Scottish care review report calls for 'radical' overhaul of 'fractured' system

A radical overhaul of Scotland's care system has been demanded after a major review damned it as "fractured, bureaucratic and unfeeling" for children and families.

The review says the failures of the current system of care for children and young people has a "human and economic cost". Picture: Stock/JPIMedia

The Independent Care Review, published today, says the failures of the current system of care for children and young people has a "human and economic cost" and needs to be urgently reshaped.

The review, which has taken three years and involved 5500 people with experience of the system including children and adults who have lived in care, and those who work in the sector - paid and unpaid - has catalogued 80 specific changes that need to be implemented by the Scottish Government and local authorities.

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It also calculates that the services which deliver and "surround" the care system cost £1.2 billion a year - while the cost of "letting down" children and families totals £1.6bn - £875m meeting the needs of care experienced people after the system has "failed" and £732m in lost income tax and national insurance.

Currently there are around 15,000 young people in care, and figures show that "care experienced" school leavers have lower attainment than other young people, that they leave school earlier, and are less likely to be in a "positive destination" nine months after leaving.

Statistics also show that a third of young offenders, and almost a third of the adult prison population, identify as having been in care, and in one study 45 per cent of young people in the care of councils were assessed as having a mental health issue.

Today Fiona Duncan, chair of the Independent Care Review launched the in-depth examination of all aspects of care in Scotland which has revealed "a system that is fractured, bureaucratic and unfeeling for far too many children and families and does not adequately value the voices and experiences of those in it."

She said: “I have heard countless stories of when the care system gets it wrong; separation, trauma, stigma and pain. Too many childhoods have been lost to a system that serves its own convenience rather than those within it.

“The Care Review has listened to what care experienced people have said needs to change and those voices have driven its work and underpins its conclusions.

“It has sought to understand how the system feels to those who live and work in and around it. And it has produced the what, how, why and when of what needs to happen next. This is a radical blueprint for a country that loves, nurtures and cherishes its children. This is Scotland's chance to care for its children, the way all good parents should.”

The report urged that the government adopt a "broader definition" of risk, to encompass, not just the risk of leaving a child with their family, but of removing the child and placing them in the care system.

It says that regulations put in place after tragedies, "have not always prevented further harm and have had a significant impact in preventing caring and loving relationships from developing."

The report states: "Scotland must listen to and absorb the overwhelming evidence of the lasting pain that removal has caused children, families and communities. This must result in a fundamental shift of thinking about when a child should be removed from their family. Scotland must broaden its understanding of risk when making decisions about children and their families

"Removing a child from their family creates trauma for the child, the family and the community. If Scotland is to change the lives and futures of children there must be a change in policy, practice and communities to change the way we all think.

"There must be a reframing of the way Scotland thinks about risk, what to prioritise, and how best to respond. Safe and loving relationships must be the starting point for Scotland’s thinking about children. Scotland must understand the pervasive and persistent harm of a lack of loving relationships."

However in the report she warns against the government attempting to "legislate for love" "A legislative framework for love would be driven by an institutional view of love that could not possibly reflect the experience of being loved and cared for," Ms Duncan said.

"To ensure the experience of being loved is possible and much more probable, Scotland must create an environment and culture where finding and maintaining safe, loving, respectful relationships is the norm.

"That will involve fundamentally shifting the primary purpose of the whole of Scotland’s ‘care system’ from protecting against harm to protecting all safe, loving respectful relationships."The report comes a day after First Minister Nicola Sturgeon completed her "challenge" of meeting and listening to more than 1000 care experienced young people, to discuss changes to the system.

Ms Sturgeon had pledged in 2016, when she announced the indepdendent review, to meet at least 1000 young people in care. At the same time she also announced the removal of the upper age limit for the £8,100 per year bursary to which care experienced students are entitled, the introduction of the Children’s Bill to ensure siblings and wider family relationships are protected where it is safe to do so and the introduction of a £33m "Care Experienced Children and Young People Fund" to improve educational outcomes.

However, the indepenent review has urged the government go futher and demanded that the "power balance" in the system be "upended" so children and young people are "always the basis of all decisions made about their lives"; that there is a focus on building and maintaining life-long relationships; that Scotland should "parent not process" children so "there is no difference between the lives of children in care and their peers"; and that families be kept together wherever it is safe to do so with the support required given at the earliest opportunity.

Ultimately, it say that with such changes children in care should be "free from stigma" and be able to live "a safe, happy life at home with their families."

Today Ms Sturgeon said:

First Minister Nicola Sturgeon said: “In 2016 I accepted a challenge to listen to the experiences of 1,000 looked-after young people because I knew the care system needed a transformation and I wanted to hear first-hand what had to change. These early conversations inspired me to announce an independent root-and-branch review of the care system.

“I have had the privilege of meeting many young people with experience of care who are doing extremely well, I have also been given the chance to see the dedication, commitment and passion of those who work in the care sector. But I’ve also heard some extremely difficult stories which portray the care sector as bureaucratic and even unfeeling.

“It is clear that despite the efforts of those within the system, the actual experience of too many people in care is not what we want it to be.

“We will keep listening to and working with care experienced people because the case for transformational change is now unarguable and their voice must shape that change. We will work with them and with local authorities, care providers and others to deliver that change as quickly and as safely as possible.”

The report is made up of a number of parts - "The Promise", which lays out what Scotland's ambition for children and young people in care should be, "The Plan" of what needs to be done, by who, by when and how, "The Money" how Scotland must change the way it invests in the care sector and "The Thank You", which gives thanks to the 5,500 people who shared their experiences.

Today the leading organisation for people who have grown up in care welcomed the findings of the review, which had promised to look at the practices, culture and ethos of the care system.

Who Cares? Scotland had called for a root and branch review of the care system because of the “intolerable and stubborn” outcomes those who experience the care system face in life. The organisation has argued that young people in care are unnecessarily separated from their brothers and sisters; aren’t respected in the formal processes that govern their lives and experience stigma as a result of their experience.

Duncan Dunlop, Chief Executive of Who Cares? Scotland said: “We want to do is congratulate Fiona Duncan for her commitment and recognise the strength of every care experienced person who contributed their voice to the review over the last three years. This was promised to be a review like no other and that is why we believe its findings should provide a platform for the kind of change that care experienced people desperately need.

“Care experienced people are capable, thoughtful and have enormous potential. What we have seen, unfortunately, are generations of people living with the consequences of a care system that focused on containing them then leaving them, rather than ensuring that they are loved and supported forever.

"We have also seen Scotland struggle to connect with how it can support care experienced people. With that in mind, we will now take the necessary time to reflect on the findings that have been published today and consider in what ways the recommendations realise our ambitions for change."

He added: “In January this year, the Care Inspectorate published figures on the early deaths of care experienced people. They said that between 2012 and 2018, 36 people in the care of the state died unexpected or untimely death. We know from our own networks that this is an under-representation, with six young care experienced people in our network dying in December 2019 alone.

"The evidence shows that what the Scottish Government chooses to do next is literally a matter of life and death. We expect to see urgent action, in the next few weeks, that makes a tangible difference to young people’s lives. Any further delay would be unacceptable.”