Monday, 27 February 2012

The tangled chain

Last month I wrote about the relief we felt when we secured a place in respite care for Euan. What happened next came as something of a blow. I've thought long and hard about whether to write about this, because in many ways this was an oversight that arose from some pretty unusual circumstances and I'm loath to add to the blame heaped on people who who are so often made scapegoats for the failures of others. On the other hand, the things I learned about the workings of the care system are, I think, worth exploring.

Euan's second respite was due in the middle of February. He was due to be picked up from school on Monday afternoon by a taxi with an escort, taken back in by taxi on Tuesday morning and sent home on his usual school bus in the afternoon. On Monday afternoon, at about 3.30pm, Magteld had a phone call from school. Euan was still there, a teacher had stayed behind with him, and he was growing increasingly anxious. There was no sign of a taxi. A call to the social work department uncovered the problem: they hadn't been able to find an escort for him. Since I'd taken the car to work, Magteld had to jump in a taxi and collect Euan from school at short notice. Instead of a night's respite we had a confused and anxious child at home, and the repercussions lasted for the rest of the week.

I won't go into the details of exactly what went wrong, except to say that it was a near-unprecedented set of circumstances. We've been reassured that it's unlikely to happen again and I see no reason to doubt that. However, we also learned that around half the taxi escorts were laid off under social work budget cuts in Glasgow last year. As a result the department is now engaged in a constant fight to source escorts for every child who needs them for respite.

It might seem like the height of inefficiency to employ two people to transport one child from school to a respite centre, until you consider the alternatives. An eight-year-old child with autism can become highly anxious in a car with a stranger. If the taxi is held up in heavy traffic - or, worse, involved in an accident - the stress can quickly become unbearable. And an autistic child in the middle of a meltdown is not somebody you want to have as a passenger.

Another solution would be for the parent to escort the child, as happens at the weekend. But Euan's school is three miles from our house and the respite centre is five miles away from both, so one of us would have to spend more than an hour travelling to take him up to respite, then do the same thing early the next morning in order to get him to school. It may be a fix, but the side-effect is that it makes the concept of respite redundant.

What we have here, really, is a classic case of good intentions in one area being undermined by cutbacks in another. Most people and politicians agree that respite is a good thing. It gives the children some much-needed support and a chance to spend time with others of their own age, while easing the stress on parents. By intervening before things reach crisis point, it helps keep families together. The last one is something politicians like to be seen to be endorsing. It's also particularly important in these cost-conscious times, as children with disabilities are more likely to
end up in foster or state care when families break down, with all the expenses and long-term complications that ensue.

I stress these are flaws in the system rather than the fault of any individual. If the problem was a matter of one person's competence or attitude it could be speedily dealt with. But it's more complicated than that. Euan's respite care involves no fewer than four elements: the social work department, the respite centre, the school and us as parents. The first two are actively involved in his respite care, but the other two need to be kept informed of developments. The lines of communication are weak, and when something unexpected happens the chain can quickly become tangled, bringing the whole process to a grinding halt. What we experienced last month was, hopefully, a one-off. But for as long as council departments and care providers are encouraged to scrap for a dwindling pot of money in the name of "efficiency", their best efforts will be wasted and families will continue to feel let down.

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