Child Health Policy - Essay Example

CHILD HEALTH POLICY Discuss Fitzpatrick’s claim that ‘The emphasis in policy making is now on minimising risks, rather than maximising social justice. Illustrate your answer in regard to every child matters and health policy, since one of the objectives of every child matters is health. Introduction: In U.K. there is development towards health care for children. However, research shows that the picture is not too bright, and policy changes and implementation of workable strategies are called for, on a priority basis. Risks and Social Justice: Risk theory has been one of the academic success stories of the last twenty years. It has wide-ranging applications in social democracy, economic globalization, and debate about modernity. In his book Social Policy and Risk, Ian Culpitt is of the opinion that neo-liberalism has generated a social culture of risks, and defeats the concepts and values of the classical welfare era. Individualism (choice, preference, consumption) has replaced collectivism ( altruism, needs, the public sphere). Tony Fitzpatrick in his review of the book, states that the emphasis in policy making is now upon minimising risks and fears rather than upon maximising social justice. (Fitzpatrick, 2000, p.508) says that neo-liberalism demonises those who are most victimised. The obsession with welfare-dependency and benefit fraud that now stretches across the political spectrum is a sign of the extent to which neo-liberal precepts have infiltrated debates about social policy reform. It is Culpitt’s view point that risk is fundamental to neo-liberal discourse, and cannot be aligned with risk society and reflexive modernisation, as other scholars like Beck believe. Beck (1999: 72-90) (as quoted in Fitzpatrick, 2002, pp.11-12) challenges the bases of traditional social policy. During the ‘first modernity’ it was believed that risks could be insured against by designing welfare institutions against the evils of want, ignorance, disease, idleness and squalor: income maintenance, education, health, employment and housing. Social changes have brought about a range of risks and uncertainties that derive from the operation of welfare systems themselves. Beck (2000a) (as quoted in Fitzpatrick, 2002 p.12)feels that a social culture of experimental diversity should be created, that allows the quick, flexible and transnational management of risks whenever they arise. Beck advocates democratisation to empower those who experience risks. Fitzpatrick (2002) p.12 states that Beck’s version of a welfare democracy would involve cultural but not necessarily material empowerment. Every Child Matters: Research commissioned by the Department of Health shows that domestic violence is a major indicator of risk of harm to children. Children are often abused physically, sexually, emotionally by the same person who has abused their mother. Children whose mothers experience violence tend to have the worst outcomes in child protection cases. Research indicates that domestic violence accounts for half of child deaths. (House of Commons, Ninth Report of Session: 2004-2005, p.3). The Green Paper: Every Child Matters (Chief Secretary to the Treasury 2003), is a report on child protection. Some of the issues identified by the report such as the recruitment and retention of childcare social workers, and the effectiveness of Area Child Effectiveness Committees, have already been implemented in various places. (Stanley, Nicky 2004, p.8). Government Policy: According to Heenan, Birrell, (2006), mechanisms for the integration of social services with health have come to dominate the debate on providing a more seamless provision of health and social care, as in Northern Ireland. Integration was considered to be inherently beneficial, with an improved continuity of care between hospital and community, for all patients and special care groups. Partnership and joint working have become a key feature of British social welfare since the late 1980s.(p.47). The White Paper: Modernizing Social Service (DOH 1998b) proposed flexible partnership working. The subsequent Health Act in 1999 enabled flexible approaches to the overcoming of obstacles to more integrated working through pooled budgets, lead commissioning and integrated provision. Government policy quickly moved on with the publication of the NHS Plan (DOH 2000), advocating stronger and deeper working together by health and social care agencies, and calling for fundamental change. The Health and Social Care Act 2001 facilitated their establishment on a voluntary basis through local joint arrangements.(p.48). Members of professional groups are prepared to transcend individual professional boundaries to achieve good outcomes for children at risk. Multi-professional training and staff development are ensured; with courses offered on a range of subjects including needs assessment, case planning, working with children who have been sexually abused, child protection training and courtroom skills.(p.58). Petrie and Wilson 1999 (p.181) state that following the implementation of the Children Act 1989, many of the organizational systems in relation to markets originally developed for adult services, have been adopted for children’s services. The widening gap between contracting systems in adult and children’s services needs to be addressed. The NHS and Community Care Act 1990, has influenced services for children by drawing the management of these services into a market framework, and small but steady growth of independent sector provision across all children’s service areas.(p.193). Children’s needs are best met by care which is sustainable and consistent, and it is essential that such care is planned strategically, developed, flexibly adapted, and supported over a period. Relational contracting is one way of supporting such developments.(p.195). In Fitzpatrick’s (2002, p.757-758) review of Kemshall’s book, he reports that need has been supplanted by risk as one of social policy’s key principles. Kemshall after giving the conceptual foundations of risk, examines the notion in terms of healthcare and child protection, with regard to strategies composed of certain contacts and procedures to be followed, for ensuring the child’s welfare. Research: Butler (1997) states that: In 1993, postal surveys were conducted regarding pre-school Child Health Surveillance (CHS) in England and Wales. Content analyses were also carried out of strategic policy statements of CHS, produced by 54 district health authorities in England and Wales. The impact of recent changes affecting the structure and operation of CHS, include: the publication of Health for All Children, the 1990 Contract for General Practitioners (GPs), the implementation of the National Health Service and Community Care Act 1990, and the changing roles of community doctors and health visitors. Four adverse findings from the survey are: 1) Fragmentation in the child health service. 2) The unwanted effects of the NHS internal market. 3) The adverse consequences of the changing role of health visitors. 4) Concerns voiced by the community doctors about the quality of CHS in general practice.( p.339). According to the Draft Work Programme on Health for 2007-2008, regarding Child Health, it is stated that support will be given for clinical studies and research projects in paediatric populations. Research issues related to child health and paediatric diseases which will be studied are: paediatric formulations of drugs against HIV/ AIDS, malaria and tuberculosis, combined forms of diabetes in children, promoting healthy behaviour in children and adoloscents, addressing knowledge gaps in pregnancy malaria, and health care intervention research, and improving pre-natal and maternal care. Fitzpatrick (2002) is of the opinion that a welfare democracy would need to maximise social justice through strategies of empowerment.(p.17). The Commission on the National Health Scheme (NHS) advocates an NHS constitution, making the NHS independent from government, and with elections to health authorities and trusts. This empowerment would help in achieving greater social justice. Conclusion: By minimising risks to children, by protection and awareness among citizens and health care workers, child welfare can be ensured. Immediate access to emergency services or help should be readily available, so that prompt action can make all the difference in a child’s life. Child health surveillance and research need to be done on a war footing. REFERENCES Butler, J.R. (1997). Child Health Surveillance in England and Wales: the bad news. Child: Care, Health and Development, Blackwell Science Ltd.Vol.23, No.4, pp.339-354. Draft Work Programme: A Thematic Priority for Research and Development Under the Specific Programme ‘Cooperation’, Implementing the Seventh Framework Programme(2007-2013), Of the European Community for Research, Technological Development, and Demonstration Activities. Fitzpatrick, Tony. (2000). Book Review ( of Ian Culpitt’s (1999) book Social Policy and Risk, Sage, London) Journal of Social Policy, Vol.29, No.3, pp. 505-536, U.K.: Cambridge University Press. Fitzpatrick, Tony. (2002). In Search of a Welfare Democracy. Social Policy and Society, Vol.1, No.1, pp.11-20. Fitzpatrick, Tony. (2002). Book Review: (Kemshall, Hazel, 2002, Risk, Social Policy and Welfare, Open University Press, Buckingham), Journal of Social Policy, Vol.31, No.4, pp.753-778. Heenan, Deirdre; Birrell, Derek. (2006). The Integration of Health and Social Care: The Lessons from Northern Ireland. Social Policy and Administration, Vol.40, No.1, pp.47-56. House of Commons, Education and Skills Committee, Ninth Report of Session 2004-2005, Vol.II., Every Child Matters. Petrie, Steph; Wilson, Kate. (1999). Towards the Disintegration of Child Welfare Services. Social Policy and Administration, Vol.33, No.2, pp.181-196. Stanley, Nicky. (2004). The Age of the Inquiry. Routledge, U.K. Read More