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"It's everyone's job to make sure I'm alright"
Report of the Child Protection Audit and Review

Appendix B

International Perspectives on Child Protection

Report of a Seminar held on 20 March 2002

Malcolm Hill, Anne Stafford and Pam Green Lister
Centre for the Child & Society
University of Glasgow

Summary of key issues

Introduction

This report provides an account of a seminar about international perspectives on child protection, held on 20 March 2002. The report presents summaries of the main discussion points and implications.

The seminar was organised by the Centre for the Child & Society on behalf of the Scottish Executive as part of the Executive's review of child protection arrangements in Scotland, 'It's Everyone's Job to Make Sure I'm Alright'. The review was prompted by an inquiry into the death of 3-year-old Kennedy McFarlane. The aims of the review were to promote the reduction of abuse or neglect of children, and to improve the services for children who experience abuse or neglect. Members of the Scottish Executive and review team attended the seminar, along with individuals from other agencies who belonged to the review's Consultative Group.

The purpose of the seminar was to provide the Child Protection review with information and ideas from other countries to stimulate learning and thinking about how the Scottish system and approach to child protection might be improved. Such comparison would give an opportunity to examine alternative directions and critically re-examine the Scottish situation in the light of the differences and similarities that emerged. One of the speakers invoked a metaphor from a famous Scot, R.D. Laing, that:

'Comparison allows you to unpickle yourself from your place in the pickling jar and see that there is a different kind of life.'

It is possible for specific ideas to transfer productively across national boundaries, as the Family Group Conference has illustrated, but usually some degree of fit is required with the existing values and structures and also some adaptation to them. Probably just as important is that a comparative view helps highlight what is desirable and feasible to change, as well as what is worth retaining and strengthening.

Child abuse and child protection can be defined in very broad terms (National Commission 1996). In order to give the seminar a sharp focus and accord with the priorities of the review, it concentrated on the identification of intra-familial abuse and responses to abuse within the family.

Contributions to the seminar covered other 'Western' countries that are reasonably prosperous and have well established welfare systems, since the transfer of ideas, policies and practices tends to be easier between countries that have similar socio-economic systems. Within that broad common ground, contributors were chosen for their ability to share knowledge about child protection systems that were different from those in Scotland and/or included innovatory approaches. It was decided not to include contributions with a focus on England and Wales or the United States, partly because the bases for child protection in these countries are very similar to that in Scotland and they have been the most important external influences, hitherto. Also many of the easily available publications relate to the UK or USA.

The speakers at the seminar covered two types of country. Firstly, were those which have welfare state heritages akin to those of the UK and US - Australia and Canada. ⁶ Secondly, details were provided about several continental Western European countries, which have distinctive traditions in relation to social and family policy: Sweden, Belgium, France and Germany (See Esping-Anderson 1990; Hantrais 1995; Hill 1995; Clasen 1999). Two of the papers concentrated on a single country - Australia (Tomison) and Belgium (Marneffe), while the other two made comparative analyses of Canada and Sweden (Khoo, Nygren and Hyvönen) and of France, Germany and England (Cooper).

The rest of this summary of key points summarises the key points made in the plenary presentations. This is followed by a review of the main issues raised in workshop and plenary discussions, which were designed to draw out the points that had most impact on participants and to identify the main lessons for child protection policy and services in Scotland. A brief concluding section highlights the most important messages from the seminar.

Contrasts in overall approach to child protection

We begin with a brief overview of the main similarities and differences among the countries considered at the seminar, then present a brief review of each.

Some oversimplification is inevitable when making broad statements about national systems, let alone groupings of systems. There is often diversity within countries, especially those that are federal or have a high degree of decentralisation. All the countries considered at the seminar had considerable common ground, but the presentations and discussion suggested a major distinction between UK-North American-Australian and continental West European approaches ⁷ (see Table 1). Each of the speakers indicated how the principles and details of the child protection systems were linked to the wider socio-economic contexts and the nature of the social welfare system. While all countries were affected by the revival of economic liberalism in the 1980s, continental West European states have retained a stronger emphasis on social solidarity and public provision.

Table 2. Differences between British/American and Belgian systems

The papers at the seminar indicated that many of the recent developments in Canada and Australia have paralleled those in the UK and USA. Child abuse inquiries, responding to and fuelling public and political concerns, have promoted a focus on attempts to establish conclusively whether or not allegations are false and to identify the risks associated with abusive situations (Parton et al 1998; Waldfogel 2002; Cooper). The common first language has also facilitated mutual influence. Tomison also points to the influence of economic rationalism. However, some provinces and states have introduced much more standardised risk assessment and case response differentiation mechanisms than in Scotland.

By contrast, Sweden, France and Germany - for all their differences - have evolved more gradually, with a strong emphasis on family support and mediation. Belgium, like its neighbour the Netherlands, introduced major changes in the 1980s with the Confidential Doctor service, which placed at the heart of the system easy access to family treatment. It was noted at the seminar that in Sweden and Belgium child protection is rooted in traditional social policies that seek to provide social assistance and public services on a comprehensive basis. This means that not only can specialist services build on the foundations of universal general provision, but they also draw on a greater measure of goodwill towards representatives of the state than tends to be the case in the UK-North American-Australian systems. Cooper noted that in contrast with France, Germany and the other continental countries, the UK also has fewer or weaker institutions mediating civil society, so that relations between government agencies and the public tend to be more distant or antagonistic.

Among the features of child protection in Canada and Australia described by Tomison and Khoo et al. were the following:

• high input into investigation;
• prominent use of risk assessment models;
• detailed agency policies and procedures;
• child protection staff with highly specialist roles and often operating separately from other child welfare services;
• targeting of attention on high risk (strong signal) cases;
• mandatory or expected reporting of abuse; and
• ready use of compulsory orders.

As Marneffe pointed out, most of these characterise British and American systems too. She singled out the following contrasts with the Belgian approach:

Table 4: Contrasts in Welfare State and child protection systems

She notes, however, that the Belgian approach has been under threat as a result of Belgian governmental responses to the Dutroux case. The inquiry prompted moves towards a risk-avoidance, controlling approach as inquiries have done in the UK. Each of the speakers noted how risk-aversion strategies tend to limit the capacity for early intervention by concentrating effort and resources on 'high-risk' cases.

Hitherto Belgium has had a clear separation of its child protection services from legal frameworks and processes. This linked with an emphasis on confidentiality and was intended to promote confidence in professionals among those needing or seeking help. Also the family therapeutic thrust of the work entails mobilising families' own resources rather than doing things to the family (Marneffe). Likewise in Sweden the service works in solidarity with parents, as part of a well developed system of social welfare offered as a right, voluntarily, and with resources to support families. The threshold for intervention is low, so that any concern elicits an early, preventive response (Khoo et al).

Culturally different understandings: culturally congruent interventions ⁸

The presentations amply illustrated the complex ways in which cultural differences between countries imbue approaches to child welfare and child protection. Examples of different cultural understandings between countries and temporal changes in orientation include the lack of a term for child protection in Sweden, the recent inclusion of neglect as a form of abuse in Canada and changes in laws regarding sexual abuse in Belgium. The British and American readiness to sever kin ties and place children for adoption following abuse is alien to French and Swedish viewpoints.

A point crystallised by Cooper and generally accepted was the necessity for interventions to be culturally congruent - i.e. the wholesale importing of lessons from elsewhere would not be feasible. Cooper argues that interventions must be appropriate to the prevailing culture and the system.

However the cultural diversity within countries was also emphasised, indicating that a country's culture should not be understood as homogenous. Illustrations include the more parentalist approach taken by Quebec, with its French traditions, than other parts of Canada, and the different timing and nature of setting up specialist teams for child protection in the Flemish and Walloon parts of Belgium. In recent years, Canadian legislation has provided greater autonomy for Native peoples to organise their children's services in keeping with their beliefs and heritage.

Yet measures have been taken which stress that children have certain universal rights, which can be insisted on. These include the emphasis in law on the child's best interests in all the countries considered. The unconditional Swedish ban on the hitting of children indicates that there no allowance on the basis of differing attitudes is seen as acceptable, although the absence of such legislation in other countries illustrates the variety of views that exist on that point. In the UK concern has been expressed that professionals may be over cautious in intervening in black and minority ethnic families. The dangers of cultural relativism of this sort might lead to black and minority ethnic children being under protected.

All the countries give some scope for variation according to local needs and influences, but Sweden appeared to have the most decentralised system, with significant powers resting with many small municipalities. In Australia, Belgium and Canada the main level for determining law and policy was at the state, province or community level. Ontario appeared to have the greatest thrust towards standardisation of detailed practice, although this trend has also been present in some Australian states.

Risk assessment

The presentations about Sweden, Belgium and France showed that, although concerns about children's welfare are thoroughly explored, this is done largely as part of broad professional or judicial assessments in dialogue with family members in order to reach a shared view of the appropriate response. Evidence was presented from Belgium to show that the introduction of its confidential health-based system, using systemic assessment and intervention, resulted in a much higher rate of referral than previously, but with a very low failure rate.

In contrast the UK, US, Canadian and Australian systems have, to a greater or lesser extent, adopted some kind of more formalised risk assessment. Cooper refers to the widespread culture in child protection of risk aversion, performance monitoring and quality assessment. Risk assessment has a gate-keeping function by producing definitions and categories, which raise thresholds for intervention. This results in fewer people receiving attention from child protection agencies, which fits well with the residual model of welfare policy.

Accompanied by policies, guides, protocols and working definitions, precise risk assessment tools have been used in North America and Australia with the aim of ensuring judgements about eligibility for services or the need for investigation and intervention are standardised and comprehensive. Tomison and Khoo et al show that there are differences in how the systems are employed. In the USA risk assessment is used primarily after a decision has been taken that abuse has taken place. Some Australian states use the model at an earlier stage, as an initial assessment tool by centralised intake centres. In Ontario three tools of risk assessment are used in order to establish eligibility for services.

Tomison identifies the benefits and drawbacks of risk assessment models. Statistical models are considered to be more accurate and less judgemental. They enable decision making to follow logical steps and be more consistent from case to case, team to team. They can help target scarce resources and reduce high caseloads. Thresholds are transparent and they can assist inter-agency working when agencies are working to a common conceptual framework.

One danger is that they can act as a rationale and means of limiting resources. Unless accompanied by family support work, they may mean that early intervention to prevent situations deteriorating is precluded. Risk assessment measures may also be applied inflexibly and result in mechanical decision making. No tool can include all abusive factors nor indicate the precise weighting that a factor or combination of factors can be given in any particular situation. Moreover, the research base for risk factor analysis has a number of weaknesses. Hence this approach needs to be used carefully, following appropriate training and alongside professional judgement.

Having considered several of the broader features and contrasts among the countries considered, we now present a brief overview of each country, summarising the material presented in the seminar plenary papers.

Developments in Australia (Tomison)

The Australian system varies from state to state, but there are many common features. Influences have included a large increase in reporting and hence workloads, a wish to provide more specialist and targeted services and a growing realisation of the extent of inappropriate labelling of cases as child maltreatment. Some states and agencies have adopted policies aiming to work more in partnership with families and to differentiate levels of risk and need. They were influenced in part by the British 'Messages from Research'. (Department of Health 1995). North American risk assessment models have also become popular. Tomison argues that the widespread use of risk assessment in Australia is in part a response to the desire to rationalise and in some instances minimise use of resources.

Several initiatives have been established to create tighter case management, notably central intake systems, differentiated responses and structured risk assessment. Central intake teams were introduced to replace more localised offices in order to reduce differences in practice, standardise responses and minimise the impact of resource issues on decision making. There is evidence of some success, for example enabling departments to target scarce resources to the most dangerous cases. However, the teams have usually experienced increased demands, which need to be planned for and responded to with appropriate resources. Moreover, performance indicators based on recorded levels of child maltreatment may encourage staff to improve the figures by re-defining cases rather than through any change in family functioning.

Often central intake teams use a differentiated response system, which relies on categorising families and then taking action that differs according to the category. A variant of this in Victoria (the Enhanced Client Outcome System) has proved popular with staff and is experienced as less intrusive by families. Like most systems, it is more difficult to implement when families are unco-operative.

Besides altering their case management systems, certain agencies have pioneered new ways of helping families. For instance, the Strengthening Families Model in Victoria provides support to families 'at risk' to prevent them becoming child protection clients. Staff work primarily to build on families' strengths rather than modify their deficiencies and seek to engage families in developing their own solutions. Multi-disciplinary teams have been established to deal with all stages of child protection from investigation to intervention. Despite developments such as this, Tomison admits that the Australian system is still struggling to develop better inter-agency partnerships between professionals and to provide parents, particularly those defined as 'at risk', the support they need to address their problems.

Like other speakers Tomison argues that the investigation-driven child protection responses of the early 1990s will fail without support and other preventative services. American evidence about the effectiveness of early intervention programmes has begun to influence Australian agencies. These are increasingly seen as a cost-effective means of preventing social ills like child maltreatment through promoting social competence and fostering resilience. Whole community projects are also proliferating. These have comprehensive strategies to promote mutual help, participation and volunteering in communities, alongside early intervention programmes.

Child protection in Ontario, Canada (Khoo, Nygren and Hyvönen)

Khoo, Nygren and Hyvönen highlight differences between Ontario in Canada and Sweden, with the former apparently having more similarities to Australia - and Scotland. The principles behind child welfare legislation in Ontario are very similar to those of the Children (Scotland) Act 1995. However, in practice there has tended to be an even more sharp emphasis on 'least intrusive intervention' for the majority of cases and concentrated attention on 'high risk' cases. Much stress is placed on efforts to differentiate cases that need full investigation and to take legal and procedural steps in accordance with detailed protocols. Central to the work is the use of highly structured and standardised risk assessment measures resembling those used in parts of Australia.

Workers have the advantage of clear guidance and standardised ways of acting. The main goals are to determine the extent of harm or dangers to children and to take measures to ensure safety. The image and status of social workers dealing with child protection is low, partly because their investigatory and intervention functions are segregated from positive family service.

A high proportion of children (compared with Sweden) are removed from home. Most are in care under a court order and in many of these cases birth parents' responsibilities and rights have been transferred by means of permanent wardship.

Protecting children in Sweden (Khoo, Nygren and Hyvönen)

In Sweden child protection does not constitute a distinct system, but is embedded in a wider system of child welfare. Indeed there is no equivalent term for 'child protection' ⁹ and the idea of investigation is alien, replaced by assessment. Social workers in Sweden have relatively high status and a positive image. This both reflects and contributes to good relations with the public in general and, usually, service users. Most staff are experienced and well trained.

Child welfare personnel operate within broad duties under family law, which leaves them considerable discretion. They have a duty to intervene if there are signs that children are showing unfavourable development. Referrals are dealt with by means of the typical methods of engaging with families and formulating social work assessments, without recourse to specific risk assessment models. The orientation contrasts strongly with that in Ontario:

Table 6. Ontario and Sweden compared

Unlike Canada (and Scotland), the principles and procedures of permanency planning have had little influence in Sweden, especially as regards the stress on use of the law to over-ride parental wishes when this is seen to be in children's long-term interests. The Swedish child welfare philosophy is strongly committed to birth family preservation (except in extreme cases). Practitioners regard foster care arrangements as a positive long-term alternative for children, so that adoption and removal of parental rights are seldom considered as options. Flexibility and patience are seen as preferable to strict time limits for progress. An example of the great lengths taken (and expense incurred) to work with families to keep them together while ensuring appropriate care is the possibility of housing whole families together for four months for assessment.

The Belgian alternative (Marneffe)

The Swedish system is very different from that in Scotland, but in many respects resonates with the situation in the UK before Maria Colwell and permanency planning, but significantly enhanced by high quality staff, a wide range of resources and family support orientation advocated during the 1990s (Department of Health 1995; Canavan et al 2000). The Belgian confidential doctor system, however, has at first sight few resemblances. The principal means of dealing with concerns about children's welfare is not through inter-agency investigations with social work agencies taking a lead role. Instead cases are handled by a multi-disciplinary team led by a medial practitioner. As in Sweden, the aim is to engage with the family as a whole on a voluntary basis, whenever possible. Assessment of harm and risk is not the main priority. Rather systemic family therapy principles and methods are used to help parents acknowledge their problems and responsibilities and to achieve change.

Not only is the Confidential Model distinctive, but its introduction contrasted with both the inquiry-driven nature of British policy change and the gradual evolution in Sweden. During the 1980s the Belgian government took a decision to revolutionise the system of child protection by creating the specialist 'Confidential Doctor' service. Marneffe herself was centrally involved in shaping the new system in Belgium, and is currently Director of one of the multi-disciplinary centres set up for prevention and treatment.

Behind the new system lay the principle of not considering child abuse and neglect to be the act of pathological parents but as having grown out of wider social problems. The new system was also designed to give the quality and respect to service users that all families and individuals should be entitled to receive. This would help minimise stigma and avoid the provision of inferior services for the 'undeserving', so that families are encouraged to approach the team in the knowledge that they will not be reported or blamed. Hence access to the service is free, anonymous, confidential and usually inclusive of both parents. When children refer themselves, then confidentiality is normally maintained unless or until the child wants the parents to be involved.

The system is clearly separated from the police and courts. Professionals are not actively looking for proof of ill-treatment, but assist the family to talk openly about family problems and the consequences for the child, in order to establish a shared plan for improving care and protection of the child. Parents are not required to make a confession, but it is made clear to them that the professionals know abuse has occurred.

The service thus has gained positive connotations for actual and potential clients, in keeping with the generally rights-based approach to welfare provision more generally in Belgium. As in Sweden, the professionals operating the service have public respect. Marneffe argues that parents are usually willing to co-operate, since they are less fearful of being punished or having their children removed than in the UK. Moreover, staff are encouraged to focus on positive change within the family, since separation is not a ready option.

The Confidential Doctor service does not deal with all child abuse cases, however. Just under 10% of abusive parents are considered impossible to cope with, for instance on account of chaotic drug addiction or chronic mental health problems. Marneffe claims that the system quickly identifies those families who will not co-operate or cannot be helped, making it possible to take legal action quickly.

Lessons from other European countries

In the final paper presented, Cooper drew on his experience of comparative research in France, Germany and several other European countries to reflect on the general values and principles that underpin different systems and to draw out possible implications for England and by extension Scotland. He argued that each system is a product of a particular history and context, so that wholesale transposition to another country is unrealistic and undesirable. Rather, it is important to see what might work in the context of the UK or Scotland.

Furthermore, no system is problem-free. In all the countries he and his colleagues studied, they found that child protection work was complex and conflicted. Therefore it is unhelpful to expect any system to be satisfactory for everyone. He argues that effective intervention is only possible if the system is flexible and supportive in relation to the anxieties and conflicts workers face.

He believes three vital and interdependent elements provide a basis for judging how systems do or should operate, namely trust, authority and negotiation. For instance the nature of authority held by key professionals and agencies is linked to the capacity to build and sustain relationships, and develop trust in those relationships. While British and kindred systems have sought certainty of judgement as the main guide to action, other systems allow more time and space for negotiation to reach consensual plans. The French Children's Judges, for example, rarely use their authority to impose measures, but instead develop trust and negotiate outcomes with professionals and families. In contrast to English Family Courts (though with more similarity to Scottish children's Hearings), cases can be considered without full legally admissible evidence. When the French children's judge does make an order, s/he is bound to seek parents' agreement, reflecting the strong emphasis on kinship continuity in French traditions. ¹⁰ As in Sweden and Belgium, this happens in a context where removing children is rarely the main option and, partly as a result, parents seem less fearful of the system. Similarly, conflict of viewpoint and interest is regarded as something to be worked with, rather than necessitating separation.

Cooper argues that the split in England between child protection work and the system of family support, as in Ontario and Australia, makes the process of using authority to build trust and negotiate more difficult. He raises the interesting notion of the need for an alternative negotiated space where conflict can be named, discussed and maybe averted (as happens in France and Belgium). The ability to negotiate depends on trust, i.e. beliefs that the other party has your interests at heart and is acting in good faith.

Interestingly, Cooper has begun testing these ideas with some success in Nottingham in collaboration with the NSPCC. A Multi-agency Consultation Forum for Child Protection has been set up for staff working with high-risk complex cases with a view to providing authoritative but reflective consultation on plans and decisions. It authorises workers to exercise professional judgement in difficult circumstances, with the long-term aim of institutionalising reflective consultation to replace the culture of proceduralism which has dominated social work practice in recent times.

Issues highlighted and discussed by seminar participants

The papers provided much food for thought and provoked widespread interest and discussion among participants. This chapter reviews issues and themes that were raised in the workshops and final plenary discussion. Workshop groups were asked to identify:

• What were the key points that interested them?
• The implications for the work of different professionals and agencies in Scotland.
• What might work in Scotland and what not?
• What changes might be needed in law, policy, services and practice?

The main points were recorded at the time and a summary is presented below, grouped into broader themes. Naturally, many of the issues are interconnected.

How much change is desirable or possible?

People were generally agreed that any alterations in the Scottish child protection system should be compatible with prevailing values and principles. Different views were expressed on whether incremental or radical change is needed. Some saw the current review as an opportunity at least to consider a fundamental transformation. The introduction of the Hearings in Scotland during the early 1970s and the Belgian child protection reforms of the 1980s demonstrated that wholesale innovation can be made. Others suggested that the political and cultural climate was not right for root and branch change.

For some, the children's Hearings already offer many of the benefits attributed to continental European systems, such as accessibility, informality and flexibility. However, there are tensions and gaps between the Hearings processes and the agency-court systems for dealing with child abuse allegations. Many cases in Scotland still need to go to court for proof and there the adversarial nature of proceedings is very difficult for children and the chances of success are low. There was interest in examining more closely the differences and similarities between Reporters and Children's Judges in France.

The wider social policy and service context

One of the key messages to emerge from speakers, endorsed by participants, was the recognition that child protection was not simply a responsibility of dedicated services. The wider system of welfare and universal provision has a crucial influence on the nature of the child protection system and its capacity to respond to children's families' needs.

Moreover, attempts to change child protection policies and services need to take account of the fact that these are embedded in the broader welfare system and affected by attitudes towards the role of the state. One workshop group suggested a combined agenda of extended universal provision, an improved social inclusion agenda and child protection services developing pro-active engagement with families.

Several seminar participants voiced reservations about the French and Belgian systems, wondering if they glossed over issues of power, gender and race. It was also observed that most Continental European professionals find it hard to understand British anti-discriminatory perspectives. This difference in outlook was apparent in critiques from Scotland of family meetings, since the presence of the abusers (who are mainly men) could place children in very difficult if not impossible positions. Another point made was that by 'dealing' with sexual abuse as a within-family matter, the dangers to children outwith the family might not be attended to.

In various ways, it was noted that systems can be affected by fixed thinking. This was illustrated by the ways in which UK-North American-Australian systems tend to pursue legal and compulsory options, while Continental European professionals tend to assume a voluntary arrangement is usually desirable and possible. In the former, adoption is a possible outcome of child abuse, in the latter it is not. A different kind of observation was that professionals and academics may have different awareness and interpretations of research evidence, especially about the nature and prevalence of sexual abuse. ¹¹

Resources

The point was made that judgements that a system was not working well could result more from the dearth of support services than from the workings of the system itself. Partly as a result of the long-standing commitment to wide-ranging public services for families in many continental countries, assessment and decisions about families were made easier by the knowledge that suitable services were likely to be available. In Scotland, current shortages and work overloads were mentioned (e.g. with respect to health visitors, Reporters, forensic psychiatric places). Lack of staff was said to have diluted some services, while the channelling of money into special projects had left mainstream services starved.

Family or child orientation

In varied ways, the French, Belgian and Swedish systems all appeared to have as their primary focus the family as a whole or the child within the family. This contrasted with British emphasis on separating the interests of children, women and men in families (also found in Ontario and Australia).

The family orientation in continental Europe was presented positively by some as enabling professionals to engage productively with parents for the sake of children and avoiding as often as possible the need to separate children from their families and communities.

Others expressed concern that the child's interests might be subordinated to parents' rights and wishes. More particularly, it was feared that while agencies sought to work with parents, children could undergo continuing abuse, A linked worry was that family therapy may not address effectively issues of gender and power within families.

Also the presumption in favour of keeping the family together might prolong an unhappy experience in circumstances where in Scotland a child would be placed in a substitute family. It was suggested that for some children living apart from an abusive parent figure, any arrangement to meet that person would be unacceptably distressing. On the other hand, the present Scottish approach may be too rigid when children want the abuse to stop but also to maintain a relationship with the abuser.

It was proposed that children and young people should have more influence on the system. For instance, young people's forums and the availability of a designated person to assist a child could be helpful.

The relationship between judicial and therapeutic systems

Child protection in Australia, Canada and England has been marked by professionals' adherence to detailed legal duties and assessments geared towards potential or actual legal measures. Participants at the seminar saw the Scottish system as having a 'softer' legal approach as a result of the Hearings, which allows for child care issues to be handled without necessarily involving prosecution. Nevertheless concern was expressed that many children do not receive quick or appropriate help when they are involved with the courts, as the majority now are. It was also suggested that all the systems with a strong legal component have low rates of self-referral.

In Belgium and Sweden, the responses to child abuse concerns, except in extreme cases, are largely independent of judicial influences. French children's judges are very much involved in determining what happens, but act in a way that to British eyes may seem more therapeutic than legal.

Discussions took place on whether it is now possible in Scotland to think the unthinkable and not prosecute abusers in child protection cases. One powerful argument in this direction is that prosecution does not achieve the desired results. Children are put through extremely difficult proceedings and rarely see a satisfactory outcome. The length of time waiting for court creates problems and delays therapeutic work. However, non-prosecution would remove the opportunity of public disapproval and sanctions for unacceptable acts.

Space for negotiation

Many were intrigued by Cooper's suggestion that it was crucial to clarify the basis of authority, trust and negotiation on which official child protection is based. Some stated that children's Hearings offered a fruitful setting for such negotiation as a matter of routine. Also attractive was the notion of a 'space for negotiation' on a more selective basis, with workers and families able to go and negotiate with external help when they had reached an impasse or were uncertain what to do. Similarly it would be useful to have access to a multi-agency consultation forum where workers can go and be supported in decision making around complex cases. One suggestion was that space should be created where people can negotiate self-reporting.

Despite the many differences in details, it seemed that Sweden, Belgium, France and Germany all shared the capacity to establish relations of trust with parents and children in order to negotiate agreed action whenever possible. Wide discretion was exercised by judges (France), doctors (Belgium) and social workers (Germany and Sweden) in order to adapt to individual family circumstances. This contrasted with the reliance on standardised procedures in the UK. That was also true in Ontario and Australia with the added dimension of highly formalised categorisations of families.

The quality, image and status of child protection professionals

The presentations had mostly examined the role of social workers as the lead professionals in child protection, except in Belgium and France. Many at the seminar were very struck by the contrast between the poor public image of social work and child protection services in Scotland and Ontario, especially compared to the favourable public regard for social work and child welfare in Sweden, the normalised access to the Confidential Doctor service in Belgium and the approachability and mutuality of French children's judges. A further point was that in the UK professionals experience a blame culture whereas elsewhere it is accepted that no system will prevent all child injuries or deaths, so there is a greater preparedness to accept risks and not to vilify individuals when things go wrong. The Dutroux scandal in Belgium has led the government to introduce changes that may undermine the trust and acceptance that has been built up by the Confidential Doctor centres.

The continuity of employment among Swedish child welfare workers also provided a striking contrast with high staff turnover in Ontario, which echoes the position in Scotland, where low job satisfaction and loss of skilled staff are common. The stability in Sweden presumably reflected greater job satisfaction and in turn was likely to foster confidence in experienced and familiar personnel. Another thought was that staff morale is likely to be better when they are given more autonomy and scope for negotiation.

It was seen as valuable for any citizen and members of families where abuse has occurred to have ready access to non-stigmatising, universal services. This could be via public health practices or school-based. Ideally such provision should be staffed by multi-disciplinary teams. The primary responsibility for children should not be owned by just one professional group. In remote areas of Australia, different professionals of necessity operate from a one-stop base. In a Scottish context, some people wondered if joint funding of child protection services and co-location of different professional groupings would be helpful. It is also necessary to ensure that good links are made between children's and adult services (e.g. in relation to drug misuse).

Community 'ownership' of child welfare and protection

The image of services signified a close connection between public trust of the system and its capacity to engage and then work positively with families. Some argued that it is a priority in Scotland to adapt and publicise the child protection system so that it gains the understanding and respect of the whole community and so that professionals are trusted to act in the interests of families. This requires gaining an active commitment by everyone to the project of child protection and child welfare, as illustrated by the saying ' it takes a whole village to raise a child'. The public were currently said to have a poor understanding of the Hearings system and the role of Reporters.

A number of people present at the seminar said that the public at large does not value children sufficiently. Also 'the family' is often idealised. Pejorative images of young people can be fostered by the media, as with respect to child prostitution. In Victoria, a public education programme has been developed to try and achieve better general understanding. School prevention programmes in Australia have now moved beyond stranger danger to encompass other forms of danger to children, including within their own families.

Confidentiality, referral and reporting

The Belgian system is premised on confidentiality, as the name of the service shows. It was recognised that this facilitates co-operation with parents, but questions were raised whether this might result in the child's views and interests being compromised.

Confidentiality is also a feature of the German approach. It was observed that confidentiality for young people, as in Germany, empowers them and may encourage more to refer themselves. Some qualms were expressed that adherence to children's wishes in this regard might act against their best interests. Also openness can help deal with problems more readily. The introduction of ChildLine as a confidential helpline service had been resisted at first, but was now widely respected.

Few families in Scotland refer themselves directly on account of abuse. Members of the public were seen as reluctant to intervene in relation to others. Schools and doctor's surgeries were seen as good access points. More children might be helped if child abuse was seen as a non-stigmatising public health issue, as in Belgium. In some parts of Australia, the school is a base for services. New Community Schools in Scotland could offer a similar opportunity.

The presentations indicated that it does not matter much whether reporting is mandatory or not. It is the response to any suspicion of abuse that is crucial.

Assessment and decision making

Some welcomed the idea of standardised risk assessment leading to differentiated responses. This could be seen as a form of triage, allowing practitioners to concentrate their efforts on the most needy. On the other hand, evidence from Australia and Canada indicates this may work poorly when it becomes largely an administrative measure. Warnings were also made about the danger that risk assessment schedules would take up a lot of staff time and lead to a more rigid response to families. Their use is also dependent on appropriate training.

More joint assessment extending beyond social work and the police could lead on to better shared understandings. Joint teams in the same location could work together effectively, though there would be a danger of becoming cut off from mainstream services. There is also a need to engage services whose primary orientation is towards adults (e.g. in relation to drug misuse, criminal justice).

Questions were asked about the checks and balances required in any system. Do the French judge and Belgian doctor perhaps have too much freedom to decide and act alone? Similarly, it seemed that social workers in Canada could operate without much external restraint.

Voluntarism versus compulsion

The idea of moving towards a system based more on voluntary agreement and partnership was attractive, but some discomfort was felt too. It was suggested that attitudes about criminality in relation to child abuse may change, as has happened with respect to abortion. Without fear of prosecution or other sanctions, some adults would be more willing to admit that they had ill treated a child and work towards change. On the other hand, might parents become too powerful in the process at the expense of children?

Removal of children from home

In the UK, inquiries, policies and practice have fluctuated in their emphasis on birth family preservation or continuity as a crucial component of children's interests and on the removal of children as a requisite for the safety and development of some children (Harding 1991). Nevertheless, in Scotland as in other UK-North American-Australian systems emergency removal remains a major if reluctant option in investigations, with adoption or permanent fostering regarded as the preferred choice for a small but significant minority of abused children. Knowledge of this has helped shape not only the anxieties of those undergoing investigation, but also the suspicious attitudes of many families in need and the public more generally.

At the seminar people were interested to learn that this is not a feature in all systems. In some European models the possibility of permanently placing a child in another family against parental wishes is barely considered and is anathema in some eyes. Presenters argued that when service providers have no alternative, they are more likely to find ways of achieving a satisfactory solution with the child's birth family. A further benefit is that families are much less fearful of professionals. Even where it seems impossible to work with the families, a 'clean break' is not espoused since the family is seen as a constant in a child's life.

Screening and unresponsive families

There was interest in the fact that across all the different types of systems, seemingly regardless of the approach, a relatively constant proportion of referred cases of between 7% and 10% proved very difficult or impossible to work. Although continental systems are usually more measured in their response than in the UK, it seemed that in Belgium at any rate a quick decision is made when families cannot be helped and alternative, usually court-based, action is needed. This ability to distinguish such families promptly would be useful in Scotland, where such cases may tie up a disproportionate amount of agency time unproductively. Canadian and Australian models do have a screening approach, but based on risk to the child more than prospects of working effectively with the family, although these two will often be related. Another matter to be addressed is the impetus in UK-North American-Australian systems to take action too slowly in some cases and too precipitously in others.

Prevention

Ideas about early intervention were generally welcome. The importance was registered of educating the next generation of parents so they are less liable to ill-treat children.

Domestic abuse

The effects on children of domestic abuse towards their mothers has received growing attention in Scotland. Reporters have experienced an upsurge in this kind of referral, as apparently have French children's judges. Uncertainty was voiced about whether this helps children. Questions were raised about whether family therapy models are appropriate or not. In particular, the emphasis on obtaining family agreement for decisions and actions could mean that parents' power and children's relative powerlessness produced outcomes not in children's interests. In Australia, school-based prevention programmes could be helpful, but the government's wish to portray the family as preponderantly benign may mean that attention to violence within the family is minimal.

Evidence-based policy

The seminar reinforced for some people the importance of having sound evidence, including comparative evidence. However, it is difficult to draw conclusions from national differences, since these can be caused by a wide range of factors. It was noted that broad indicators of children's well-being tend to reflect standard of living and levels of general welfare provision, rather than the specifics of child protection systems. Thus, both Sweden and Canada have very good records in this respect, even though the approach to child protection is very different.

Cooper observed that ideas about child welfare systems are culturally specific, so it is difficult to reach agreement about how to judge outcomes and is more useful to consider principles. The presentations emphasised the value of understanding differences and similarities in daily practice and the assumptions, often taken for granted, that underpin practice in different countries.

Several participants wondered if presenters were talking about the same kinds of family and levels of difficulty or risk, when describing different types of response. It was also unclear how far the apparent success of continental systems in facilitating co-operation in the majority of families was accompanied by a failure to gain a purchase with tough cases. Conversely, the UK-North American-Australian investigative approach may discourage openness generally, but use of the law may help some children where otherwise family closure would leave children unprotected from harm. Set against this is evidence from Australia and Scotland that authorities can be rendered powerless by the insufficiency of legally admissable evidence, whereas continental European professionals or children's judges have the authority to proceed.

Research can guide more specific developments. For instance, evaluations have shown the value of intensive home visiting, yet in Scotland the health visiting service is currently being cut back.

Several participants were conscious of significant gaps in the information routinely available in Scotland to guide policy-making and provide feedback about the operation of the system. There was interest in the idea of a 'Clearing House' along the lines of the Australian one outlined by Tomison. Funded by the federal government, it has an information, advisory, support and research role. There was interest in exploring the possibility of something similar for Scotland.

Conclusions

The aims and length of the seminar were not intended to create consensus about a way ahead for Scotland, but rather to stimulate thinking about possibilities for change. Hence this concluding section of the report does not provide a blueprint for action, but highlights some of the issues that apparently had a strong impact on most participants or that evoked divided responses.

In one way it can be seen as reassuring that all of the systems were grappling with similar issues and none was free of problems or dissatisfactions. In particular, everywhere it is difficult to cater for those families with little capacity to change.

Each of the papers contained details about innovations that might be adapted to the Scottish context, but there was broad support for the view that the most important thing is to be clear about the values and principles that should underpin services in Scotland dealing with child abuse and neglect. Also it was accepted that cultural differences shape welfare systems in various ways, reflecting different values and perceptions as regards child-family and family-state relations, so that grafting ideas from elsewhere needs to be done when they can adapt to the local context and vice versa. 'Bolting on' isolated developments may have limited success. Similarly, the capacity of specific child protection or child welfare measures to achieve change is limited unless they rest on a foundation of good universal services.

Equally it is important to examine or re-examine prevailing assumptions that affect choices and decisions. In several European countries, plans and actions may be seen as either restricted or liberated by the fact that court action is seen as a rare option and that domestic adoption of older children against parental wishes is virtually unheard of. Conversely, professionals in Scotland may be diverted from offering help or working towards voluntary solutions with parents, because of the emphasis on legal solutions.

Allowing for these cautionary comments, two contrasting directions appear possible.

The more fundamental one would be to align the system more with continental West European practices. Key features would include:

• a range of flexible preventive and therapeutic resources;
• an agency, profession or multi-disciplinary team taking the lead role in responding to concerns about children, This requires well qualified staff acting with flexible discretion and trusted by the public, service users and government;
• ready access by children and parents, as well as professionals, to the lead agency sited in a non-stigmatising context, ideally linked and identified with universal services;
• an emphasis on thorough assessment of problems and needs as well as risk, rather than investigation;
• therapeutic help offered quickly without the need to worry about forensic and evidential considerations;
• the goal of achieving solutions agreed with parents and children on a voluntary basis wherever possible;
• resort to the use of courts in only a small minority of cases, but with early identification of those families where this route is necessary; and
• allowing children's wishes about confidentiality and contact with abusing family figures to have a major influence on the timing and nature of communication and decisions.

For the most part, the feedback at the seminar on these qualities of continental systems and their impact was positive. Many of them run against the grain of British social policies, state-citizen relations and judicial traditions, but the Scottish children's Hearings system offers both a precedent for change and a value base that is more consistent with the above elements than the current thrust of central government, local government and court policies and practices. Legal requirements would have to be loosened for professional/judicial autonomy to operate as it does in Sweden, Belgium and France. The requirement to place more trust in achieving voluntary solutions with parents is appealing, but in the context of serious abuse is contrary to trends in the UK. These have moved away from a stress on family unity and optimism about change towards an emphasis on children's separate rights and confidence in the appropriateness of one parent or alternative families meeting their needs. Likewise the British propensity to consider separation when there is persistent violence towards children or women and preparedness to consider long-term compulsory 'clean breaks' would need considerable modification to accommodate a view that children's best interests are almost always located within persisting family relationships, even when these have been negative and disruptive.

Evidence about Ontario and Australia indicate an alternative direction, which involves refinement and standardisation of case and risk management. This would probably entail a less substantial adaptation of the present procedures and mechanisms for handling child abuse in Scotland. Among the key elements might be:

• specialised and possibly centralised intake systems;
• clear categorisation of families so that different kinds and levels of service are provided according to need and risk;
• better targeting of resources;
• more co-operative relationships with families where risk is not high;
• greater consistency of response; and
• emphasis on the child's safety as the primary consideration.

On the whole the presenters indicated more disadvantages than advantages in this approach, especially within a context of limited support services. However, there were also indications that as part of an overall strategy with a strong preventative component, developments along these lines can help overcome pervasiveness of suspicion and compulsion, while retaining the capacity to safeguard the care of children in extreme circumstances with unresponsive parents.

In all the countries considered, evidence indicated the importance of having a child protection service staffed by skilled, experienced people with high public status. Where this occurs in parts of Europe, it is associated with a willingness of society and the authorities to trust in professional judgement. Moreover, in Sweden staff turnover is low and job satisfaction reasonable, whereas in much of Scotland there is low morale and high staff turnover (as in Australia and Canada). These points suggest that attention and resources must be committed to professional education and public information.

In every presentation, the drawbacks were pointed out of having child protection arrangements too closely aligned with judicial processes and segregated from broader child welfare, family support or health promotion systems. Continuity with universal services fosters co-operation and reduces stigma. Yet all systems use compulsion for a minority of extreme cases.

It is important to clarify the relative balance among needs, risks and rights. Each system attempts to meet children's needs, protect children from harm, solve family problems and support parents, but they have different emphases and thresholds for making safety the over-riding consideration. In both continental Europe and parts of Australia, as well as elsewhere, a recent shift has been to work wherever possible with family strengths rather than deficits.

Certain specific ideas were attractive to many participants. The notion of creating space and time for negotiation is useful. Professionals are likely to welcome the opportunity to have time and access to external people in order to discuss their concerns informally. This could be particularly applicable when they are uncertain or the risks not great, without or before invoking the full child protection procedures.

In Scotland, as elsewhere in the UK, a recurrent problem has been the difficulty of giving children effective therapeutic help, because of the way action has been driven by the need to gather evidence for courts. This has often added to children's distress rather than alleviated it (Roberts and Taylor 1993; Westcott and Davies 1996). The Belgian Confidential Doctor system makes very early access to help possible, though some would not wish to import the emphasis on including abusive parents. In different ways, other systems as in Germany appear able to let (older) children's wishes guide communication and action. It would also be beneficial in Scotland to extend the multi-agency co-operation that has been established with respect to investigation into joint or collaborative therapeutic work, as in Belgium and parts of Australia. Whole community preventive strategies are consistent with current social inclusion initiatives in Scotland.

Another valuable measure would be the capacity to identify quickly families who are very unlikely to respond to change efforts. In this respect the prompt assessments made by Confidential Doctor teams produced outcomes that are aspired to by the risk assessment and differentiated response mechanisms used in Ontario and parts of Australia, even though its orientation is otherwise quite different.

A number of issues evoked complex responses and require further thought and discussion. This applied particularly to confidentiality and power relationships.

Evidently plans for any changes in Scotland should be based on thorough assessment of the strengths and weaknesses of the present child protection system, as has been carried out by other elements of the Child Protection review. The seminar showed that there are alternative values, principals, ways of staffing and organising services and specific mechanisms that could help improve arrangements to promote children's welfare and safety in Scotland.

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