Early Intervention? Why not No Intervention?


BigbenLast week I attended the launch of The Deciding Time published by the Early Action Task Force. Early Action – usually referred to as Early Intervention – has a good deal of support in official circles.

Indeed, not only did the debate take place in Westminster but none other than Louise Casey, Director General for Troubled Families at the Department for Communities and Local Government, was there to respond to the report. I confess my own position isn’t one of enthusiasm. Though I found Casey surprisingly engaging – and oddly endearing – with her no nonsense case against the ‘liberals’ that dominate in welfare and social care circles; like many who hold to orthodox opinion about the supposed need to intervene in families to arrest their spiralling intergenerational decline, she was far less controversial than she imagined.

Like I say, she got a number of things right. ‘There is nothing wrong with being judgemental’ insisted Casey, presumably hoping to pre-empt the frankly none-too-apparent outrage of the invited audience. That is what we ask social workers to do all the time, she quite rightly said. While I am no fan of the dubious grounds on which families are disrupted and potential carers refused the opportunity to start new ones; where there is cause to intervene it should be done with the not insignificant authority that the law allows. As I’ve commented before it is the failure to act on that authority rather than the stock-diagnosis of professionals not ‘working together’ that is so often to blame when things go wrong.

But that doesn’t make the case for earlier intervention or more intervention, just better intervention. Indeed I would argue – as I did with Casey at the launch – that the problem isn’t one of when to intervene but of whether to intervene at all. Whether its with regards her current brief or her previous high profile roles as head of the Respect Task Force and before that director of the Anti-Social Behaviour Unit; she has made a career of responding to problems caused by too much – not too late – intervention. Rather than quibbling with the timing, something for which the evidence is at best mixed and the grounds for doing so evidently illiberal, wouldn’t it be better not to intervene at all?

Now I confess in my own modest career working in the public sector I too have worked on an early intervention or prevention project or too. They’re hard to avoid in my line of work. But they don’t have to be illiberal. Actually, I think the approach can be defended up to a point. For instance, working with older people who may be at risk of being accommodated into a health or social care setting – with all of the attendant loss of independence and the expense involved in providing that more intensive care and support. If it is possible to find ways in which they might be able to continue to live in the community with a little more support – whether its insulating their home from the cold, arranging for somebody to pay them a regular befriending visit, or getting adaptations fitted in their home so they are less likely to trip and fall – then that is a good early intervention in my book.

Having said that, even then, because we live in a culture of presumed vulnerability and incapacity that is only amplified in the health and social care sectors, there is the danger of over-identifying needs and deepening levels of dependency; rather than encouraging people and the communities of which they are a part to fall back on their own resources or become more self-reliant. While public services are often dysfunctional and if not under-funded certainly badly targeted, it is important to get that relationship between state and society right. It is all too easy to undermine people’s confidence or sense of responsibility for themselves by intervening too much – something that welfarism, ‘troubled’ families policy and social care provision are blatantly guilty of.

So while the issue of how to use scarce public resources more wisely to support those who need it is very important, and The Deciding Time is a contribution to that discussion worth engaging with; we need to acknowledge first of all that investing in the greater public good can sometimes be as much about withdrawing state support for those who don’t need it rather than necessarily doing those interventions sooner or even differently. Whatever policy makers do they need to be sure that they don’t create more problems for society than they solve. As I said to Casey that’s how we got into this mess.

One thought on “Early Intervention? Why not No Intervention?

  1. One of the questions is always who pays for the intervention. A personal care provider will not pay the physical work to a home to make warmer and safer that reduces the need for residential care. The housing provider’s performance measures do not allow the saving generated by the adaptations in terms of avoiding residential care to be a decision making factor. Indeed the move to affordable rather than social rents gives a perverse incentive to create the relet.

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