At any one time the state is parent to about 60,000 children in England. The vast majority enter care because of family problems, rather than because of their own behaviour. Children are taken away from their parents for their own protection. Sadly, once they are in care, the future for most of them is bleak.
Fewer than 10 per cent of children in care achieve five A-C GCSE grades, compared to half of all young people. In 2002, 59 per cent of care leavers finished school without any qualifications. Fewer than half were in education or employment at 19, compared to 86 per cent of all 19 year olds. Care leavers are far more likely to end up in prison. In the most recent data available, one quarter of the adult prison population has been in care and almost 40 per cent of prisoners under 21 were in care as children.
Of the 60,000 children in care in 2003, the majority, over 40,000, lived with foster carers, 3,400 were adopted, over 6,000 were still at home but under supervision and 9,600 were looked after in children's homes, secure units, hostels, lodgings or residential schools. There are problems with every part of the system. Adoption is still only available to a small number of children, because by the time they enter the care system for good they are often too old to be adopted. There are too few foster carers, they are poorly rewarded and many of them have little training. And after the abuse scandals in children's homes, residential care remains shrouded in controversy.
The government talks about preventing children entering care and has developed some excellent initiatives, such as Sure Start, to boost the resilience of vulnerable families. But it has signally failed to develop a strategy to address the problem of parents who are addicted to drugs or alcohol. The result is that 6-8,000 children arrive in care each year primarily because of parental substance misuse, when earlier intervention might have kept many of them with their families.
The history
Adoption peaked in the late 1960s; thereafter the number of babies put up for adoption declined sharply owing to legalised abortion, access to contraception and reduced stigma attached to single parenthood. Residential and foster care became the primary means of dealing with vulnerable children. By 1975, children's homes housed nearly 40,000 children, out of a total care population of 100,000.
Many children enter care because of physical or sexual abuse at home. But in the 1970s sex abusers infiltrated children's homes, making such children victims twice over. Children who tried to testify at the time were not believed; some were even punished for "telling lies." It has taken up to 20 years for some of the abuse to come to light and most police forces in England and Wales are still investigating the allegations. The journalist Christian Wolmar estimates that the number of victims could be above 5,000, with 2,000 alleged perpetrators, although some parliamentarians believe that certain allegations are false.
The abuse in residential care homes has led to 11 separate inquiries, among them the "pin down" and the Waterhouse inquiries, which recommended stringent guidelines. As a result of the care home scandals, the Children Act 1989 placed a legal duty on child protection services to try to keep families together. There was a preference for fostering before residential care. When Labour came to power in 1997, it introduced 11 new objectives to improve the lives of children in care. The five-year project cost £885m.
Then in February 2000 came the death of Victoria Climbié, who had been privately fostered by her great-aunt and then subjected to a life of torture and abuse. The government asked Lord Laming to investigate her case. He found that she had been seen on 12 different occasions by childcare professionals. Laming recommended the creation of an electronic tracking system for children, 150 children's trusts, the amalgamation of health, education and social services, and a children's commissioner for England.
The government responded with the children's bill in March this year, which has recently returned to the Commons from the House of Lords to enter committee stage in mid-October. The bill will create an independent children's commissioner for England, albeit with limited powers. There will be electronic children's files, children's directors responsible for all local authority services and children's trusts. The children's minister Margaret Hodge described the bill to me as "the legislative spine of our mission - that all children develop their potential and none fall through the net." Yet many children's charities remain critical of the bill and one veteran of child protection, Roger Singleton, chief executive of Barnardo's, is sceptical that a new body will bring about real change.
Entering care
Out of 11m children under 18 in England, nearly 400,000 come into contact with social services each year as "children in need." But only around 80,000 of them are taken into care in that 12-month period. When a child is assessed as being "at risk" because of neglect or physical, emotional or sexual abuse, a child protection conference is held. At this stage, the child is added to the child protection register and a child protection plan is drawn up. If no progress is made in the case, the child may be placed with foster carers or kinship carers but without a legal order. If all goes well, they are returned home. Otherwise (legal) care proceedings might start, usually taking place at a family proceedings court. After such care proceedings many children are removed from their family, although a small number are looked after at home under a care or supervision order. Social workers have a duty to place the child with relatives or close family friends if possible. In the absence or unsuitability of kinship care, social workers consider other options such as fostering or adoption. It is at this stage that siblings are often split up, with an older child being fostered and younger children being adopted. One recent study found that "sibling separation was viewed as the defining moment in their childhood when children lost faith in their social worker and felt truly alone."
Children enter care for many different reasons, including family illness, mental health problems, disability, overwhelming poverty, domestic violence and family break-up. The number of children in care at any one time fell to 55,000 in 1996, but since then has crept up again to around 60,000. There are several reasons for this increase. Children are staying longer in care and there has been a small increase in the number of child asylum-seekers (4 per cent of all children in care are unaccompanied asylum-seekers). Initiatives like Sure Start promote earlier identification of problems. Margaret Hodge says she is "not worried by the actual numbers going up. Probably the number has grown because of our better ability to spot children's needs."
Yet while the needs may be spotted earlier, specialist services which might keep children at home are thin on the ground. And there are two other factors which are contributing to the rise. Social workers in 12 local authorities interviewed by the Thomas Coram Research Unit identified them as domestic violence and parental substance misuse (PSM).
The problem of drugs and alcohol
"Hidden Harm," a recent report by the Advisory Council on the Misuse of Drugs, estimates that 2-3 per cent of children in England and Wales (and up to 6 per cent in Scotland) live with a drug-abusing parent. The government's strategy unit estimates that as many as 1.3m children are living with a parent with a drinking problem. The latest estimate by two academics, Judith Harwin and Donald Forrester, is that almost 10 per cent of all children in England and Wales are living with a drug or alcohol-misusing parent. Based on these and many other studies, it is possible to estimate that between 30 and 40 per cent (6-8,000) of the children entering care each year for the first time do so primarily because of substance misuse. Some children are taken to get fixes in dangerous locations, others are locked in their rooms for hours on end. Parents spend money on drugs, leaving children lacking milk, food, nappies and clothing. Alcohol misuse is strongly linked with domestic violence and emotional detachment.
Harwin and Forrester have found that few social workers receive training in substance misuse. (There is no requirement in the social work degree to study substance misuse although there is to study disability and mental illness.) Despite alcoholism being associated with violence and emotional abuse, alcoholic parents are often allowed to keep their children, while newborn babies are often removed from drug-addicted mothers. What help there is for alcohol and drug addiction is concentrated on the individual. Family services are very thin on the ground. A recent report by the NSPCC could only find 14 family alcohol services throughout Britain.
In Middlesbrough, social services director Jan Douglas became aware a few years ago that heroin was harming the city's children. "In 1999/2000 heroin began to bite in Middlesbrough. Over the next 12 months we saw an increasing number of children going on to the child protection register. We analysed what was happening and it was clear that 80 per cent of the neglect cases were on the register because of heroin. We were seeing parents who couldn't even change a nappy or feed or wash their babies. The increase in numbers was exploding our capacity to cope."
With colleagues, Douglas and a visionary local doctor created a drugs action team to tackle the problem. The team now runs a programme with heroin-dependent mothers, the council runs parenting support classes and if parents do not turn up for treatment they are visited at home. Over the last 12 months, the number of children on the child protection register has decreased by 30 per cent. Douglas says that they have not solved the problem, but have contained it. "We have not seen a big reduction in the number of parents using substances, but we have reduced the impact of misuse on family life."
A more intensive service in Cardiff, Option 2, is called in when a drug-addicted family is about to lose its children. A trained therapist works round the clock with that one family for four to six weeks. The families are evaluated several times in the first year after treatment, and 85 per cent of the families still have their children with them a year after commencing treatment. The project costs around £2,000 a year per child, compared with £31,200 a year for a child in the care system. Similar services have now been set up in Conwy, Denbighshire and Northampton, and other local authorities are examining this new approach.
The government has been slow to grapple with parental substance misuse. The recent NHS "Framework for Children" report sets new standards for coping with PSM and the department of health has declared that children of substance-misusing parents should be identified quickly and their needs met. But there is no new money or targets at which to aim.
Perhaps most disappointing was the publication of the government's long-awaited alcohol harm reduction strategy earlier this year, which says nothing about alcohol-dependent parents, concentrating instead on the link between alcohol and antisocial behaviour. Richard Velleman, Britain's leading expert on the impact of addiction on children and families, is dismayed: "I'd give them three out of ten only. They are starting to pay attention to the impact of substance misuse on families, but we have not seen any action."
Although Margaret Hodge is the lead minister for children in care, she was surprised when I presented her with evidence about the high proportion of children coming into care because of PSM. "I can't say I was aware that the figures were so high. We are having discussions with the department of health and the home office to develop a much more coherent approach on prevention and treatment, but it is early days." Hodge asked me to send her office all my data on parental substance misuse, yet despite my requests for a response, none has been forthcoming.
A move to fostering?
As concern about residential care increased in the 1980s and 1990s, government and local authorities turned back to fostering. Fostering has traditionally been short-term help for families in crisis, but it has evolved into a much longer-term option for many children. Five years ago, around two thirds of children in the care system were returning to their parents within six months. That figure dropped to 43 per cent in 2001-02.
Traditionally fostering was done by what Felicity Collier, chief executive of the British Association for Adoption and Fostering (Baaf), calls "a huge volunteer base of carers, usually mothers, who had the capacity to look after other children while their own were at school. But fewer children needed fostering then, and fewer women went out to work."
Most foster carers are not paid. They are given allowances for the child and in some cases extra funding for children with special needs. Training and assessment last for around six months. Hodge says that she is "looking at the training and rewards system in place at present."
Ian Sinclair of York University has been tracking almost 600 foster children since 1998. He found that most children had a good experience of fostering. "This is not a horror story. More than half of the children wanted to be in their foster placement until they were 18. The great majority said that they were happy with their foster placement." But fostering cannot easily replace family life. "Customs about television, what happens at weekends, the use of space, in-jokes can all make a child feel isolated," he said.
Sinclair believes that there is a key problem with fostering. "Despite the fact that most foster carers are good, the system does not provide what adoption provides, which is permanency." His study found that in the three years between the survey and the follow-up, 62 per cent of children had moved from their original placement. Some of these children will have returned home, which can be good news. Yet Sinclair has found that often children fail to thrive when they are returned to their family. He believes that we need to be less sentimental about the family - that in some cases, parents should be told that they can have their children back only if they are prepared to change. And Sinclair argues that fostering needs to become a longer-term, even permanent option for some children, requiring an expansion of the foster care workforce.
Fostering has benefited recently from the growth of kinship care, where relatives or family friends look after children who would otherwise be fostered by strangers. In parts of the US, Australia and continental Europe, kinship care has become the norm for fostering. Yet kinship care accounts for only 17 per cent of all fostering arrangements in this country, and is still growing very slowly. Many families fostering blood relatives complain that they do not receive the same allowances that stranger foster carers receive and do not get access to the specialist training they need.
Victoria Climbié's case exposed the dangerous and unregulated world of private fostering. Nobody knows how many children are privately fostered in Britain, but Baaf estimates the numbers to be anything between 10,000 and 20,000 children. Private foster carers are supposed to notify local authorities, but most ignore the requirement. The children's bill has proposed a registration system for private fostering, but Baaf is still campaigning for a more strictly regulated system.
Adoption generally produces the best outcomes, yet during the 1980s and early 1990s it became increasingly unpopular with many social workers. In the mid-1990s, the social services inspectorate (SSI) attacked local authorities, saying that many of them were marginalising adoption. In particular, the SSI criticised the length of time that ethnic minority children were staying in the care system while social workers looked for an ethnically matched family.
Labour came into office in 1997 pledging to update the adoption system. In 1998, a local authority circular made adoption a key component of its 11 objectives to improve the lives of children in care. The government also reformed the system with the Adoption and Children Act, legislating to increase the support available to adopters. Six per cent of looked-after children in 2002-03 were adopted (3,500 from care, 540 of whom were adopted by their foster carers). Since 1999-00, there has been a rise of 30 per cent in adoptions and the government has a target of an overall 40 per cent rise between 2000 and 2005.
Yet Felicity Collier at Baaf believes it will be "difficult to find placements to reach this target." Baaf is campaigning to extend a new type of adoption, called concurrent planning, in which young babies who are at risk are removed from their families very early on and are placed with prospective adoptive parents who are also trained as foster carers. If the birth family does not change within a very short time, the baby stays with the adoptive parent. Collier praises the model. "Birth family advocates would say that it is difficult for birth families to regain care in this situation and it is hard on the adoptive parents as well, not knowing if they will keep the child, but adults need to take that risk rather than the child."
The government has also tried to increase the ethnic diversity of adopters and has relaxed the rules on ethnic matching to encourage more children from ethnic minorities to be adopted.
Residential care
More than half of all the resources devoted to the care system are spent on residential care. The current cost of a residential place is around £1,840 a week, compared with around £300 a week for fostering.
Residential care is expensive partly because complex systems have been put in place to protect children from sexual abuse. But outcomes from these homes still remain poor. Sinclair found that nearly a third of school-age children were not in school. Children who had been in residential care for more than six months were faring particularly badly. Four out of ten had either been convicted or cautioned for the first time.
Another problem is that following the abuse scandals it is hard for residential workers to express any kind of warmth or intimacy towards children. Clare Chamberlain, who directed the recent Blueprint project, asking children and social workers in the care system how it could be improved, says "Workers have lost confidence in what is allowed and what is not allowed. They have no confidence in how to comfort children." She also reports that workers feel forbidden from keeping a bond going with a child leaving their care.
Paul Ennals, chief executive of the National Children's Bureau, feels that children are paying a high price for safer but more bureaucratic systems: "Because of the way the spotlight has been turned on the care system, a lot of personal contact has gone. The thing that we all remember as children is the warmth of physical contact… I think the pendulum now needs to swing back a little. Not so that children are unsafe again, but back to recognising that we all need warmth and love."
Prevention better than care
The care system has many excellent foster carers and adopters, some well run local authority homes and, in recent years, more investment and attention from government. But local authorities differ widely in the standard of care they deliver, and the lack of respect for local authorities and social workers means that many people working in the care system feel undervalued, as do the children. Moreover, national responsibility for children in care can sometimes slip between the home office (crime), the education department (care itself) and the health department (health).
Children in care miss out on the loving and consistent care that families provide. Many of them interviewed by the Blueprint project felt that they were not treated with dignity by the system. Social workers move on; children are moved from one foster carer to another. Warmth and trust have been lost in the flight towards safe systems. Children find it difficult to see their siblings. When they move placement, their belongings are chucked into bin-bags, rather than packed into suitcases. Hodge believes that "there were some very powerful messages from Blueprint. We have now changed the system so children in care can stay at friends' overnight without police checks, but we need to sort out other problems. This binbag situation is frankly awful."
The government has now introduced personal advisers and a career plan for every young person leaving care. It has also set ambitious educational targets for children in care. Yet in 2002, only 38 per cent of local authorities met a target that levels of education and employment for 19-year-old care leavers should be 60 per cent that of their peers. The Institute of Education estimates that no more than 1 per cent of care leavers go to university, compared to 35 per cent of young people in general.
But above all the government has to work on reducing the number of children coming into care. Sure Start local programmes and the Children's Fund are providing more help in improving parenting capacity, but even more emphasis must be placed on preventing children entering the care system. In particular, services for families with drug and alcohol problems need to be expanded throughout the country. Without progress in education and employment outcomes for children in care, it is very likely that their children in turn will also be socially disadvantaged and more likely to end up in care themselves.
