In 1980, June Lait and I published Can Social Work Survive?, the first critique of British social work aimed at the general public. She was a lecturer in social policy and a former social worker; I was a psychiatrist who had regular and friendly contact with social workers. But we both felt that social work had become vague and grandiose, and we compiled quite a lot of evidence to make our case. We even reported studies showing that well-intended social work interventions could be not just unhelpful but harmful. Our work was published in The Spectator, and it touched a nerve. ‘Of course social workers don’t do harm,’ one critic fumed.
This week we have seen the horrifying report of the multiple failures of social services in Rotherham, which meant that at least 1,400 children have had to suffer terrible sexual abuses at the hands of (predominately Asian) paedophile gangs. The Rotherham report suggests, as June and I suggested 34 years ago, that social workers excel at empathy but lack the ability to carry out ‘coherently planned action’. Social work with troubled teenagers is doubtless even more challenging today than it was in the 1980s, yet the report’s conclusions reveal many of the unhelpful institutional and ideological features that we identified are still with us. In one major review, we noted, 82 per cent of the statutory reports for children in foster care were overdue (in 53 per cent by more than three months). The Rotherham report by Professor Alexis Jay, a former social work inspector, also noted that ‘referral and assessment teams were responding too slowly…assessments were not completed on time’. Even when they eventually arrived, ‘Many reports failed to assess the risks to children and their families.’
It seems these were not just individual failures, occasional and regrettable exceptions in a generally efficient professional culture, but a persistent feature of a profession that emphasises doing good rather than doing it efficiently. This happens despite the fact that social workers have relatively modest case loads, especially compared with doctors.
In Rotherham, political correctness about race seems to have paralysed police and social workers. The report says that ‘-several staff described their nervousness about identifying the ethnic origins of perpetrators for fear of being thought racist’. This seems drearily familiar — even if race was less of an issue in the social work of the 1980s.
As worrying as the excess of political correctness in Rotherham, however, is the continuing resistance of social work to controlled, sceptical, independent studies of its effectiveness. In contrast to medicine, that resistance has long been a very prominent feature of social work in Britain (and in most other countries). Often, social workers not only resisted evaluation but blamed the messenger when the impact of social work interventions was shown to be either marginal or negative. Some claimed that social work was an art, not a science, and thus not to be judged by the normal criteria of effectiveness.
Another feature of social work that sets it apart from medicine is the way in which promotion in the profession nearly always means progressive withdrawal from doing actual social work (whatever that is) with real, messy human beings. In medicine, the most difficult and challenging patients are usually seen by the most senior and experienced doctors. If you are sufficiently ill to be in hospital, you will be treated by a very well qualified team. In contrast, if you are sufficiently disturbed to need to be in a children’s home, you will often be looked after on a daily basis by the equivalent of care assistants. Admittedly this may not matter much, because there is still little evidence that a high qualification in social work confers many advantages on the disadvantaged individuals they are meant to help.
Time and again, when a scandal such as Rotherham is revealed, we cry out, ‘How could our social services have let this happen?’ We should ask ourselves a more fundamental question: does social work actually work? The report from Rotherham suggests that social workers haven’t learned much in the last 30 years, and that the answer is still ‘not very well’.