Eileen Munro
London School of Economics and Political Science
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Health Risk & Society | 1999
Eileen Munro
Abstract Risk management has become the dominant activity in child welfare services in Britain. It has the praiseworthy aim of identifying vulnerable children and protecting them from harm. However, it is becoming clear that efforts to achieve the desirable goal are producing unexpected and wholly undesirable side effects so that it is arguable that the child protection system is, on balance, doing more harm than good. This article analyses what has been happening in terms of the logic of risk assessment. It examines the way the concept of risk has moved to centre stage and details the unintended repercussions. Professional practice has been strongly reactive to public pressures. Society, however, has unrealistic hopes of the feasibility of developing accurate risk assessments and little appreciation of the pain caused to families by assessment procedures. It is argued that radical changes are needed in societys perception of child welfare and their expectations of professionals before we can create a ch...
Ethics and Social Welfare | 2007
Eileen Munro
Emerging child welfare policies promoting preventive and early intervention services present a challenge to professional ethics, raising questions about how to balance respect for service users with concern for social justice. This article explains how the UK policy involves shifting the balance of power away from families towards state and professional decision making. The policy is predicated on sharing information between professionals to inform risk and need assessment and so poses a problem for the ethic of confidentiality in a helping relationship. This article examines the arguments for information sharing and questions whether the predicted benefits for children outweigh the cost of eroding family privacy and changing the nature of professional relationships with service users.
Journal of Social Work Education | 2002
Eileen Munro
THE DEBATE BETWEEN Bruce Thyer and Tomi Gomory in the Winter 2001 issue of this journal provided a stimulating example of scholarly argument, and I am delighted to have the opportunity to make a further con tribution. Their articles brought out a num ber of significant issues relating to improving the knowledge base of social work practice. I want to pick up on two themes that emerged: the role of theory in evaluative research and the way evidence tests a theory. In this journal, it is hardly necessary to reiterate the case for evidence based practice but both of these themes seem to me to be fundamental to its develop ment and to the profession moving away from a predominant reliance on personal skills and intuitive knowledge. I find my self agreeing and disagreeing with both Thyer and Gomory to some extent and my concern is to propose a third, modified po sition on the issues. It is difficult in the
Health Risk & Society | 2010
Eileen Munro
Improving outcomes for children is a major concern in developed countries. This article examines the Every Child Matters (ECM) policy in England that seeks to integrate strategies for tackling a range of risks in relation to children, both risks of harm to themselves and harm they may pose to society. The emphasis is on early identification and intervention to reduce the numbers who go on to experience serious problems. The government cites research as providing the evidence to permit screening and targeting of ‘at risk’ children. However, ‘at risk’ refers to a range of adverse outcomes with different, though overlapping, causations. This article questions whether the research base permits an acceptable level of screening for individual children at risk in some general sense and raises concerns about potential harmful consequences.
European Journal of Operational Research | 2016
David C. Lane; Eileen Munro; Elke Husemann
This paper concerns the innovative use of a blend of systems thinking ideas in the ‘Munro Review of Child Protection’, a high-profile examination of child protection activities in England, conducted for the Department for Education. We go ‘behind the scenes’ to describe the OR methodologies and processes employed. The circumstances that led to the Review are outlined. Three specific contributions that systems thinking made to the Review are then described. First, the systems-based analysis and visualisation of how a ‘compliance culture’ had grown up. Second the creation of a large, complex systems map of current operations and the effects of past policies on them. Third, how the map gave shape to the range of issues the Review addressed and acted as an organising framework for the systemically coherent set of recommendations made. The paper closes with an outline of the main implementation steps taken so far to create a child protection system with the critically reflective properties of a learning organisation, and methodological reflections on the benefits of systems thinking to support organisational analysis.
Journal of Research in Nursing | 2012
Eileen Munro
The issue of wastage caused by missed appointments features prominently at a time when cost-saving measures become ever more important in the health care economy. Missed appointments are said to cost the NHS in the region of £600 million per annum. Various strategies are being tried and tested to ensure that people attend their appointments (or are in for domiciliary visits) including texting and phoning reminders. Clearly, attending for health care is generally in a person’s best interests. However, in the UK, if appointments are missed, then the usual outcome is a ‘three (or even two) strikes and you are out’ approach with a notification to the General Practitioner. In this paper we will argue that the seemingly widespread ‘Did Not Attend’ (DNA) routine described above is not appropriate where children and young people are concerned. The issue here is that the child or young person ‘Was Not Brought’ (WNB) to their appointment, rather than the fact that they DNA. This is important, because not only is access to health care their fundamental right (United Nations Convention on the Rights of the Child, 1989: Article 24), but failure to attend for health care is recognised as a child protection issue within statutory definitions of neglect. Failings in presenting children for health care is also known to feature prominently in cases that have reached the threshold for Serious Case Reviews, and this paper summarises the evidence in this respect. We conclude the paper by suggesting that reconceptualising child and young person DNA as WNB will lead to positive interventions to safeguard and promote the welfare of children that go beyond the missed appointment to a move towards the child-centric practice described in recent key reviews.
Journal of Forensic Psychiatry & Psychology | 2004
Eileen Munro
The Department of Health is introducing a mandatory reporting system for adverse events in the NHS which will replace the statutory inquiries held when someone with a mental illness commits a homicide. This is part of a radical transformation in the way that errors and adverse outcomes are investigated and in the types of solutions that will be sought. Inquiries after homicides have typically investigated whether there was an error or omission by professionals involved in the care of the perpetrator that was causally significant. If human error is identified, then the inquiry team tends to see it as a sufficient explanation and the investigation ends. Experience in other fields has found that such limited investigations do not produce effective lessons for preventing future tragedies. It is necessary to regard human error as a symptom not a cause and ask why that person performed that action in those circumstances. In particular, one can examine the systemic factors acting on the professional and consider whether they made a mistake more likely. This article shows how radically different this change is and contrasts it with the current procedure of inquiries. It is argued that the new approach holds the promise of more effective learning but it requires major developments in research design. It also requires a fundamental cultural change in the NHS to a more open organization where errors or mistakes (the raw data of the system) can be reported without fear of retribution. The obstacles to achieving this are discussed.
Evaluation | 2017
Louise Caffrey; Eileen Munro
There is growing interest in evaluating policy implementation in ways that grapple with the complexity of the process. This article offers an example of using systems methodology to explore how the child protection policy in child contact centres has functioned in practice. Rather than just asking the traditional evaluation question ‘is it working?’ this study sought to understand how the policy was working and how it was interpreted as it interacted with other systems, producing conflicts, local variation and emergent effects. It illustrates how the systems concepts of ‘emergence’, ‘local rationality’, ‘socio-technical systems’ and ‘feedback for learning’ can contribute new knowledge and understanding to a complex policy evaluation problem.
Archive | 2018
Eileen Munro; Andrew Turnell
While professional practice that respects children’s rights in child protection ultimately depends upon the actions of professionals, this chapter illustrates how the way their role is constructed within an organization helps or hinders them. An example from England illustrates the range of organizational change that has been needed both to allow and also to support rights-based practice.
Child & Family Social Work | 2018
Eileen Munro
The argument is made for having a positive error culture in child protection to improve decision making and risk management. This requires organizations to accept that mistakes are likely and to treat them as opportunities for learning and improving. In contrast, in many organizations, a punitive reaction to errors leads to workers hiding them and developing a defensive approach to their practice with children and families. The safety management literature has shown how human error is generally not simply due to a ‘bad apple’ but made more or less likely by the work context that helps or hinders good performance. Improving safety requires learning about the weaknesses in the organization that contribute to poor performance. To create a learning culture, people need to feel that when they talk about mistakes or weak practice there will be a constructive from their organization. One aspect of reducing the blame culture is to develop a shared understanding of how practice will be judged and how those appraising practice will avoid the hindsight bias. To facilitate a positive error culture, a set of risk principles are presented that offer a set of criteria by which practice should be appraised.