Carers for children in crisis deserve the best

Horrific cases involving children and young people make headlines with depressing regularity

Horrific cases involving children and young people make headlines with depressing regularity. The sad thing is that the public outrage which results is usually temporary. Without fundamental change in the system, these cases will continue to occur.

Children in need and poverty appear to be low on the priorities of most governments until they are forced into action by a particularly awful case or the demands of a High Court judge. Those who are homeless now, or in dire need of specialist treatment and accommodation, must receive what they need. Equally, however, we must try to minimise the chances of children ending up in need of such high-level intervention.

Vulnerable children receive low priority and this spills over to the people who work most intensively with them. Everyone knows what a social worker is, but for most people childcare work only signifies providing care for children of working parents. For that reason, I shall use the term social care to refer to the very different role of working with children whose life experiences have been damaging.

Social care, whether in community or residential settings, is extremely sensitive and delicate work. In spite of its importance, as Niall McElwee, the course director in social care in the Waterford Institute of Technology, has said, at best it is often seen as a "semi-profession." For example, one could not imagine the health boards hiring a physiotherapist, providing her with six weeks' training and then letting her loose to practise. Yet that is what happens frequently in the area of social care. The health boards could legitimately counter that it is impossible to find qualified people. But why is it so difficult? And what is going to be done about it?


The answer lies partly in the low pay and difficult working conditions of this "semi-profession". Take overnight work. Typically, someone employed in a residential setting would work from 3 p.m. to 3 p.m. the following day. Officially, they are supposed to be asleep for an eight-hour period, but the reality is very different. A not unusual scenario would be to get to bed around 3 a.m., only to be wakened again an hour later, and then still have to get up at 7 a.m. to get the children out to school.

For this eight-hour period, the expert group on various health professionals recommends payment be raised to the princely sum of £25. Staggeringly, it makes no other recommendation on pay. Yet social care is notoriously badly paid, to the extent that some prefer to be termed project workers, because that receives better pay.

But pay is only one factor. Probably as many as 40 to 50 per cent of people employed in social care are not qualified. Certainly, many of those who have worked a long time in social care may have far more to give than the proverbial "wet behind the ears" graduate. But it does reinforce the "semi-profession" status.

There is no central register, much less a tracking mechanism for the profession. Even the minimal Garda clearance is only available to current or prospective health board workers. In no sense do I wish to blacken the reputation of the vast majority of dedicated people who work in social care, but it is well known that paedophiles often take up work with ready access to children, and move from facility to facility to avoid detection.

After 20 years of lobbying, the Government is finally moving towards a central statutory register, to be called the Council for Allied Health Professionals, beginning with 12 professions. The proposed registration body would have a central secretariat and separate panels for each profession. This means people would eventually be unable to get work in these areas unless they were registered with this body.

I am reluctant to criticise this initiative because any registration is a positive step, particularly in relation to fitness to practise issues. However, it is difficult to avoid the impression that the Department of Health is putting financial considerations ahead of logic in the composition of the proposed umbrella body. The 12 professions are care workers, social workers, psychologists, physiotherapists, radiographers, chiropodists, speech therapists, occupational therapists, dieticians, environmental health officers, biochemists and medical laboratory technicians.

As Niall McElwee put it in an address to the Irish Association of Care Workers (IACW): "In some ways it is extraordinary that this would even be proposed for social care practitioners, as very little of their current training is around medical issues."

But the Government is adamant this body must be self-financing. An umbrella body is therefore required because some of the smallest groups, such as dieticians, could never finance their own regulatory body through their fees. Social care workers may be included here because they are the largest group, followed by social workers, so their registration fees could effectively subsidise the other professions. In a State "awash with money" should finance be the guiding principle?

Care workers and indeed social workers need a regulatory body which addresses their specific needs. What in the name of God do social care workers have in common with chiropodists and biochemists? How will a centralised administration deal with such unrelated professions?

Although not entirely happy, most of the professions are co-operating, because they fear the registration they have begged for years will not happen at all if this model is not adopted.

There are many obstacles ahead, however, and more than most for the social care profession. A joint committee has been set up to look at standardising training in social care, how to manage the transition to everyone eventually being qualified, and to make the minimum entry standard a degree.

All of these are important steps, but they will be useless unless the whole care of children is co-ordinated and the voices of parents, children, front-line professionals and academics given due weight. Responsibility for children's issues is spread across numerous government departments, who have no culture of co-operation. So "adhocracy" prevails. Against the odds, front-line professionals often provide superb service, but should it be so difficult for them to do so?

Paul Bailey, president of the IACW, has described the situation in social care as a "catastrophe".