eleven - ‘Healthy’ networks? NHS professionals in the child protection front line

Summary

Introduction

This chapter concludes our examination of the operation of provider networks in child protection. Its aim is to illuminate the experience of collaboration on the part of the main health professional groups engaged in child protection work at the front-line level. Studies of interprofessional and multiagency cooperation have tended to stress notions of ‘reciprocity’ and ‘consensus’ and have typically under-emphasised the factors that may operate to impair effective collaboration. One reason for this relative inattention to conflict is the way in which the network is conceptualised. Approached metaphorically, the idea of ‘networks’ suggests an interconnected web of well-established relationships, ”… a smoothly interlocking system of reciprocal roles” (Whittington, 1983, p 268). The focus of analysis is thus typically on the composition or structure of this relationship system. Attention to the dynamics of interprofessional networking, however, rather than to their formal structure, is also important and may reveal a number of underlying conflicts or tensions. As much as the conditions of reciprocity, the areas of tension may be instructive in explicating the day-to-day operation of a particular network.

To understand these dynamics we have argued the relevance of Benson's (1975, 1983) model of the ‘interorganisational’ network as a mini ‘political economy’ (a series of mutual resource dependencies) operating within a wider political economy (the relevant policy sub-sector/sector). Within networks, effective collaboration will hinge on the degree of equilibrium obtained across four dimensions (ideological consensus, domain consensus, positive evaluation and work coordination). Factors both internal and external to the network, however, may operate to disturb this equilibrium on any or all of its key dimensions. These may be the result of sub-structural elements (wider organisational/professional imperatives) affecting the internal balance of power and authority. Or they may be external, resulting from the links of member groups/organisations to power relations within the wider policy sector or society more generally. For Benson, three possible states of disequilibrium may follow:

• • forced coordination (high on work cooperation, but low on domain or ideological consensus and positive evaluation);

• • consensual inefficiency (low levels of work coordination, but strong on domain and ideological consensus and positive evaluation);

• • evaluative imbalance (high on work cooperation and strong on domain and ideological consensus, but low on mutual positive evaluation).