Skip to main content

Language: English / Gàidhlig

Loading…
Chamber and committees

Education and Culture Committee

Meeting date: Tuesday, May 21, 2013


Contents


Taking Children into Care Inquiry

The Convener (Stewart Maxwell)

Good morning and welcome to the Education and Culture Committee’s 16th meeting in 2013. I remind all present that electronic devices should be switched off at all times.

Under agenda item 1, we will take oral evidence as part of our inquiry into decision making on whether to take children into care. The themes for today’s session are neglect and permanence, with a specific focus on joint decision making and partnership working. I welcome our witnesses: Donald Urquhart, independent chair of the child protection committee in Glasgow; Jo Macpherson, representative of the community planning partnership in the West Lothian Council area; Jim Carle, of NHS Ayrshire and Arran and chair of the child health commissioners national group; and Hugh McNaughtan, authority chair of the Glasgow children’s panel. Good morning to you all.

I remind the witnesses, as I did the committee before the witnesses came in, that we have a tight agenda. Therefore, where someone has already covered the point, it might not be necessary for people to answer all the questions if they have nothing specific to add. We will begin with a question from Liz Smith.

Liz Smith (Mid Scotland and Fife) (Con)

Good morning. I start by putting on record my view, which I think is shared by the committee, that the written evidence that has been provided to us has been very helpful.

One difficulty that the committee is wrestling with is how to ensure that there is top-class guidance for professionals on how to look after the best interests of each individual child and at the same time to get some consistency. Can you comment on the difficulties in that approach?

Jo Macpherson (West Lothian Community Planning Partnership)

Particularly with regard to child neglect, there are many challenges to getting a consistent approach. In West Lothian, we have tried to tackle that through a programme of multi-agency training for our professionals that helps to identify some of the impact of child neglect on future development and behaviour.

A critical issue that makes it problematic to have a completely consistent approach to tackling neglect is that neglect can be an on-going or chronic situation, which requires a thorough assessment of when to intervene in the individual situation—assuming that the need to intervene has been identified. We need to be realistic about the areas in which we want to have a greater level of national consistency, given the need to look at the individual child’s life circumstances and what it is like for that child to live in that particular family.

How close are we getting to a situation in which consistency can be applied to the issues that you have described?

Jo Macpherson

We have a much greater understanding and definition of child neglect—with areas of physical or sexual abuse, it is easier to have that clear understanding—so we have more of a shared appreciation of the potentially very serious impact that early neglect can have on children’s future lives.

We still need to do work on helping our professionals to intervene when appropriate. There is a range of toolkits or assessment models that can assist professionals in making those serious decisions. In our area, because of the difficulties with identification, assessment and intervention in child neglect, we are involved in a study with the National Society for the Prevention of Cruelty to Children that is looking at the effectiveness of the graded care profile, which is one particular assessment toolkit. It is too early to say whether that will be effective, but we have invested some time and resource in that.

Outwith those toolkits, is there a sufficient number of well-trained professionals who are able to provide the training for the people who are involved in that process?

Jo Macpherson

We have many skilled and experienced professionals who work hard each day to support very vulnerable children and their families in communities, but there are challenges for all agencies. For example—my background is in social work—from managing the fieldwork teams in West Lothian, I know that retaining experienced staff is a challenge. We need to work hard to ensure that we retain that level of skill.

One of the written submissions made the point that there is a

“lack of clarity regarding when to share information”.

Can someone explain a little more the background to that problem?

Jim Carle (NHS Ayrshire and Arran and Child Health Commissioners Group)

The various agencies might have significant information that would have a real impact on how a particular child is treated, but we lack the integrated information systems that would allow us to share that information well and early enough in the child’s life to intervene at a point at which we could prevent some of those children from being received into care. There are systems in development just now and there is a lot of good practice, but we will have good practice only if we have good information. Arguably, information from health, which is my area, is not being well shared.

Is that an information technology problem, or is it to do with the management of people?

Jim Carle

There is a significant IT problem and we need to invest in IT systems that share information. As my submission says, we have a pilot model for that in NHS Ayrshire and Arran and in a couple of other areas in Scotland, but that is a serious issue.

We also have issues around a lack of a common culture among the agencies that approach children and young people. Arguably, a lack of value is placed on the information that health may have and how that may impact on the treatment plan for a child. Certainly, with the predictive factors that allow us to look at the family history, the child’s early history and the history of the siblings, we are not making best use of the information by utilising it to guide us in intervening early enough.

Is that information available and the issue is just about best use, or is there is a problem in some health areas that not enough information is provided?

Jim Carle

There is a combination of both those issues. In some areas, we have very good information that is not well shared. We always have islands of good practice—there are some excellent practitioners out there, and I would not want to take that away from them—but there is information on things such as foetal alcohol syndrome, which we do not currently screen for. If we are not aware that a child has been affected by foetal alcohol syndrome, we might not treat that child appropriately. That type of thing needs to come into play.

We are just beginning the process of gaining information from adult services in those cases where a parent may have an issue with mental health or alcohol or obesity or tobacco that has a direct impact on the child. To a certain extent, we are still treating the symptoms and not the causal factors. We need to move to a process similar to getting it right for every child that can be applied for every family rather than just for every child. We should look at the family as a whole unit and not just the child as an isolated factor within the family.

Liz Smith

Let me finish my questions by asking about that issue of getting the right culture. It has been put to us by a few witness panels that we need to ensure that the right culture is out there. What are the barriers to adopting that correct culture?

Donald Urquhart (Glasgow Child Protection Committee)

Before I answer that question, let me pick up on the information issue, which is a recurring theme in reviews of cases in which things have gone wrong. I think that there is a big issue about the way in which we train professionals on data protection. We need to give them a real understanding of what they can and cannot share.

Helpful guidance was provided by the Scottish Information Commissioner about six weeks ago, which talks about the issuing of information under the GIRFEC approach, and it is not seen as something that professionals should not be doing. As Jim Carle said, some practitioners are good at sharing information effectively, but there are also people who are less confident. I think that it is a training issue. We do not invest in training professionals. My background is in policing and I know that police officers are not as confident about sharing information. The point that we make in training is that children have died because we have not shared information rather than because we have shared it. We need to change the culture.

09:45

Part of the difficulty of partnership working, particularly on thresholds in terms of neglect, is that there are practitioners who come from a completely different organisational culture, and that makes it much more difficult. It is not that people are desensitised to the conditions in which they find children, but the reasons why they find them in those circumstances will be different. A police officer might attend a call and see something that causes them concern. For a social worker, it might be slightly different. That is a difficult one to crack. It is about the different organisational cultures.

Thank you.

I have a practical question. If a social worker, a health visitor, a headteacher or whoever is alerted to an issue, how do they then check what is happening in the other services? How does that happen practically?

Jo Macpherson

In the main, people pick up the phone and have a conversation. Although there might be disagreements between services and agencies, that is not always unhealthy or unhelpful. Disagreement can lead to the challenging of perspectives and positive interventions. I can speak only from a West Lothian perspective, but agencies are picking up the phone every day and having conversations with one another, saying, “We have a concern”, “What does this mean?”, “What do you know about this family?”, “Do you have similar concerns?” and “What should we do?”.

If it is a telephone-based system, presumably it relies on people writing notes—

Jo Macpherson

Yes. Clearly, a telephone conversation would be an initial point of contact. In other situations, it is important to bring people together in a formal meeting to share information and agree a support plan or what further actions are needed, to involve families in that and secure the best support for them.

Neil Findlay

If there is no IT-based system, the system relies on telephone calls and people writing notes. If something happens and then, say, you have to phone a school and the teacher is in the classroom, you immediately have delay. I think that you can see where I am going with this. A telephone-based system relies on people writing notes and keeping records. Inevitably, with the workloads that people have, things will be missed. Are we not still in the dark ages on this?

Jo Macpherson

I am sure that we could have better IT arrangements in place to support practitioners’ work, but we still have to have human contact and connection.

Of course.

Donald Urquhart

There is a danger in assuming that IT is a panacea. It is not, because if someone is updating a record using a computer, they still have to take time to do that. There are issues about whether a written record is less efficient than an IT record. If we had an integrated system, an updated record on a computer that could be shared with other agencies would be infinitely preferable, but at the moment we do not have such systems.

Returning to the original question about initial concerns, all areas in Scotland have in place child protection procedures that deal with how professionals should raise concerns initially. If it is not a child protection situation in which the child is at immediate risk of harm, GIRFEC deals with the identification of concerns and encourages the person who has lead responsibility for the child to convene a meeting of interested or relevant professionals to discuss concerns that might be at a much lower level, but which might still require some intervention over and above the delivery of a universal service.

Procedures are in place, and GIRFEC is being rolled out across the country. The extent to which it is rolled out will be different in different areas, but I think that a culture is beginning to be embedded that is about the interests of the child and a partnership approach to ensuring that the child gets what they need, to address the concerns.

Jim Carle

I reiterate that good practice relies on individuals talking to one another. It is important that we do not regard IT systems as some kind of panacea. We are moving rapidly towards having integrated IT systems. In NHS Ayrshire and Arran there is a common system across all health professionals who deal with children, so people input information into a single IT database. With our local authority partners, we are piloting AYRshare, which is a common system, currently with input from social work and health—education is about to come online, if we can resolve some IT issues, and we are working with the Scottish Children’s Reporter Administration and the police, to enable them to access the system.

Common IT systems are being developed rapidly and information can be shared, but the key point is that good practice relies on good practitioners. It is the analysis of the information that it is important to get right.

Neil Findlay

I do not dispute that. IT cannot replace human beings. We have had that debate in the context of the careers service.

In our papers, the example that you gave from Ayrshire and Arran is mentioned in the context of

“pockets of good practice across Scotland”,

but it is not suggested that such good practice is widespread. Although some areas are doing well, it sounds as though many more have problems. It also says in our paper:

“This level of IT provision is essential to collating information and can help to identify cumulative neglect early.”

Given what the committee has heard over the months, should we make a clear recommendation to Government that investment in the area is critical?

Jim Carle

My colleagues and I would find that extremely helpful. Significant investment in the area would be positive.

Systems must be properly integrated, which means that they must meet the needs of all partners. If I may speak from a personal point of view, I would want something that was shared throughout Scotland rather than developed in individual health boards. We need a fully integrated system. That would help in a number of ways, including in the development of predictive techniques, so that we can identify the group of children that we are talking about earlier and intervene, perhaps preventing a number of children from having to be looked after or accommodated.

Do the other witnesses agree? I am cautious about saying that, because I know that there have been some spectacularly bad public sector IT projects.

Hugh McNaughtan (Glasgow Children’s Panel)

The situation has been a bit shambolic at times, across the country.

From my experience of being on the children’s panel and related committees in Glasgow, I can say that because of Glasgow’s volume and compactness, an approach that works is the non-offence referral management—NORM—project, whereby people from the reporter administration, health, education and the police meet fairly regularly in each area to consider what is coming up. Health visitors probably see a lot at a very early stage and can bring things in.

I do not know whether NORM would work in every authority, given the distances involved, but some sort of national system to tie in good practice, perhaps through IT and videoconferencing, might well help. Some direction and on-going money would be needed to make it work.

Is housing involved in the project?

Hugh McNaughtan

Yes. Sorry, I forgot to mention housing; it is the whole gamut in a particular area. I have always felt—probably because of my experiences a long while ago—that housing officers probably see more than anyone else does before a child gets to school, at which point it is the teachers who see things.

Jo Macpherson

For some years now, West Lothian has had a system in which information is shared across agencies. However, it is probably time to review and advance the system.

Donald Urquhart

With the advent of Police Scotland last month, one IT system is being rolled out to replace eight different systems. The consolidation of the police’s IT system certainly presents an opportunity; I am not quite sure how advanced such moves are in health, but at least it is a start. As Jim Carle said, it would be a significant advantage in identifying at an early stage or predicting problems. However, it can be seen as a panacea and it is essential for practitioners to speak to one another.

I will take two very quick questions from Joan McAlpine and Clare Adamson.

Joan McAlpine (South Scotland) (SNP)

First, I apologise to the committee and the panel for my late arrival.

On Mr Carle’s comment about the desirability of screening for foetal alcohol syndrome, do you agree with an expert in this area who a couple of years ago suggested that the syndrome was more widespread than many people believed? What might be the implications of such screening?

Jim Carle

The most recent evidence supports my belief that foetal alcohol syndrome is far more widespread than we have previously thought. Of course, we should consider not only its impact on the child but the fact that people out there who are themselves victims of foetal alcohol syndrome are now parents in their own right and are trying to bring up children with a number of challenges.

I have no doubt that foetal alcohol syndrome is far more widespread than is recognised, and screening is clearly important because early identification of that group of young children means that we can make appropriate and effective interventions in their lives. There are children right now who I do not believe have been diagnosed accurately and are therefore not being treated effectively. For example, social workers and health professionals commonly use cognitive behavioural therapy to tackle these children; however, this is a group of children who will happily say yes to every question that you put to them and leave you with the impression that they have understood what you said when in fact they have not understood anything. They have learned by rote how to respond to you and know how those issues will then be picked up.

Given the issues with alcohol in Scotland, it is important that we develop some kind of national screening programme for foetal alcohol syndrome.

Clare Adamson (Central Scotland) (SNP)

I have a very quick question that I am afraid brings us back to the technical stuff. Last week, we took evidence from two academics who talked about expert systems that would trigger certain things and prompt people to take particular action in particular circumstances. Given what you have said this morning, is it simply a data-sharing system that has been put in place or does it have an expert element? If it does not have an expert element, are you aware of any expert systems outwith Scotland that fulfil such a function?

Jim Carle

The Ayrshire and Arran system is not what you would call an expert system in that it is not predictive; it simply shares—or attempts to share—information from a number of agencies in an effective way and the social worker or health professional performs the expert function by reviewing and pulling together that information.

At this point in time, I am not aware of any programme that would effectively pick up and pull together, for a certain house, all the information on, for example, the number of doors that have been broken into, the number of windows that have been broken or the number of missed appointments with a general practitioner. In fact, such a system would make me a bit nervous because I think that we need to rely on very well-qualified and experienced professionals who are able to analyse the data. For me, the issue is much more about the next stage and pulling together the data effectively to ensure that the individuals who work with the child in question can see all the available information, no matter whether it comes from the parents, the grandparents, the siblings or the individual child. All that information must be available to the professional.

Hugh McNaughtan

I think that Bruce Perry in America has such a programme. However, from the programmes that I have read about and which he has spoken about, it seems that they ride roughshod over people’s rights. We would need to be very careful about how much information would be available, how it would be shared and who would have access to it.

10:00

Colin Beattie (Midlothian North and Musselburgh) (SNP)

I have three questions. Last year, the Scottish Government published a risk assessment toolkit that was supposed specifically to identify and respond to child concerns. I am interested to know whether the witnesses feel that that was effective, particularly in light of some of the evidence we have already been given.

We have taken evidence from the likes of NHS Lanarkshire, which commented on the variations between professions in relation to thresholds for neglect or significant harm, and the same evidence exists about good-enough parenting. Obviously that is a great concern. It is quite basic to say that there should be an identifiable threshold that is common across the country. Does any training lead you to believe that we are moving towards a common understanding or that a common threshold is starting to appear? I am concerned if variation exists across the country.

The other thing is that there seems to be—

Colin, can we stop there and let the panel respond? You can come back in.

I am sorry. I was too enthusiastic.

You were quite enthusiastic, yes.

Donald Urquhart

The risk assessment work was undertaken by a colleague of mine in Glasgow on behalf of the Scottish Government. It is being rolled out currently.

Rather than being a completely new approach, the risk assessment is a combination of a number of approaches to assessing risk and equipping professionals with the capacity to analyse what they have in front of them. As Jim Carle said earlier, it is all very well having information but it is the professional analysis of what that information means that shows whether there should be interventions. It is useful to put all the information together but the idea is not new. At the end of the day, the real test is the ability of professionals to understand what they are seeing and to decide whether action is required.

The second point was about common thresholds. I have already said that, because of organisational cultures, a police officer seeing a set of circumstances would respond in a different way from a social worker or a health visitor. Because of the nature of the organisations within which they work, it will be difficult for them to develop a common threshold. Colin Beattie said that it is basically common sense but it is not quite as simple as that. I am not suggesting that common thresholds are not something that we would work towards but it is difficult to achieve them. We have been struggling with them for some time, and we are not quite sure how best to achieve them. That is my view.

Jim Carle

A common threshold might not be an achievable goal in reality, and I am not sure how helpful it actually is. Each child has to be treated as an individual, and there are too many permutations or variations in the issues that impact on that child to establish a common threshold.

We can have more training in common, and we can have more understanding. For example, the child protection training that we get as professionals varies depending on which profession we come from. An awful lot of work could be done to make the training more common across all the different agencies that contribute to this work, and our training could be pulled together in a number of other areas.

I would very much like to see a situation in which the police, social workers and other health professionals are trained together on certain issues. That process itself would develop a shared understanding of the different agencies’ roles and remits, which would lead to better practice, as uncovered by the GIRFEC pathfinder process.

Jo Macpherson

I agree with that. There is great value in training across agencies so that they have the opportunity to explore what definitions are, what they mean for individual children, how we make effective assessments of complex situations, and how we best plan to support children and their families. There is certainly evidence that suggests that understanding and shared awareness is positively affected by on-going multi-agency training.

That approach does not get away from the complexities that individual cases throw up, which will come down to individuals having robust assessments in place, including assessments of capacity for parents and caregivers to change within a timescale that meets the needs of children. There are serious difficulties and complexities involved in that.

Donald Urquhart

The value of joint training cannot be stressed enough. One of the key issues is the development of a working relationship between professionals. The ease with which professionals can pick up the phone and speak to someone they already know, because they attended joint training, makes sharing information much more effective.

Some of the significant case reviews have shown clearly that there is exceptionally good practice within Scotland—though there is also bad practice, which we are working hard to address. Joint training contributes significantly to that good practice.

Colin Beattie

I understand the comment that each case is individual. There are all sorts of different thresholds with which people are working. As a layman, I think that there must be concern that children perhaps are at greater risk in some areas than in others, because of the variation in the thresholds.

Hugh McNaughtan

I, too, speak as a layman. It is possible to look at thresholds, but thereafter we need to look at the individual child. Once the threshold is triggered, what needs to be provided? Is the question one of how quickly the parents will be able to change things for the child? There are different thresholds; the question is whether social work, education, or health practitioners can deal with the particular instance that arises. There might need to be some sort of basic trigger point; what happened to an individual child after that point would need to be dealt with on a case-by-case basis.

Colin Beattie

I will move on to my third question.

Obviously, there is a whole bunch of different professionals involved in every case. The evidence we have taken indicates that professionals tend to start from scratch every time they become involved, instead of building on what the previous professional has achieved up to that point. I wonder whether there is a way in which professionals might trust the judgment of the people who worked on the case before, instead of starting the whole thing again, which means that the clock starts again for the child. That seems to be the basis of the information I have received. Do you have a view on that?

Jo Macpherson

There can be a tendency to reassess situations. Sometimes that is demanded by our processes, either through children’s hearings or court procedures, and it is not possible to take assessment activity that has happened in the past and say that that is still relevant. However, we certainly need to prevent as many reassessments, or cases being started again, as we can, because that contributes to delays in the assessments and in the critical decisions being made.

Donald Urquhart

Evidence from significant case reviews shows that that is an issue on occasions. We need to equip professionals with the knowledge and confidence to rely on the work that has gone before them when they take over a case and to say, “We are not starting from fresh here; there is a history to this particular child or family”, so that they can work from the point where the previous practitioner left off.

Part of the problem is having the time to sit down and read what might be quite a significant, sizeable file and look at what has gone on in the child’s life. The pressures under which practitioners work can make that a very difficult thing to achieve. We must recognise that practitioners are working under significant pressure because of resourcing issues.

Have you had a chance to look at the Children and Young People (Scotland) Bill? Do you have any views on the extent to which that legislation might address some of the concerns that we are discussing this morning?

Jim Carle

I should admit from the outset that I am on the group that is drafting the guidance for that bill and so, clearly, I would argue that it does address those concerns.

I think that you have to declare an interest. [Laughter.]

Jim Carle

Everything that we are saying is being supported already by the named professional and GIRFEC process. That approach supports joint interagency working and is looking at culture, systems and practice. Over time it will have a significant impact on the work that we are doing.

The approach is extremely welcome, and the next critical stage will be the roll-out from children’s services to adult services. We will have to ensure that we have all the information that we require to make a full assessment of the individual child’s needs—that is where we must go next.

Hugh McNaughtan

In situations in which there is a reassessment, children who are a bit older—and even some children who are only eight or nine—begin to think, “Here’s someone else asking all the same questions. Nothing happened before, so why should I bother answering this time?” As time goes on, the assessment can be less and less fruitful for that reason. We must not lose focus on that because, whatever the process is, the child must be at the centre.

Donald Urquhart

My knowledge of the Children and Young People (Scotland) Bill is not as comprehensive as it could be, but I know that some of my fellow chairs, particularly in the west of Scotland, have concerns about the obligations that it will place on them at a time when resourcing is under significant pressure. That is not to say that the principles of the bill do not take us in the right direction. As Jim Carle said, as GIRFEC becomes embedded and becomes second nature to professionals, we should begin to see a significant difference.

Neil Bibby (West Scotland) (Lab)

I want to ask about families who might fall between child protection services and universal services, in particular the health service. Health professionals are sometimes the only people who come into contact with children who are potentially at risk, so only they can identify neglect and harm.

GPs are often regarded as autonomous in the health service. I understand that the General Medical Council has issued good guidelines to GPs on child protection procedures but that GPs are not compelled to attend multidisciplinary meetings or undertake training. Are GPs interacting sufficiently with other agencies? What onus is put on GPs, and what more can be done to ensure that they engage? What happens if a GP refuses to take part in multidisciplinary work?

Jim Carle

I think that GPs are the same as any other group of professionals. We have some excellent GPs and some extremely good GPs, who will go the extra mile to be involved in a case of any type and particularly a child protection case. However, GPs are private contractors to a greater extent, and they are entitled, under the national contract that is in place, to act in the way that you outlined.

We would like a closer working relationship with GPs, and we would very much like there to be joint training with GPs, as well as with other professionals. We would like GPs to be much more engaged with us and to take issues forward.

I hesitate to be critical of GP colleagues, who really do go the extra mile. However, GPs see themselves as being the pivotal point at which issues can be raised with other agencies, for those agencies to take forward. GPs perhaps think that, once they have identified an issue, another agency will take it forward and they will not be directly involved. That aspect of the culture could be challenged so that things develop in a different direction and GPs become part of the wider team.

We have heard concerns about the pressure on health visitors. How big are their case loads? Are they too big?

10:15

Jim Carle

The main concern is that health visitors should have the appropriate amount of time to enable them fully to assess the children in their case load. Health visitors work really hard and do an excellent job, but in some areas they are overburdened and do not have the time or resources to enable them to make a full assessment of every child for whom they are responsible.

In some areas, including my area, the health visiting service has been completely reconfigured. In Ayrshire and Arran, we focus on pre-birth to five, working tightly with our maternity services team, and health visitors no longer work directly with GPs. We have moved health visitors away entirely from older age groups; they focus more comprehensively on much younger children, under the early years framework.

We can do something to change practice, but we currently do not have enough health visitors out there. We have a real concern about the number of health visitors who are approaching retirement age and our ability to recruit replacements for them. As we get better at working together, the burden on health visitors and other professionals is becoming greater.

We need more time and more resources. The issue is not going to go away. Some things could help, such as an integrated IT system, to enable us to access information appropriately and timeously. However, if we want to resolve the issues for the population of children in Scotland, the bottom line is that we need more professionals on the ground, working more tightly together.

Neil Bibby

We talked about sharing information. How do we share information and take an holistic approach to a child while maintaining confidentiality? Does the ethos of confidentiality in the health service present a barrier to multidisciplinary work and joint assessment?

Jim Carle

Yes, that can be a barrier. There are groups whose professional guidance—from the colleges, for example—will not fully align with the new guidance for the Children and Young People (Scotland) Bill. We are approaching different colleges to ensure that the guidance that they issue to their members is aligned with Government policy and the bill.

There is a challenge, for example in relation to getting adult mental health services to share information on a parent or carer whose mental health issue or treatment plan might impact negatively on a child’s upbringing. We must convince professionals that the solution for their adult is entwined with the solution for the children in the family. There is no healthy child without healthy parents, and there are no healthy parents without healthy children. We need to take a whole-family approach to resolving the issue.

We are rapidly getting places under GIRFEC. I think that we are convincing more and more professionals to get on board. Information sharing is becoming easier, but the issue is not resolved and we are certainly not at the end of the road.

What resourcing problems are agencies experiencing?

Jo Macpherson

For social work, one of the biggest challenges over the past two years has been retaining experienced staff. When staff depart, the people whom we recruit to replace them are invariably newly qualified. The challenge is to ensure that we do not overburden our remaining experienced staff, so that they can do their best work, while not overexposing staff and social workers who do not have the relevant experience to work in complex and high-risk situations, because that is not safe for them, for families or for the organisation.

We have taken measures, through mentoring and joint working for example, to address the issue and minimise its impact. For example, social workers and health professionals do joint visiting so that there is a shared approach to safety among the professionals who are involved.

Where are the experienced staff going?

Jo Macpherson

In statutory children’s practice teams that I manage, social workers have usually moved to social work jobs that they perceive to be less demanding or challenging on a daily basis, where they feel that they will have more opportunity to do more constructive and in-depth work.

Do they move to other authorities, or do they go outwith the local government system?

Jo Macpherson

Some go to the voluntary sector or move to specialist jobs in other services, such as criminal justice. Many people leave for family reasons, too. It is not all about escaping, but there is no doubt that there are pressures on staff who work in highly complex and challenging situations.

Neil Findlay

You said that some staff move for professional reasons. We have heard in evidence that there is less time for the remedial work that social workers want to get involved in. There is less time to help people, as opposed to being the big bad social worker who does something bad to people. Is that a reason why people move on? Do they think that there are better opportunities to do the work that they are trained to do, as opposed to the side of the job that is not very nice?

Jo Macpherson

That can be a feature. People can want an opportunity to do more intensive and, as they perceive it, therapeutic work. However, many people remain in post who are very skilled, who have practised effectively over the years and who work effectively with other agencies. There is mutual trust between professionals who know each other and work well to support families.

What flexibility do you have to help you to retain experienced staff whom you do not want to leave? Is there such flexibility?

Jo Macpherson

Yes. We have created flexibility by increasing the number of social worker posts. That has enabled highly experienced social workers to have more time to focus on the more positive and direct work with families that they appreciate. Some of the other work has been moved to the newer social workers who can manage it. We have created more capacity, in the hope that that will stabilise our recruitment position and help us to retain our more experienced and qualified staff.

Is pay an issue?

Jo Macpherson

I do not think that it is the main issue.

Neil Findlay

The Association of Scottish Principal Educational Psychologists talked in its submission about a forthcoming shortage of educational psychologists. When I was a member of West Lothian Council, the administration cut educational psychologist posts. The Scottish Government says that there is no longer a shortage of educational psychologists, but that is not what the association says. Do panel members think that there are such shortages?

Jo Macpherson

I am not aware of any.

Jim Carle

I am not aware of any. If we are to distinguish between children with significant behaviour problems and children who have a mental illness, there is probably a need for a more robust role for educational psychologists and an argument for increasing the workforce. However, I am not aware of issues.

Is that because that is not your field of expertise or because you do not think that there is a problem?

Jim Carle

Educational psychologists are directly involved in all the multi-agency groups with which we work and in the locality groups under the integrated children’s services plan. We work quite heavily with educational psychologists. I am not aware of specific issues.

In my experience in teaching, the waiting times for appointments with educational psychologists were huge. Is that still the case?

Jim Carle

It is much less the case than it was when I was in practice. I have not looked at the national situation, but we do not have that issue locally.

Neil Findlay

That is interesting. At last week’s meeting, Brigid Daniel said:

“If you are going to remove a child from a situation, you need to do something to fix the situation before they go back.”—[Official Report, Education and Culture Committee, 14 May 2013; c 2362.]

Who provides the services that will “fix the situation” before the child is returned to the family?

Hugh McNaughtan

As a panel member, I would expect to look at various things if we were to make an order for a child. If there was an addiction problem, we would expect the parents to sort that out, although we cannot put that in an order. If the problem was something else, we would expect education or social work services to deal with that if they could do so. We are talking about whatever is needed at that point for a family.

As has been said, we have got to make parents realise that they need to act quickly because, although nine months pass in the blink of an eye for us, that is a long time to an eight or nine-year-old. To get children stability and move them back home—if that is going to be possible—we need the parents to work with whoever they need help from. For instance, parents may need help with anger management, because anger can be brought on by addiction. We need everyone who is involved in the process to decide what is needed and ensure that the parent knows that they have to act quickly.

Jo Macpherson

A lead professional should be involved with every child and family to co-ordinate the work that needs to be done to ensure that children can safely return home to their families or their parents in a reasonable timeframe. That work should be clearly outlined, defined and measurable, so that people know when the targets have been met and when the child can return home.

That is part of the issue that we are investigating. There might be a temporary fix: the child goes back and then everything starts again. That gets to the crunch of what we are looking into.

Jo Macpherson

In West Lothian, most of the children who become looked after away from home probably do not return home quickly. Such a lot of work is done to support families and children living at home in their own families that, when the decision is taken that children should no longer remain at home, a more permanent form of arrangement is likely to be needed. We are eternally grateful to the kinship carers in West Lothian who look after so many of our looked-after children and provide good care and the possibility of positive outcomes for those children.

Neil Bibby mentioned health visitors’ case load. What would a typical social work case load be in West Lothian for a children and families social worker?

Jo Macpherson

A social worker works with about 15 families. We tend to take a view of families, as opposed to individual children. Some social workers work with fewer than that; that depends on the level of complexity and on their experience.

That is interesting. I think that it was said that the case load in Glasgow is 30 to 35 families.

Donald Urquhart

I think that it is. As the chairman of the child protection committee in Glasgow, I would say that that number is not indicative of the number of children involved, for example, as Jo Macpherson said. When the family group is very complex, the number of cases that a social worker carries is likely to be significantly fewer.

To go back to the question about health visitors, the scale of the problem in Glasgow is significant, compared with other authorities in Scotland, to the extent that we benchmark against other areas in the United Kingdom that have a similar demographic. We face issues of such a scale that we have to look at what areas such as Manchester and Birmingham are doing, at what the results of inspections by the Office for Standards in Education, Children’s Services and Skills in those areas are and at what we can learn from the experience down there.

The significant challenge in Glasgow concerns neglect. There are a number of reasons behind that, such as drug and alcohol issues, mental health issues, poor quality housing and so on.

George Adam (Paisley) (SNP)

The submission from the health commissioners suggested that there is not so much cross-boundary working together by organisations. To get that form of strategic planning, what would be the best way forward? Would it be to work with community planning partnerships and ensure better working together in that way? What is the panel’s view?

10:30  

Jim Carle

I think that community planning partnerships are located within the boundary, if you like, but the issue that we have is from the boundary into boundaries. As always, community planning partnerships certainly have a role to play in supporting the professionals, but the issue is at a slightly higher level than that. In this context, we are talking about community planning partnerships ensuring that their professionals have in place a health needs assessment for every child who is going to be transferred from a unit in a health board or local authority area to another area.

We must implement effectively the current guidance and legislation for those children and young people. I do not think that we are doing well enough on ensuring that the children who become looked after at home or looked after and accommodated have full health assessments in place. We have the information, but we are not pulling it together into a single format and we are not sharing it well enough with other agencies, including those across health boundaries. I would not want to pretend that we have got to the bottom of that issue yet, because it is a significant area for improvement.

Does Jo Macpherson have anything to add?

Jo Macpherson

I do not.

What did Jim Carle mean when referring to a higher level? How would you be able to interact at a higher level?

Jim Carle

The new inspection process that the Care Inspectorate has recently piloted includes health services and is picking up issues. In North Ayrshire, in our area, the inspectorate looked at children with a health needs assessment who had moved into the area and found that the assessments were quite poor.

The health service needs to recognise that it is responsible for the child and that it still has corporate parenting responsibility for every child who is born in its area and returns to it. We must develop systems that encourage and support that ownership so that we do not lose those children to the morass of different agencies trying to work together.

We have clear guidance that says that each child should have a health needs assessment completed. We also have the guidance on what is required in child and adolescent mental health services. Because of a number of issues, such as the availability of staff and resources and the speed with which transfers happen, there is a lack of notification from local authority partners outwith our area—not the partners that we work with, in the main—of when children come into our area, for example. That is a significant area for improvement, but that is now recognised and we are trying to push forward quite rapidly on it.

Neil Bibby has a brief supplementary question.

Neil Bibby

I will follow up on resources, specifically in Glasgow, which Donald Urquhart said has a particular problem with health visitors. We have heard that social workers’ case load is possibly higher in Glasgow than in, for example, West Lothian. Do areas such as Glasgow that have a particular problem or high numbers of children in care have sufficient resources? Is enough emphasis placed on such issues in money being diverted to areas such as Glasgow?

Donald Urquhart

I am the independent chair of the Glasgow child protection committee and I am not as closely involved in the financial issues in terms of the settlements for Glasgow City Council and NHS Greater Glasgow and Clyde, so I am probably not in the best position to respond to your questions. However, at yesterday’s child protection committee meeting, we discussed the amount of work that has gone on in relation to looked-after and accommodated children and the amount of additional investment that the council has committed to reducing the number of children in residential care and diverting them into kinship care or foster care. A significant amount of resources has been channelled towards that, which has been diverted from other areas of the local authority’s budget.

The senior social work manager who spoke to a paper yesterday said in response to a question from one of our health service colleagues that it is difficult to identify the demand sitting behind the number of children who are accommodated. That unspecified demand is a dark figure that we do not know about and which is likely to have resourcing implications.

One issue in particular applies across Scotland. In a discussion recently with our link inspector from the Care Inspectorate, there was an indication that all the professionals who deal particularly with child protection, which I am directly concerned with, are working under pressure. That reflects the resources available. There is only so much efficiency that we can get out of an individual before they begin to suffer. A huge amount of really good work is going on individually and on a multi-agency basis but, when people are under pressure, they will give at some point. The people who are likely to suffer from that will be children and families.

We have to be conscious that we are placing a significant burden on individual practitioners. That situation applies across all the agencies and the third sector organisations that contribute to looking after children effectively in Scotland.

The Convener

Thank you very much. I thank all the panel members who have come along this morning to give us evidence.

I suspend the meeting briefly so that we can change panels.

10:35 Meeting suspended.

10:39 On resuming—

The Convener

We have our second panel of witnesses today for our inquiry into decision making on whether to take children into care. I welcome to the committee Carolyn Brown, who is an area depute principal psychologist and is from the Association of Scottish Principal Educational Psychologists; Dr Helen Hammond, who is a paediatrician; and Detective Chief Superintendent Gill Imery of Police Scotland. Good morning to you all and thank you for coming.

Clare Adamson will begin the questioning.

Clare Adamson

We have taken evidence on the different methods for referring to the hearings system, and it was noted in evidence that 80 per cent of non-offence referrals to the hearings system are from the police. Last week, one of the academics who gave evidence—Brigid Daniel—suggested that the hearings system needs to be reserved for cases in which compulsory measures are necessary. What are your opinions on that? Do the police really continue to refer children to reporters in such large numbers, in comparison with other agencies? Why do so many of those referrals not reach the hearings stage?

Detective Chief Superintendent Gill Imery (Police Scotland)

I can certainly answer the first part of your question, on the motivation behind referrals from police officers. Members will appreciate that first-line officers have an insight into people’s lives and homes that many agencies do not. Officers are trained and encouraged to identify vulnerability, and the grounds on which they refer range from children being in a household in which there has been a domestic incident, to a parent having been arrested for a crime, to its being apparent through attending an address for an unrelated issue that there is neglect in the home, to the way in which the home is set up; for example, there may be no food or adequate heating or clothing for the children in the house.

It is one of the performance indicators for the new national force—Police Scotland—so we are very interested in keeping track of the level of referrals from us. We started as one force for Scotland on 1 April. In the first month, Police Scotland’s 14 divisions made more than 10,000 referrals to other agencies. In Edinburgh alone, the figure was more than 1,000 in one month. I appreciate that that is a high level of referrals.

There might be an argument for tiered referral. My view is that we should not dissuade front-line police officers from highlighting their real concerns about what they see in their duties, as I have described.

Obviously, I am not best placed to respond to the second part of Clare Adamson’s question, on what happens thereafter, and I do not think that my colleagues would necessarily respond either—I am not landing them in it.

The Convener

I know that you cannot answer the second part of the question, but does that indicate any issues with the referral process in the first place? In other words, are police officers correct in saying that children should be referred to the children’s reporter? Should the children be referred elsewhere? Is the fact that the number of referrals does not equate to the number of hearings indicative of an issue in how referrals are being made?

Detective Chief Superintendent Imery

I think that it is. I should clarify that the numbers relate to referrals to all agencies, but there is something in there about trying to separate out the lower-level concerns; I am not talking about things that meet the threshold for child protection per se. Colleagues on the previous panel referred to GIRFEC. Police Scotland is very committed to getting it right for every child and to working with partner agencies across the country to do that. The introduction of a named person in a school or health environment to deal with lower-level concerns is really positive. We could start to differentiate between concerns that are very early indications of what might manifest as problems later on, and quite chronic issues that are pressing and which need a response now. I suppose that we are all motivated to try to invest in the former in order to avoid the latter.

10:45

Carolyn Brown (Association of Scottish Principal Educational Psychologists)

Under the GIRFEC framework, there are multi-agency groups in some areas in Scotland—in some areas they are called young offender management groups—through which the police and other agencies work to divert certain youngsters to interventions that are more appropriate than a children’s hearing. For instance, if a young person has been charged by the police, some kind of drug intervention, work in school or other approach might be more appropriate.

A number of different routes can be taken, and that can help to manage referrals to the reporter, to an extent. In some instances, the approach has meant that referrals have dropped by as much as 50 per cent.

I will come on to questions about sharing information. Detective Chief Superintendent Imery talked in a previous answer about the possibility of having two tiers of referral. Will you expand on how that might work?

Detective Chief Superintendent Imery

In this area, which used to be the Lothian and Borders Police area, child concern forms were piloted in an attempt to capture lower-level concerns that would not meet the threshold for a child protection referral to the reporter, so that there could be intervention at an early stage. We are in the process of transition to the new service, and we are taking good practice from all over Scotland, so Police Scotland is looking at rolling out child concern forms as part of our approach to vulnerability in communities. Now that we have amalgamated the forces, we have a fantastic opportunity to get the best of all worlds and to ensure that there is a consistent response throughout Scotland, so that communities receive the same level of service, wherever they are.

The previous panel and witnesses at last week’s meeting said that there are in some cases difficulties to do with sharing accurate information, particularly for health professionals. What are the barriers to effective information sharing?

Detective Chief Superintendent Imery

As always, it comes back to training and communication. In truth, there should be no barriers to information sharing. In this country we have come an awful long way in overcoming inhibitions about sharing information. Data protection is oft blamed for inhibiting such sharing, but the legislation makes it very clear that information can be shared to prevent crime and to protect people—especially children. I am not for a moment saying that that works everywhere to the same extent.

However, there has been enormous progress and there is no reason why information sharing should not happen. GIRFEC is a good shared principle, to which we are all working. One of our performance indicators is to do with the percentage of case conferences to which police are invited and which we attend—it is currently about 90 per cent across Scotland. There is real willingness to share information. As I said, if anything, we are sharing too much.

Liz Smith

You said that there is willingness to share information, which might be true, but we have heard concerns about people’s ability to do so, partly because people come from very different professions and the system is not unified. Do you have comments on information technology or other concerns that the previous panel talked about?

Detective Chief Superintendent Imery

There are challenges to do with systems that do not speak to one another. We have that challenge in Police Scotland, which has legacy systems from eight police forces, all of which held information in different formats, to varying degrees. Part of the work on identifying vulnerability that I am talking about is the creation of a vulnerable persons database that we can all share and contribute to. That is the situation within one agency and I am sure that it is replicated with other colleagues.

I think that the system is working. There are workarounds; locally, people are creative about finding workarounds and sharing information appropriately, either at an inter-agency referral discussion stage, at the very earliest stage, or later at a case conference in the more formal setting.

Dr Helen Hammond

Health has often been seen as the big culprit in not sharing information. We have come a long way in the past 10 to 15 years in terms of GMC guidance, the guidance that medical defence unions give to practitioners and so on, so people are much clearer now not only that they may share information but that they have an obligation to share information—certainly in child protection situations.

That is not as clear if we are at that earlier level of concern about neglect in families—before we have reached a child protection threshold, which seems, in a sense, to free people up to share information. We have a little bit more work to do on training and support for professionals who are involved in the GIRFEC work streams at that earlier level. That is coming along and we are making good progress. People have a much better understanding of what the Data Protection Act 1998 says and means, but there are questions about what is relevant and proportionate and how we ensure that information, once it has been shared, is kept up to date.

Liz Smith

Concerns have been expressed in evidence, including the concern that it is very difficult to get professionals to agree on definitions of neglect. To what degree does that lack of agreement on the extent of neglect compromise the work that you do?

Dr Hammond

I think that people understand—certainly health professionals are clear about neglect. There is an issue of varying thresholds; in a city such as Edinburgh, practitioners who work in certain parts of Edinburgh probably have a higher threshold for what they think amounts to neglect than do professionals who are working in more affluent areas.

Is that a problem?

Dr Hammond

It is a problem because it leads to a lack of equity and consistency. Again, once we are working more regularly in a GIRFEC way—in an interagency way—across Lothian, applying the same principles and pathways, that should improve. However, there has been a problem with varying thresholds.

Liz Smith

You have highlighted the issue in Lothian, where you believe GIRFEC can change things. Are some local authorities better at working in a GIRFEC way and at ensuring that we do not have that problem, while in other local authorities that problem is more prevalent?

Dr Hammond

In Lothian, I work across four different authorities, but I am not clear about the situation across the whole of Scotland so I cannot answer the question.

Carolyn Brown

The situation is complex, as has been established in various written submissions. You have to look at it in a number of different ways. There is a lack of standardisation of resources among the professions and a lack of standardisation of procedures. On the procedural element and the structures that local authorities and health boards have in place, we are working towards that, from a GIRFEC point of view. There has been some success on that, but I agree with Dr Hammond that there is still work to be done.

Sharing of protocols is crucial, but we need to do that with an eye on the whole of Scotland. A significant further look at resources is needed in respect of achieving parity across Scotland. We have already heard about health visitors and I think that educational psychologists were also mentioned. In both those professions—along with others, I suspect—there is no standardised provision.

Would you defend a policy to include health visitors in the key groups that can address the issue at the very earliest stages?

Carolyn Brown

I will leave that question for my health colleague, but it seems as though there is a good argument for that.

Dr Hammond

The past 10 years has seen a shift away from health visitors having direct contact with very young children towards their having other roles and responsibilities, which has been an unplanned result of pulling back on regular surveillance of children.

We all understand that health visitors should not be routinely and repeatedly seeing very healthy, normally developing children, but we have lost something in terms of the direct contact between families and health visitors, which allows families to bring concerns and problems to their health visitor, whom they know well, and allows the health visitor to have a really good grasp of developmental stages and to pick up issues early on.

Not everybody would share that view, but as a paediatrician I can say that, from children’s point of view, we have lost something. Health visitors are hugely important. They are the first line of our defences in terms of picking up children who have problems and families who are in difficulty. We need to redress the balance in that respect.

Neil Findlay

Dr Hammond said that in different areas of Edinburgh there are different thresholds or different views of what constitutes neglect. One of the issues that we have heard about throughout the inquiry is hidden neglect, or “middle class neglect”. For example, parents who are professionals might be more articulate in challenging you and the assessments that you make. Will you tell us about your experience of dealing with such situations and the challenges that they throw up?

Dr Hammond

It is more difficult to identify neglect of that sort. Sometimes we identify it when a child is physically not growing. Sometimes we see it in the child’s social and emotional development, if they are experiencing emotional deprivation in a very busy household. Such issues are very difficult to address. It comes back to our understanding of the breadth of neglect, and to training and knowledge of the research literature.

Carolyn Brown

It is very difficult to pick up that sort of neglect. The sorts of difficulties with which the youngsters present follow through to schools. A great deal of evidence gathering and a great deal of skill are required. It also goes back to the point about information sharing. There is an issue about balancing children’s rights with parents’ rights under the legislation, which can be damaging to young people in the circumstances to which you refer.

Can you explain that a bit further?

Carolyn Brown

In relation to the legislation on additional support needs, the more articulate parent may make a case that is more to do with meeting their needs than the child’s needs. That might relate to placing a child in a special school when that is not really required.

Detective Chief Superintendent Imery

The police insight is into children who come from more troubled backgrounds. The insight that the police as an agency can have into children who might meet the threshold for care is skewed towards households to which we would be more likely to be called. The issue of hidden neglect, which occurs behind a façade of professional affluence, is much less likely to come to the fore, from a police perspective.

Are professionals robust enough in challenging such parents?

Dr Hammond

Those of us who have had a lot of experience probably are. However, I worry about the next generation. It takes a lot of experience, knowledge and understanding to be able to manage such situations. A strong multi-agency, multidisciplinary team approach is also needed. In those cases, we need to share the evidence and understanding that we have and make a plan together about how to address the situation. Families in those circumstances can be very difficult to tackle.

11:00

Carolyn Brown

That is right, and it takes up a lot of resources and time.

Colin Beattie

We have received evidence that many kinds of assessments are done by different professionals at different times. There seems to be a strong indication that professionals tend to go through a process of reassessment of what the previous professional has done, without taking into account the judgment, experience and skills of that other professional. Is there any way to stop things going back to scratch every time? That seems to be a waste of time, and it could delay things for the child.

Carolyn Brown

I do not think that professionals do go back to scratch on every occasion. There are a lot of good examples of very effective joint professional working. The structures and processes to provide the capacity for professionals to work together have to be in place, and co-ordination mechanisms are required in local authorities to ensure that the information is being shared.

At times, there is confusion among certain professionals about what information is most appropriate, which can lead to an identification of a need to do further assessment. There was talk earlier of a common culture, which is sometimes referred to as a shared language, but there is work still to be done in that regard. For instance, when a youngster leaves education, it is highly effective to ensure that all the educational information is made available, alongside everything else, rather than their having to do an IQ test to access services. That is an example of where we could break down more barriers.

Colin Beattie

The Association of Scottish Principal Educational Psychologists makes the point:

“A shared multi-agency perspective about neglect does not currently exist within local authorities.”

It might be an aspiration to get there, but we are not there at the moment.

Carolyn Brown

That is right. I do not know whether my colleagues wish to comment about that. As we have already mentioned, there are pockets of very good practice and there is a national risk assessment tool, and we are working towards a national framework that captures all that, but we are not there yet. That is exemplified by what we experience on the ground as regards some young people—but not all.

What needs to be done to improve that?

Carolyn Brown

We need to do a number of things. We need to develop an overall national framework that incorporates specific data gathering around the extension of looked-after protocols. In local authorities, more and better predictive data needs to be used with regard to the resources that we actually need. The risk is that, when we are working together to identify neglect, any resource shortfall in the local area could impact on the identification process.

We have already said that resources are variable—specifically, the availability of professionals and of adequate care resources. I suggest that we need to consider how to address that, as well as refining the joint practice and shared information processes that we already have. We cannot have one without the other if we are to get the most effective provision. The difficulty at the moment, which has been mentioned, is the current pressures on staffing and the local authority cuts. All this is having to be done within limited budgets.

Neil Bibby

Strategic resource planning is also mentioned in the written evidence from the Association of Scottish Principal Educational Psychologists, which states:

“There is a pressing need to address staffing shortfalls in specialised support services.”

Will you expand on the resource issues? Which specific areas lack resources? Is it one particular agency or is it across the board?

Carolyn Brown

You have already heard from other people that there are significant pressures across most services. I think that that is true of everybody. I do not particularly want to make this a platform for educational psychologists but, in the written evidence, I draw attention to the fact that educational psychologists are in a difficult place at present in terms of staffing. In 2001, when the Currie report was sanctioned by the Scottish Government, it was deemed that there was a crisis in the educational psychologist provision across Scotland. At that point, the provision was just under 380 full-time equivalent psychologists. It is now 388, and the difficulty is that we have had our funding cut.

Some 25 per cent of psychologists are over 55, so they are eligible to retire shortly. We are concerned that we will be unable to attract educational psychologists to the profession in future, and we are worried that we will not be able to fulfil our integral role in carrying on all the implications of GIRFEC and the young people’s bill.

Neil Bibby

Would you say that there are not enough staff for multi-agency decision making? Is the result of that for children in care that one agency drives an agenda and the others acquiesce? That could happen if, for example, educational psychologists do not have the necessary resources or time.

Carolyn Brown

There is a risk of that. I do not want to go on about educational psychologists, but they have a unique role. They work at all levels of the system, which is critical to contributing to planning for young people in care. We are aware that it is difficult to recruit psychologists to rural services as it is. The answer is yes, basically.

Neil Bibby

My next question is on GIRFEC and, for want of a better phrase, the postcode lottery, given that there are different policies in different areas and they have different impacts. GIRFEC has been with us since 2006 and it has been further developed since then. What is preventing GIRFEC from working properly?

Dr Hammond

The issue was getting all the protocols, pathways and training in place, and now it is about resources. To follow on from the comments of my educational psychology colleague, I add that the world of paediatrics is under great stress at present. It is extremely difficult to recruit, particularly to the community paediatrics part of paediatrics and to child protection and services for vulnerable children. That is a huge issue. Although, in a sense, the paediatrician plays a relatively small role in the big picture, they are important. I go back to what my colleague said about confronting some very difficult situations. In giving medical evidence to courts and so on, paediatricians play a crucial role.

In particular, there is a tendency to see the assessment as more important than the contribution that the professional might make to a multi-agency, multidisciplinary planning meeting. However, from where I am sitting, health professionals of whatever kind can often contribute more in that multi-agency setting to a good discussion about the child and to making a plan for the child than they might do sitting in their consulting room doing an assessment. We need to be thoughtful about that and we need to be careful in our planning about how we shape health services so that we properly support GIRFEC and the pathway for looked-after children and child protection.

Detective Chief Superintendent Imery

One barrier is the structure in Scotland, where we have 32 local authorities, 14 health boards and previously eight police forces. Police and fire are the first agencies to have undergone that kind of radical restructuring, but there is definitely an issue about the extent to which we can achieve consistency as one part—and, actually, the smaller part—in such discussions. By the time an issue gets to us, it is too late and everything else has not worked. The police are only a tiny part of the whole context, but they are the only part of our response to communities in need that is being reorganised.

As I mentioned earlier, we currently have the chance to identify leads for areas of work or workstreams to provide a direction for all police response across Scotland, but there is no such equivalent in other settings. From a partnership point of view, that can be challenging because, when I am setting up groups for Scotland, I am looking for someone who can sit with a similar mandate for areas such as education and health to realise consistency for public protection across the country. At the moment, we cannot do that.

Joan McAlpine

I have a brief supplementary for Ms Brown on what she said about the difficulties that the 2001 report threw up for educational psychologists. What is your view on the response to that 2001 report? I am surprised to learn that more educational psychologists were not recruited as a result, given that there was probably more money around then than there is now.

Carolyn Brown

At the time, more educational psychologists were recruited and the courses were fully funded. In the survey data that ASPEP collects, which we have given to the Scottish Government, we have basically seen a fall in the number of educational psychologists in Scotland, which was much higher five years ago than it is now. Off the top of my head, I cannot quite recall the number, but it was way over 400. Over the past three years, there have been significant cuts across Scotland, so that is why we are back to square 1.

Neil Findlay

You have partly answered this, but we heard competing evidence this morning from Mr Carle, who said that there was no issue, as far as he was aware, with the provision of educational psychology. However, we have heard a completely different perspective from you. Certainly in my experience of teaching in schools, there were huge waits for initial appointments, delays and all that kind of thing. Is that the reality on the ground at the moment?

Carolyn Brown

I heard Jim Carle’s evidence, but I would refer back to my point about the lack of standardisation across Scotland. It may well be the case that there are more educational psychologists in Ayrshire, but that is perhaps for those authorities to comment on. However, certainly, on the ground, most psychological services in Scotland are reporting that they are struggling. The data that we have collected shows that at least 60 per cent of services are reporting that they are having difficulty meeting all their statutory requirements.

11:15

The Convener

To be fair, it was not just Mr Carle who said that. Mr Findlay asked all four members of the first panel about that, but none of them thought that there is a particular issue with educational psychologists. It is interesting that your opinion is clearly at odds with the opinion of those four witnesses.

Carolyn Brown

I take that point, and I heard that. That is understandable because, obviously, those witnesses might see educational psychologists turning up to the meetings that they have prioritised. On Neil Findlay’s point about the waiting list in schools, psychologists have always tried deliberately not to have waiting lists, but there is no doubt that they are having to prioritise meetings and not turn up to things or start to have waiting lists.

Neil Findlay

We all have heavy workloads, as the second item on our agenda verifies but, if our work is delayed, no one is harmed or injured. However, if your workload and that of the professionals with whom you work get so large, people are harmed or injured—that is the reality. Are the professionals with whom you work struggling with the amount of work that they are having to take on? We are trying to establish what the case load of professionals is. How many people would, say, an educational psychologist have on their case load?

Carolyn Brown

Again, that is variable across Scotland. Psychologists tend to work on an area basis, with clusters of schools and population. Some psychologists work to 6,000 per psychologist; others work to less than that. It is complex because of the range of services that psychologists offer, which go from casework to being part of strategic planning groups and research. I do not want to take up the committee’s time, but I am happy to give you more information about psychologists’ workload.

That is why you are here.

If you want to write to us with detail, we would be happy to accept that.

Carolyn Brown

I would be happy to do that if it would be helpful. We have a workforce planning report that I would be happy to send to the committee.

Thank you.

What about other professionals with whom you work? You deal with those people day in, day out. Are certain professionals or sections struggling, or is it just everybody who is under pressure?

Carolyn Brown

Are you talking just about psychologists?

No—I am talking about the professionals whom you work alongside in any discipline.

Carolyn Brown

The answer is yes. I back up what has already been said to the committee, which is that professionals generally are working under pressure. One role of psychologists is to support school staff. We provide quite a lot of support even just to headteachers in dealing with the pressures that they feel they are under. It is fair to say that the pressure is throughout the system.

Would any of the other panel members care to comment on that?

Dr Hammond

I think that that is right—the pressure is across all disciplines. Certainly in health, people are feeling the pressure and having to prioritise in a way that they would not have done previously. For example, a paediatrician will now go to a child protection case conference only if there is a specific reason to do so, because we just do not have time. That is not in children’s best interest. Carolyn Brown is right that the situation is the same across the board.

I thank the panel for attending. The session has been helpful. If any of the panel members wishes to send us additional information, we would be most grateful for that.

11:19 Meeting suspended.

11:24 On resuming—