Privatisation – the wrong solutions

The letter 'Are we failing children in care?' from Richard Jones and Ruth Tully (April 2017) raises some concerns that we – involved in delivering such psychological services for looked after children and young people in Glasgow – do share. But the authors, we believe, go on to recommend the wrong 'privatisation solutions'.

Sadly, in Glasgow, we have the largest cohort of Looked After Children in the country (at over 3200) and utilise the principles of Getting It Right For Every Child (GIRFEC) as enshrined in the Scottish Government legislation in relation to supporting their development and meeting their needs. Issues relating to the mental health of Looked After Children are, in our view, generally the outcome of poverty and the poverty related issues of neglect, abuse and addiction and, as such, should be considered by universal services at the earliest stage of intervention as a priority. In fact, all who work for local authority services in Scotland are considered to be the Corporate Parent of these children and have a duty by law to support their welfare. For Education, Social Work Services (SWS) and Health this has meant a wide-scale investment of time in the capacity building of staff (e.g. teachers, support assistants, nursery workers, residential care workers) in attachment theory and embedding the Nurture Principles in educational and care establishments throughout the city.

Working together as children's services has been vital for Social Work, Health and Education. For example: Social Work has invested many millions in building new Residential Children's Units (RCUs) within the city and promoting their education within the normal range of schools available there; Health provide a range of therapeutic responses designed to best meet the needs of the children and young people they see and is currently also investigating services which can be provided within schools and working with Education to ensure robust implementation and maximising impact outcomes; and Glasgow (Education) Psychological Service (GPS) work with staff/carers within schools and outwith (e.g. kinship carers, provided foster care and residential care) to build capacity with the express aim of supporting relationships and reducing placement breakdowns. Where therapy is required, we aim to use that which builds relationships in the care and school environment and is recommended by NICE for 'Children on the Edge of Care', e.g. Video Interaction Guidance (see Educational and Child Psychology, Vol. 33 No. 2, June 2016, for more about our approach).

In this respect, we are in fact moving further away from the private sector where, from all our experience, the selected examples of integrated service delivery of the type above would be so much more difficult to achieve and where governance can be needlessly complex. UK government spending policy has certainly put pressure on the delivery of these integrated psychology services in schools and care placements. In spite of these austerity-led difficulties we would not see the solution as spending more on external private agencies. During a child's lifetime, we have a duty to target the support to children and young people in many different ways. The level of coordination required for this integrated universal and targeted service delivery would not, in our view, be achievable via privatisation.

In fact, when our articulated policy/practice is not felt to be having the impact we had anticipated, we are bold in jointly investigating – through our multi-agency steering group – potential improvements. A current example is that GPS is in the process of undertaking a full-scale self-evaluation of its work – regarding Looked After Children and young people – involving partners in SWS and Health who will challenge as 'critical friends' and will validate the evaluation of impact. In this way GPS would hope to be responsive to the need for any change and engage as partners in the necessary joint planning in continuing to improve services to those in this cohort who are very vulnerable. This would be so much more difficult, if not impossible, with fragmented privatised services.

Fiona Williams

Glasgow Psychological Service

Julie Metcalfe

Glasgow Children and Adolescent Mental Health Services