As the proposed Ministry of Vulnerable Children shows, we do not take prevention seriously.

In 1920, someone wrote in the Maoriland Worker, ‘The politician is like the person who would build an ambulance at the bottom of the cliff, instead of constructing a good fence at the top.’ The image seems to have been coined in a late-nineteenth-century poem by the English temperance activist Joseph Malins. It has stuck around in New Zealand ever since, although we do not take much notice of it.

The Maoriland Worker quote is particularly apt because of its focus on politicians. I completely understand the concerns of ambulance drivers struggling with the broken bodies and spirits at the bottom of cliffs and demanding more resources. They dare not look up to see more tumbling down and certainly not to the top completely lacking effective fences.

Last week I was involved in publishing an article in the New Zealand Medical Journal about the costs of Fetal Alcohol Spectrum Disorders, (FASD), which are caused by the permanent damage to the baby’s forming brain when the pregnant mother drinks alcohol. We think about 1 percent of the population suffer from the resulting loss of cognitive competence, although the severest cases, like Teina Pora, are only about a tenth of these.

The article estimates the costs to society of the loss of productivity from FASD. We do not have the data to be able to add the costs of additional health services, ineffective education services, additional social security and pressure on justice and corrections services. But even ignoring these, we got a figure in the range of $49 million to $200 million for 2013. You may think this is small but, to put it in perspective, think of the figure if everyone had FASD. It would cost us between $4.9 billion and $20 billion a year (plus all those other costs).

What the research is saying is that we can spend up to $49 million a year on an effective preventive fence and society would be well ahead. Prevention is amazingly simple: a woman who is pregnant or might get pregnant should not drink, although the whole village has to support her. 

By coincidence, last week the government released an ‘action’ plan to deal with FASD with the princely annual spending of $4m. It is not all on prevention, some of the parents with FASD children desperately need ambulance support. The good news is that it is a start; we’ve acknowledged that we have a real problem and we are beginning to do something about it – including at the top of the cliff. 

Elsewhere we are obsessed with the bottom. Last week also saw the announcement of a new Ministry for Vulnerable Children to be broken out of the Ministry of Social Policy – a redisorganisation of CYPS, the Child and Young Persons Service.

The new Commissioner for Children, Judge Andrew Becroft, says he will not be using the name. ‘To be immediately confronted with a badged official - someone from the Ministry for Vulnerable Children - it's a big load to place on families that struggle and it's a big label to put on children.’

Hear, hear. I’d go a bit further. In my experience all children are vulnerable. Fortunately, most of the vulnerabilities are dealt with by parents at the top of the cliff. Sometimes the fences fail; some of those who fall down are picked up by the public welfare services – others by the health, education and justice service; some hardly at all.

Becroft went on to say that he will only use the ministry's Maori name, Oranga Tamariki because its Maori translation ‘the wellbeing of our young’ better shows the vision of the new ministry. I appreciate his point but am still uncomfortable, since it will be too easy to associate vulnerable children with Maoriness.

There appears to be a deeper problem captured in the name. What on earth were those who designed the ministry thinking? You have a sense that they are completely out of their depth and should be moved on. Whatever the ministry is to be called, those involved in designing it will make a hash of managing it. Perhaps they should be assigned to constructing fences. (Yes, I include the Minister, Anne Tolley. Too many of our cabinet ministers lack political antennae.)

The underlying problem is that ‘vulnerability’ – whatever it means – exists on a spectrum. The ambulance drivers carve off one part of the spectrum as the problem and ignore the rest. They may talk about prevention, but their concerns are limited – fences on the last rocks the kids tumble off. They don’t have a holistic view of the whole spectrum and especially the role of parents at the top of the cliff. Shouldn’t that be in the ministry’s remit? If it were, it would be a Ministry for Children and be concerned with strengthening all families and not just filling in for them.

That is why it would be better to abandon this potential train wreck and leave the services in the Ministry of Social Policy, commissioning a new, more sensitive team to design a comprehensive approach to supporting children. One which pays a lot more attention to strengthening families and sees ambulances as indicative of – perhaps inevitable – failures to have built totally secure fences.

 

Comments (1)

by Megan Pledger on August 22, 2016
Megan Pledger

The "vulnerable children"  names means it can de-emphasize the "and young people" part of their old name.   What's the bet that money for services to young people will be quietly reduced and if the media ever get around to asking about it then they'll just go on about how their remit is about "vulnerable children".

 

 

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