Developing congruent children's services to improve child well-being

Developing congruent children’s services to improve childwell-being

Nick AxfordResearcher, Dartington Social Research Unit, Lower Hood Barn, Dartington, UK

ABSTRACT

This paper explores whether different concepts of child well-beingcall for different ‘service styles’ and, if so, whether these styles candovetail together to form a congruent pattern of children’s services.The first part draws on the distinguishing features of five approachesto conceptualizing well-being – need, rights, poverty, quality of lifeand social exclusion – and their empirical manifestations (‘condi-tions’) to identify different emphases or ‘styles’ in service provision.The second, more discursive part of the paper explores potentialcontradictions between these service styles, for example, betweenneeds-led and rights-based approaches or between policies to tacklepoverty and combat social exclusion.The third part examines whetherand how such contradictions can be minimized to achieve greatercongruence and discusses the need to consider the orientation ofchildren’s services in respect of interpretations of child well-being.

Correspondence:Nick Axford,Dartington Social Research Unit,Lower Hood Barn,Dartington,TQ9 6AB,UKE-mail: [email protected]

Keywords: children’s services, need,poverty, quality of life, rights, socialexclusion

Accepted for publication: June 2008

INTRODUCTION

Children’s services in the UK and other Westerndeveloped countries are informed by at least five dif-ferent approaches to conceptualizing well-being: need,rights, material resources, quality of life (QoL) andinclusion (Axford 2008a). A previous paper (N.Axford, unpublished) drew on theoretical and empiri-cal analysis to identify the defining features of theseperspectives and to chart the relationships betweenthem. It argued that all are useful lenses throughwhich to view well-being in the sense that each onesheds different light on children’s predicament: theyall offer what Sen (2000) calls ‘analytic advantage’.

It could be argued that this helps to foster a richservice mix, increasing the chances of improving chil-dren’s outcomes. However, it might also bring adanger of encouraging policy-makers to speak with aforked tongue, that is, to devise and enact initiativesthat are inherently contradictory. In turn, this createscomplexity insofar as practitioners are expected toreconcile potentially competing emphases in theirwork: to meet need and uphold rights, to tackle childpoverty and enhance children’s QoL – in other words,to ‘do everything’. It is therefore necessary to explore

whether different concepts of child well-being callforth different ‘service styles’ and, if so, whether anawareness of these different emphases can help informa more ‘congruent’ pattern of children’s services.

The first part of this paper focuses on service style.Of course, no archetypal service exists for any of the‘conditions’ of being in need, having one’s rights vio-lated, experiencing poverty, having a poor QoL orbeing socially excluded. Rather, most services in thisdynamic, resource-restricted and heavily legislatedfield of work exhibit a mix of styles or emphases. Theproblem is that we are often not aware of this, yet theinherent tensions created by this situation help toexplain why stakeholders often feel pulled in differentdirections. Drawing on the distinguishing features ofeach of the concepts and their empirical manifesta-tions (‘conditions’), it is possible, for each one, to distilout the characteristics of a pure ‘service style’; that is,an approach that is geared solely towards addressingthe condition in question. This is necessarily an arti-ficial exercise, a heuristic device, to highlight the dif-ferent emphases.The second, more discursive, part ofthe paper explores potential contradictions betweenservice styles. The third part examines how suchcontradictions can be minimized to achieve greater

doi:10.1111/j.1365-2206.2008.00579.x

35 Child and Family Social Work 2009, 14, pp 35–44 © 2009 The Author

Journal compilation © 2009 Blackwell Publishing Ltd

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congruence. A congruent set of services will beinformed by agreement concerning desired outcomes,by consistent thresholds regarding who receives whatkind of intervention and why, by knowledge of whatservice styles are potentially effective for the conditionin question and by an appreciation of the potentialconflicts between different service styles.

SERVICE STYLES

Meeting need

In a previous paper (N. Axford, unpublished), a childwas deemed to be in need if his or her health ordevelopment was actually impaired or likely to becomeso in the absence of remedial services. This group ofchildren have a multifaceted range of needs and, assuch, require different types of service (Axford 2008b).Indeed, the same need may be met by different satisfi-ers, depending on the circumstances; for example, abrick house and an igloo both meet the need for shelter,and there are various ways of preventing and treatingchild maltreatment (Barlow et al. 2006).

However, several cross-cutting features of needs-ledservices may be identified. One is a focus on outcomedefined in terms of healthy development. This pushestowards services being based on scientific evidence of‘what works’. The concern with averting likely as wellas actual impairment means that a needs-led approachto children’s services is disproportionately likely toengage with the concepts of risk and protective factorsand so embrace techniques designed to prevent orintervene early in the chains of risk that lead to devel-opmental difficulties (Little & Mount 1999). An addi-tional feature is that need-orientated services allow forinterventions to be tailored to each child’s situation.They lean towards having a personalized element,rather than being ‘one-size-fits-all’.

Upholding rights

A right is a claim to be treated in a certain way.Rights-orientated children’s services are thereforecharacterized by procedures and sets of standardsintended to dictate the conduct of individuals andorganizations. Moral rights are easily dismissed asunrealistic aspirations, so they tend to evolve intosharply defined legal entitlements, with parallel dutiesand liabilities clearly specified and measures in placeto enforce them (Nickel 1987).Thus, compliance withthe UN Convention on the Rights of the Child(UNCRC) is monitored in terms of administrative or

process indicators, such as the number of facilities forchildren with learning difficulties, rather than in termsof how children are doing, for example, academicattainment or health (Kilkelly 2006). The rules andprocedures specify duties of assistance and forbear-ance (for individuals and organisations) and coveraspects of provision (material goods), protection(preventing interference with personal integrity) andparticipation (enabling the exercise of individual lib-erties). Further, claimants need not prove theireligibility, desert or neediness – so preserving theirdignity – (Fox-Harding 1991) and different individu-als should be treated equally, so that those with similarcomplaints get near-identical responses: there is lessdiscretion than there is with needs-led provision.

It is common for fairly blunt instruments to bedeployed to get third parties to behave in a way thatrespects children’s rights. Moral rights are enshrinedin charters and harnessed to cajole individuals andorganizations to attain appropriate standards ofbehaviour towards others with, for example, variousnon-profit campaign groups pressing for strongeradherence to the UNCRC (e.g. Keenan 2007). Inrelation to legal rights, typical mechanisms aredemanding compliance with detailed regulations andpenalizing or ‘shaming’ defaulters, perhaps throughlitigation, with the intention of galvanizing duty-holders to act properly (Lyon 2007).

Tackling poverty

Poverty is the inability to afford goods and activitiesthat make up customary living patterns in a society(Gordon 2006). It is not uniform, however, with dif-ferent types of poverty reflecting the duration andspacing of episodes (Ashworth et al. 1994; Hill &Jenkins 1999). The most obvious solution is to maxi-mize family income, for example, by increasing therates at which state benefits are paid. Efforts may alsofocus on moving unemployed young people andparents into paid work, for instance, by equippingpotential employees with new skills, providing betterchild care facilities or using tax credits and top-upbenefits to ‘make work pay’. Initiatives may have acoercive element, for example, deliberately suppress-ing the value of unemployment compensation so thatit acts as an incentive for people to seek jobs or with-drawing assistance from those who are consideredable but unwilling to work.

A further strategy involves reducing a household’svoluntary or involuntary expenditure. This mightinvolve cutting the proportion of gross income lost to

Congruent children’s services N Axford



tax, for instance, by boosting tax allowances. There isalso evidence that targeting state benefits at mothershas a positive effect on children’s living standardsbecause they are more likely than men to ensure thatthe family’s basic requirements are met before spend-ing money on luxuries (Goode et al. 1998).

It is also possible to improve living standardsdirectly, notably by repairing substandard housingand improving access to good quality shops, leisurefacilities and other services, such as dentists, hospitalsand libraries. Packages of interventions that are tar-geted at specific areas are a popular method of doingthis, at least in the UK, which has witnessed a series ofsuch programmes over the last 50 years (SEU 1998).If implemented well, such strategies can reduce theamounts that poor families must spend on heating,transport and food, and attract local investment whichcreates employment; however, they also have consid-erable weaknesses, not least that most poor childrenlive outside poor areas (Gordon 2000).

Enhancing the quality of life

QoL may be defined as a child’s subjective well-beingand personal growth in a healthy and prosperous envi-ronment (Lane 1996). The multifaceted nature ofQoL means that there are many ways in which it canbe enhanced. Children’s natural and built environ-ments can be improved, including air quality, land-scape aesthetics, efforts to make the streets safer andbuilding parks and playgrounds on previously derelictland (Chaskin 2006). Anything that contributes to thedevelopment and sustenance of healthy and fulfillingrelationships between children and their family,friends or the wider community also plays a role.Thisincludes toddler groups, youth clubs, mediationbetween parents, and various fiscal, social, ceremonialand legal measures can encourage extended familiesto strengthen children’s support networks (Baker1996). Then there are activities and experiences thatgo beyond the functional and serve to enrich life – art,music, sport, spirituality and so forth. Of particularnote are services that improve children’s access to thecountryside, entertainments and various other sourcesof enrichment – youth hostels, school trips, extra-curricular clubs and discounted admission rates tomuseums, for example. Attempts to improve chil-dren’s physical and mental health also follow from aQoL agenda, in particular their ability to functionwithout pain, how they feel about life and their abilityto appreciate it. Here one might include child andadolescent mental health services, special equipment

for children with disabilities and hospices for childrenwith chronic illness.

These efforts are largely focused on children’sobjective circumstances, but some aspects of chil-dren’s services might be interpreted as addressingthe subjective component of QoL. Thus, the concernwith eliciting and heeding individuals’ preferenceshas been manifested in the drive towards jointdecision-making, for example, through family groupconferences. Also relevant here are efforts to improvechildren’s personal resources so that they gaingreater benefit from their objective circumstances(Lane 1996). Education is critical in this respect inenhancing children’s cognitive complexity and intraining them to appreciate beauty or exposing themto spiritual and other uplifting experiences. There isa growing emphasis in schools today on the social,emotional, creative and physical aspects of develop-ment as well as on academic achievement (Huppert2005; Layard 2005).

Combating social exclusion

Social exclusion refers to a child’s involuntary andsomewhat catastrophic detachment from mainstreamsociety owing to an accumulation of disadvantages(Burchardt et al. 1999; Room 1999). Any measurethat forges, repairs or helps to sustain a child’s socialties – to education or the labour market (or otherproductive activity), to friends and family, to the widercommunity and to civic and political institutions –therefore helps combat social exclusion.Although anti-exclusion measures are often multi-pronged, mostfocus on one or other of the main social ties.These maybe considered in relation to three discourses of socialexclusion in UK social policy (Levitas 1998).

The first of these concerns a self-excluding moralunderclass, a supposed – many would say non-existent – residuum of the long-term unemployed,criminally inclined and sexually irresponsible. Thisperspective gives rise to measures for making youngpeople and families integrate in the civic or politicalsense. Many such measures penalize or display intol-erance of even fairly low-level anti-social behaviour,while moral education is aimed in part at curbingsexual promiscuity among young people and punitivesocial assistance rates are used to discourage idle-ness. Citizenship modules in school curricula andcorrectional or diversionary courses for youngoffenders are about helping children to understandother people’s views, to respect major institutionsand to take responsibility for their actions. Second is




the social integrationist policy discourse, in whichthe main priority is participation in productive activ-ity. Numerous means are used to keep children ineducation, training or work, including provision inmainstream schools for children with learning orbehavioural difficulties; legal injunctions and finesfor parents who appear to condone their offspring’struancy; financial and other incentives for schoolsnot to exclude pupils; and training schemes forschool leavers. There are also various approaches tohelping children and parents to stay integrated insocial networks. Examples include measures to main-tain contact between children cared for away fromhome and their families (Bullock et al. 1998) and‘contact centres’ for children to meet with absentparents in cases where breakdown was acrimonious(Kroll 2000). Third, protagonists of the redistribu-tionist viewpoint advocate action against childpoverty (see earlier in this paper).

Three themes run through these approaches. First,all address risk factors of social exclusion. For example,low attainment, poor health and a substandard physi-cal environment all make it difficult for children toparticipate in certain activities – whether by makingthem unemployable or less able to sustain social rela-tionships or isolated from activities in the community.Thus, as Hills (2002) contends, a better understand-ing of process enables a more active welfare stateaimed at preventing social exclusion as opposed to amore passive orientation that responds to problems.Second, many initiatives are coercive; they attempt to‘re-insert’ children and families into specific spheresof activity or behaviour patterns, often in ways that theindividuals themselves would not choose.Third, mostapproaches focus on the excluded, not the excluder(s)– what Veit-Wilson (1998) refers to as the weak andstrong models, respectively; the former attempts toalter the handicapping characteristic of the excludedand to enhance their integration into the dominantsociety, whereas the latter centres on restraining theexcluding force.

CONTRADICTIONS BETWEENSERVICE STYLES

The tensions between different service styles are notself-evident. Instead, it would be reasonable to thinkthat efforts to meet children’s needs dovetail withwork to uphold their rights, and so on. While this isoften the case, an analysis of the literature and originalsurvey data indicates that these concepts and theirempirical manifestations are less closely related than is

often assumed (Axford 2008a, N. Axford, unpub-lished).The focus of this part of the paper is thereforeon the role of services in creating or perpetuatingthese disjunctions.

Services to meet need

Services to meet children’s needs exist in tensionwith rights-driven responses in several respects.According to Donnison (1982), the flexibility or dis-cretion that is innate to responses to unmet needtends to generate guidance (rather than rules) whichcan be interpreted such that someone who techni-cally is not entitled to assistance receives it (and viceversa). From a rights perspective this might be per-ceived as an insecure basis for distributing welfareresources to children and families, because it allowsproper forbearance and assistance to be withheld atdiscretion.

A needs-approach also arguably draws generallymore on the evidence of ‘what works’ than does arights-orientated response, which views children associal actors and therefore pays greater attention touser opinion. In health, for example, children withchronic illnesses may have their right to influencedecisions about receipt of drugs or surgery overriddenby well-meaning adults, who are vulnerable to criti-cisms of being authoritarian or paternalistic.

Further, whereas a needs-approach is moreinclined to provide limited services for children andfamilies, and to expect that this will be sufficient andwelcomed, rights protagonists tend to be concernedwith countering structural problems and so empow-ering clients to lead more autonomous lives (Barnes1998). It is the difference between, say, a disabledyoung person attending a special day-centre becausethat is what agencies offer and the same childbeing enabled via improved transport and anti-discrimination practices to secure paid work. Thistension has its roots in the difference between thesociological perspective, which focuses more onpower relations, and the psychological interest inmore apolitical, local and individual interactions(Woodhead 1997; Mayall 2002).

Lastly, the more nuanced nature of needs-ledresponses means that agencies may not intervene inthe case of, say, a child who is smacked by a parentif there is evidence that the incident was a one-off ortook place in a generally warm and loving environ-ment. From a rights perspective it might be arguedthat this constitutes negligence because it leaves thewrongdoer unpunished and the child vulnerable to




further violence. An expert in the aetiology of devel-opmental impairment, however, might contend thatsuch occurrences rarely cause lasting damage (e.g.Zielinski & Bradshaw 2006) and that removing thechild from home or taking action against the perpe-trator would be even more harmful. This issue illus-trates why the task of practitioners in assessing andintervening in the lives of children and families canbe so complex. Layered on top of this are severalfactors that influence which discourse gains theupper hand – the views of consumers, the law onsmacking (with its attendant nuances – Lyon 2006),pragmatic considerations and so on (Axford 2008a,pp. 178–180).

In relation to poverty, there is little reason to thinkthat needs-led services will harm either a family’sincome or their living standards. However, there areseveral reasons why needs-led services may not con-tribute greatly to children’s QoL (beyond ensuring amodicum of material well-being).

Most obviously, need satisfiers are not necessarilydesirable – indeed some are extremely unpleasant;examples include harsh disciplinary regimes toremedy young people’s behavioural problems or theuse of distressing therapy sessions to cure phobias orheal emotional scars. Moreover, what is sufficient tomeet a child’s needs will not necessarily enhance theirQoL: ‘met need’ is not the same as ‘flourishing’ (Doyal& Gough 1991). Indeed, it is partly because the meritsof the need satisfier are crucial to QoL that health andsocial care tend to be organized more around a con-servative concept like need, leaving the market to dealwith wants and desires. It is also because keepingthings from getting worse is considered morally pre-ferable (measure for measure) to making things better(Goodin 1988).

Need-orientated services are also geared primarilytowards enabling individuals to achieve agency per serather than to act out a particular life plan.Thus, thoseitems that are required in order to pursue specificpersonal goals are technically ‘wants’, not needs. Forexample, thrill-seeking activities might be ‘essential’for some young people, but policy-makers concernedprimarily with ‘children in need’ are unlikely to investin such provision. Aspects of services that do helpchildren to enjoy or obtain what they want are argu-ably more QoL-focused, for example, a local footballteam or a holiday club. It is telling that in the prelimi-nary evaluation of the UK pre-school programmeSure Start, the relational aspect – measurablyimproved bonding between mothers and youngpeople – was almost seen as a by-product of changes

to behavioural and learning outcomes, even though itmight be considered central in terms of children’sQoL (Jordan 2006a). It is understandably frustratingfor practitioners when what they count as ‘success’ isdismissed by others, but this is because differentstakeholders often have different goals which, in turn,are informed by different discourses of well-being.

Initiatives to meet need may also render the indi-viduals they seek to help vulnerable to social exclu-sion. For example, teaching children with behaviouralor learning difficulties in a non-mainstream school ispotentially stigmatizing and can isolate them fromtheir friends and communities (Cullingford 1999;Rabiee et al. 2005). From a more right-wing perspec-tive, it has even been argued that state support forunemployed or anti-social young people perpetuatestheir exclusion from society by failing to encouragethem to enter the labour market or to conform tobehavioural norms (Murray 1990). Again, practitio-ners can find themselves caught between a rock and ahard place – on the one hand expected to help those inneed but on the other hand criticized when they dobut on the basis of some other agenda.

Services to uphold rights

The rigidity that often characterizes a rights-orientated approach – owing to the application ofrules and procedures to constrain the behaviour ofduty-holders – can militate against delivering pack-ages of support that meet children’s needs for affec-tion, warmth, self-esteem and so on. For example,Smith (1997) argues that regulations in the UK aimedat protecting children against abuses of power haveturned foster and residential carers into ‘technicians’who must perform certain tasks and, in so doing,squeezed out some of the experiential qualities –responsiveness, comfort, appreciation and so forth –that help meet the aforementioned needs. A furtherway in which respect for rights may generate orprolong need is by allowing the wishes of service usersto dictate the intervention. For instance, there is adanger that vulnerable children are encouraged tomake decisions about their education and family lifewithout sufficient professional guidance concerningtheir best interests (Thomas & O’Kane 1998). Again,the complexity of the decisions faced by practitionersand policy-makers is apparent; there is little doubtthat more needs to be done to ensure that children’srights are respected (Aynsley-Green et al. 2008), butunless we are careful there can be unforeseen unde-sirable consequences.




Children’s QoL also risks being damaged – or atleast it may not be enhanced – by interventions aimedat protecting children’s rights.The somewhat bureau-cratic culture that a rights perspective can promotemeans that assistance can end up being quite sterile orsanitized. To caricature, what is sufficient to fulfilformal requirements and to allow a supervisor to tickthe relevant box on a check sheet need not involve anyenthusiasm or kind words on the part of the provider.Such relational elements – what might be referred toas ‘bedside manner’ – matter far more when viewedfrom a QoL perspective (Jordan 2006b) but under-standably play second fiddle in a resource-restrictedperformance culture.

Whereas rights are intended primarily to guard chil-dren against what is bad for them, measures toenhance QoL are more concerned with providingwhat is good (Bullock et al. 1994).This tension may becharacterized as the difference between a child in resi-dential care being entitled to protection from abuseand the same child being enabled to enjoy foreignholidays or sports activities; the latter adds to but isnot necessary for the former, which in policy terms isusually of greatest significance.

A further aspect of the tension between rights andQoL orientations is that rights help to resist the utili-tarian temptation to trade-in the interests of a smallnumber of people in order to secure a greater sum ofthe lesser interests of many people (Waldron 1993).They (rights) serve autonomous individuals, notwider society. One contention, therefore, might bethat they stand in the way of significant improvementsto children’s QoL. For example, the quality of manychildren’s lives would be vastly improved if schoolbullies were excluded or punished more severely, butthe children doing the bullying share rights to educa-tion and to physical protection that guard againstmore draconian interventions. Teachers will be famil-iar with the difficult decisions that this tension creates.

In relation to social exclusion, the more confronta-tional and litigious service responses that a rightsapproach promotes have the potential to weaken chil-dren’s social ties. Applied in the context of familybreakdown, for example, such interventions can easilyset child against parent, particularly if efforts topromote participation in decision-making result in achild being expected to choose which parent to livewith (Cooper 1998). Other aspects of a rights-orientated approach may also undermine a child’sintegration in various spheres of activity. Affirmativeaction to counter discrimination may involve separat-ing disabled children from their peers, while encour-

aging young people to think in terms of their rightswithout equal attention to their responsibilities couldconceivably tempt them not to participate in certaincollective endeavours – from contributing their labourand volunteering in the community, to keeping incontact with family and obeying the law.

Services to tackle poverty

As a rule, alleviating poverty by raising low incomesand improving inadequate living standards is unlikelyto generate need. It is also difficult to imagine howanti-poverty measures could infringe children’s rights,unless of course they are coercive; for instance,making a teenage mother choose between the optionsof work or losing benefits arguably denies her the rightto influence her life course.

It is easier to envisage how efforts to tackle povertycan cause children’s QoL to deteriorate. For example,unemployed young people who are coerced into paidwork may experience unpleasant working conditionsor find that the new responsibility results in stress andless time for recreation. Similarly, area-based regen-eration projects might help some local residents toclimb out of financial hardship but at the same timereduce the amount of green playing space andincrease traffic and pollution.

There may also be instances when tackling povertyincreases the risk of social exclusion. Anti-poverty ini-tiatives that require cuts in personal expenditure arelikely to jeopardize a family’s social ties. This isbecause participation in most spheres of activity costsmoney – for smart work clothes, for buying drinks andtickets when out with friends, for phone calls andtravel if volunteering for a community project, for giftson special family occasions and so on. In addition, itmight be argued that increasing social assistance ratesmakes it easier for young people to survive reasonablyand comfortably outside the labour market, diminish-ing the incentive provided by punitive benefit rates tofind and keep employment [what Esping-Andersen(1990) calls ‘de-commodification’, as it makes it easierfor an individual not to have to sell his or her labour].This argument is an important factor in making gov-ernments reluctant to take more radical action onchild poverty.

Services to enhance the quality of life

Efforts to improve children’s QoL are unlikely to gen-erate need. Indeed, needs-led responses may actuallybe enhanced by attention to QoL issues. For instance,a systematic review of studies to see if doctor–patient




relationships have a therapeutic effect irrespective ofany prescribed drug treatment found that a warm,friendly and reassuring manner is more effective thanformal consultations without reassurance (Di Blasiet al. 2001). In children’s services, the quality ofimplementation is increasingly seen as key to achiev-ing desired results measured in terms of children’shealth and development (Bumbarger & Perkins2008), although as ever this is easier said than done inthe context of staff shortages, inadequate training,heavy caseloads and so on.

Policies aimed at improving children’s QoL are alsounlikely to increase the risk of poverty or impede itseradication. However, they may have a counterpro-ductive effect in relation to social exclusion, particu-larly if concerns about the quality of activity in certainspheres prevent the relevant social tie from beingforged or repaired. For instance, social workers mayresist returning home a separated child if they con-sider his or her carers to be abusive or if the home isan insufficiently stimulating environment. Profession-als with child protection responsibilities are all tooaware of the dilemmas created by these competinggoals.

Services to combat social exclusion

Policies to promote inclusion may increase children’svulnerability to developmental impairment (need) orfrustrate attempts to address it. For instance, a truant-ing child encouraged to attend school may be thevictim of bullying, while efforts to force children toimprove their behaviour – perhaps by threatening theirparents with prison – may actually exacerbate familyconflict and other risk factors that contribute to theimpairment. These situations are likely to be rare,however.

More likely perhaps is the coercive nature of manypolicies to combat exclusion also violating the rights ofindividuals. So, young people who fail to accept theoffer of a job or who behave anti-socially may bethreatened with the withdrawal of entitlements tosocial assistance, and parents who persistently appearto condone their children’s truancy may be in-carcerated. Making state support conditional in thisway goes against the grain of granting assistance asan entitlement. These contradictions arise becausewhereas rights are about being free to do certainthings, inclusion – at least as it is interpreted inso-called ‘ThirdWay’ social policy (Jordan with Jordan2000) – entails obligations in the form of expectationthat individuals (including children) will participate in

the community and market as consumers, taxpayers,workers, carers, altruistic volunteers and so on. Inclu-sion is performed, not claimed.

A further argument for why efforts to combat exclu-sion are connected with violated rights is that somepolicies aimed at fostering inclusion legitimate pre-vailing inequalities by diverting attention away fromthe radical change required to protect individuals’rights (Barry 1998). The kind of ‘workfare’ pro-grammes used to insert school-leavers into poorlypaid and even dangerous jobs are examples of this –what Sen (2000, p. 28) calls ‘inclusion on bad terms’.Promoting inclusion may also link children intospheres of activity characterized by rights abuses, suchas a neglectful family; social workers face a constantstruggle to balance vulnerable children’s right to pro-tection with their simultaneous right (and that of theirparents) to a family life.

In relation to poverty, some initiatives to combatsocial exclusion require the unemployed parents totake low-paid work, so including them in the labourmarket but leaving them with insufficient income toafford some basic necessities for their children(Levitas 1996). Entering paid work generally reducesthe amount of means-tested benefit to which individu-als are entitled and renders them liable for more tax.Disjunctions like this arise largely because inclusioninitiatives strive primarily to connect the excluded intothe mass of society. Anti-poverty measures, by con-trast, are more likely to be concerned with reducingthe economic distance between citizens (whetherexcluded or included). They also tend to focus onincome and material living standards, whereas tocombat exclusion it is necessary to address relationalfactors – to look at ‘impoverished lives, and not just atdepleted wallets’ (Sen 2000, p. 3). Effectively, the twoapproaches have different roots: concern with equalitypromotes the avoidance of poverty, while the goal offraternity fuels attempts to prevent exclusion from thecommunity (Sen 2000, p. 24). This tension creates aheadache for policy-makers in the sense that one goalis difficult to achieve at the same time as the other; itis significant that after a decade of initiatives toaddress poverty through paid work, the UK govern-ment will miss its 2010 target of halving child poverty.

Finally, a focus on exclusion tends to evoke concernabout the existence rather than about the quality of asocial tie. For instance, the concern first and foremostis with ensuring that a pre-school child is attendingnursery or playgroup; it is not with how he or she istreated there or if the facility is clean and wellequipped (relevant to her QoL). Similarly, in an exclu-




sion equation, living with family or being part of othersocial networks counts for far more than whether ornot those relationships are nurturing. Nor does itmatter that much if the inclusion is compelled, eventhough it is less likely to promote subjective well-being(Gore & Figueiredo 1997).

ACHIEVING GREATER CONGRUENCE

A central contention of this paper is that underlyingsome of the complex decisions and heated debates inchildren’s services (and social policy more widely)are tensions between different discourses of childwell-being and their associated assumptions aboutgoals and means of achieving those goals. To a largedegree, it is not possible to resolve these tensions noris it fair to say that one view is right and the otherswrong. The different perspectives exist and are hereto stay, and they have the potential to be helpful byenriching the service mix. However, recognizing thatthey exist in tension does make it possible to try tominimize the contradictions between them whendevising and implementing policy and so achievegreater congruence.

A congruent pattern of services might be consid-ered to have four features. First, interventions aredesigned so that they have the potential to be effectivein preventing or alleviating a specified condition. Sec-ondly, those interventions are targeted accurately, thatis, they reach children with the condition in question.Thirdly, when interventions do not bring about – orhinder efforts to prevent or alleviate – other conditions,they may be said to complement one another.Fourthly, when interventions aimed at preventing oralleviating one condition also help to address another,they may be said to achieve some degree of synergy.These possibilities can be illuminated by consideringtwo brief case studies drawn from a re-analysis of datafrom a survey of parents on an inner-London housingestate in 1998 (Axford 2008a).

Robert, aged 8, was deemed to be in povertybecause his mother was not in paid employment andthe family was dependent on basic social assistance.His mother frequently required money from charityand social services to get by and also had rent arrears.He was therefore excluded economically but other-wise relatively well integrated; for example, he livedwith his mother and sibling and was linked into socialservices and receiving appropriate help. In this case,efforts to prevent social exclusion by enabling hismother to find paid work could alleviate the family’spoverty, but only if the wages were adequate for the

family’s needs. There could also be a danger of creat-ing other difficulties, for example, if the mother’s newworking hours were anti-social and required Robert tospend time alone or if she ended up being morestressed trying to juggle work and inadequate child-care. Both could contribute to behavioural and emo-tional difficulties for Robert, rendering him ‘in need’.There is therefore a need to consider how the mothermight be supported to make the transition to work.

Another example is Nadia, aged 12. She and herfamily lived in chronically overcrowded accommoda-tion (four children to one bedroom), but there was noevidence of the housing agency taking remedialaction. On these grounds her rights under theUNCRC to privacy and decent living standards weredeemed violated, and she could be said to be in needgiven how overcrowding can contribute to poorbehaviour via parental depression and consequentinconsistent parenting. Re-housing the family wouldbe one solution that would simultaneously uphold herrights and help meet her needs. However, if this isdone in a way that does not involve some consultation,it could violate her right to participate in decisionsthat affect her. Moreover, if it involves moving heroutside the area or splitting up her family, it could alsohave detrimental effects on her QoL and degree ofinclusion; currently, Nadia enjoys swimming, takespart in Arabic classes and is described as ‘happy andsettled’.

If contradictions can be minimized then, arguably,the ideal scenario would be for all five conditions to beaddressed. No politician with responsibility for chil-dren’s services is going to say publicly that he or shewishes to focus on meeting children’s needs but doesnot worry about poverty, just as no practitioner willclaim that he or she aims to promote children’s QoLbut ignores social exclusion. However, the service mixwill betray differences of emphasis with respect tointerpretations of well-being, even if these are notarticulated explicitly.This is because, as has been seen,it is difficult to do everything at once, even if this is anormal, even laudable, instinct; the desired outcomesand the means of achieving them exist in tension withone another. It is also because decisions about theservice mix are made and adjusted continually bypolicy-makers and practitioners, whether consciouslyor not. Such decisions are influenced by moral con-cerns, legal imperatives, pragmatic constraints, scien-tific evidence and public opinion or consumer views.A reasonable hypothesis is that the ‘centre of gravity’of children’s services shifts depending on the relativestrength of the factors that shape policy. For example,




moral concerns and the consumer perspective arearguably inclined to make services more rights-orientated (because they emphasize the individualperspective), whereas the pragmatic and scientificinfluences favour a needs-led approach (because theyencourage using evidence to address impairment).

A related paper (N. Axford, unpublished) arguedthat, used carefully, all five concepts discussed here(need, rights, poverty, QoL and social exclusion) canact as useful lenses through which to view and under-stand children’s well-being, and so, hopefully, informimproved services. By implication, it is unhelpful ifdifferent concepts become the preserve of particularprofessions or if policy-makers (and managers andresearchers) abandon one in favour of another.To loseany is to see less clearly, and there is value in seeking,where possible, to maximize congruence and, wherenecessary, to agree what is to be given more or lesspriority in the pursuit of improved child well-being.

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Developing congruent children's services to improve child well-being