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Community Affairs References Committee
17/04/2015
Out-of-home care

KEMP, Mr Anthony Philip, Deputy Secretary, Children and Youth Services, Department of Health and Human Services, Tasmania

[16:04]

Evidence was taken via teleconference—

CHAIR: Welcome. I remind senators that the Senate has resolved that an officer of a department of the Commonwealth or a state shall not be asked to give opinions on matters of policy and shall be given reasonable opportunity to refer questions asked of the officer to superior officers or to a minister. This resolution prohibits only asking questions on opinions of matters of policy and does not preclude factual questions around the policies and how they were adopted. Officers of the department are also reminded that any claim that it would be contrary to the public interest to answer a question must be made by a minister and should be accompanied by a statement setting out the basis for the claim. Can I just double-check that you have been given information on parliamentary privilege and the protection of witnesses and evidence.

Mr Kemp : Yes.

CHAIR: We have your submission. I invite you to make an opening statement, after which we will go to questions.

Mr Kemp : My opening statement will be very short, given we have a very short period of time. Tasmania welcomes the opportunity to present and to be part of a conversation in regard to out-of-home care with the Senate Select Committee on Health. I very much appreciate the opportunity and also your facilitating me to do this by teleconference.

Tasmania is in a very interesting time in its evolution of out-of-home care. We have a very long tradition in regard to some of our provision of service, and I think it would be fair to say that as part of the conversation today we will be talking to you about some of the areas of concern that we know we have and that we have been very transparent and open to discuss and that, secondly, we have a plan which is evidence informed and based upon international research around how we can build upon what we have, recognising the limitations of both the fiscal environment and also the opportunities for our staff to progress our out-of-home care services.

I think it is a very exciting time, but it is extremely challenging. I do not underestimate the complexity and the difficulties that we are going to face, but we have a very reflective process underway which commenced about a year ago. Phase 1 is coming to its conclusion fairly shortly and phase 2 is about to commence. I am sure I will be giving more details to the committee on questions in that regard. We welcome the opportunity to share our thoughts with you and we welcome the opportunity to provide any level of clarification and respond to every question that you put to us.

Senator SESELJA: Thank you, very much, for your submission. I have to admit that I have most of it, but not all of it, so I apologise if I have missed a couple of bits. One of the things that struck me is that your submission is quite transparent. It talks about some of the failings in the past and some of the gaps which you are clearly looking to address, which is very positive. In your submission, in the section 'Practice gaps', you say:

Getting in too late: The threshold for intervention has risen as a demand management requirement …

Could you explain that to the committee. Does that mean that as a result of there being more reports there is a higher threshold for intervention because of the resources? Is that a reasonable explanation or is there something else?

Mr Kemp : It is a fair question. I am not entirely sure that it is related simply to a 'resource equals gap' conversation. We are one of the smaller states, so our numbers are small compared to others but proportionally significant. Last year we received 12,000 notifications of concern about children. Of those, only a certain number would reach the threshold of concern that would require a statutory response. I think across jurisdictions—I have worked in South Australia as well as Tasmania, and I am obviously not from either of those, as you can probably tell from my accent—the issue about children who are notified and then re-notified and, in some cases, re-notified on a number of occasions means that when the threshold is crossed and children have met the statutory engagement process they may have experienced quite a protracted history of concern, harm and, in some cases, abuse, which means that perhaps the only response that is available at that point may well be an out-of-home care safety arrangement. So the further down the process you move towards significant harm and significant risk of harm, the more likely it is that one of the only responses left to ensure safety is an out-of-home care placement, and that clearly places significant strain on an out-of-home care system. That was the point that we have certainly come to recognise here in Tasmania and it is not unique in to Tasmania in managing that front door, which we call the child protection system.

Senator SESELJA: On that specific point, where is the blueprint for change up to? Is that being implemented as we speak? Or has it already been done? Where are you up to on that?

Mr Kemp : That blueprint was launched in June last year. The first phase of that was the restructure of our sibling and residential and therapeutic services for children in out-of-home care. That is what we refer to as phase 1. Today at five o'clock we have completed the tendering process for the first phase, we have finalised the evaluation committee and the minister has signed off on the preferred or identified providers. Clearly, I am not in a position to say any more than that today. We agreed that we would have this by the end of April so we are on time for phase 1. Phase 2 has already commenced, which is a complete restructure of our family based care environment and which is a far bigger challenge because, numerically, we have more children in that arrangement.

Senator SESELJA: So what is the specific response to getting in too late? Is it early intervention? What does that look like?

Mr Kemp : One of the things that I have always been at pains to say both at the royal commission and here today is that when you reform an out-of-home care system, you must reform the whole system. The out-of-home care system is not a system that works on its own. It is a process that entirely is related to the child protection system and it is also entirely connected to systems that protect children. I think from the child protection point of view, we have got a significant challenge on our hands. We are working towards redevelopment. At a certain level, there is not much we can do internally in the child protection system to slow down the stream of traffic because that is an issue outside our front door. But inside our front door, we need to be more nimble and more flexible in putting in age-appropriate responses to children at risk and that is part of a separate process that we are engaged in here in Tasmania, which is beyond the conceptual stage and is working towards some modelling of a new way of thinking about how we deliver child protection in Tasmania.

The bigger story clearly is the challenge that we all face. It sounds a bit trite but the phase that is trotted out regularly is that child protection is everybody's business. We have got to find better ways of putting speed bumps in front of the child protection system. Because by the time that children get into a child protection system, I think it is fair to say, a whole load of processes have not worked as well as they could have done whether that be education or health or income support or housing. All of these create risks to children. So by the time they come to us, there are a lot of things that maybe could have been done along that child's life that were not done.

Senator SESELJA: Just a process question: in coming to this blueprint, was their specific consultation with children and young people who either are in care or have been in care?

Mr Kemp : That is a good question. I think it would be fair to say that there probably wasn't in terms of it being a discrete survey or a discrete process of consultation. The blueprint is actually a structural conversation. It is about what we have to do in our agency to ensure that what we know intuitively we need to do is done. Secondly, it is evidence informed. I have had the privilege of working in child protection for 30 years both in Europe and here. We know what we need to do, because the research is very clear in this space.

So the question has always been: what is stopping us rather than what is it we need to do? Thirdly, we have a significant body of knowledge about what children in care are telling us about their care experience both before coming into care, whilst in care, leaving care and post care. From that point of view, I think there was a very strong body of evidence that basically said, 'Get on with it.'

Senator SESELJA: You raise a range of issues that are of concern. But I am just going to pick out a couple: staffing of residential-care arrangements. We have already heard some evidence about some residential care which is substandard. Obviously, you have highlighted that, in the past and perhaps at present, staffing of some residential-care arrangements is characterised by staff who do not have specialist professional training or accreditation, or who have inadequate supervision and limited access to training. You said this has resulted in situations where the only service provided to the most chaotic and vulnerable children is adult monitoring rather than specific care intervention. This is a concern. What about the facilities as well, just while I am on that? We have heard about some facilities that are substandard. Are you satisfied that the facilities for residential care are up to scratch in Tasmania?

Mr Kemp : I think there are some facilities that are better than others. The literature tells us very strongly about the optimal home-care environment which is a purpose-built arrangement, which is fit for purpose and fit for practice. I think that we have some way to go in Tasmania to work towards an architecture of residential-care homes, which is moving away from private rented facilities—houses that you and I might live in being adapted to a care environment. For some sibling arrangements that may well suffice but, for the more complex and chaotic children, particularly those who are in the adolescent years, I think we have a long way to go. We certainly have significant work to do to bring our stock, for want of a better word, towards purpose-built facilities into the future.

Senator SESELJA: Would there be a random inspection regime for those kinds of facilities?

Mr Kemp : I will talk from my experience in Ireland. In Ireland we have HIQA, which is an independent inspection unit for residential care, which is run separately by the state. Having been in residential care as a manager for many years I know what that looks like and feels like. We do not have anything in Australia that is equivalent to that, which I think is problematic. We have local arrangements at a state level, of funding agreements, visitations and processes but, because we do not have an architecture of inspection or an architecture of quality assurance through audit inspectorates, we are making a good stab at keeping an eye on facilities and ensuring that they are safe, fit for purpose, practical and so forth. But that does not get distilled into a central repository, which it does in, for example, Ireland and most of Europe.

Senator SESELJA: Fair enough. That might need to be looked at as well. What are the latest figures on the number of children and young people in out-of-home care in Tasmania?

Mr Kemp : We are fluctuating with, give or take, five or six children between about 1,050 at the moment. We have an ever-so-slightly decreasing number, as opposed to the trajectory we have been on for a while now, which has been upwards, which is nationally consistent. I think we were the first, if not the only state last year that actually recorded a I think it was a two per cent or a 1.8 per cent reduction in children in care as the total number. But it is around about 1,050.

Senator SESELJA: Of those, nationally, I think, the figures have been around 70 per cent in long-term care—or, if you say two years plus. Are they comparable in Tasmania?

Mr Kemp : Yes. We are finding that, whilst the numbers—and this is what the data telling us across all the jurisdictions—it is not so much that there are more children coming into care necessarily; what you have is a population of children staying longer in care. And, therefore, basically there is nothing coming out the other end; they are staying for much longer.

Senator SESELJA: Why are kids staying longer in care? Is there a policy shift? I have been asking this of a number of witnesses. Is there a policy shift? Are we seeing the courts give longer term orders? Why are they in care longer than they have been in the past?

Mr Kemp : The first part of that is that some children will always be in care long term. There will always be a percentage of children that simply cannot go home. Secondly, it goes to your opening question about the high threshold. If you are getting in at a point where risk of harm is significant, the chances are that the family's capability or competence to develop safety for that child are significantly compromised. And, therefore, change is unlikely, because earlier intervention, in terms of family support long before child protection needs to get involved, has been suboptimal. And I am talking from a research perspective here—not necessarily everyone experiences that. So you end up with children who come from families where their needs are significant, their trauma is significant and their healing process is long. Secondly, their families are chaotic and have co-morbidities of a range of issues which are not ameliorable through quick resolution—drug and alcohol issues, mental health, family violence are not things that are solved by attending a parenting course. These are long-term systemic and enduring risk factors which do not get resolved, and for as long as the child cannot go home the child stays in care.

Senator SESELJA: I understand that, but, if we are seeing an increase in the number of kids in care and a driver of that is that they are staying in there longer, that suggests something has changed. Presumably it has always been complex to deal with drug and alcohol issues, as you say, or violence issues, but we are seeing kids stay longer and we are seeing, therefore, more kids and young people in care. You are not able to point to any sort of shift in attitudes or policy which has led to this? One of the things we heard from the last witness was that effectively there has been an attitudinal shift in the way that perhaps child protection agencies look at things—from a risk basis—so more kids are taken out of home, and then if they stay longer obviously there are going to be more in care.

Mr Kemp : That is the million-dollar question. At one level, I am not persuaded necessarily that the attitudinal shift of keeping children in care longer is the case from my experience. What I see both here and internationally is this extraordinary dilemma between the reunification of children when it is patently obvious that they should not be going home—we have a shifting environment in the courts, whereby very often applications for long-term orders are turned down and you end up going from multiple one-year orders. Yet we are trying to get children home that should not be going home, and that is a significant problem—and it was apparent in the Chloe Valentine case that was released recently. Who is the primary client here: is it the family or is it the child? If your legislation mixes those two up to a point where people are not able to put the primacy of the child's needs, then you end up with this extraordinary dilemma where children are staying longer and longer in care, because we cannot stabilise them or make them supported. We cannot get them home.

I think one of the things that has changed is the complexity and the enduring nature of the types of needs these families have, and the types of support that they now need, I think, are simply not there. My days of practising 20 or 30 years ago being able to get access to psychiatric support for a mental health issue or drug and alcohol was reasonably easy to do—or certainly easier than it is now. What we do find is that, in the absence of those supporting architectures to help families get back on their feet or at least resolve the risks that they have got, children stay longer in care, because families are not getting the level of intervention that they need and they are specialist supports. They are not things that child protection services offer; they are things that need to be resolved at a clinical, therapeutic, medical, housing, education level. I think, genuinely, that they become more and more problematic to get hold of in a sustained way.

Senator SESELJA: It is interesting you talk about child centred support, because that is where I want to go next. In your blueprint you talk about a child centred support care system. I had a similar discussion with the New South Wales department, and I said, 'You're now talking about a child centred support system. Was it not child centred before?' They said that actually in many cases it was not. I think it was the most honest answer we have had, and I am interested in your views. With all of the previous gaps and problems that you have identified and some of that confusion, has it been child centred before?

Mr Kemp : I think there has been a confusion over the years between family focused and child centred. I think your previous comment that somebody said no is correct. I think we have over the years lost sight of who our primary client is. I think one of the contributors of that—and certainly in my days as a researcher this was an area of particular interest to me—is: what has been the role of inquiries, inquests and processes in terms of the safeguarding of children? The evidence is very, very strong now that the production of tens of thousands of recommendations, which are aimed at keeping children safe, I think, have actually made agencies safe but not necessarily made children safe.

Eileen Munro's work in in the United Kingdom, particularly, is something I would very strongly recommend people read, because the evidence is clear: when you create an ordered society whereby people are basically ticking and flicking recommendations rather than actually spending time working with children, that is when we have lost sight of who the client is. That is where child centredness disappears and agency compliance with rules, regulations, procedures, policies and goodness knows what else means that the 80-20 rule of 80 per cent of your time spent with the child and 20 per cent spent doing the paperwork has been inverted. We now have workers spending 80 per cent of their time on compliance based work and 20 per cent of their time with families. Now something is bizarrely wrong with the system when we have got to that point.

Senator SESELJA: Mr Kemp—and I will need to finish up, because I know the chair is keen to ask questions—I did ask the same question of New South Wales. They have got their blueprint for their way forward and theirs is somewhat different. One point of difference that I would identify and ask you why it is different is: if I look at this child centred support care system for Tasmania, it has got a diagram. It has got a child in the middle. It has got all sorts of different models of care. It does not mention adoption, whereas in New South Wales, they have included family reunification, kinship care and then consideration of adoption. You have got 700-odd kids and young people who have been in long-term care. You have said that there is a percentage of kids who can never go home. Why is that not part of that diagram? Why is that not part of a child centred supported care system?

Mr Kemp : The issue about adoption is as much a policy question as it is a conceptual idea. We have what is called a transfer of guardianship. We have transferred over 200 children from guardianship under the secretary to guardianship under the carer. It is not full-blown adoption, but it provides the carer with complete guardianship roles and responsibilities. We have a very proactive approach around that. The issue is about whether adoption becomes a part of the child protection response. We do have an adoption department here and we recently adopted a child from care, but that does not happen very often. That question has been reinvigorated as a result of the statements by the South Australian coroner two weeks ago. We are certainly keen to have a much larger conversation at both the Commonwealth level and the state level about the role of adoption in the child protection system.

Senator SESELJA: There does seem to be a little momentum. New South Wales has taken a different approach. South Australia's response to the coroner appears to be that they will now be considering that sort of thing as well. So I think it is a really important discussion. I have run out of time, but I thank you for your answers.

CHAIR: Can I pick on this adoption issue. We had some evidence this morning where a child had been in care for a very long time and expressed very strong support for being adopted and was not able to be for various reasons. We had other evidence in the same report that said that young people did not want to be adopted, that they wanted to maintain their family connections et cetera. It seems to me that when a young person is able to articulate what they want that is a different position to whether they want to be adopted or be in permanent care. Many of them want to go back to their families but there are difficulties there. The issue is with younger children. The approach in New South Wales, particularly when children are very young, is if the child has been in care for a certain period of time and they are likely to go into permanent until they are 18.

My thoughts are informed through having chaired the forced adoption inquiry and hearing about past bad experiences and I have nervousness about what is driving the adoption system. We know from experience it is young children predominantly who are adopted and that becomes the driver for the system, as it was in the past. People go into it with very good intentions. I am not saying they do not or that the department does not have good intentions. But other drivers can be put in place. The outcomes for the kids when they are older will be different, even though it is an open adoption. What is your experience, because you have obviously had a great deal of experience? I know there are a lot of questions there. Also, are you aware of any research that has been done on the outcomes of open adoptions versus closed adoptions for the child (a) as they grow up and (b) for their life outcomes?

Mr Kemp : I will answer the last question first. I am not personally aware of any research in regard to adoptions and the outcome measurements for closed versus open. It is not my area of expertise. But having worked in the child protection system for a number of years, I am aware that there is a body of research around very young children being adopted early on and then the number of children who are subsequently handed up to the child protection system because the adoptive carers cannot cope is quite significant. I think that is an issue we all have to be alert to. A lot of these children have fairly significant trauma even at a very young age or may even be born with a number of predisposing factors to risk, harm and mental health, and when they start manifesting themselves later on, it does not always end well. So we have to conscious of that. I am not sure what your first question was, I am sorry.

CHAIR: What then becomes the drivers of the system? Is it facilitating the needs of adoptive parents or the child?

Mr Kemp : I am not sure how to answer that. It is such an emotive issue in terms of the severance of a child's biological guardianship rights to a parent, or a birth parent to an adoptive parent. In Australia we have the whole issue of the stolen generation and the legacy that that has provided for us. I think we have to be so careful to ensure that child protection is a statutory state intervention as a safety net about children who are not safe at any moment in time.

Adoption has a role to play in the suite of opportunities and options we have. But we need to make sure that we do not fall into the same traps that our predecessors have done, which is that it is all-in or nothing. It has to be seen as part of a continuum and not seen as a standalone facility for a cohort of care givers who have other issues that they need to resolve. I am not sure that I have answered your question, but I know that the whole area of adoption is a landmine. I think we have to have a mature conversation and leave the emotions at the door if necessary, because we have to if we are to work out what the role of adoption is—not if it has a role, but what the role of adoption is in looking after children.

CHAIR: In answer to my second question, you raised the issue of children having ongoing contact with the care system because the adoptive parents are unable to cope with a child that has trauma and complex behaviours, or even issues from birth. I presume it means things like FASD.

Mr Kemp : Yes, it can be alcohol-induced syndromes, Munchausen, or a whole load of predeterminants in the pre-birth arrangements that are clearly not evident at the child's time of birth.

CHAIR: You said there is some evidence of that. Are you able to provide the references for that?

Mr Kemp : I will see if I can dig some stuff up for you. I has certainly been an experience in my time when I was managing a whole region in Ireland where we had a number of families who were handing back children—that sounds very crude, but that is exactly what it was—saying they could not cope and this is not what they had signed up for. It is a feature that we have to think about.

CHAIR: That would be appreciated. My next question concerns an issue that came up very strongly in Tasmania, and we got some very powerful evidence for some care levers on transitioning. In terms of blueprint and the new approach, can you take us through how you foresee that happening differently under the new approach?

Mr Kemp : There are three ways. The first one is that managing the transition from leaving care is a case management responsibility in the first instance. We have to shift our way of thinking about young people leaving care to it being a process and not an event. Very often it is looked at as getting them to 18 and then walking. We have to change the paradigm in which we understand that process. That is a case management issue and I think we have some strengthening to do in that space in terms of helping our case managers to be more proactive, particularly the older the child. We do have systems across the world that tend to work towards the primacy of the most vulnerable children, which are of course infants and babies. They can act as a diffusion point, whereby a significant amount of our time can be taken up correctly, but at the cost of working with adolescents who are in care or need to be in care. We need to get that bit right.

One of the things we are doing in Tasmania is moving towards a youth stream. A lot of the kids in care, particularly youths and adolescents, do not need a child protection response but need a youth response, a response that is appropriate and age related. Being a social worker I will say with the greatest of respect that social workers are not always the best people to do that work. Youth workers and people who are qualified in youth work can be far more in tune with supporting young people through that transition period.

Secondly, our out-of-home care providers need to step up and step into this space of being more proactive about understanding that the process of leaving care starts many years before a child leaves care. We need to get them working far more towards shifting the paradigm from it being a tick and flick approach to something that is a discernible and tangible intervention in the life of a child and not an accidental thing—if you are lucky you will get it and if you are not lucky you will not.

Thirdly we need to be far more clear about the post-care architecture that supports children who have been in care. I have a child who is over the age of 18, and she still does not know how to live independently. Yet here we are asking these children to move out of a care environment into an unstructured arrangement. I think we need to move our paradigm from independence to interdependence and thinking about how all of the parties who need to make that transition work come to the table and understand the needs of these children far better than I think we do at the moment.

CHAIR: One point that has come up around Australia but I particularly remember one young woman in Tasmania talking about is that her foster family started talking to her from when she was around 15, and she found that quite destabilising. I certainly did not start talking to my son about leaving home at 15.

Mr Kemp : She is right—absolutely. I did not talk to my daughter about it, either. But something changes for the life of these children when they reach 18 and are in care and that is not the same for a child who is not in care.

CHAIR: We have had a lot of evidence and support for shifting the age to at least 21.

Mr Kemp: I have noticed that Scotland, which probably leads the world in residential care, has just moved it to 24, I think.

CHAIR: Others are advocating 25, but 21 seems to be a common one.

Mr Kemp: If we go with the first principle, is 18 a suitable age? Many of the young people in care are chronologically the age of 18 but emotionally they could be extraordinarily much younger.

CHAIR: Where are you coming out on that point in Tasmania?

Mr Kemp: Obviously that is a matter for government policy. It is a part of the narrative that is sitting around the whole out-of-home care arrangements. It will be dealt with within that context.

CHAIR: But it is not part of the new process at the moment?

Mr Kemp: No, legislative change is not part of the new process at the moment.

CHAIR: Thank you very much for the information you have provided to us in your submission and for taking the time to see us today. We appreciate it very much.

Mr Kemp: I wish you well in your task and I look forward to seeing the findings. We will work with you in cooperation on that when it comes out.

CHAIR: Thank you to Hansard and the secretariat and to all our witnesses and those who made submissions.

Committee adjourned at 16:43