Book contents
- Frontmatter
- Contents
- Acknowledgements
- Introduction
- one Models and metaphors: the theoretical framework
- two Policy communities and provider networks in child protection
- three Knowledge and networks
- four Accountability, agencies and professions
- five Power and politics in the NHS
- six Reluctant partners: the experience of health and social care collaboration
- seven A system within a system: the role of the Area Child Protection Committee
- eight Agents of change? The role of the designated and named health professionals
- nine Sleeping partners: GPs and child protection
- ten Health visitors and child protection
- eleven ‘Healthy’ networks? NHS professionals in the child protection front line
- twelve Conclusion
- References
- Index
four - Accountability, agencies and professions
Published online by Cambridge University Press: 20 January 2022
- Frontmatter
- Contents
- Acknowledgements
- Introduction
- one Models and metaphors: the theoretical framework
- two Policy communities and provider networks in child protection
- three Knowledge and networks
- four Accountability, agencies and professions
- five Power and politics in the NHS
- six Reluctant partners: the experience of health and social care collaboration
- seven A system within a system: the role of the Area Child Protection Committee
- eight Agents of change? The role of the designated and named health professionals
- nine Sleeping partners: GPs and child protection
- ten Health visitors and child protection
- eleven ‘Healthy’ networks? NHS professionals in the child protection front line
- twelve Conclusion
- References
- Index
Summary
Introduction
In the preceding chapters we have favoured Benson's ‘interorganisational’ approach as potentially the most helpful in explaining relationships within child protection networks (1975, 1983). We argue that his insistence that these relationships, theorised in four interrelated dimensions (domain consensus, ideological consensus, positive evaluation and work coordination), are not context-free but are rooted in ‘sub-structural’ influences, fits well with empirical evidence concerning provider networks in child protection. Benson's theory, however, is relatively silent on the role of the state in orchestrating policy implementation or in defining the parameters of acceptable practice surrounding interorganisational cooperation. In the case of child protection provider networks, the state's ‘presence’ relates most obviously to the dimension of work coordination (via regulatory and performance frameworks) although this is also mediated by the attributes of the three other dimensions. Benson's particular contribution, the identification of sub-structural factors (external power/interests and/or the motivations of ‘parent’ organisations) as determinants of the superstructural level, is germane to this chapter's focus on accountability. We suggest that the differing ability of provider agencies and professionals to resist the state's regulatory capacity (in both democratic and managerial forms) is important in understanding their engagement in child protection processes and that this can be explained with reference to substructural elements.
Network theory as proposed by Rhodes and Marsh (1992; Marsh, 1998) is of limited help since it focuses on ‘meso’ or ‘apex’ level relationships. The participation of professional groups in the core policy community assumes their members’ support for the decisions they make. This arrangement, however, is insufficient to explain the failures or success of policy implementation, as regulation by explicit rules and guidelines also shapes policy at the level of practice. However, these mechanisms cannot be taken for granted. They are both fallible and at times contradictory, as agencies and professionals have different interests and obligations. In the case of professionals these obligations may variously be to the employer (for example, a trust), agency (NHS or local authority), profession or society. As there are clear differences in the susceptibility of different professions to the regulatory state, it is important to explore the complexities of accountability, its functionality to the modern state and the reasons why different accountability frameworks operate for different professional groups.
- Type
- Chapter
- Information
- Working Together or Pulling Apart?The National Health Service and Child Protection Networks, pp. 51 - 64Publisher: Bristol University PressPrint publication year: 2001