorate Noun 1. 2003, Every Disabled Child Matters 2006). From their point of view the key problem is not failure to identify the need but lack of access to help because the thresholds for service are so high. It is arguable ar·gu·a·ble adj. 1. Open to argument: an arguable question, still unresolved. 2. That can be argued plausibly; defensible in argument: three arguable points of law. that while there is such a high level of known unmet need, children's services would be unwise to put their energies into uncovering yet more need that they cannot meet. The English policy of increasing monitoring and inter-agency data sharing about lower level problems will lead to a huge rise in the number of problems being identified by professionals but there is, at present, no sign that services will have sufficient resources to respond to all, and decisions will need to be made about who should be offered services. Moreover, screening at this stage has the same problems of inaccuracy in·ac·cu·ra·cy n. pl. in·ac·cu·ra·cies 1. The quality or condition of being inaccurate. 2. An instance of being inaccurate; an error. as in primary prevention, leading both to injustice for some children of being falsely given an adverse label and to injustice for other families in need who are inaccurately deemed too low risk to merit a service. To meet the level of known need, the two key resources are trained professionals and money. For both, there are significant issues of availability. In the UK, there are continuing problems of recruiting and retaining staff in social services and nursing. The numbers of health visitors who play a key role particularly in relation to children under five is dropping. In social work, there have been significant problems in recruitment and retention since the mid 1990s, with vacancy rates up to 40% being reported in some areas (Douglas 2002). CAN SURVEILLANCE BE HARMFUL? The intentions behind the extended surveillance of children's development are benign but this does not necessarily mean that the effects are benign. A number of concerns have been raised about the dangers of surveillance for family life. First, there are concerns that it undermines the responsibility and power of parents whose primary role in raising children is enshrined in law (UK Children Act 1989). While it is accepted that the State needs to intervene, often coercively, when there are concerns about child abuse and neglect, the new UK policy will extend the degree of intrusion considerably. The child protection system operates on a negative basis, criticising parents for actions or omissions that are considered harmful considered harmful - Edsger W. Dijkstra's note in the March 1968 "Communications of the ACM", "Goto Statement Considered Harmful", fired the first salvo in the structured programming wars. but tolerating a diverse range of parenting styles Parenting style is a psychological construct representing standard strategies parents use in raising their children. One of the best known theories of parenting style was developed by Diana Baumrind. outside of this area. The new system will seek to monitor and judge a much wider range of aspects of parenting in the course of judging children's development and assessing their needs. However, the basis for making such judgments needs to be examined. There is no one scientifically evidenced style of "good" parenting. While there is sufficient medical evidence to warrant judging whether a child's physical growth rate is within healthy limits, there is no equivalent knowledge base for measuring the connection between parenting styles and cognitive, emotional, and behavioural development. For many aspects of child development, there are rival theoretical approaches, e.g. the psychoanalytic psy·cho·a·nal·y·sis n. pl. psy·cho·a·nal·y·ses 1. a. The method of psychological therapy originated by Sigmund Freud in which free association, dream interpretation, and analysis of resistance and transference are and behavioural schools of psychology. Professionals trained in one approach will reach different assessments about a child than those trained in the other. In the UK policy, children who are considered to have needs in addition to those met by the universal services will have a "Common Assessment Framework" form completed on them and their families. This form requires a judgment about whether disciplinary methods used by the parents are "appropriate" and this provides a good example of the difficulty. Consensus can probably be reached about some practices that are definitely "inappropriate" but there is considerable disagreement about what is acceptable. The recent debates in New Zealand about whether smacking smack·ing adj. Brisk; vigorous; spanking: a smacking breeze. Noun 1. smacking - the act of smacking something; a blow delivered with an open hand slap, smack was appropriate or not illustrate the high degree of controversy that such judgements can arouse. There is a danger that parents will find themselves at the mercy of whoever is carrying out the assessment of their child, with some professionals considering their behaviour acceptable and others criticising it. Scientific knowledge is not all that matters when it comes to assessing children. Assessment unavoidably involves values and beliefs about how a person ought to behave. Societies have always recognised that moral values and religious beliefs play a significant part in determining how parents bring up their children and contemporary societies seek to tolerate the cultural diversity that exists. A second issue of concern is the inaccuracy of risk predictions. Any risk prediction leads to a number of false positives and false negatives. This raises the question of what number of false positives (children inaccurately deemed at risk) is acceptable. This is a moral not a scientific judgement (Hammond 1996). The risk predictions stemming from the application of the new policy will have serious stigmatising consequences for children who are considered "at risk" of some adverse outcome. The Prime Minister, for example, has talked of midwives identifying "the future menaces to society" in utero in utero (in u´ter-o) [L.] within the uterus. in u·ter·o adj. In the uterus. in utero adv. (Blair 2006a). A child born with this label will find the world treats him or her differently as a result. How many innocent babies is it acceptable to harm by mislabelling them? Indeed, how harmful might the label be even if proved correct? A third area of concern about surveillance is its impact on the relationship between family members and professionals. Confidentiality has been a major principle in the caring professions except in cases of child abuse and neglect. However, data sharing is a key element in the proposed electronic system and the UK government has pledged to "remove the legislative barriers to better information sharing" (HM Treasury 2003:13). Evidence suggests that the loss of a guarantee of confidentiality will affect parents' and children's willingness to confide in professionals (Munro 2007). Research on children's views has consistently found that they accept the need for information sharing when there are concerns about significant harm but, on other matters, they are reluctant to talk if there is a risk that the information will be divulged to others (Children's Rights The opportunity for children to participate in political and legal decisions that affect them; in a broad sense, the rights of children to live free from hunger, abuse, neglect, and other inhumane conditions. Alliance for England 2006, Hilton and Mills 2006). Indeed, even with child abuse, the lack of confidentiality has a negative effect. Research on children using ChildLine, a confidential phone service, highlighted the importance of the confidentiality: The offer of confidentiality is one of the prime reasons children call ChildLine. One of the most common questions they ask of our counsellors is, "Are you going to tell anyone about this?" (Easton and Carpentieri 2004:25) The fourth and final concern I wish to consider is the risk that children who are being abused and neglected may be afforded less protection by the State under the new system. This echoes the concern in the quote at the beginning of this article that it is a mistake to assume that more information leads to better decisions. At first glance, increased surveillance might be thought to lead to a greater chance of seeing which children are suffering but, in reality, there are serious grounds for concern. The basic problem is that by magnifying the amount of data being collected so much, there is a risk that cases of serious abuse will be hidden in the deluge Deluge (dĕl`y j), in the Bible, the overwhelming flood that covered the earth and destroyed every living thing except the family of Noah and the creatures in his ark. of data about lower level concerns.
The reality of this risk is well-evidenced by experiences in other areas
of data collection (Anderson 2001). The UK Information Commissioner,
giving evidence to the Select Committee for Education and Skills, summed
up the problem: "when you are looking for Looking forIn the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. a needle in a haystack For the epidode of the TV series House, see . A needle in a haystack is an English idiom that refers to an object (or a person) that is difficult to find because it is lost, mixed in, or buried within a much larger space, mass, crowd, or group of some other objects. I am not sure it is wise to make the haystack even bigger" (Information Commissioner 2005). CONCLUSION Economic and political changes are altering the environment in which children are raised. The competitive impact of the globalisation of the economy makes it more important for both New Zealand and the UK to have a well educated workforce capable of carving out carving out Managed care adjective Referring to the practice of allowing healthy persons in small employer groups to buy lower cost health insurance policies, while workers who are sicker must buy more expensive high-risk pool coverage a place in the global market. At the same time as external economic forces are increasing governments' concern about children's development, neo-liberal economic policies are seeking to reduce public spending on universal services that, in the days of the welfare state, made a major contribution to providing the benign environment in which children could flourish. In the UK, social inequalities have widened considerably since such economic policies were first introduced by the Conservative government in 1979. The social and individual factors that are predictive of poor outcomes for children have worsened with child poverty, for example, going from one in ten to one in three children. As a result, the primary preventative strategies have been less successful. Both countries experienced a period of more extreme neo-liberal economic policy at the end of the 20th century and now have governments that are trying to reverse the effects this had on children. The New Labour government in the UK has been making efforts to tackle many of the factors, such as poverty, poor schooling and poor neighbourhoods, that influence children's development. At the same time as working on primary preventative strategies, it has also been trying to improve secondary prevention- providing help for lower-level problems so that some at least are prevented from escalating into serious, tertiary-level problems. It is in this area that the government has seen a role for surveillance, screening, and targeting of children and parents. By creating a professional network monitoring The term network monitoring describes the use of a system that constantly monitors a computer network for slow or failing systems and that notifies the network administrator in case of outages via email, pager or other alarms. all children's development and by making it responsible for ensuring that children achieve the targets that the government has set for their development, the government is radically reducing the responsibilities of parents and redefining the relationship between the State and the citizen. The key factors associated with this policy seem threefold. First, there is a concern to keep costs down by limiting services to those children assessed as at high risk of the key adverse outcomes of poor school achievement, delinquency, ill health and early parenthood. Secondly, there is an unjustified level of confidence in the ability of professionals to make accurate screening judgements and to offer effective help. Thirdly, there seems to be a loss of confidence in parents, a belief that they can no longer be trusted to have their children's welfare at heart, or perhaps a concern that they will not share the same priorities as the government. This article has not opposed the aim of offering more primary and secondary preventative help to families; it has taken issue with the way this is being done. It entails a shift in the balance of power between families and professionals, and this has been criticised on both pragmatic and ethical grounds. There is a lack of evidence that professional monitoring and screening, using an agenda set by the government, will do better in improving outcomes for children than a good professional network that listens and responds to the worries of children and parents. It is an irony of neo-liberalism that as the State increasingly withdraws from the economic market, it becomes increasingly involved in the surveillance and regulation of individuals. REFERENCES Anderson, R. (2001) Security Engineering, Wiley, Chichester. Barnardo's (2007) It Doesn't Happen Here, Barnardo's, London. Blair, A. (2006a) BBC BBC in full British Broadcasting Corp. Publicly financed broadcasting system in Britain. A private company at its founding in 1922, it was replaced by a public corporation under royal charter in 1927. News interview, 30.8.06, available from www.bbc.co.uk. Blair, A. (2006b) "Our nation's future: Social exclusion" speech to Joseph Rowntree Foundation The Joseph Rowntree Foundation[1] is a social policy research and development charity, seeking to better understand the causes of social difficulties such as poverty and housing and explore ways of overcoming them. , York, 5 September, www.pm.gov.uk/output/Page10037.asp. Brown, K., and K. White (2006) Exploring the Evidence Base for Integrated Children's Services, Scottish Executive, Edinburgh. Children's Commissioner (2006) Weaving weaving, the art of forming a fabric by interlacing at right angles two or more sets of yarn or other material. It is one of the most ancient fundamental arts, as indicated by archaeological evidence. Pathways to Wellbeing: An Integrated Framework, Children's Commissioner, Wellington. Children's Rights Alliance for England (CRAE CRAE Combat Readiness Assessment Exercise CRAE Common Record Analysis Environment CRAE Centre de Recerca de l'Aeronàutica i de l'Espai (Aeronautics and Research Center; Barcelona, Spain) ) (2006) Children and Young People Talk about Information Sharing, CRAE, London. Daniel, B. (1999) "Beliefs in child care: Social work consensus and lack of consensus on issues of parenting and decision-making" Children and Society, 13(3):179-91. Department for Education and Skills The Department for Education and Skills (DfES) was a United Kingdom government department between 2001 and 2007. It was responsible for the education system and children's services in England. On 28 June 2007 the department was split in two by Gordon Brown. (2006) "Fact sheet: Information sharing practice" www.ecm.gov.uk/informationsharing [accessed 2 February 2006]. Department of Health (1995) Child Protection: Messages from Research, HMSO HMSO (in Britain) Her (or His) Majesty's Stationery Office HMSO n abbr (BRIT) (= His (or Her) Majesty's Stationery Office) → distribuidor oficial de las publicaciones del gobierno del Reino Unido , London. Department of Work and Pensions (2007) Households Below Average Income, Department of Work and Pensions, London. Douglas, A. (2002) "Care in the capital" Community Care, London. Easton, C., and J. Carpentieri (2004) Can I Talk to You Again? Restoring the Emotional and Mental Well-Being of Children and Young People, ChildLine, London. Every Disabled Child Matters (2006) Off the Radar: How Local Authorities' Plans Fail Disabled Children, EDCM EDCM Every Disabled Child Matters (UK) EDCM European Direct Capital Management EDCM Engineering Design Criteria Manual EDCM Electrode Dressing Continuity Monitor , London. Farrington, D. (2006) "Childhood risk factors and risk-focused prevention" www.pm.gov.uk/output/Page10035.asp. Feinstein, L., and R. Sabates (2006) Predicting Adult Life Outcomes from Earlier Signals: Identifying those at Risk, report for the PMSU, www.pm.gov.uk/output/ Page10033.asp. Foundation for Information Policy Research (2006) Children's Databases--Safety and Privacy, Information Commissioner's Office, Wilmslow, Cheshire. Gigerenzer, G. (2002) Reckoning with Risk, Allen Lane, The Penguin Press, London. Hammond, K. (1996) Human Judgment and Social Policy: Irreducible irreducible /ir·re·duc·i·ble/ (ir?i-doo´si-b'l) not susceptible to reduction, as a fracture, hernia, or chemical substance. ir·re·duc·i·ble adj. 1. Uncertainty, Inevitable Error, Unavoidable Injustice, Oxford University Press, New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of . Hilton, Z., and C. Mills (2006) "I Think It's about Trust": The Views of Young People on Information Sharing, Office of the Children's Commissioner, London. HM Treasury (2003) Every Child Matters, The Stationery Office, London. Information Commissioner (2005) Evidence Given to Select Committee for Education and Skills, House of Commons House of Commons: see Parliament. , London. Laming, H. 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Barlow (2003) "Systematic review of instruments designed to predict child maltreatment child maltreatment '…intentional harm or threat of harm to a child by someone acting in the role of a caretaker, for even a short time…Categories Physical abuse, sexual abuse, emotional abuse, neglect…', the last being most common. during the antenatal and postnatal postnatal /post·na·tal/ (-na´t'l) occurring after birth, with reference to the newborn. post·na·tal adj. Of or occurring after birth, especially in the period immediately after birth. periods" Child Abuse Review, 12:416-439. Social Services Inspectorate (2003) Annual Report, Department of Health, London. Solomon, E., C. Eades, R. Garside and M. Rutherford Rutherford (rŭth`ərfərd), borough (1990 pop. 17,790), Bergen co., NE N.J., a residential suburb of the New York City–N New Jersey metropolitan area; inc. 1881. Several pre-Revolutionary houses remain there. (2007) Ten Years of Criminal Justice Under Labour: An Independent Audit, Centre for Crime and Justice Studies, London. Sutton, C., D. Uttting and D. Farrington (2005) Support from the Start: Working with Young Children and their Families to Reduce the Risks of Crime and Anti-Social Behaviour, Home Office Research Brief RB524, London (March 2005). UNICEF (2007) Child Poverty in Perspective: An Overview of Child Well-Being in Rich Countries, Innocenti Report Card 7, Innocenti Research Centre, Florency. U.S. Preventive Services the duty performed by the armed police in guarding the coast against smuggling. See also: Preventive Task Force (2004) Review of the Evidence: Screening Children for Family Violence, Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality, n.pr formerly known as the Agency for Health Care Policy and Research, this agency researches the quality of medical care and health services. , Rockville, Maryland Rockville is the county seat of Montgomery County, Maryland, United States. According to the 2006 census update, the city had a total population of 59,114, making it the second largest city in Maryland. , http://www.ahrq.gov.clinic/3rduspstf/famviolence. Woods, D., and E. Hollnagel (2006) Joint Cognitive Systems: Patterns in Cognitive Systems Engineering, Taylor and Francis, Boca Raton, Florida Boca Raton ("bōkə rə-tōn") is a city in Palm Beach County, Florida incorporated in May 1925. As of the 2000 census, the city had a total population of 74,764; the 2006 population recorded by the U.S. Census Bureau was 86,396. . Eileen Munro (1) Reader in Social Policy London School of Economics The School is a member of the Russell Group, the European University Association, Association of Commonwealth Universities, the Community of European Management Schools and International Companies, The Association of Professional Schools of International Affairs as well as the Golden (1) Correspondence Dr Eileen Munro, Reader in Social Policy, London School of Economics, Houghton St., London WC2A 2AE; Email: E.Munro@lse.ac.uk; Phone: 44 207 955 7349. (2) The UK government is responsible for deciding on children's policy for England only; Scotland, Wales Wales, Welsh Cymru, western peninsula and political division (principality) of Great Britain (1991 pop. 2,798,200), 8,016 sq mi (20,761 sq km), west of England; politically united with England since 1536. The capital is Cardiff. and Northern Ireland Northern Ireland: see Ireland, Northern. Northern Ireland Part of the United Kingdom of Great Britain and Northern Ireland occupying the northeastern portion of the island of Ireland. Area: 5,461 sq mi (14,144 sq km). Population (2001): 1,685,267. have separate systems and none are, at present, planning to implement similar information and communication technology solutions. |
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