I received a copy of this book from the publisher (Policy Press) in return for a fair and considered review. I approach this book from the perspective of a current practitioner (in health services), but with an academic/research background.
This is an excellent review of the underlying politics and interests underlying the prevailing social investment model of early intervention for children in the UK, and it is particularly excellent and thorough in dismantling the ‘Emperor’s New Clothes’ fetishisation of poorly interpreted neuroscience which forms the basis of much policy and current practice in early intervention. The historical roots of this approach provided fascinating background to what has become a largely cross-party consensus (though for differing reasons, depending on one’s political hue) that individual work with children and their primary caregiver (primarily the mother) is prioritised over the improvement of the social and material conditions in which children and their families live. The outlining of the various interest groups involved (political, business, philanthrocapitalist, and certain practitioner groups), as well as their problematic co-opting of poorly- (or over-) interpreted brain science, laid bare the underlying (not always entirely philanthropic) motivations for the development of this consensus, and paved the way for a blistering – and very timely – exposure of the overal social investment consensus as effacing gender, race and class factors impacting on children’s development. Further insights from practitioners highlighted indeed how, as the authors state on p.119, “Practitioners work in contexts where there is little internal questioning about the general endeavour of early intervention”, but instead accept the over-simplistic and poorly interpreted brain studies as a foundational evidence base and theoretical justification for their practice – a situation which arguably also applies to the policy makers and managers charged with developing and implementing these practices.
Whilst the book is specific to the UK context, in fact it is primarily England-focused, with just a couple of mentions of other policy initiatives (primarily the Named Person, currently contested and undergoing revision in the light of significant opposition and legal challenge) in Scotland. I would have liked to have seen a little more from parts of the UK other than England, whilst recognising that the underlying points and background apply to early intervention policy across the UK nations. Another concern echoes a previous Amazon reviewer*, which is that whilst this is an excellently argued and thorough academic critique of the current situation in policy, and in fact it does indeed end with a call for a collective rather than individualised response to social harm, moving away from an all-encompassing prioritisation of “risk” (a call with which I entirely agree), nevertheless as a practitioner I found I was looking for some practical suggestions of what to do in cases where individual responses and involvement with individual families is entirely justified, and required quickly. There may well be scope for further work in this area, if the authors are able to link with practitioners, academics, policy makers and service managers who share their concerns and misgivings. I would also have liked to have seen more input from professional bodies, as the bulk of those participating in the case study and interview part of the book were from the voluntary or non-statutory sector (it was unclear whether the FNP nurses interviewed were working within or outwith the NHS, although earlier the book had identified the decoupling of the FNP service from other statutory services in England). Perspectives from groups such as the Institute of Health Visiting, or other social work bodies, for example, would have been interesting and may have added a further layer of nuance to the authors’ arguments.
Overall though this has provided me with an immense amount upon which to reflect as a practitioner, and I recommend it wholeheartedly. It would be ideal not only for students of social policy and health/social work management, but also would offer valuable insights to practitioner training courses (social work, teaching, health visiting, etc).
Thank you very much to Policy Press for this opportunity!
* Simon Haworth on 29 September 2017 included in his amazon review the following, with which I absolutely agree: “One potential criticism is that, perceptive and value-based as the book is, it does at times seem to move too far way from the dilemma-laden nature of frontline practice, where difficult and emotive decisions do need to be made to protect children, even when it is evident that the system has failed the family.”
Jackie Kirkham 