Editorial: All-Party Parliamentary Group for Children Discusses Integrated Care (UK). Are you yawning already? Part 2

'important and well-paid mouths are flapping but I doubt any usable wind is being generated'

The optimistic thought behind this limp initiative is that there is some magical process by which directives from well-paid people at the top of government, statutory services and charities will directly influence what support is given to babies, children and families at the grassroots (where, by and large, people are not so well paid).

If this magic trick had any merit, it would have worked already at some point during the last fifty years.  It has not. We still have a sad, fragmented, hotchpotch approach in which people in health, education and social care mistrust each other, do not understand each other’s thinking and simply do not want to work together. This is true at all levels from ministries down.

The top-down approach does not work. It is a dead idea that should have been put to rest long ago. A few worthy people in a new parliamentary group wringing their hands just adds to the futility. Of course, there are examples of good practice when people at the grassroots work well together. But this is always in spite of top-level policy and not because of it. The success factors here are that practitioners listen to families – really listen – and then apply common sense.  No magic is needed.

Why does the top-down approach fail babies and children who need extra support for their development and learning? The following short extracts are from 'Early Child and Family Support Principles and Prospects: For parents and practitioners impatient for change' (2022. PDF available):

• • Policy and practice can be perverted and distorted in the filtering down
  • The new work survives for only a short time
  • The new work does not spread out horizontally at the grass-roots to embrace children and families beyond the limited scope of the initial new initiatives or pilot projects.

“It is unlikely that senior people at the top of our vertical organisations can share the same long-term commitment and passion for improved support for these children and families that we find at the grass-roots. This is inevitable. While they might initially give everything to a new initiative to build or reform early child and family support, they will have other pressing challenges on their desk next week or next month.

“The same will be true for managers lower down in the hierarchies. These middle managers who have the responsibility to pass down the new work will have varying levels of passion, commitment or enthusiasm and will accordingly vary in the amount of time, energy and resources they want to devote to it. The same must be true for the practitioners at the grass-roots who work with children and families. Each will have attitudes about the new policies and practice and views about the benefits or challenges they bring to their present way of working and to their professional standards...

“Sadly, perversion, distortion and delay in enacting new policies at the grass-roots can happen even when the new policies come in some sort of legal framework....”

In the UK, we are desperate for effective integrated early child and family support. I do not see it coming from this new fancy parliamentary group.

Peter Limbrick

April 2022

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