Abstract
Four years ago, the journal carried an editorial about the implications of political moves to the ‘right’ for looked after children, noting the opinions being expressed at the time by the likes of Trump, Le Pen and Brexiteers (Bullock, 2017). This trend was reviewed again last year, blissfully unaware of the forthcoming pandemic that has stifled political discussion (Bullock, 2020). So, it is opportune to ask, how is COVID-19 likely to affect disadvantaged children and the services they receive?
Relevant in the search for answers is the 2017 journal article that charts the history of the concept of disadvantage and the ideologies underpinning responses to it (Parker and Bullock, 2017). It stresses the significance of definitions of need and the power of those who construct them and explains how eligibility criteria are set to limit user numbers and control costs. It also shows how the constant demands on governments to tackle society’s ills have been confounded by moral and practical issues and how this tension is manifest in the design of individual services.
But what is significant about the COVID-19 pandemic is that unlike many other social problems, its scope, indiscrimination and fatal effects override the dilemmas that haunt most welfare planning as everyone is a potential victim, all qualify for expensive treatment, age and gender pose no barriers, there is no associated blame or stigma and no contention about who deserves help. Eligibility tests only apply to administrative matters, such as who gets furlough payments. As a result, cost concerns have been cast aside, rationing is seen as immoral, the strength of the pathogen constrains professional discretion and the perennial challenge of inter-agency collaboration is not a stumbling block as the NHS is bearing the brunt.
But the effects are not just medical. All areas of life are affected: living situations, accommodation, family and social relationships, physical and mental health, education and employment, social and anti-social behaviour, leisure activities and finance. Equally important is the fact that these areas are interconnected in that problems in one produce difficulties in others, creating chains of effects where, for instance, sickness leads to unemployment which produces depression which results in child neglect, thus linking factors that would not normally be perceived as related. Moreover, for children there is the added complication that many of the areas involve transitions – in education, relationships, personal development and leisure – many of which have to be made at the same time. It is hardly surprising that failure in one can damage success in others.
The wider effects of the pandemic are reported daily and, following the list of life areas above, include rent and mortgage arrears, family tensions with associated domestic violence and child maltreatment, impaired mental health, disrupted education, restricted leisure facilities and increased expense for families stuck at home. Moreover, these risks are greater for certain groups, such as the poor, elderly, chronically sick and BAME communities, but no one is immune as revealed in Miller and colleagues’ article on foster carers’ self-care and well-being in this edition.
The responses to COVID have been equally remarkable. A Conservative government with a sizeable majority has paid the wages of millions of workers, subsidised industries, closed schools and restricted freedom to travel, all contrasting with the individualistic competitive-market philosophies expounded in its election manifesto three months earlier.
These problems will hopefully reduce as the pandemic wanes, but some long-term effects are inevitable after such huge social disruption. The historical paper assesses the political and social impact of upheavals and crises and concludes that pride of place must go to war. It upsets the established order, shatters political creeds and demands fresh ways of doing things and prompt solutions as weaknesses and shortcomings are exposed. The Boer War (1899–1902) revealed the extensive unfitness of young men that precluded them from joining up which, given the context of a resurgent Germany, jeopardised the country’s security. Something had to be done about the health of the nation’s children. The quality and availability of milk became a major focus, with the result that a school health service was introduced and free school meals provided in the most deprived areas.
The First World War led to further important policy changes in all sorts of areas. Take housing, for example: shortages intensified during the war, giving landlords the opportunity to charge rack rents, often from the families of soldiers at the front. As some 90% of housing was privately rented, anger against exploitative rents and profiteering grew and rent control was introduced in 1916. Although this was intended to be a temporary measure, it lasted for nearly 50 years and legislation to encourage the building of council houses soon followed, eventually breaking the stranglehold of private landlords.
Even more radical changes followed the Second World War, during and after which the welfare ‘system’ underwent its most far-reaching shake-up. For example, as both troops and civilians were injured by enemy action, the existing health system was inadequate to deal with these casualties. Free medical care had to be provided, which made it politically impossible not to make it universally available or to abandon it after the war. There was no going back to pre-war arrangements. Subsequent conflicts have had the same effects, for instance the cost of the Korean War called for economies elsewhere, one of which was the imposition of prescription charges for the first time.
Another important consequence was growing public sympathy for ‘no-blame’ victims, such as war orphans, widows and bombed-out families, and the establishment of communal facilities such as civic restaurants. In addition, new technologies and treatments were developed. The ‘shell shock’ phenomenon of the First World War caused an important page to be turned in psychological understanding and theory while the recent wars in Iraq and Afghanistan have produced major advancements in trauma treatment, surgery and rehabilitation.
It is tempting to think about the services that are required to combat the effects of upheavals in terms of specific individuals or groups. However, looked at historically, it has been the development of universal services that has reduced the extent of severe disadvantage; in particular, public health measures and compulsory education from the latter part of the 19th century, improved nutritional standards from the early decades of the 20th and, not least, the emergence of the ‘welfare state’ during and after the Second World War. It is worth recalling that the five ‘giant evils’ depicted in the Beveridge Report of 1942 – squalor, ignorance, want, idleness and disease – were tackled to a greater or lesser degree in the cascade of social legislation that followed. The Poor Law was dismantled, a national health service established, a social security system put in place, an educational programme launched, slum clearance expanded and a commitment to full employment made. Although progress was and has been uneven, these reforms constituted a major onslaught on the disadvantage and deprivation revealed in the earlier turmoil.
So, what are the likely long-term effects of COVID-19? Will they be as profound as a major war? Will they merely accelerate existing trends, such as moves to home working and distanced learning or will they be radically different?
Initially, it is clear that the country was unprepared for such a major crisis and contributing to this must be the rundown of public services during the preceding decade. Compounding this is the dominance of poverty in the underlying narrative of the spread and distribution of the infection. Behind the medically high-risk factors – old age, underlying health conditions, frontline exposure – the poor in all of those categories are more likely to die from the illness and even those who remain healthy suffer more financially. The rising income inequality in the UK and the realities of food poverty can no longer be ignored.
For children, the deprivation is especially marked in education (and for the elderly in care homes), which has suffered disproportionately and has displayed little evidence of the crisis planning that has, so far, saved the NHS from collapse The legacy of lost opportunities, increased mental health issues and a sense of bitterness and injustice among young people and their parents are likely to have long-term repercussions, as they will undoubtedly feel that the young have paid the highest price to cope with a disease that primarily affects the old.
What actions are likely, and will they benefit looked after children?
Initially, it is clear that to achieve radical change, planning for the future must move from an individualistic to a more collective response to society’s problems. For this to happen, a state of the nation review of equality and fairness in society, perhaps leading to a Beveridge Report for our times, seems essential. This would need to capitalise on a national perception that income inequality has gone too far and should be reined in by measures such as a higher minimum wage and some form of wealth tax. The perceptions that increased taxation is politically unacceptable and that high welfare expectations can be met with low taxation must be confronted.
It would also help if the rundown of key public services was reversed. The NHS, which had seen a decline in performance even before the current crisis because of cuts, is the obvious priority but not to the neglect of other services.
Lastly, there should be a new deal for the young. The absence of a national care strategy for deprived children, coupled with the poor quality of provision and the lack of status and training among staff, has been highlighted and the Education Secretary has already launched an independent review of children’s social care that builds on the Department’s COVID-19 response programmes and initiatives to improve families’ access to vital services. But the need is for something greater – strategies that enhance the prospects of the whole next generation to fully participate in the benefits of an advanced society through decent, affordable housing, better employment prospects and greater and lifelong educational opportunities.
The upheaval caused by the pandemic may not be as great as a major war, but it provides a unique opportunity to consider social possibilities. Looked after children will always be a minority but their experiences are symbolic of much wider social philosophies; what happens to them will reflect the humanity of whatever else develops.