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Historical amputations and lessons

 

Warning, yet again this blog post contains testicles – like the last one (and no doubt, some critics would say, most of them so far have been b******s throughout)

 

In the early days of surgical procedure, one man stood as a giant amongst his fellow professionals. Liston, often called “The Fastest Knife in the West End”.  In those days, prior to anaesthetics, the priority was to get the job done quickly, to get the ordeal over with as soon as possible and hopefully leave the patient alive.  One of Liston’s specialities was limb amputation, and he was well reknowned for being able to remove a limb in less than two and a half minutes. Of course, during one of his lightening fast amputations he took the patients testicles along with the leg. On another, it is said that he was sawing and cutting so fast that he took his assistant’s fingers off in the process, and also accidentally cut a nearby spectator. As the patient, spectator, and assistant ALL died of their wounds, this is said to be the least successful operation in history, having had a 300% death rate.

BUT overall , the death rate in Liston’s procedures was 1 in 10, as opposed to the usual 1 in 4.  And of course, Liston left medicine with one of the biggest advances ever, being the man who introduced anaesthesia to British medicine and gave it world-wide credibility (the chloroform he used was in practice in America, but Liston popularised its use).  Ironically of course, this made his lightening fast surgical skills rather redundant, as for the first time a surgeon could work with care and precision without risking the patient’s life.

 

It occurs to me, therefore, and this little vignette seemed a decent illustration of it, that speed isn’t always the best measure of something, and that being faster and faster for the sake of it doesn’t necessarily achieve the best results. The Family Justice Review looked very carefully and thoughtfully at how we could make care proceedings more efficient – meaning both faster and less costly, taking as an unspoken premise that our system was already getting good results and what we had to do now was just get them quicker and cheaper.  We already had the leg amputation techniques down pat, we just needed to get more efficient at it.

As has been evident to me from writing this blog, and thrown into even sharper focus with the furore about the decision of the President in Re J 2013, there’s a counter opinion to that unspoken premise. There are plenty of voices saying that actually, we aren’t currently getting the core function of family justice (to achieve the right and fair outcome in cases) and that speeding up the process isn’t going to put that right.

Now, I happen to believe that in the overwhelming majority of cases, if one looked at them independently, they would be achieving the right and fair outcomes. One can’t realistically expect a parent who loses their child to feel anything other than hurt and aggrieved and devastated. You’re not ever going to reach a system whereby every parent nods at the end of the case and says “Yeah, that was a fair cop”, but are those who speak out about the system just parents who haven’t come to terms with an awful and painful (but objectively fair decision) or are they actually as they report, the victims of injustice? Are even some of them?

 

I don’t mean do social workers sometimes make mistakes? Of course they do. All professions make mistakes. I mean, do we have confidence that the system we have in place – which gives the parents the chance to see the evidence against them down on paper, to see all relevant records, to have free legal advice, to question witnesses who accuse them of things, to call their own witnesses to support them, and all of that being determined by a Court who are unbiased and fair and start from the principle that children ought to be at home with parents if at all posible – does that system, catch the times when social workers have got it wrong, have come to a conclusion that might not be the best for the child?

I personally believe and hope that our system does that, but it doesn’t really matter what I believe and hope. We deal in evidence.  When the State is given power by the Government, to make recommendations about whether children should live with families, or be adopted, and where the Court is given power by the Government to make the decisions about whether those recommendations are correct; we need to remind ourselves that those powers are exercised in the name of the public, and it is therefore essential that the public have confidence that a system is in place that whilst individual errors might sneak through from time to time, is not inherently flawed or failing.

 

This is a debate which needs to take place. Not just ‘how can we do it cheaper, how can we do it faster’   – but is the system strong enough to get things right and learn from those cases where mistakes are made?  It was very easy in Re J to allow criticism of social workers to take place in the public domain, but did the Court really “own” their own decision-making? That child was removed, and remained in foster care because the Court decided so. The LA ask for the orders, but the Court decide whether or not to make them. If there’s blame there  (and we really don’t know about Re J, because no information about the case is in the public domain) part of that blame rests with the Court too.

With that in mind, I can see why the President is in favour of greater transparency, both in his plans to publish anonymised judgments as a matter of routine and in the RE J case of allowing criticisms of the system in language that might seem emotionally loaded to remain in the public domain (so long as the identity of the child remains secret). In doing so, an awful lot changes, and as yet, we don’t know how much will change and in what ways. As the ruler of China said about his thoughts on the French Revolution “It is too early to say”

 

With these changes, the 26 week timetable, the financial pressure on family law solicitors and the prospect of more and more advice deserts spreading across the country, these are watershed moments for family justice.  I’ve seen in a relatively short few years, cases move from the occasional parent being a heavy cannabis smoker to large proportions of cases being about heroin and crack addiction; I’ve seen the internet move from dial-up and “Page not found” – effectively a slower form of Ceefax, to becoming a fixture in most people’s lives, somewhere that can make publishers, documentary makers, journalists of almost anyone who chooses to be one. The times, they are a changing.

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About suesspiciousminds

Law geek, local authority care hack, fascinated by words and quirky information; deeply committed to cheesecake and beer.

3 responses

  1. EXAMPLES OF HOW RULES OF EVIDENCE HAVE BEEN DISCARDED IN THE FAMILY COURTs WHEN GRANTING INTERIM CARE ORDERS.
    1:- Statements from the local authority are shown to the judge but rarely to parents.Family and friends of parents are routinely excluded from the court but groups of social workers are allowed to stay in the court to listen to their colleague’s testimony whether they are witnesses or not.
    2:- Parents representing themselves are denied the opportunity to cross examine witnesses appearing against them.Judgements,reports from experts,and position statements are either witheld or given to parents at the last minute (too late to read and analyse them properly).
    3:- Parents are routinely refused permission to call for a second opinion when “experts” and Doctors have testified against them.If parents record contacts with their children, or interviews with experts or social workers judges routinely refuse permission for these recordings to be heard yet they always allow recordings and video evidence to be heard if produced by police or social workers.
    4:-Parents whose children have been taken are routinely and wrongly told that they may not talk to ANYONE about their case.
    5:-Parents are threatened with jail if they protest publlcly when their children are taken.They are also jailed for “breach of the peace” or “harassment” if they dare to trace and then contact their own children after adoption.Parents are therefore” twice gagged” contrary to the Human Rights Act ,Article 10 entitling all persons “freedom of expression”,ie freedom of speech.
    6:-Local authority barristers in court often read out statements from absent persons as though they are themselves witnesses but they cannot be questioned.
    7:- Most solicitors refuse to let their clients speak and then agree to all care orders demanded by social services.They tell the hapless parents “it is better not to oppose the interim care order ,but to wait for the final hearing”,ignoring the position set out below (in red) where L.J.Thorpe makes it very clear that the parents are so prejudiced by the proceedings thereafter that it is “very difficult to get a child back” after a removal hearing.
    8:-Judges routinely castigate parents who wish to speak or who represent themselves even though they have the right to do so;Their evidence and their arguments are usually ignored in the judgements.
    9;-Parents representing themselves are often given an hour or two’s notice to appear in court but solicitors are given weeks !
    10:-Parents are punished for “risk” ie not what they have done but for what they might do in the future! “Risk of emotional abuse” is favourite because there is no legal definition of this and it is usually impossible for parents to defend themselves against “predictions” by so called “experts” who are often unqualified (20% according to the latest report by professor Ireland commissioned by the government!)
    11:-Judges give social workers the power to withold parents’ contact with their children” in care” as a punishment for saying they love them and miss them or that they are fighting to get them back .Foreign children are forbidden to speak their own language with their parents or relatives,mobile phones are confiscated,and children in care are denied these basic rights that are however accorded to murderers and rapists in prison!They use this power to gag parents and force them into complete submission !
    12:-Parents are in effect condemned for offences against their children on “probabilities” 51% instead of beyond reasonable doubt.They can be acquitted in the high court and,the appeal court,and even when all charges have been dropped by the police social services can overule all those bodies and condemn parents on 51% probability (nearly half the time they could be wrong!) and take their children into care with a view to forced adoption.
    13:-Parents who were themselves in care or who were abused in childhood are often judged unfit to be parents as a result.Their past misdemeanours such as shoplifting,or destruction of property (often 10 years ago or more)
    are inevitably used against them during proceedings in court to prove them unfit parents.This would be illegal in a criminal court.
    14:-Parents often forfeit their children for “failing to engage with professionals”The very persons who tell them and their neighbours that the children will never be returned !
    15:-Parents faced with forced adoption lose their children for life, without being allowed a hearing by jury.
    16:-Under the UN Convention on children’s rights,and a recent Supreme Court case (W a child), children have a RIGHT to be heard in court but are usually denied that right.
    17:-Solicitors routinely tell client parents to agree to interim care orders or they risk never seeing their children again.A lie !
    18:-Social workers are legally obliged to place children with relatives if possible but either ignore this or find pretexts to fail them on assessments
    19:-Human rights to free speech and freedom of movement are breached by gagging orders, confiscating passports,and even “prohibited steps” that limit parent’s movements and can force them to remain in the same flat or house indefinitely !
    20:-The Children Act specifically instructs social workers to reunite families wherever possible and to place children removed from their parents with relatives.In practice couples are urged to separate,to quit their jobs and go on benefits so as to keep awkward contact times with their children and to be free to meet social workers etc for meetings whenever summoned to do so.Relatives such as grandparents,aunts,and uncles are set aside to be “assessed” and are more often than not failed on the grounds that they are too friendly with the parents or maybe had a difficult past 10 years ago, or more simply that they are too old in their forties or fifties even though this does not apply to fosterers .Theory and practice are a long way apart in our family courts;
    Family torn apart in 15-minute court case by Judge James Orrell …
    Lord Justice Thorpe said on Appeal “I am completely aghast at this case.There is nothing more serious than a removal hearing,because the parents are so prejudiced in proceedings thereafter.Once you have lost a child it is very difficult to get a child back.” The hearing above lasted only 15 minutes after a doctor “expressed the opinion” that bruising in the ear of one of the three children looked as though it was caused by pinching .The parents were not allowed to give any evidence!Their three children had all been forcibly removed until they were ordered to be returned by Lord Justice Thorpe on appeal.

  2. I agree with the points made by Forced Adoption, above, because our experience with many clients has been similar.
    However, what also became clear during the “process” was that we were all being processed -families. advocates and social workers alike. We were all on tramlines going only in one direction, There were two controlling mechanisms: policies of the last two governments prioritising adoption (or as one of our Jewish clients called it, ‘redistributive eugenics’), and the computer programme which efficiently helped to erase the ethical and professional standards of social work. See
    http://bjsw.oxfordjournals.org/content/39/7/1197.full
    on the Tyranny of the Common Assessment Framework by Sue White et al in the British Journal of Social Work.
    Had the educational standards of social work not been lowered following the Seebohm Report , which led to generic training, perhaps we would have had a profession with the know- how and ethical base to challenge what was happening. Instead, like the volunteers in Stanley Milgram’s book Obedience to Authority, they could excuse themselves as cogs obeying higher authority and happily ticked the boxes which did not require them to think too deeply.
    As a result of their failure to protect their own professional standards, social workers are now widely hated and distrusted. It has been interesting to observe the same clients in meetings with different social workers – both nice and nasty., The style was less toxic, but the process was just as damaging. And as a group used to working with midwives, we were shocked at their ignorance, including lack of familiarity with the contents of their own professional journals.

    Jean Robinson, President, Association for Improvements in the Maternity Services

    • Jean

      You have shown up what many other true professionals recognise, that social workers are just not professional or deeply knowledgeable (e.g. about the conflicting studies in published papers- they just regurgitate the taught theory of their classroom).

      I have had health professionals ‘off the record’ make very unflattering comments showing their views of the social work establishment. To them it serves a ‘pass on function’ for clients that they also have to treat. I.e. it is a part of client being processed through a system because everyone in the different parts of the system takes a fixed role.

      Unfortunately multi-skilled and disciplined people, although a few exist, are rare in professional settings or willing to cross boundaries of their discipline, time constraints etc. hamper this as well as attitudes of unions to protecting different ‘professions’ as separate.

      Of course in many countries of the world such separation of roles would just not be possible.

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