Thursday, 2 June 2016

Importance of effective triage after the murder of Liam Fee

Sarah Nelson, CRFR Associate

The shocking, prolonged abuse and murder of two-year-old Liam Fee by Nyomi and Rachel Fee has brought understandable outrage, pain and recrimination amongst Scottish public, politicians and media. But this is not the best climate in which to think clearly about improving child protection. What was actually the greatest failing in this case, which calls for urgent remedy?

It was the failure to lodge in a single place, and then to flag up, many separate concerns being reported about Liam’s safety and welfare - from a nursery, from a childminder, GP, neighbours and so on – along with any concerns raised about other children in this household. Raising a big red flag to police, social work and health, that immediate investigations were needed: a form of alarm system which today’s computer systems are more than capable of devising.

We now have to ensure in Scotland that best-practice from within and from elsewhere is followed in our IT systems, which will indicate multiple or urgent reports to all the multi-disciplinary agencies involved in child protection. The gradual development of MASH hubs (Multi-agency safeguarding hubs) in England * has improved ‘triage’ . It calls for more attention.

These hubs enable the key agencies, all working together in one office, to investigate quickly - when concerned reports come in - what is already known about suspected abusers and vulnerable children. This system also emphasises the importance (and responsibility) of other agencies, not simply social work, in keeping children safe and pooling their own information. Dundee City Council is currently developing such a hub (known here as a screening hub), but we now need a rapid review of such developments and planned developments across Scotland, and how best- practice in their use might be advanced.

The Named Person scheme has to fit coherently and comfortably into a triage system. This scheme has other purposes besides child protection, including support for parents. But to be effective in abuse cases, named persons need to be linked into any ‘red light’ system, they need access to the numbers of concerns being made about a child, and they need the authority and status to call for a child protection investigation. Yet health visitors for instance have low professional status, despite their great importance in observing problems over time for both parents and children.

This desperate case should give impetus to examining calmly what improvements need to be made for Named Persons if their role in protection is to be strengthened.

Effective triage limits the number of serious cases which need to be addressed and prioritised. Thus it limits staff workloads. Instead however, a panicked, scattergun approach often comes in the aftermath of tragedies. The fallout after highly-publicised child deaths such as that of ‘Baby Peter’ Connelly in 2007 (Haringey LSCB, 2010) brought such professional terror of another high-profile toddler death that care orders for young children and babies greatly increased throughout the UK, when there were suspicions of physical abuse or neglect (McLeod et al, 2010). Thus numbers of children in England subject to a child protection plan increased by 47% between 2008 and 2012; and numbers on child protection registers increased in Scotland by 23%.

Such reaction greatly increases the workload of staff who are already overworked. It often pulls in families who were not at risk after all. Its use has been disproportionate against vulnerable, disadvantaged working class single mothers and victims of domestic abuse, women who were often not protected themselves from sexual and other abuses which led to their mental ill-health or substance misuse. It has diverted police and social work attention, protection and resources from vulnerable older children and teenagers who – particularly south of the Border- have been the widely-ignored, disparaged victims of organised sexual exploitation (Nelson, 2016).

Let us not make such similar mistakes, in fearful response to public outrage.

Haringey Local Children Safeguarding Board (LCSB) (2010) Serious Case Review: Baby Peter, 2nd Review. London: Haringey LSCB,October

McLeod, S., Hart, R., Jeffes, J. and Wilkin, A. (2010) The Impact of the Baby Peter Case on Applications for Care Orders, Slough: National Foundation for Educational Research.

Nelson, S. (2016) Tackling Child Sexual Abuse: Radical approaches to prevention, protection and support, ch.4. Bristol: Policy Press



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