Playing the Blame Game

Go-to-jail300The issue of blame is never far from a social worker’s experience. We all know the media horror story of the now vindicated Sharon Shoesmith (social worker in the Baby P case) and we are taught to be prepared to defend our every decision. This issue has recently become sharper for me for two reasons: 1. the recent experience of a colleague and friend of feeling blamed for a death at coroner’s court, and 2. David Cameron’s brilliant idea of jailing social workers who “wilfully neglect” children.

I have been thankful to so far escape a trip to the coroner’s court, despite the high risk service user base with whom I work. Apart from the natural shock and sadness of knowing that someone you tried to help has died, and any blame you may be placing on yourself, it is quite another thing to have a courtroom full of people, including a coroner and the person’s own family, question your practice. The purpose of a coroner’s inquest is explicitly not to lay blame, but to determine causes of death and it is also possible for the coroner to make recommendations to prevent further deaths. In my friend’s case, the verdict was suicide, which was obvious to my friend, knowing the facts of the case. However although the coroner decided that my friend had not been neglectful, he did not shy away from trying to imply guilt anyway. He referred to her as “inexperienced” and repeatedly and aggressively asked questions such as: what makes you qualified to make such decisions about risk? and why didn’t you ask a doctor for advice?

The implication was that social workers should not be working in mental health – an attitude that is thankfully on it’s way out as people acknowledge the social context of mental health problems. The further implication was that doctors are better placed to deal with mental health and should be involved in every single referral. Leaving aside whether this is desirable, it would be impossible with current resourcing in my trust. Interestingly Jeremy Hunt’s demands for consultants to work 7 days (forgetting that they already do) have received a backlash with many doctors pointing out that in fact the reason why deaths are more common for people admitted at the weekend may well have something to do with the fact that other supporting services, such as social work have been stripped away, leaving doctors dealing with inappropriate cases at the weekend. Another example of blame being inappropriately and pointlessly laid at the door of practitioners struggling in an overloaded system.

And are there any winners from the blame game? Sadly I doubt whether the experience of coroner’s court could really have brought much solace to the family members. Although hopefully they may have had some questions answered I can’t help thinking this aim might be better met in an informal meeting. No recommendations were made about changing the practice of either individuals or organizations. But at least one individual was made to feel bad for what was almost entirely outside of her control.

And so we come to the proposal to jail social workers for “willful neglect” in children’s care. In no other profession is such a thing acceptable. Doctors are not jailed if they fail to cure a fatal cancer, so why should social workers be jailed for failing to predict and prevent someone else from attacking a child? Nobody goes into social work in order to deliberately allow abuse to occur – the fact is we’re all in it for the money!

Seriously, how is making someone more nervous going to improve their practice or help recruit new social workers? Instead it reinforces the risk-averse, box-ticking, back-covering culture that is so corrosive to true relationship based work, as workers become more concerned about looking like they’ve done the right thing than actually doing what’s best for the service user. Perhaps this is in fact what David Cameron and Jeremy Hunt are trying to do: look like they’re acting tough on child protection and on the NHS by pointing the finger of blame at workers on the front line. They would do better to address the real issues causing child abuse and hospital deaths, amongst which we could certainly cite the effects of austerity: soaring caseloads, slashed services and eroded quality of life through the attack on benefits.

And here’s one for debate: if social workers can be jailed for willful neglect of a child, what should be the punishment for politicians who willfully neglect children’s services?

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