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Friday, 27 January 2012

Call for vitamin D infant death probe

Call for vitamin D infant death probe

By Andrew Hosken Today programme, Radio 4

Coloured X-ray of the weakened bones and bowed legs of a child suffering from rickets Vitamin D deficiency can cause diseases like rickets

Two senior paediatric pathologists say they have discovered vitamin D deficiency in a significant number of children who have died of Sudden Infant Death Syndrome.

The doctors say that vitamin D deficiency and associated diseases such as the bone disease rickets could potentially explain deaths and injuries that are often thought to be suspicious.

And they fear that children with such deficiencies may have been taken away from their parents and placed in foster care for no good reason.

Dr Irene Scheimberg and Dr Marta Cohen believe their findings merit further investigation and research.

“I think there should be a commission that studies all these cases [which would] take into consideration the age of the children, the gender, the race and the way in which the way these families live – particularly when the children are still alive and living in foster care when they could be back with their families,” said Dr Scheimberg, based at the Royal London Hospital in Whitechapel.

The findings in children from London and Yorkshire followed the discovery by Dr Scheimberg in 2009 of congenital rickets in a four-month-old baby whose parents had been accused of shaking him to death.

Chana Al-Alas,19, and Rohan Wray, 22, were acquitted of murdering their son Jayden after the jury learned that his fractures, supposedly telltale signs of abuse, could have been caused by his severe rickets. Dr Scheimberg also discovered rickets in Jayden’s mother.

Michael Turner QC, who defended Miss Al-Alas, told the BBC that he was shocked by the lack of knowledge about vitamin D deficiency of some of the expert witnesses at the trial, held at the Old Bailey.

A newly born baby Bones of small babies with vitamin D deficiency can fracture with little or no real force

“No-one had ascertained until the post-mortem that baby Wray was suffering from congenital rickets; no-one had ascertained that the mother was vitamin D deficient herself,” he added.

“So we had a senior radiologist failing to diagnose rickets; we had a senior radiologist from Great Ormond Street Hospital failing to diagnose congenital rickets; and even more worryingly – in respect of the senior radiologist at Great Ormond Street – failing to understand in any way, shape or form the importance of vitamin D on the endocrine system [hormone-secreting organs] in the body.”

But a spokesman for Great Ormond Street Hospital challenged Mr Turner’s version of events.

“Jayden’s death was tragic. He came to Great Ormond Street with very severe injuries including a fractured skull and brain damage, and multiple other fractures. For the two days he was here, our priority was to try to save his life, but sadly this was not possible.

“Rickets, as conventionally understood, is diagnosed either from X-rays, biochemical tests, clinical findings, or a combination of these. We’re confident in the clinical view from our staff that his X-ray appearances were within the range of normal, and did not show definitive features of rickets.”

“Two radiologists reached this view at the time, and subsequent independent review by two other radiologists agrees with this view. We understand the diagnosis of rickets was made after his death, not from any X-ray findings, but through examination of samples under a microscope.”

In London, Dr Scheimberg discovered vitamin D deficiency in a further 30 cases. Vitamin D deficiency was found to be a cause of death in three cases. Cardiomyopathy, a disease of the heart muscle, was discovered in two small babies. A third died of hypocalcemic fits, a condition of low serum calcium levels in the blood caused by vitamin D deficiency.

Vitamin D deficiency was a co-existing finding in the sudden and unexpected deaths of eight children, so-called Sudden Infant Death or Sids; in five children with bronchial asthma and another five with combined bacteria-polyviral or polyviral infections. Two of the babies, including baby Jayden, also had fractures.

In Yorkshire, Dr Cohen found moderate to severe levels of vitamin D deficiency in 45 children, mostly infants aged less than 12 months, who died of natural causes. Of the 24 sudden infant deaths Dr Cohen investigated from this group, 18 – or 75% – were deficient in vitamin D.

Dr Scheimberg said severe vitamin D deficiency could make the bones of small babies very brittle and capable of fracture with little or no real force.

Continue reading the main story

“Start Quote

We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood.”

Dame Sally Davies Chief Medical Officer

“We need to investigate the vitamin D levels of these children carefully and the circumstances in which the bones fracture,” she explained.

“Obviously if you have bones that fracture easily then they will fracture easily they will fracture with any normal movement like trying to put a baby grow on a baby you will twist their arm. In a normal child you won’t produce anything. But in a child whose bones are weakened and [who have] an abnormal cartilage growth area, then it’s easier for them to get these very tiny fractures or even big fractures.”

Vitamin D is actually a hormone, and endocrinologists are experts in how the body is regulated by the hormone excreting glands – or endocrine organs.

Stephen Nussey is professor of endocrinology at St George’s Hospital at Tooting in south London. He believes that, despite repeated government recommendations on vitamin D supplementation, vitamin D deficiency is still not being taken sufficiently seriously by the authorities.

“Lizards are quite like humans in their vitamin D. Their dietary intake is pretty low and they need to have sun exposure and you need to have a light in the enclosure in which you keep your lizard of the right wavelength.

“If you don’t have one of those lights your reptile will get osteomalacia [adult rickets] very similar to humans. I guess the RSPCA would quite rightly prosecute you if you didn’t give your reptile vitamin D.

“But there’s no action taken against you if you don’t give it to your daughter. So that rather illustrates the importance placed on vitamin D for your reptile rather than giving it to your daughter.”

Earlier this week, the chief medical officer for England, Dame Sally Davies, wrote to doctors, nurses and other health professionals advising them to consider vitamin D supplementation for certain at risk groups, including pregnant mothers.

Mother and daughter The chief medical officer has said those at risk should take vitamin D supplements

“We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” she explained.

“Many health professionals such as midwives, GPs and nurses give advice on supplements and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at risk groups.

“The Department of Health has also asked the Scientific Advisory Committee on Nutrition to review the important issue of current dietary recommendations on vitamin D.”

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DAVID CAMERONS SPEACH AT THE COURTS OF HUMAN RIGHTS

Human Rights

Wednesday 25 January 2012

 

"the Court has got to be able to fully protect itself against spurious cases when they have been dealt with at the national level"

This is a ‘check against delivery version’ of the Prime Minister’s speech.

 

Prime Minister David Cameron:

 

“Once in a generation, each member has the honour of leading the Council of Europe.

Today, I want to speak about the once-in-a-generation chance we have, together, to improve the way we enhance the cause of human rights, freedom and dignity.

We have an ambitious agenda for the coming months…

…to reinforce local democracy…

…to combat discrimination…

…to strengthen the rule of law across Europe.

But the focus of our Chairmanship, as you know, is our joint effort to reform the European Court of Human Rights.

The role of the Court has never been more challenging.

As the Council has expanded, more and more people have applied to seek justice.

We need to work together to ensure that throughout these changes, the Court remains true to its original intention: to uphold the Convention and prevent the abuse of human rights.

So today, I want to explain why I believe the Court needs reform and set out some of the proposals on the table.

 

UK Commitment to Human Rights  

First, I want to make something clear.

Human rights is a cause that runs deep in the British heart and long in British history.

In the thirteenth century, Magna Carta set down specific rights for citizens, including the right to freedom from unlawful detention.

In the seventeenth century, the Petition of Right gave new authority to Parliament; and the Bill of Rights set limits on the power of the monarchy.

By the eighteenth century it was said that:

“this spirit of liberty is so deeply implanted in our constitution, and rooted in our very soil, that a slave the moment he lands in England, falls under the protection of the laws, and with regard to all natural rights becomes instantly a free man.”

It was that same spirit that led to the abolition of slavery…

…that drove the battle against tyranny in two World Wars…

…and that inspired Winston Churchill to promise that the end of the “world struggle” would see the “enthronement of human rights”.

As he put it, victory in that war was the “victory of an ideal founded on the right of the common man, on the dignity of the human being, and on the conception of the State as the servant, not the master, of its people.”

These beliefs have animated the British people for centuries – and they animate us today.

When the Arab Spring erupted, the UK was a principal supporter of resolutions at the UN Human Rights Council.

We are leading EU partners in maintaining pressure on Syria.

We have played a key role in securing EU sanctions against Iran.

Through the UN, we are working to empower women in Afghanistan, Iraq and the Middle East.

We have pledged additional money to the Special Fund for Torture Prevention.

And we are contributing to the Council of Europe’s own Human Rights Trust Fund.

All these are clear signals of our belief in fundamental human rights.

And if called to defend that belief with action, we act.

When the people of Libya were reaching for the chance to shape their own destiny, Britain stepped forward with our allies to help.

Visiting Tripoli a few months ago, seeing the crowds of people who were jubilant and free, I was reminded of what Margaret Thatcher once said:

“the spirit of freedom is too strong to be crushed by the tanks of tyrants”.

It is our hope that this spirit of freedom spreads further – and we will continue to support those reaching for it across the Arab world.

We are not and never will be a country that walks on by while human rights are trampled into the dust.

This has a lot to do with Britain’s national character – a love of freedom and an instinctive loathing of over-mighty authority.

But it is also about our national interest – to live, travel and trade in a more open, secure world.

When a government respects its citizens’ human rights, that makes for a more stable country – and that is good for all of us.

It was that great champion of freedom, Vaclav Havel, who said it best:

“Without free, self-respecting, and autonomous citizens there can be no free and independent nations. Without internal peace, that is, peace among citizens and between the citizens and the state, there can be no guarantee of external peace.”

In other words, a commitment to human rights is both morally right and strategically right.

 

Achievements of the Council and the Court  

So I want no one here to doubt the British commitment to defending human rights…

…nor the British understanding that the Council of Europe, the Convention and the Court have played a vital role in upholding those rights.

But believing these things does not mean sticking with the status quo…

…because as we are agreed, the time is right to ask some serious questions about how the Court is working.

Over sixty years ago the Convention was drafted with very clear intentions.

It was born in a continent reeling from totalitarian rule…

…shocked by the brutality of the holocaust…

…sickened by man’s inhumanity to man.

Its purpose was clear: to spread respect for vital human rights across the continent – for life, liberty and the integrity of the person.

It has achieved some vitally important things over the decades: exposing torture; winning victories against degrading treatment in police custody; holding heavy-handed states to account.

And since the Berlin Wall fell, it has played a major role in strengthening democracy across central and Eastern Europe.

Of course, we should remember that oppression and brutality are not just facts of Europe’s past.

As we sit here today, in Belarus there are people being thrown into prison for their political beliefs.

Dissidents’ voices are being silenced and their rights are being crushed.

What is happening less than a thousand miles from here underlines the continuing importance and relevance of the Council, the Convention and the Court.

It reminds us that now, more than ever, we need a Court that is a beacon for the cause of human rights, ruthlessly focussed on defending human freedom and dignity, respected across the continent and the world.

It is in that spirit that I have come here to speak to you today.

Because today, the ability of the Court to play this vital role is under threat.

As I see it, there are three inter-linking issues that should cause us concern.

 

Too many cases  

First, the Court is being compelled to do too much, and that threatens its ability to do what is most important.

We have seen a massive inflation in the number of cases.

In the first forty years of its existence, 45,000 cases were presented to the Court.

In 2010 alone, 61,300 applications were presented.

This has created a huge backlog – more than 160,000 cases at its peak.

There can still be a delay of some years before cases are heard, which means tens of thousands of people with their lives on hold.

These will inevitably include some of the most serious cases: of detention; torture; people who have had their fundamental rights denied.

Let me be clear: impressive steps are already being taken to filter out inadmissible cases more quickly.

The Court should be congratulated on that – but a new problem is emerging.

More and more of the backlog is now made up of admissible cases that, according to the current criteria, should be heard in full.

Again, the Court is doing good work to deal with this.

A system to prioritise the most important cases is in place.

But the sheer volume risks urgent cases being stuck in the queue.

That means the very purpose of the Court – to prevent the most serious violations of human rights – is under threat.

 

Court of the fourth instance  

This flood of cases is linked to the second issue.

The Court is properly safeguarding the right of individual petition – and it’s a principle the UK is committed to.

But with this, comes the risk of turning into a court of ‘fourth instance’…

…because there has already been a first hearing in a court, a second one in an appeal court, and a third in a supreme or constitutional court.

In effect that gives an extra bite of the cherry to anyone who is dissatisfied with a domestic ruling, even where that judgement is reasonable, well-founded, and in line with the Convention.

Quite simply, the Court has got to be able to fully protect itself against spurious cases when they have been dealt with at the national level.

A good start has been made with Protocol 14, which makes clear that cases aren’t admissible if there is no significant disadvantage to the applicant.

The initial case where the protocol has been used shows exactly the kind of thing I mean.

The applicant was taking a bus company to court for 90 Euros compensation, because they felt their journey from Bucharest to Madrid hadn’t been as comfortable as advertised.

One of the matters at issue was that they didn’t provide fully-reclining seats.

The domestic courts had turned him down, and he was taking his case to the Court.

Now I think we can all agree that fully-reclining seats would be very desirable on a trip from Bucharest to Madrid…

…but we can also agree that this is a completely trivial case, and is not the kind of case that should be heard here.

The Court agreed – and quite rightly rejected the claim.

But this case just underlines how important it is for the Court to have that consistent power to control the cases it admits.

 

Slim margin of appreciation  

The third issue is that the Court is, quite rightly, determined to make sure that consistent standards of rights are upheld across the 47 member states…

…but at times it has felt to us in national governments that the ‘margin of appreciation’ – which allows for different interpretations of the Convention – has shrunk…

…and that not enough account is being taken of democratic decisions by national parliaments.

Let us be frank about the fall-out from this issue.

As the margin of appreciation has shrunk, so controversy has grown.

You will know that in the UK there is a lively debate about the way human rights law works, and how our own national courts interact with Europe.

Yes, some of this is misinterpretation – but some of it is credible democratic anxiety, as with the prisoner voting issue.

I completely understand the Court’s belief that a national decision must be properly made.

But in the end, I believe that where an issue like this has been subjected to proper, reasoned democratic debate…

…and has also met with detailed scrutiny by national courts in line with the Convention…

…the decision made at a national level should be treated with respect.

Another example of this – and one we can all agree on – is in the area of immigration.

At Izmir, we collectively invited the Court, “to avoid intervening except in the most exceptional circumstances.”

All states agreed that the Court was, in some cases, too ready to substitute its judgment for that of reasonable national processes and all agreed that that was not its role.

In other words, it should not see itself as an immigration tribunal.

Protecting a country from terrorism is one of the most important tasks for any government.

Again, no one should argue that you defend our systems of rights and freedom by suspending those freedoms.

But we do have a real problem when it comes to foreign national who threaten our security.

In Britain we have gone through all reasonable national processes…

…including painstaking international agreements about how they should be treated…

…and scrutiny by our own courts…

…and yet we are still unable to deport them.

It is therefore not surprising that some people start asking questions about whether the current arrangements are really sensible.

Of course, no decent country should deport people if they are going to be tortured.

But the problem today is that you can end up with someone who has no right to live in your country, who you are convinced – and have good reason to be convinced – means to do your country harm.

And yet there are circumstances in which you cannot try them, you cannot detain them and you cannot deport them.

So having put in place every possible safeguard to ensure that ECHR rights are not violated, we still cannot fulfil our duty to our law-abiding citizens to protect them.

Together, we have to find a solution to this.

These concerns are shared by many member states.

And at the heart of this concern is not antipathy to human rights; it is anxiety that the concept of human rights is being distorted.

As a result, for too many people, the very concept of rights is in danger of slipping from something noble to something discredited – and that should be of deep concern to us all.

Upholding and promoting human rights is not something governments and courts can do alone…

…it is something we need all our societies to be engaged with.

And when controversial rulings overshadow the good and patient long-term work that has been done, that not only fails to do justice to the work of the Court…

…it has a corrosive effect on people’s support for human rights.

The Court cannot afford to lose the confidence of the people of Europe.

 

Right moment for reform  

Taken together, these issues threaten to shift the role of the Court away from its key objectives.

The Court should be free to deal with the most serious violations of human rights; it should not be swamped with an endless backlog of cases.

The Court should ensure that the right to individual petition counts; it should not act as a small claims court.

And the Court should hold us all to account; it should not undermine its own reputation by going over national decisions where it does not need to.

For the sake of the 800 million people the Court serves, we need to reform it so that it is true to its original purpose.

Already 47 members are agreed on this, and great work has been done.

Now we would like to use our Chairmanship to help progress that work.

This is the right moment for reform – reforms that are practical, sensible and that enhance the reputation of the Court.

 

Our proposals 

So we are looking to improve the efficiency of the Court.

New rules could enable it to focus more efficiently and transparently on the most important cases.

We want to improve the procedures for nominating judges.

The Assembly needs consistently strong shortlists from which to elect judges – and  clear guidelines on national selection procedures could help with that.

And we are hoping to get consensus on strengthening subsidiarity – the principle that where possible, final decisions should be made nationally.

It is of course correct that the Court should hold governments to account when they fail to protect human rights.

In these instances it is right for the Court to intervene.

But what we are all striving for is that national governments should take primary responsibility for safeguarding their citizens’ rights – and do it well.

Subsidiarity is a fundamental principle of the Convention, and at Izmir, we were all clear that more needed to be done to give it practical effect.

For that reason, we will shortly set out our proposals for pushing responsibility to the national system.

That way we can free up the Court to concentrate on the worst, most flagrant human rights violations – and to challenge national courts when they clearly haven’t followed the Convention.

Of course, re-balancing this relationship is a two-way street.

The other side of the deal is that members get better at implementing the Convention at national level.

That is why, in the UK, we are investigating the case for a UK Bill of Rights, and thoroughly examining the way our liberties are protected.

Parliaments also have a key role – and we are proud of the role that our own Joint Committee on Human Rights plays.

And of course, this Assembly makes a vital contribution, helping states to honour their obligations.

Together, through these institutions, we can reduce the number of violations and ultimately ease the burden on the Court.

 

Conclusion 

Let me finish today by saying this.

With this Chairmanship we have a clear opportunity to agree a practical programme of reform.

Built on the noble intentions of the Convention.

Forged through consensus.

Driven by a belief in fundamental human rights and a passion to advance them.

This is undoubtedly a challenge – but it is a challenge we can meet together.”

PM speech on the European Court of Human Rights (ECHR) - Number 10

PM speech on the European Court of Human Rights (ECHR) - Number 10

Assessment and Diagnosis of Posttraumatic Stress Disorder

Lords vote against charging parents to arrange child maintenance

Thursday, 26 January 2012

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Children of all ages need to be able to rely on protection from the state

Children of all ages need to be able to rely on protection from the state

Vulnerable teenagers are often left to struggle alone as services concentrate on either children or adults

Teenage girl wearing gold sovereign rings and gold chains
Services often fail to identify or respond to risks that older children face, says Carlene Firmin. Photograph: Josephine Soughan/Simon Pentle/Rex Features

The conviction earlier this month of Gary Dobson and David Norris for the murder of Stephen Lawrence has given me a renewed sense of optimism and reminded me that change can happen, even if it takes years.

The strength and determination of the Lawrences and their supporters has not only seen shifts in practice within the police force but has ensured justice for a young man. Achieving that justice, even for one young person, required monumental movement across an institution that many believed was impenetrable. It makes me wonder whether change and justice for other young people and children can be achieved in other areas.

Older children experience a range of risks: some are victims of violence in their intimate relationships, others are killed or seriously injured by their peers. Thousands of older girls are at risk of genital mutilation, according to Home Office figures, some are forced into marriages or are victims so-called honour-based violence, others are sexually exploited. Many children run away and end up homeless, some are addicted to drugs or alcohol, or live in households where substance misuse is prevalent – the list goes on. The Children Act 2004 is clear that a child is a child up to their 18th birthday, and that all children should be protected from harm. Yet this sound legislation is applied in a practical environment that often fails to identify or respond to risks that older children face, and is determined by a range of services and entrenched societal attitudes that communicate conflicting messages about what abuse is and who needs protecting from it.

A child can consent to be in a sexual relationship from age 16 but cannot be a victim of domestic violence in that relationship until they reach 18. A girl can enter a domestic violence refuge with her mother at any age, but many refuges will not take boys with their mothers once those boys reach age 14. In the confusion, many services struggle to respond.

When I used to go and speak to children in schools across the country, I wanted to be able to say to them that if they were being abused I knew what the response of services would be: they would know how to keep them safe. The fact that I couldn’t, and still can’t, is unjust.

Last year, the Munro review into child protection started a process of opening up and challenging child protection practices that may have seemed as impenetrable as the police force once did. However, improving children’s services alone will not provide solutions for protecting older children. They encounter a mosaic of interventions from health, criminal justice, education and housing agencies, to name a few. Whose responsibility is it to offer protection, and what should this protection look like?

Extending services that deal with violence against adult women to include older girls will not provide the safety needed: they are not adults. Likewise, children’s services often fail to respond to the different risks faced by older children.

Changing policing practices and achieving justice for Stephen Lawrence seemed like an impossible dream. In 2012, policing is not perfect, but change has happened. Whether it’s tackling gangs and serious youth violence, child sexual exploitation, or violence in teenage relationships, we urgently need practices that protect all children from all forms of abuse.

• Carlene Firmin is a principal policy adviser at the Office of the Children’s Commissioner for England. She is writing in a personal capacity.

Children of all ages need to be able to rely on protection from the state

Children of all ages need to be able to rely on protection from the state

Vulnerable teenagers are often left to struggle alone as services concentrate on either children or adults

Teenage girl wearing gold sovereign rings and gold chains
Services often fail to identify or respond to risks that older children face, says Carlene Firmin. Photograph: Josephine Soughan/Simon Pentle/Rex Features

The conviction earlier this month of Gary Dobson and David Norris for the murder of Stephen Lawrence has given me a renewed sense of optimism and reminded me that change can happen, even if it takes years.

The strength and determination of the Lawrences and their supporters has not only seen shifts in practice within the police force but has ensured justice for a young man. Achieving that justice, even for one young person, required monumental movement across an institution that many believed was impenetrable. It makes me wonder whether change and justice for other young people and children can be achieved in other areas.

Older children experience a range of risks: some are victims of violence in their intimate relationships, others are killed or seriously injured by their peers. Thousands of older girls are at risk of genital mutilation, according to Home Office figures, some are forced into marriages or are victims so-called honour-based violence, others are sexually exploited. Many children run away and end up homeless, some are addicted to drugs or alcohol, or live in households where substance misuse is prevalent – the list goes on. The Children Act 2004 is clear that a child is a child up to their 18th birthday, and that all children should be protected from harm. Yet this sound legislation is applied in a practical environment that often fails to identify or respond to risks that older children face, and is determined by a range of services and entrenched societal attitudes that communicate conflicting messages about what abuse is and who needs protecting from it.

A child can consent to be in a sexual relationship from age 16 but cannot be a victim of domestic violence in that relationship until they reach 18. A girl can enter a domestic violence refuge with her mother at any age, but many refuges will not take boys with their mothers once those boys reach age 14. In the confusion, many services struggle to respond.

When I used to go and speak to children in schools across the country, I wanted to be able to say to them that if they were being abused I knew what the response of services would be: they would know how to keep them safe. The fact that I couldn’t, and still can’t, is unjust.

Last year, the Munro review into child protection started a process of opening up and challenging child protection practices that may have seemed as impenetrable as the police force once did. However, improving children’s services alone will not provide solutions for protecting older children. They encounter a mosaic of interventions from health, criminal justice, education and housing agencies, to name a few. Whose responsibility is it to offer protection, and what should this protection look like?

Extending services that deal with violence against adult women to include older girls will not provide the safety needed: they are not adults. Likewise, children’s services often fail to respond to the different risks faced by older children.

Changing policing practices and achieving justice for Stephen Lawrence seemed like an impossible dream. In 2012, policing is not perfect, but change has happened. Whether it’s tackling gangs and serious youth violence, child sexual exploitation, or violence in teenage relationships, we urgently need practices that protect all children from all forms of abuse.

• Carlene Firmin is a principal policy adviser at the Office of the Children’s Commissioner for England. She is writing in a personal capacity.

Are there innocent parents convicted of shaken baby syndrome?

OSTEOGENESIS IMPERFECTA AND OTHER BRITTLE BONE DISORDERS

RADIOLOGICAL FEATURES OF THE BRITTLE BONE DISEASES

Radiological_features_of_the_beittle_bone_diseases.pdf Download this file

RADIOLOGICAL FEATURES OF THE BRITTLE BONE DISEASES

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FRACTURED OF THE FEMUR FISH ODOUR COPPER DEFICIENCY IN PRETERM

FRACTURED OF THE FEMUR FISH ODOUR COPPER DEFICIENCY IN PRETERM

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1626757/pdf/archdisch00783-0069.pdf

FRACTURE OF THE FEMUR FISH ODOUR COPPER DEFICIENCY IN A PRETERM

spiral_fracture_copper_deficiency.pdf Download this file

Vitamin D may not explain fractures in babies

Vitamin D may not explain fractures in babiesin Share 

 

NEW YORK | Tue Apr 12, 2011 4:23pm EDT

 

(Reuters Health) - Unexplained bone fractures in babies are usually due to abuse, but researchers have suspected that sometimes they could be due to low vitamin D levels. A new study now casts doubt on that idea.

 

Vitamin D is needed for healthy bones, and an overt deficiency can cause rickets, a softening in children's bones that may lead to pain and deformities like severely "bowed" legs and abnormal curves in the spine.

 

X-rays of kids with rickets show some of the same abnormalities commonly found in abused children. And some researchers have speculated that low vitamin D levels - even those not low enough to cause rickets -- could be the true cause of some bone fractures blamed on abuse.

 

To look into that question, researchers at Children's Hospital of Philadelphia measured vitamin D levels in 108 babies and toddlers treated for broken bones at their center. Out of every 10 fractures, seven were due to accidents and three were blamed on child abuse.

The researchers found that relatively low vitamin D levels were common -- but no more common among the children thought to be victims of abuse.

Nor was low vitamin D more common among children with multiple fractures (a potential sign of abuse) versus those with a single broken bone.

"Our study indicates that a low vitamin D level should not discourage consideration of abuse when a child presents with unexplained fractures," lead researcher Dr. Samantha Schilling told Reuters Health in an email.

She added that "it is possible, and likely, that at some threshold, very low vitamin D levels contribute to fracture susceptibility in children." But this study was not designed to show what that threshold is.

In fact, Schilling said, no studies have been done to pinpoint a vitamin D "threshold" below which children's fracture risk goes up. Even when it comes to rickets, she noted, the correlation between vitamin D levels and rickets severity is unclear.

The findings, published in the journal Pediatrics, are based on 108 children younger than 2 who were treated for bone fractures over 1 year. Schilling's team found that eight children had a vitamin D deficiency, while 34 were deemed to have insufficient levels (not low enough to be considered a deficiency) and 66 had sufficient levels.

The researchers found that children with fractures thought to be caused by abuse were no more likely to have a vitamin D deficiency or insufficiency.

In addition, low vitamin D was no more common among these abused children than it was in earlier studies of healthy children, the researchers say.

On the other hand, the findings do not necessarily mean that unexplained bone fractures in babies are always due to abuse, or that low vitamin D has no role in such cases, according to Dr. Colin R. Paterson, who wrote an editorial published with the study.

"I believe that not just vitamin D deficiency, but a number of other bone disorders, can cause fractures that can readily be misinterpreted as child abuse," Paterson, a retired staff physician at the University of Dundee in Scotland, told Reuters Health in an email.

"It has often been assumed," he said, "that if parents are unable to provide an explanation for fractures they must be lying about assaults inflicted by themselves or others."

But, Paterson said, it is possible for rickets or certain other bone disorders -- like the genetic brittle-bone condition osteogenesis imperfecta -- to make young children vulnerable to fractures even with "normal handling."

Infants and children with bone fractures do not routinely have their vitamin D levels measured, according to Schilling, because there is no evidence that it's useful to do so.

She added, though, that it might be helpful in cases where an exclusively breastfed infant has a fracture. That's because breast milk is low in vitamin D, and unless breastfed infants are given vitamin D supplements, they are at risk of having "suboptimal" levels.

To help prevent that, the American Academy of Pediatrics recommends that breastfed infants be given daily vitamin D drops. (Infant formulas are already fortified with the vitamin.)

Young children can get their vitamin D from fortified cereals, milk and orange juice, or from the few foods that contain the vitamin naturally -- like fatty fish and egg yolks. Experts recommend that infants get 400 IU of vitamin D per day, while children ages 1 and up should get 600 IU.

SOURCE: bit.ly/dR64Lc Pediatrics, online April 11, 2011.

WHAT IS VITAMIN D DEFICENCY

Untitled

Wednesday, 25 January 2012

Social workers feel powerless to protect neglected children

Social workers and police 'powerless' to intervene in child neglect cases

Social workers and police 'powerless' to intervene in child neglect cases

Children are at risk of neglect because the authorities feel “powerless” to intervene and protect them, a study warns.

A mother and her daughter have been fighting a care order - Child protection system tears two more happy families apart
Professionals say they do not have the powers necessary to protect children from neglect. Photo: ALAMY

Martin Beckford

By , Social Affairs Editor

7:00AM GMT 23 Jan 2012

The report by the charity Action for Children found that half of social workers and a third of police officers felt they were unable to get involved in suspected cases of poor care by parents.

Four in 10 social workers said the threshold was too high before they could act to help at-risk children while half blamed a lack of resources for their inability to help.

Eighty per cent fear cuts to public services will make it even more difficult to intervene and prevent children being neglected by parents who may be drug addicts or alcoholics, who may have mental health problems or simply be too poor to provide for their families.

Overall, 81 per cent of the 2,174 professionals questioned by the University of Stirling said they suspected children they encountered were being neglected, up slightly on the 78 per cent figure recorded in 2009.

Half of the primary school staff surveyed said they wanted to be able to report “less serious suspicions” before problems at a pupil’s home became worse, with teachers reportedly suffering sleepless nights as they worry about children in their care.

The report, published on Monday, highlights the continuing dilemma faced by safeguarding workers over when to take action about children who may be in danger.

In the Baby P case, professionals ranging from doctors to the police were accused of missing dozens of opportunities to save the toddler’s life by taking away from a violent home.

But in the wake of the scandal, social workers were said to have taken many more children into care, leading to delays in the family courts and vulnerable young people left waiting for foster homes or adoptive parents.

Dame Clare Tickell, Chief Executive of Action for Children, said, “Neglect corrodes childhoods, robbing the most vulnerable children of hope, happiness and life chances. All our findings point to the stark reality that neglected children and their parents are being identified, but neither the professionals nor the public feel empowered to help or intervene, particularly at the early stages.

“When it comes to child neglect the reality is, we are only tackling the tip of the iceberg, and there are many thousands out there in desperate need. We are currently missing critical opportunities to help, and putting valued professionals in an impossible position.”

Professor Corinne May-Chahal, Co-Chair of The College of Social Work and Professor of Applied Science, Lancaster University UK, added: “Unlike physical and sexual abuse, where the signs can often be very obvious, identifying neglect is more complex creating a barrier between getting the child and family the help they desperately need.

“The point at which social workers can intervene in cases of neglect is too high. This high threshold allows the challenges families face to deteriorate to the point where they need urgent help.

“Even when a child has been identified as being neglected, social workers struggle to get them the support they need due to a lack of time or resources.

“The system, in its current state, falls short in providing the safety and security neglected children need. It is important that social workers are given a stronger role in early intervention and that services are appropriately organised to achieve this aim.”

Action for Children wants the Government to help authorities across the country gather more information about the effectiveness of services, and to improve access to early support services.

Ruth Cartwright, England manager for the British Association of Social Workers, said: “The issue of neglect of children is itself being neglected by the system.

“Social workers and other professionals need to have many resources and ways of helping a child apart from removing them from the family home, which is always absolutely the last resort, and these resources and services are not as available as they once were.

“Even if removal is justified in the social worker’s professional opinion, it is can be hard to persuade managers and those who hold the purse strings of this, and the chances of this step being sanctioned by the courts are quite slim.”

http://www.telegraph.co.uk/health/children_shealth/9028868/Social-workers-and-police-powerless-to-intervene-in-child-neglect-cases.html

Borderline Personality Disorder and Bipolar Disorder—Distinguishing Features of Clinical Diagnosis and Treatment

Protecting Our Children: why I let cameras into my department

Protecting Our Children: why I let cameras into my department

A new documentary series gives an authentic account of child protection social work. Bristol's director of children and youth services explains why the council agreed to give film crews unprecedented access.

Protecting Our Children
A scene from the BBC2 three-part series, Protecting Our Children.

Is social work the most hated profession? Annie Hudson, Bristol city council's director of children and youth services, admits that "when you tell someone what you do, it can be a real conversation stopper."

One of her team, newly qualified social worker Susanne, says some of her relatives won't own up to having a social worker in the family.

Susanne is at the centre of the first episode of the new fly-on-the-wall documentary, Protecting Our Children, which starts on BBC2 on 30 January. It's the second time that Bristol social services has opened its doors to the BBC; the 2004 BBC1 series Someone to Watch Over Me followed its children's services staff, while the new three-part series focuses on the work of the child protection team.

The first two episodes each follow an individual case, while the third looks at three separate cases. This approach, says Hudson, allows viewers to see the complexity of day-to-day child protection work: "We wanted to open up in a public way what the lived experience of child protection social work is like, the ebb and flow of working with families, balancing care and control."

The cameras spent more than a year with the team, and during this time the department was twice inspected by Ofsted; there was a change of government, and austerity measures started to take effect. Although the film crews followed these developments, the production team decided to concentrate on the child protection team's cases rather than the wider context.

Annie HudsonAnnie HudsonHudson, who has been children's services director at Bristol for the last three years, was at the council when the first series was filmed and transmitted. It was commissioned following the Victoria Climbié case and aimed to shine a light on a profession that had hit rock bottom.

The new series was partly prompted by the fallout from the Baby P case with social workers once again shouldering the blame for a child's death, and the production team spent more than a year in discussions with the council, NHS trusts in Bristol, family courts and the police before filming started.

The result is a remarkable series with unprecedented access to child protection specialists and their clients. At a special preview screening in London, attended by a number of social workers past and present, members of the audience praised the production team for presenting such an authentic account.

But the real test for the programmes will be whether they help to shift the public's perception of the profession.

Hudson says social workers have been wary of media attention because they believe it only focuses on the negative. The first programme's title 'damned if they do, damned if they don't' sums up the feeling.

In the third film, Hudson says, one of the team comments that there never seem to be headlines when there has been a success in social work. "I think that people have been very wary and defensive and very reluctant to open up," Hudson says. "This is our small scale attempt to address that."

She hopes that the series will challenge public perceptions of the profession by giving viewers a better understanding of what social workers do. "We are an accountable profession, we are a public service that people should be able to understand."

The production partner for the series is the Open University, which has prepared a range of resources to go online to coincide with its transmission. The OU recorded a spike in interest in its social work courses following the Someone to Watch Over Me series and the production team anticipate a similar response to the new series.

Hudson hopes the series will prompt more queries from potential foster carers, and the local authority is also preparing for more referrals from members of the public worried about children's welfare having seen the issues raised in the programmes.

As the series nears transmission, Hudson admits to feeling a sense of responsibility on behalf of her staff, and the social work profession as a whole: "I am not the producer and I am not in [the programmes] but I felt a bit like a mother hen about it because there is a responsibility to other people and you want it to be a good project that opens other people's eyes."

• The BBC2 series Protecting Our Children starts on Monday 30 January at 9pm

http://www.guardian.co.uk/social-care-network/2012/jan/25/protecting-our-children-bbc-documentary?INTCMP=ILCNETTXT3487

HOSPITAL SORRY FOR FORCED ADOPTION VIDEO

Untitled

Ethics and Child and Adolescent Psychiatry

Cost to county of lying social workers: $10.6 million

Camilla Cavendish’s 10-Point Plan before the Education Select Committee

Camilla Cavendish’s 10-Point Plan before the Education Select Committee

 

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Camilla Cavendish’s 10-Point Plan before the Education Select Committee

Camilla Cavendish’s 10-Point Plan
Camilla Cavendish[1] is Associate Editor and columnist at The Times. In 2009, she was campaigning journalist of the year for exposing miscarriages of justice which convinced Government to open the family courts – but not enough. Here is her 10-point plan that is waiting to be implemented:
  1. Open family courts to the press in all but exceptional circumstances (as recommended by the Constitutional Affairs Select Committee)
  2. Let any parent or carer accused of abuse call any witnesses they need in their defence. At the moment, they are routinely refused permission to do so.
  3. Give automatic permission for parents who are refused legal aid to get a lay advisor to help them present their case. This is routinely refused.
  4. Remove the restrictions that prevent families from talking about their case (as recommended by the Constitutional Affairs Select Committee).
  5. Review the definition of “emotional abuse” across local authorities, to make sure that it cannot become a catch-all for overzealous officials.
  6. Provide an automatic right for parents to receive copies of case conference notes and all evidence used against them in court, just as they would in a criminal trial.
  7. Create an independent body to oversee the actions of social services, with proper sanctions. If that body is to be the General Social Care Council, make it easier for parents to go directly to that body rather than having to face delays from the local authority.
  8. Let children in care waive their right to privacy, if they wish to speak out. For gagging children is surely not consistent with promoting their welfare.
  9. Restructure CAFCASS, the Family Court Advisory Service, from being an organisation that reports on the parents to the courts to one that actively promotes the parenting needs of children. The primary focus should cease to be assisting the court process. It should be diverting parents away from contested hearings into the making of parenting plans.
  10. Review the recent legal aid cutbacks that are deterring lawyers from taking on these complex family cases. It is quite wrong that desperate parents are unable to find a lawyer to help them in their time of need.
Among her articles are – unfortunately behind the ‘paywall’ of The Times:
  • Camilla Cavendish – the campaign
  • Children are safer with their natural families
  • Catch-22 that condemns a child to grow up with strangers
  • When the stakes are so high, parents want to be heard.
As Jeremy Bentham (1748 – 1832) wrote:
Publicity is the very soul of justice. It is the keenest spur to exertion, and the surest of all guards against improbity. It keeps the judge himself, while trying, under trial.
In the darkness of secrecy, sinister interest and evil in every shape, have full swing. Only in proportion as publicity has place can any of the checks, applicable to judicial injustice, operate. Where there is no publicity there is no justice.”
This is the last page of my second submission to the Education Select Committee, a portfolio of nine cases. The first submission is a general overview, since individual cases are not supposed to be submitted.

Ken Clarke: 'use mediation over courts'

Features

Ken Clarke: 'use mediation over courts'

23 January 2012

Justice Secretary Ken Clarke has urged separating couples to consider mediation when they separate or divorce, instead of turning to the courts.

He met family mediators in Milton Keynes who work with couples and families to reach agreements when they separate or divorce - especially where children are involved.

Mr Clarke said:

'In the vast majority of cases mediation is a much more sensible way for couples to conduct their separation – it is quicker, cheaper, less confrontational and it encourages people to resolve their issues rather than turning to judges and lawyers.'

Rules introduced last year mean that all separating couples must complete an assessment to determine if mediation is a better option for them. The Government has already increased spending on mediation from £10m to £25m each year, to allow separating couples to mediate.

Mary Banham-Hall, Mediator at Focus Mediation in Milton Keynes, said:

'Mediation brings couples together in a neutral and non-hostile environment to improve communication and focus on any children’s needs. The impartial mediator helps the couple to resolve their differences and settle child residence and contact, along with every aspect of their financial settlement in a thoughtful and co-operative way.

'It can be fast and cost effective and can achieve a huge saving in legal costs – plus people can start to solve their problems rather than fighting over them. It is the best way to end relationships, if they have to end'.

Foster system held back by council fear of criticism

Foster system held back by council fear of criticism

By Jenny Cuffe Reporter, File on 4

Child sitting on floor With a shortage of foster parents, the need for homes for children has never been greater.

A culture of fear has led some councils to protect themselves more than the children in their care, according to the government’s child protection adviser.

Professor Eileen Munro was responding to “distressing failings” in the foster care system highlighted by the BBC.

They include children being removed from homes because of unsubstantiated allegations.

The government says it has committed to overhauling the fostering system.

With 65,000 children in care in England alone, and with a shortage of foster carers, the need for homes has never been greater.

But the BBC’s File on 4 programme has found evidence of foster carers being shut out of the system following disputes with social services departments.

Professor Munro, from the London School of Economics, said councils were often too quick to remove children from foster homes because they were afraid of criticism.

Continue reading the main story

“Start Quote

Professor Eileen Munro

If people are in a very defensive, compliance culture, they’re very scared of saying they made a mistake”

Professor Eileen Munro Government adviser

“So you end up with many agencies starting to protect themselves from risk more than the children from risk,” she said.

“What can happen is that if people are in a very defensive, compliance culture, they’re very scared of saying they made a mistake.”

In one case, an experienced Derbyshire foster mother had a baby suddenly taken away from her because of unspecified concerns from social workers.

After threatening to take legal action, Lisa – not her real name – discovered she was accused of taking the baby to the doctor too often.

Lisa asked for access to her file via the data protection act, which showed a catalogue of errors.

“One of the things that sticks out specifically for me is my youngest daughters accesses child adolescent and mental health services (CAMS) which is the mental health body.

“They had written to say social services had written and said that CAMS had concerns over me and my daughter,” says Lisa.

“When I argued it with them and said ‘you never told me that’ they said ‘no you’ve missed out the word no, we had no concerns over her’.”

After three years, Lisa finally got a full retraction from Derbyshire social services.

Her name cleared, she returned to fostering only to run into more problems and social workers now refuse to work with her.

Lisa said: “There are an awful lot of children out there and they could have done with keeping someone who is actually experienced at looking after the child.

“I miss caring for the children. I loved what I did and I was good at what I did.”

In a statement Derbyshire County Council said it stood by its decision, but admitted mistakes had been made.

It said procedures had been changed to ensure this did not happen again.

Foster carers ‘integral’

In another case a vulnerable young man was removed from the home he had known since he was four, after Manchester City Council received a referral from his school.

Continue reading the main story

Find out more

Man and child holding hands

File on 4 is on BBC Radio 4 on 24 January at 20:00 GMT and Sunday 29 January at 17:00 GMT

There were allegations that he had made vague references which led to the suspicion he may have been locked in a cupboard or wardrobe.

He was placed in a residential unit and his foster mother Ann – not her real name – who had looked after him for 14 years, was not allowed to see him.

Even when an investigation found no evidence of abuse, council officials refused to let the teenager return home and continued to bar Ann from seeing him.

When his behaviour deteriorated, he was given psychiatric drugs to keep him calm.

“They had put a nappy on him, when he doesn’t wear nappies. I couldn’t believe it,” said Ann.

Continue reading the main story

“Start Quote

Matt Dunkley

We need to judge by what happens in the majority not the minority”

Matt Dunkley Association of Directors of Children’s Services

In 2010 the Court of Protection ruled that the council had acted unlawfully in depriving him of his liberty and right to a family life, and criticised social workers for ignoring his close relationship with his foster mother.

He is now back with his foster family and is suing Manchester City Council.

In a statement the council said they strongly believed they did the right thing, but admitted they went about it in the wrong way.

Mark McGhee, the lawyer who brought the case, said it was a landmark case because it recognises that over a period of time a foster carer can become so integral to an individual’s well-being that to all intents and purposes they takes over the parental role.

Matt Dunkley, president of the Association of Directors of Children’s Services, said it was important to balance these individual cases with the many others where fostering was successful and transformed children’s lives.

“In the great majority of cases, it goes right and we need to judge by what happens in the majority not the minority,” he told the BBC.

A Department for Education spokesperson said the government has already committed to overhauling the care system, including fostering, and would set out more details later this year.

File on 4 is on BBC Radio 4 on Tuesday 24 January at 20:00 GMT and Sunday 29 January at 17:00 GMT. Listen again via the Radio 4 website or download the podcast.

Putting children first – £20 million to help separating families

In Determination Of Child Abuse, Socioeconomic Status More Influential Than Race

In Determination Of Child Abuse, Socioeconomic Status More Influential Than Race

In Determination Of Child Abuse, Socioeconomic Status More Influential Than Race

CHILD NEGLECT 2011 ACTION FOR CHILDREN

action_for_children.pdf Download this file

Lone child migrants returned to France under secret deal

Lone child migrants returned to France under secret deal

By Hannah Richardson BBC News education and family reporter

Eurotunnel Many of the children would have come from camps near Calais, says the children’s commissioner

Border staff turned back lone “vulnerable” children who failed to claim asylum when they arrived at UK ports, under a secret “Gentleman’s Agreement” with France, it has emerged.

England’s children’s commissioner Maggie Atkinson revealed that under the 1995 deal, lone children arriving without travel papers were deported.

The UK Border Agency ended the removals last year after she intervened.

She is now seeking the details of how many children were affected.

Dr Atkinson has been working behind the scenes with the head of the UKBA to bring the practice to an end, but she has now made the issue public for the first time in her report, Landing in Dover, published on Tuesday.

‘Vulnerable children’

In it, she said: “Children arriving unaccompanied in the UK are some of the most vulnerable that my office deals with. Of the relatively small number that enter the country each year, most are seeking asylum.”

She added that they were entitled to protection and humanitarian assistance under the UN Convention on the Rights of the Child, and should be treated in a similar way as an orphan might be cared for by his or her local authority.

The report summarises the results of an investigation into the experiences of unaccompanied children arriving in Dover, Kent.

Dr Atkinson said it was during the course of the investigation that she was given a copy of the so-called “Gentleman’s Agreement” by UKBA staff.

“Further enquiries (with which UKBA co-operated fully) clarified that children who did not register a claim for asylum at the point of entry faced a real risk of being returned immediately to France under the terms of this agreement,” she said.

Continue reading the main story

“Start Quote

We know of at least seven children who experienced this in 2010 and it is likely there were others”

Dr Maggie Atkinson Children’s Commissioner for England

This clashed with the UKBA’s duty to safeguard children and promote their welfare, she added.

“We know of at least seven children who experienced this in 2010 and it is likely there were others.”

In 2010 some 1,700 lone children applied for asylum in Britain.

But a Home Office spokesman could not say how many children who had not applied for asylum had been removed from Britain.

Dr Atkinson told the BBC News website: “These unaccompanied children are usually young to mid-adolescent children aged around 14 to 16. They come from very difficult, war-torn countries or repressive regimes.

“If you take, for example, some of the Afghan boys who have arrived here, they have taken about two years to cross two continents in the most awful conditions, sometimes trafficked, sometimes exploited, sometimes paying vast amounts which they have to work to pay back.

“If they have a bit of nous or they have been briefed they can claim asylum, then they are put through the official system.

“If they don’t claim asylum then under this ‘Gentleman’s Agreement’, as it was presented, they were simply returned to France.

Trafficking victims

“It seems nothing was written down, it was a gentlemen’s agreement, and they would disappear when they got back to France.”

She said it was impossible to know how many children would have been turned back in this way, but she was now asking the UKBA to answer this question.

The agreement was in place between 1995 and August 2011, when Dr Atkinson raised the issue with the UKBA chief executive Rob Whiteman.

In his November letter responding to Dr Atkinson, Mr Whiteman said the agreement was not exclusive to Dover, but had been used at Newhaven and Southampton as well.

He added: “Since you have raised this subject with us, we have had a further think about whether the continued operation of this agreement remains appropriate for children.

“I am pleased to inform you that we think the current practice of removing unaccompanied minors to France under the Gentleman’s Agreement should cease immediately.”

He also said that of the seven known cases that Dr Atkinson had raised with him, two had had re-entered the UK and had been upheld as “potential victims of trafficking” when they claimed asylum.

Immigration minister Damian Green welcomed the report, saying the main recommendation had been already implemented at Dover, which is that interviewing should be postponed until after a child has had a period of some days to recover from their journey and secure legal representation.

“We will respond to the report more fully later this month.”

CHILDREN LANDING IN DOVER CHILDREN COMMISSIONER

Landing_in_Dover_-_FINAL_NON_EMBARGOED_REPORT.pdf Download this file

THE CODE OF ETHICS FOR SOCIAL WORKERS BASW

Employers “making it impossible” for social workers to practice ethically

Home > > E-Bulletin > Employers “making it impossible” for social workers to practice ethically

Employers “making it impossible” for social workers to practice ethically

18th January 2012

The British Association of Social Workers (BASW) has updated its Code of Ethics for social workers as evidence emerges that frontline workers being put under pressure to turn a blind eye to unethical practice.

BASW’s affiliated Social Workers Union (SWU) says it has seen a marked increase in complaints from practitioners concerned and angry at the impact of unmanageable and unrealistic caseloads which leave service users increasingly vulnerable.

Growing numbers of worried callers to SWU’s telephone duty service are backed up by a survey of members in which 81% expressed concern at unmanageable caseloads – 56% said they are very concerned.

The development coincides with BASW’s decision to revise its Code of Ethics, a definitive document that has underpinned social work practice since 1975. The code outlines the duty of social workers to safeguard the interests of often vulnerable service users by ‘whistleblowing’ on bad practice.

Commenting on the launch of the revised code and the worrying trend reported by social workers, BASW chief executive Hilton Dawson says:

“We are concerned that government cuts and local authority implementation of this resource rationing is making it impossible for social workers to practice to the standards rightly expected of them by BASW’s Code of Ethics.

“For example, we have members approaching SWU to tell us that cases are being allocated to named social workers, when crippling caseloads mean that they are sitting in a pile on someone’s desk and that no one has the time to actually work on them.

“Managers are being pressured to push cases through an administrative system, and crossing their fingers that nobody dies. Now, more than ever, the rights of social workers to stand up and blow the whistle on unethical practice must be protected.”

BASW is sending a copy of the revised code to all chief executives of local authorities, asking them to share it with staff, as well as allowing BASW to engage with social workers.

Read more in BASW’s Huffington Post blog.

 


Employers “making it impossible” for social workers to practice ethically | British Association of Social Workers

Employers “making it impossible” for social workers to practice ethically | British Association of Social Workers

Are social workers buckling under unmanageable caseloads?

Are social workers buckling under unmanageable caseloads?

Social workers are increasingly complaining of unmanageable caseloads but while some say they now step in only in a crisis, others say practices include manipulating the system. Jessica Fuhl reports


Are social workers buckling under unmanageable caseloads?
81% of social workers have expressed concern at unmanageable caseloads. Photograph: Terry Smith Images / Alamy/Alamy

"It is not unusual for social workers to not to be able to sleep. We're under pressure, and we live on a 'reactive crisis' approach to our work. There's a huge amount of work and it's increasing."

Rachel Smith works as a safeguarding manager in a local authority in the south west. Since the death of Baby P in 2007 she says proceedings have increased by 49%. On a day-to-day basis she struggles to cope.

Balancing caseloads is an increasing complaint in the world of social work, some might say it's becoming notorious. In Smith's local authority, there physically aren't enough social workers to deal with the work that they have coming in. New cases sometimes can't be taken on and end up staying with assessment teams, where a backlog starts to form there too.

The problems with allocating and managing caseloads at the local authority Rachel Smith works at are not unusual. Social workers in local authorities across the country are struggling with the volume of work they have to deal with and a recent survey conducted by the Social Workers Union (SWU) revealed that 81% of social workers expressed concern at unmanageable caseloads, with more than half (56%) claiming to be "very concerned".

At Smith's local authority, there are so many cases and so few workers to distribute them around that cases are 'allocated' to social workers who have already left the authority so they aren't seen as unallocated.

"They openly put in their self-report to Ofsted that all their cases were allocated when they had left at least 25 child protection cases in the names of workers who had left," she says.

Not taking on new workers, devoting time and training to new practices such as personal support plans and budgets, and increased managerial assessments are all problems facing the profession as they struggle to find time and resources to manage cases effectively.

No formal training on caseload management is given in social care training, and since Baby P a culture of fear of closing cases has also developed. Social workers have also said there is a nervousness or lack of understanding from some senior managers. Some have expressed concern that managers don't always have the experience of frontline social work to offer effective support and distribute cases to workers appropriately.

Some social workers believe that a large part of the problem may be that social services are increasingly seen as a default service to many; service-users that don't fit in to other areas are sent to social workers who are already struggling with work demands.

The context of social work is changing in other ways too. Martin Wood has been qualified as a social worker in a rural local authority for two years and explains that social work used to be about holding people's cases throughout their lives, where as now it is just when crisis hits.

"People who need help which should have been picked up earlier are now only referred to us when there is an immediate problem," he says. "In that way we're on a back foot from the start. Crisis management and safeguarding takes up a huge amount of time."

This has been helped in some local authorities through a greater emphasis on caseload weighting. At Cheshire and Wirral foundation trust, cases are assessed on factors other than face-to-face service user contact, such as meetings, supervision, court dates and joint visits before they are distributed appropriately across the team.

Another possible solution to consider may be to outsource social workfrom the third sector. In Suffolk, services provided by social enterprises or companies are commissioned by the council but although the amount of money spent on services has dropped, the workforce at the council has also been dramatically slimmed down.

Employing experienced but unqualified workers to carry out roles in social work that do not necessarily require a qualified professional is another option, but one that does not sit so comfortably at a time when more young qualified social workers are without jobs than ever before.

A spokesperson for the College of Social Work (TCSW) acknowledged that heavy caseloads are not an uncommon problem for social workers, but said that there are resources that can help.

"The Social Work Reform Board has agreed employer standards which apply to all employers of social workers. TCSW strongly recommends that these standards are used to ensure good supervision and case load management."

Wood, however, doesn't think the issue can be solved easily. "It comes down to social work values. Social work is a vocation and its very hard to say to someone who needs support 'I don't have the time'. They need someone there.

"Yet on a basic human level, we all have burnout. There's only so much you can do physically, emotionally and psychologically."

"Most people enter social work because they want to make a difference, and the worst thing is when you feel that you can't – this is something to do with caseloads."

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WELCOME

Welcome to my Parents Against Injustice blog on Google.
The aim of my blog is to highlight the injustice,and corruption that occurs within the family courts,and to expose Social Services shoddy practice, which results in Parents loosing their children to forced adoption, on the evidence given by expert witneses who give conflicting or misleading information, which gratifies the needs of Local Authority's
Please join me,and add your story about Social Services System abuse.

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