Baby P: some questions

I wasn’t planning to write anything about the Baby P case, thinking it tasteless to pontificate about something so horrible. But since others have lowered the benchmark, here are four questions.
1. Aren’t there a lot of cognitive biases here? Camilla Cavendish says a mix of groupthink and Bayesian conservatism may have led social workers to under-estimating the danger Baby P was in. But aren’t we also at risk of committing the hindsight bias?  With hindsight, things look as if they were inevitable when they were in fact only vague possibilities?
And of course, there’s also the confirmation bias. Every pub bore who thought social workers were Guardian-reading bed-wetters thinks this shows their ineptitude.
2. Aren’t we holding social workers to impossibly high standards? I mean, we don’t expect the police to catch all or even most criminals, we don’t expect hospitals to avoid all unnecessary deaths, and we certainly don’t expect politicians to make perfectly rational judgments. So why expect perfection from social workers? The fact is that they have to take huge decisions under immense uncertainty. Errors are inevitable. The question is: what sort of errors should they make? Should they err on the side of intervening in which case they might prevent abuse but at the expense of breaking up some tolerable families? Or should they regard taking children into care as a last resort, and so risk children’s lives? In conditions of necessarily limited knowledge, one of these mistakes will be made?
3. Have we drawn the line in the right place here? The legitimate* reason for hating seeing children put into care is that they do so awfully badly there; four-fifths end up with no GCSEs.
But is this because state care is worse than even poor parenting? Or might it instead be due to selection effects? If kids from only the very worst parents go into care, you’d expect them to do badly at school simply because they have a poor genetic inheritance and/or a bad start (pdf) which perhaps even good care can do little to ameliorate (except at a huge price?) If this is the case, then our aversion to putting kids into care rests at least in part upon a simple fallacy - post hoc ergo propter hoc - and we are endangering lives unnecessarily.
4. The DCSF says “proper procedures” were followed after it got a complaint about Haringey social services in 2007. This has naturally caused outrage; how can “proper procedure” lead to the death of a child?
So how should we interpret it? One possibility is that this is mere procedural fetishism - the belief (not confined to the public sector) that as long as the boxes are ticked and the papers in order, then outcomes don’t matter.
But there’s a more benign possibility. Under uncertainty, errors will be made. In this case, we cannot judge processes by single outcomes, as even the most effective process will lead to bad outcomes sometimes. Instead, the best we can do is to have in place a process that, on average, minimizes error. And in this case, following “proper process” will be the right thing to do not because it will always achieve the right outcome - nothing can do that - but because it minimizes error. If so, the DCSF is right.
But how can we tell which process minimizes error? We can’t run market-style experiments in which many differing processes compete alongside each other.
Which leaves us vulnerable to the possibility that the claim that “proper procedures” are in place is no more than a mix of unscientific wishful thinking and special pleading. 
I don’t pretend to have any answers here. All I want to do is raise the possibility that perhaps a tiny bit of progress can be made by at least avoiding the most egregious intellectual errors.
* Is keeping families intact really an end in itself? I'm not sure.

Comments

[passer by]

..Or we could say that as the social workers are working in what they believe to be a social "scinece" we are just holding them up to their own pseudo scientific standards, a mirror to themselves so to speak.

As for the politics, only idiots make them same mistake twice, and we at least got to see close up the moral vacuum that the modern Labour party lives in.

[jameshigham]

Aren’t we holding social workers to impossibly high standards?

Had to stop and think about that. It might be so.

[john b]

"only idiots make them same mistake twice"

Eh?

"the moral vacuum that the modern Labour party lives in"

Double eh? They weren't the ones trying to make political capital out of a dead baby...

[Diversity]

passer by

Thank you for the word "scinece". It nicely describes things held up to be seen as
science - which aren't. As in "We economists practice the dismal scinece".

Chris Dillow

Most everyone makes mistakes. Some of them kill people - in quantity on the roads.

Because our mistakes can harm and kill other people, we need to be held to account for them. Why? To reduce the likelihood of their being repeated. Where gross mistakes are made and repeated, whoever is responsible for the bad mangement of that situation needs to be held to account.

The problem is not "impossibly high standards"; social workers in other areas meet their professional standards and are proud of it. The problem is that standards will slip if we are not held responsible for our mistakes in delivering to them.

I have no idea who needs to be held to account in this case; but good mangement demands that they should answer for whet they have done and not done.

[john b]

The point is, there are two sorts of 'mistake' - there's the "driving at 100mph while drunk and killing a pedestrian you didn't mean to hit" type of mistake, and there's the "driving while sober in a way that didn't break any laws and killing a pedestrian you didn't mean to hit" type of mistake. The first, you punish severely; the second, you commiserate with the poor bugger involved and don't punish them at all.

There's no evidence so far that any of the actions by the social workers in this case fell into the first category rather than the second.

[passer by]

"only idiots make them same mistake twice"

Yep that does seem to describe harrigey social services pretty well.

And it is a "moral Vacuum" when you think its OK for the Haringey SS to investigate themselves. What is politics for if not working out how we should govern ourselves?

[John Meredith]

I agree with the thrust of this article, but I think this misses the point:

"Aren’t we holding social workers to impossibly high standards? I mean, we don’t expect the police to catch all or even most criminals"

We may not expect the p[olice to catch every criminal, but if we found they had interviewed the criminal 60 times in connection with some delinquency, and STILL not caught him, we might think they had something to answer for.

[Paul]

1. Yes and no. It is reasonable, sometimes, to say that people are seeing things with hindsight. However, this can also be used to excuse any incompetence. If SSD cannot detect repeated violence with twice weekly visits over a long period of time, is there any point in them at all ?

2. Same answer. It's the insane inconsistency which is the problem. To use the hospital example, you might hold a doctor to account if they cut the wrong leg off. There is a case to be made that SSDs have a problem (as do Health and esp. Police) of far too many people dossing around filling forms and not enough front liners. This means that there's no time, so decisions can verge on guesswork.

3. Both are right. A lot of children in care come from broken backgrounds. Children's Homes (mainly thanks to the current rules which means you can't stop someone leaving to sell their body for drugs, for example) make them worse and teach those that are okay how to be bad.

4. Proper procedures just means they passed it on to CSCI. It doesn't mean they did anything or checked anything afterwards. The primary aim for people is to avoid responsibility ; CSCI will have passed it round the houses as well.

It is true that a lot of complaints are stupid ones, but anything backed by a Lawyer should be taken reasonably seriously.

[Charlieman]

Passer by: "And it is a "moral Vacuum" when you think its OK for the Haringey SS to investigate themselves."

It is absolutely right that Haringey SS investigate themselves. In this case, it is also right that they are investigated independently. The latter does not preclude the former, nor does it mean that an internal investigation is a waste of time.

CD: "But is this because state care is worse than even poor parenting?"

I'm only qualified to observe and ask questions too. Today is the 60th birthday of a man whose parents had minor roles in his upbringing and who was delivered into private boarding education at an early age. The BBC has some footage of him as a small child, shaking his mother's hand before he was whisked away. Many of us may regard him as an emotional foul up, but he did receive a good education and moral foundation.

So if the rich can leave it to others to bring up their kids, why is state care so crap? After the extraordinary James Bulger murder, the perpetrators went through state funded rehabilitation, not punishment -- possibly for moral reasons, possibly for economic ones. Now that the Tories are on board with the concept that you might spend money today to head off future social problems, shouldn't we be asking for a proper care system for vulnerable children?

CD: "Instead, the best we can do is to have in place a process that, on average, minimizes error."

Processes are how you make paint in a chemical factory or assemble sewing machines on a production line. Processes are what you get when management believe that a system can solve problems better than human beings.

[john b]

"So if the rich can leave it to others to bring up their kids, why is state care so crap?"

See: the Barbican vs the Broadwater Farm Estate.

[Bob B]

FWIW I suspect local authority social workers tend to be under-resourced, over-worked and under-paid for what they do.
In that context, social workers tend to serve in the role of professional scapegoats for systemic failings in child protection such as with Victoria Climbie or the present case.

In the course of the 1990s, we also had the (bogus) epidemics of Satanic Abuse and Munchausen's Syndrome By Proxy as well as the horrendous and extensive cover-ups of abuse in local authority care homes mainly by staff. Try this link:
http://www.guardian.co.uk/politics/2003/jul/06/children.childprotection

I've no idea as to what the solution is although I think that public recognition of what the realities are is a necessary condition for trying to get there.

[Jonathan Calder]

I don't think we are holding social workers - a term which in such cases serves as a convenient shorthand for all public sector professionals - to impossibly high standards. We do not expect them to prevent all child deaths.

But when a child is seen 50 or 60 times, isn't it then reasonable for us to expect them to keep him alive?

If it is not, that must have profound implications for the claims that social workers make for themselves and the status we accord them.

[septicisle]

John: You raise a good point, but the police themselves decided in this case that there wasn't enough evidence against the mother or the grandmother (who was also suspected) for charges to be brought. Likewise, the HSS did look into whether Baby P should be taken into care; the legal advice came back that the threshold for doing so had not been met. If we're going to blame anyone, it has to be spread around, and the witch-hunt going on at the moment isn't doing so.

[Dipper]

but but but this is a story of modern Britain.

There's the introduction of computerised processes and a de-skilling of professionals.

There's the perfect paper trial of decisions that failed the child

There's the apparent removal from the organisation of a desenting individual - organisational unity being put ahead of debate about how to do the right thing.

So I think its fair game.

[ian josephs]

Social services plead shortage of staff and financial resources as excuses for overlooking torture of children(even after 60 visitsto baby P ).In other European countries they take children from parents only if they have been severely phsically abused but in Britain we waste most of out valuable resources fighting cruel cases in secret courts to remove children and even new born babies at "risk of emotional harm" and similar lesser reasons.The parents of baby P WOULD NEVER HAVE GONE TO COURT to fight for his return if he had been taken earlier as parents that violently physically abuse their children avoid courts like the plague !

Physical torture KILLS KILLS KILLS !!!
Emotional abuse does NOT
Poor school attendance does NOT
A cluttered house does NOT
Witnessing domestic violence does NOT
Hostility to the “professionals” does NOT
A parent with learning problems does NOT
Where therefore should the “SS” priorities lie?
I’m only asking !!
I would have thought myself it was MORE IMPORTANT to concentrate on preventing babies being tortured rather than the more common rush to remove babies AT BIRTH from mothers whom some highly paid psychobabble merchants have decided may at some future date emotionally harm their babies !Crystal ball gazing ?

[Debbi Abbis]

I haven't heard any mention of the way we fail to value children in this country. Staying at home to look after children is considered a 'non-job' and yet what could be more important than bringing up the next generation to become worthwhile and fulfilled individuals who have something to contribute? Unless we recognise the value of bringing up children, children themselves will be undervalued. An attitude that leads to the potential of child abuse. We don't need to find blame amongst the social workers who do an incredibly difficult job, we need to change the culture of our society, and respect those who bring up their children to be the future of this country. We also need to help those who have not learned to appreciate the wonderful creatures that they have created and protect them from anyone who threatens their welfare in any way at all. The most basic animal instinct encourages maternal protective behaviours, how have we manage to squeeze these out of some members of our society?

[Bob B]

Try this from The Times, 6 July 2008 on:

"Family justice: the secret state that steals our children - Every year thousands of children are taken from their parents, largely on the say-so of ‘experts'. It is a secret and sometimes unjust process and the system must change"
http://www.timesonline.co.uk/tol/comment/columnists/camilla_cavendish/article4271773.ece

[Coca]

Debbie Abbis, I am a stay-at-home mother myself but I still don't believe putting mothers back in the home full-time is the answer.

Firstly, I don't think society has done anything to "squeeze out" maternal behaviour - there are a lot of myths surrounding such behaviour, and the truth is that in every society and every culture there are individuals who lack the normal instinct to protect their offspring.

The difference is that in our society, we have no extended networks of people to take over as substitutes in such cases. I guess you could say that the social services should act as an extended network, but of course they can never be compared to people who actually know and love a child.

I think that rather than creating further isolation by making it the norm for mothers (why not fathers, by the way?) to stay home, and potentially putting the risky cases even further from view, we should work on building a community where a child's welfare is EVERYONE'S responsibility. I know it's a cliche, but "it takes a village..." etc.

[roy charles]

REGARDLESS OF THE OUT COME OF ANY ENQUIRY INTO THE DEATH OF BABY P ALL THE PERSONELL
IN THE HARINGEY CHILD WELFARE DEPT MUST BE FOUND GUILTY OF INCOMPETENCE, NEGLIGENCE AND COMPLETE FAILURE TO CARRY OUT THE JOB THAT THEY ARE PAID TO DO THAT THE CHILD IS NOW DEAD IS PROOF OF THESE FACTS, SACK THE LOT OF THEM. PRIMARILY FOR THESE FAILURES,
SECONDLY AS A.SIGNAL WARNING TO ALL OTHERS CONCERNED IN THE WELFARE OF CHILDREN AT RISK
AND FINALLY THAT THIS WILL RESULT IN AVASTLY IMPROVED SERICE THAT WIL REALLY PROTECT THESE VUNERABLE CHILDREN IN FUTURE.

SICK AT HEART

[Bob B]

Try this:

"Maria Ward [the social worker handling the Baby P case] was allegedly juggling 18 different cases at the time of Baby P's death in August 2007, when Haringey Council's own guidelines were for no more than 12 cases to be allocated to each social worker. Haringey have claimed her case load was 7 families.

"Miss Ward's alleged predicament mirrors that of Lisa Arthurworrey, the social worker who had responsibility for Victoria Climbie when the eight-year-old was killed in Haringey in 2000. Miss Arthurworrey had 19 cases on her hands – a workload which Haringey said at the time was too high.

"Yet seven years after Haringey was criticised in the Laming report into Victoria's death, Miss Ward, 39, was struggling under similar pressure, partly because a quarter of Haringey's posts for social workers were vacant at the time."
http://www.telegraph.co.uk/news/uknews/3473893/Baby-P-Haringey-Council-broke-its-own-rules-on-caseloads-for-social-workers.html

[Just an FYI]

I'm only qualified to observe and ask questions too. Today is the 60th birthday of a man whose parents had minor roles in his upbringing and who was delivered into private boarding education at an early age. The BBC has some footage of him as a small child, shaking his mother's hand before he was whisked away. Many of us may regard him as an emotional foul up, but he did receive a good education and moral foundation.

He regards himself as an 'emotional foul up'. He claims that he was horribly bullied at school, emotionally neglected by his parents and not all that academically successful. Just an fyi.

(He regarded his years at a secondary school in Scotland, Gordonstoun, as "absolute hell." He was picked on mercilessly by the other boys, who got a kick out of bullying the future king, and he often lay in bed in the dark fending off punches, pillows and thrown slippers.)

[Charlieman]

Just an FYI: "He regarded his years at a secondary school in Scotland, Gordonstoun, as "absolute hell.""

Nonetheless, he packed off his own two sons to a private boarding school (Eton). Perhaps his thoughts about education are selective, according to whether he is looking for pity or something else. Further, he may consider himself "not all that academically successful", but few people would regard him as academically bright in the first place.

My instincts oppose private education of the public school type, but the model suggests that it is possible for children to be raised "successfully" outside a conventional family. The experiences described in the article below back this up, although I doubt whether the method is scalable:
http://news.bbc.co.uk/1/hi/education/7523211.stm

[madmeg]

Ok I'm going to be totally contentious and say I have some sympathy for the Doctor who examined the child 48 hours before he died and failed to notice the broken back and ribs- what I hear you scream- how negligent was she?
well lets set the scene- This is not some newly qualified, inexperienced young thing fresh out of med school doing the first job that comes up but someone who has a good looking cv and has done the job for years. On the day she sees the child she is acting as a locum- so there is no evidence that she had ever met the child before or knew the case history. We all know how the wonderful UK health services expect Drs to meet its paper targets by seeing 3000 or so patients a day so the Dr has probably 10 min to see the patient and read the case notes. The child has not been brought in because he's sick but for a development clinic so she is not expecting a sick/injured patient. The mother (who from other reports we know to be spectacularly good at lying to and manipulating the case workers who saw her - and the house- on a regular basis) appears helpful and does not bring up any problems. The child is obviously upset and appears mildly unwell and so the Dr decides that rather than poke and prod at him and make him worse she will do a short session and not a full exam. Of course I would expect that a development clinic would include seeing the child walking but I can easily see how the broken ribs were missed. Unfortunately this woman's minor act of kindness to a "poorly" child led indirectly to his death.
As an ambulnace worker I have been to children bropught in by their apparently caring parents for infections etc. It is notoriously difficult to get vital signs on small children and worse if they are upset. If the child does not appear at any immediate life threatening risk then why make their life worse by having a stranger doing strange things to them? Needless to say having read this case in the future I shall be more suspicious of even the most attentive partents and check the kids out more thoroughly!

[Dani]

If it was a simple case of they genuinely thought it was okay for the baby to stay at home, why did they spend 6 months with holding vital evidence, and trying to cover up their actions, or lack of them? And this was information that no one had seen before, vital evidence that could have led to the cps and the police taking action against Mrs A and Mr B long before the death of the child.

Sadly this goes way beyond a few mistakes now, because the more we hear about the case, the more we hear that actually, they had all the evidence yet chose to do nothing with it. They saw the bruises, were in the house on a regular basis and new the type of state it was in, new there was a friend outside of the family having regular contact with the child and playing a part in his care, they could see the child wasn't gaining weight, she wasn't as compliant with the care plan as social services have led us all to believe. She regulary missed appointments with everyone involved with her, and was regulary not attending the parenting course.

While I do understand social workers have an incredibly hard job, they are trained to spot signs of abuse, trained to see through the lies of parents, and when social workers do not do their job properly, and in this case, this is how it seems, then every child on their books is at greater risk.

It is foolish to limit these problems to Haringey council, this is a nationwide problem. There will be many children under care plans still being left in the home because social services choose the cheaper option as opposed to the right option.

A big part of a social workers job is to protect children who are at risk of abuse and neglect. This is what they train for, what they study for. If they are not up to the job, they shouldn't be doing it.

When a person takes on the job of a social worker, they know they are going to work in condtions where they will be understaffed and ealing with high case loads, that is no excuse for gross negligence.

[roy charles]

An awful lot of pompous,verbal posturing,by know it all sub intellects,but does any of it help,or assist in the matter 9n hand?.
One thing only I suggest,is that all future recruits to the child welfare services should be of mature age and with a wide experience of dealing with people. In other words endowed with commonsense and fair degree of cynism . Forget the degree in Sociology!! What ever that may mean.Old Soldier

[Thunder Denton]

It was the "higher ups" who over rode the people on the ground. It was the people on the ground whose judgment is most accurate (the police and case workers).

Heads should roll, but it seems to me that politics is blocking the firing of these "supervisors".

[Eissa]

Ok. 60 times to 1 house, be realistic. The kid should have been taken after the 3rd complaint. This is the most tragic, unbelievable, groosim story I have ever heard or seen. If your social workers get paid the money they should damn well do there job. Would your job keep you if you didn't do it right? May every angels sweep up Baby P and take him to heaven and every satinic ghost live in the lives of everyone who caused this and take them to hell.