Good news from Africa

This table is drawn from a recent study looking at the fall of mortality in Kenya. It points to a general trend: across Africa, more children are surviving.

Under 5 mortality (per 1000 live births)

	Previous studies (1998-2007)	Most recent study (2005-2009)
Benin	160 (2001)	125 (2006)
Ethiopia	166 (2000)	124 (2005)
Ghana	111 (2003)	80 (2008)
Kenya	115 (2003)	74 (2009)
Liberia	110 (2007)	114 (2009)
Madagascar	94 (2004)	72 (2009)
Mali	229 (2001)	191 (2006)
Namibia	62 (2000)	69 (2007)
Niger	274 (1998)	198 (2006)
Nigeria	201 (2003)	157 (2008)
Rwanda	152 (2005)	103 (2008)
Senegal	121 (2005)	85 (2009)
Tanzania	147 (1999)	112 (2005)
Uganda	152 (2001)	128 (2006)
Zambia	168 (2002)	119 (2007)
Zimbabwe	102 (1999)	83 (2006)

The factors behind increased survival are claimed to be

• “more democratic and accountable governments
• more sensible economic policies,
• the end of the debt crisis and major changes in relationships with the international community
• new technologies that are creating new opportunities for business and political accountability, and
• a new generation of policymakers, activists, and business leaders.”

There are problems – such as the recent (hopefully short term) increase in mortality in Liberia. But the trend is clear, and it is very good news indeed – especially for those who are concerned about population increase, because there is a clear and strong association between infant survival and the number of children a woman must have.

Report of the Welfare Reform Committee

The Scottish Parliament’s Welfare Reform Committee has issued its stage 1 report. They express “grave concern” about the current progress of welfare reform, making these points:

• changes to the benefits system will remove lifeline benefits from large numbers of vulnerable people;
• the means of applying for new benefits is complex …
• 330.000 people are caught within an appeals system that overturns two thirds of these assessment results …
• there will be major impacts on the independence of disabled people, and on child poverty and homelessness levels;
• the likelihood of individuals and families getting into serious debt … is increased;
• the Department of Work and Pensions … has done limited work to assess the impacts on different groups …

There is also a short section on the issue I have been raising:

“Social Fund
103. In its early consideration of the Bill the Committee harboured some concerns about the absence from it of powers in relation to the discretionary elements of the Social Fund, which have been devolved.
104. The Committee also received written evidence from Professor Paul Spicker, Grampian Chair of Public Policy at the Robert Gordon University. In his evidence Professor Spicker contends that there are legal competence issues for the Scottish Government in undertaking some aspects of welfare reform, including the
discretionary elements of the social fund that have been devolved:
Professor Paul Spicker – There needs in particular to be a residual power to promote welfare and to give financial assistance to any person – the same power currently possessed by English local authorities. As things stand, the promotion of welfare, and payments of financial assistance to individuals by way of benefits, are ultra vires.
105. In her evidence to the Committee on 1 May, the Cabinet Secretary explained that the Scottish Government will put in place interim arrangements using the general power of wellbeing that local authorities possess, along with a section 30 order to facilitate that 107 . In the longer term the proposal is to introduce a social fund bill in 2013-4, coming into force in 2015. The Committee welcomes the clarification from the Cabinet Secretary on interim arrangements for council tax discounts and the social fund and looks forward to assessing these arrangements and contributing to their development in due course.”

Life expectancy and pensions

A report by PWC on pensions draws attention to some fairly startling projections about life expectancy; they claim that pensioners born in 2050 will have an average life expectancy of 104. The source of the prediction are tables produced by the Office of National Statistics – this link goes to their main projection. For people born in 2050, the projection is that 48.4% of males, and 55% of females, will live to 100. The ONS also note that “As only one person worldwide has ever been verified as living beyond 120, estimates of numbers surviving to very old ages are highly uncertain.”

There are no strong reasons here for immediate panic. Even if the pension age stays at 66, people born today will not get their pension until 2078; and the troublingly long-lived babies of 2050 will get their pension in 2116. That is far enough away for our great grandchildren to be able to do the sums, probably a little more effectively than we can.

Value for money in child care

The recent events in Rochdale, where under-age girls were forced into prostitution, have mainly focused on other issues. Prostitution has been a long-standing problem for young people in care – vulnerable teenagers who have been abused and sexualised at a young age, are often open to the opportunity, and no institution has ever found a satisfactory resolution. One of the issues which came out of the recent case was that one young girl who was placed in a single unit, with six full time workers, nevertheless managed to spend one or two nights a week out – 19 times in three months, which sounds worse.

The cost of this private unit whas been reported variously at £225,000 to £250,000 a year. Most authorities have some children farmed out in this sort of arrangement. That poses a question which has mainly been considered at much lower levels of need – whether such intensive childcare is justifiable. We know that the outcomes of formal care are generally poor, and that many arrangements end up making things worse. But there is a standard, default comparison: how a child would fare in substitute family care instead. What are the objections to paying a full-time foster parent a living income – say, £40,000 a year – instead of paying £225,000 for six-full time workers?

There are four main objections, and none of them seems to me to stack up. The first is professional training. I think we have to ask what a very damaged child needs to have provided on a 24 hour, 365 basis – thoughtful, systematic intervention or a secure, protective life style. There is no reason why these cannot both be done – but also no reason why they have to be done at the same time. The second is the variable quality of foster care, including – in the worst cases – abuse. That is true, but the same is true of residential units. Many local authorities take the view that they cannot pass an ungovernable child to any but the best foster parent. While I understand their reticence, the illusion is that they have a better option in residential care.

The third is that it is not possible to pay someone a large amount of money in a fostering allowance without treating them as an employee. That’s not right – this is family support, and family support doesn’t have respite or hourly rates of pay – but clarification of the law would help. The fourth is that while one can pass legal responsibility to a private provider, a local authority cannot pass it to a foster parent. That is true, but it shouldn’t matter. Local authorities are not minimising harm to a child by keeping the child in residential care instead. In relation to the third and fourth points, both hang on current constructions of legal responsibility. If the law is working against the child’s best interests, we should change it.

There are no general rules, but in every case where a child is in residential care, the question needs at least to be asked: why is this child not in substitute family care instead? If the only objections are the four I have mentioned, they should be overruled. Increasing the use of substitute care in the most difficult circumstances will inevitably lead to some bad decisions, and some disasters, but let’s be blunt: it’s disastrous now.

Scotland’s powers and the Social Fund

This is from a discussion from the Scottish Parliament’s Welfare Reform Committee, 1st May 2012:

“Jackie Baillie: Evidence from Professor Paul Spicker suggested that the Scottish Government does not have the power and competence to deliver benefits and the replacement social fund, and you appear to have opted to use local government powers, through a section 30 order. Is that why you said that you are considering introducing a social fund bill in 2013-14?
Nicola Sturgeon: We would need the section 30 order to legislate, as well. We have chosen the approach that I described partly for reasons of speed, so that we can get the interim arrangements in place, and because we are confident that we can do it in such a way. Our preferred approach of legislating later is just that—a preferred approach—and is not being taken because we consider that we require primary legislation. However, because of the interaction with social security we need a section 30 order, combined with the general power to advance wellbeing that local authorities have, to put the arrangements in place.
Jackie Baillie: Was he correct to say that there are issues of competence, which you have managed to overcome?
Nicola Sturgeon: To whom are you referring?
Jackie Baillie: Professor Paul Spicker.
Nicola Sturgeon: Before I could say whether he was correct I would need to look at the evidence. I would be happy to do so and to tell the committee what we think of it, if that would be helpful.
Jackie Baillie: It would be helpful to our consideration to understand what powers the Scottish Government has and for what purpose you would seek a section 30 order.”

So – am I right? The straight answer is, I don’t know. The issues are complex; the powers conveyed by the devolution settlement relating to local government can be read in different ways; in the event of a dispute, it is often difficult to know what an authoritative interpretation would look like. My main concern in raising the matter publicly now is to ensure that any resolution will not involve delay, confusion or denial of service to people in need. The resolution seems to hang on what the proposed section 30(2) order actually says. I am reasonably confident that the problems can be ironed out, but any practical solution is going to need to clear the ground so that Scottish and local government can operate effectively.

Personalisation falls short

This is the abstract of an article I’ve written, newly published in the British Journal of Social Work.

Personalisation offers individualised treatment in circumstances where markets do not operate. Personalisation is described variously as a process involving an individualised assessment and response, the expression of individual preferences and choices, or a process in which users and professionals negotiate a common understanding of the needs of the individual. The core arguments for individualised approaches are effectiveness, efficiency and responsiveness to need. However, personalisation sometimes falls short of the claims made for it. It is not always effective, because matching people to resources is time-consuming, difficult and dependent on so many conditions that mismatches are inevitable. It may be inefficient, because it is difficult to deliver selective services without either misplaced provision or inappropriate denial of service. There is only limited support to be found for the belief that services have become more responsive to individual circumstances as a consequence of personalisation, or that they are better matched to need. The case for personalisation has to be argued and proved in the context in which it is applied.

ESA assessments: new figures

Figures were released in March for the reassessment of ESA claims, and in April for new ESA claims. The reassessment figures show that over time, increasing numbers of people who formerly claimed Incapacity Benefit are being found as fit for work – 37%, when in the pilots it was 22%. The new claimant figures show that diminishing numbers of people are being found fit for work – 46% of claims, when in mid-2009 it was 67%. Those findings are consistent with each other – we should expect more people receiving benefit to be entitled than there are among people who claim – but both seem to show important shifts in practice over time.

The percentage of successful appeals also seems to be falling, down to 3!% for new claims. As before, 9 out of 10 people who apply with neoplasms (cancer) and congenital or chromosomal disorders (e.g. Downs syndrome) are not fit to work, and 7 out of 10 in both groups go to the Support Group (for those with the greatest levels of incapacity).

Saving for a rainy day

Why don’t public sector agencies have any savings to protect them against unforeseen events? The answer is, simply, because they’re not allowed to. If government agencies were able to decide for themselves when or what to spend, the Treasury would not be able to control public expenditure at any particular time. And public sector agencies aren’t allowed any slack, which is viewed as “waste”. They’re not generally permitted to transfer money between specified budgets, or across financial periods (a process known as “virement”). Danny Alexander, the Chief Secretary of the Treasury, has announced that the Treasury is winding down its contingency funding, and that government departments must now set aside 5% of their funding to meet contingencies. This presumably means that they must be prepared to reallocate budgets – which is equivalent to having no contingency funding at all. It also means that the capacity of every department to deal with major events is conditional on its own resources, rather than risks pooled across the sphere of government. Perhaps this is prudent housekeeping, but I can’t see how.

Personal Independence Payment

I have been looking at the consultation paper about Personal Independence Payment with some puzzlement.
The purpose of this reform was to replace the Disability Living Allowance, which the government thought was broken. This reform holds to the same basic structure as DLA – “care” and “mobility” components, and the denial of mobility support to older people unless their condition develops earlier. There is very little in the document which tries to deliver what the government claimed they could deliver – a personalised, sensitive and responsive benefit, administered through professionals. That is probably a good thing; it may make sense for physical support and care to be highly responsive, but people want and need support for income to be stable and reliable. There is also little in the reform that deals with the kinds of issues that have presented genuine problems, notably the response to mental disorders and conditions like multiple sclerosis that fluctuate frequently. That is not so good; people need the system to be consistent and predictable, and at present there is little prospect of either. As so often happens in benefit reform, it seems all too likely that the government will discover that their reforms have not had the effect they imagined, and they’ll have to come back for more.

JSA for the victims of domestic violence

With the winding down of Income Support, we are losing the main residual benefit that is available for people with very low income who don’t fit other pre-set categories. The DWP have announced a new rule, “easing” conditions for JSA claimants who have been victims of domestic violence. “Victims will be offered a period of support without worrying about looking for work.” This is very much to be welcomed, and I hope the precedent will be extended to others in catastrophic or unpredictable situations.