Fiona Duncan: "There is an urgency. This is children’s lives we are talking about"

The Independent Care Review, which reports tomorrow after an exhaustively detailed consultation, is a once-in-a-generation scrutiny of our care system, with far-reaching recommendations for change. It is not unreasonable to expect that other countries might look upon it as a model for their own systems.

The review was announced by Nicola Sturgeon at the SNP conference in October 2016. The First Minister promised that it "would look at the underpinning legislation, practices, culture and ethos, and it will be driven by those who have experience of care. This is not something that any other country has ever done before”.

She also made the telling point that people with care experience are twenty times more likely than the rest of the population to die before they are 25.

Over three years, the Care Review has listened to more than 5,500 experiences. Over half of the voices were children and young people with experience of the care system, or adults who had lived in care, and different types of families. The other voices belonged to the paid and unpaid workforce. Over half of those on the group overseeing the work are care-experienced themselves.

Six wide-ranging reports will be published: The Promise, The Pinky Promise, The Plan, The Money, Follow the Money, and The Rules.

Fiona Duncan, the chair of the review, has never been under any illusions as to the scale of the task needed to ensure that the care system puts children first. She has previously described the system, at its worst, of being "manufacturing plant for homelessness" and that it sometimes operates in "silos, rubbing up against one another and creating delays, barriers, stigma, and the child is often ricocheted around this operating structure".

"I felt that the promise made to children and young people by the First Minister allowed for a very different approach", Duncan told The Herald yesterday. "Typically, a review reviews the system and how it operates, and I felt that was an opportunity to actually review the experience and understand how it feels, and make sure the system adapted to experience rather than the other way around. I was really concious that it had to look, feel and sound different from the outset".

Was the scale of the task daunting? "I don't think I understood the scale of the task in the beginning", she acknowledges. "Taking time to get to know children and young people and their families, to travel to where they were so that they were in places where they felt safe, and to go as often as necessary in order to build a relationship and trust, so that I could understand what really mattered to them ... Only through doing that did I get a true understanding of the scale of the care system.

"It would have been really easy to make an assumption that the system kicks in at a specific point - for example, when a child is removed from their family. But actually it operates before that. And when a young or young person leaves care, that is not when the system's impact ends. The impact lives with them forever".

Duncan was unable to go into any forensic detail before the report's launch, which will be streamed live on the Care Review's Facebook page at 2pm tomorrow. "What I can say is that the team listened to 5,500 experiences. From that unprecedented level of engagement we have learned and understand things that have enabled the review to come up with conclusions that will challenge the care system.

"What we learned from children and young people is that they're not universally listened to, both in the huge decisions that impact on their lives -- where are they going to stay? With whom? What school will they go to? How long they will be in that place? -- but also in day-to-day decisions, such as whether they can go for a sleepover.

"One of the major challenges the Care Review has to pose, regardless of its conclusions, is -- we're not listening to young people, children and their families enough. We're dealing with specific incidences rather than the whole set of circumstances.

"There are some major cultural challenges around that -- power, and risk -- as well as structural challenges, because many of the young people I met told me the most intimate and traumatic thing that had ever happened to them.

"We've been really careful not to ask them to stand alongside me and tell the world their story so that the Care Review is delivered, because it would be awful for people to have to re-live their experiences.

"So there are a lot of structural, cultural, systemic challenges around just getting it right, to listen to children and young people.

"They have to have more choice about who they engage with", Duncan continues. "The workforce -- paid and unpaid -- has to be enabled to do this, so there are issues around culture, around respecting young people.

"The workforce has told us about the time it takes to build a relationship with young people. There are some rules that prevent people from developing trusting relationships. Short-time shift-work patterns prevent children from developing a bond with the person who's in their life.

"It's huge", she concludes. "It touches, probably, all aspects of the care system”.

All 32 local authorities have been working closely with the Care Review, she adds. The Children’s Hearings system, the Children’s Reporter, the Care Inspectorate have all told her they are on board.

So does this mean it will be implemented? “It has to happen”, comes the unambiguous reply. “Because Scotland can’t ask its traumatised children again to tell their story to another review in order to figure out what has to change. It has to happen.

“The way the review has been organised is unprecedented. It understands the experience of the system. We have looked at the conflation of poverty with neglect. We’ve looked at trans-generational patterns of care. The most important thing we’ve done is to understand children and families. Nothing of this scale or ambition has been done before”, she adds. “So it’s difficult to say ’no’.

“We understand how much we spend in Scotland on care; that’s never been done before.

“There are children who are failed by the care system, and they go on as adults facing the disadvantage racked up as a result of the care system. There’s a huge cost associated with that, in terms of housing and homelessness services and mental health services and the justice system. We now know how much Scotland serves on failure-demand services as a consequence of failing its children”.

As of this moment, according to official figures, there are 14,738 young Scots currently in care. Thirty per cent of them will become unemployed; 45 per cent will suffer mental health issues; six per cent will become homeless. That represents a lot of human misery and wasted potential, and hints at the burden of extra costs that have to be shouldered by society as a whole.

Will Sturgeon be willing to enforce the review’s recommendations? Duncan says she sees the First Minister’s pledge to listen to the voices of 1,000 care-experienced young people as evidence of her “personal commitment” to the issue.

“So I’m hopeful that, as a consequence of the review being so comprehensive, and her personal commitment, that it will be difficult for her not to say ‘yes’.

“But the Scottish Government alone can’t make this happen. It’s down to local authorities as well, and charities, and organisations working around such as areas as learning disabilities, asylum seekers and refugees. It will take a small army of people to deliver this Review, and they will have to work collaboratively on it”.

There is, roughly, a ten-year timescale for things to change comprehensively, for a new, genuinely child-focused culture to be imbued. “But there is an urgency. This is children’s lives we are talking about. The pace of change has to be fast.

“That said, there are major structural and resource implications involved, and these will necessarily take time. We need to build alternatives to our secure-care setting, for example, and it will take time to get that right.”

Fiona Duncan believes that the review she has chaired and formulated is the most rewarding and challenging thing she has ever done. She has travelled to every part of the country and spoken to hundreds of people. As she puts it, she has sat in more beanbags than she can possibly count. “I can now get out of one without using my hands”, she says with a quick smile.

The Review is now be in the hands of others. But she will, she says, be keeping a very close eye on what happens next. Scotland, she believes, cannot afford to get its care of children and young people on the wrong path for much longer.

* https://www.carereview.scot/