To see the twins, Jimmy and Wayne Grant, together — on one of our home visits — is to understand something of what the paediatric term ‘failure to thrive’ means. Jimmy is a chubby, rose-cheeked boisterous two-year old. He appears to be a happy, mischievous boy, running, playing, talking and laughing. He comes to his mother for help and comfort and cuddles up to her spontaneously. He responds readily to her attention and affection. She smiles at him, picks him up, sits him on her lap, plays with him, answers his questions, watches his movements, warns him when he is in danger.

On the edge of the room, like a stranger, stands Wayne — posture rigid, staring fixedly at us. He isasad, lethargic looking child, very small and extremely thin. His pale face throws into relief the dark shadows under his eyes. He remains in one spot, as if at attention; by now he is gazing unswervingly at his mother. She takes no notice of him. When asked to call Wayne over to her she looks in his direction; as she does so her face hardens and her eyes are angry. She addresses him with a dry command; when he hestitates she shouts at him.

In this paper, I will discuss the importance of early intervention with vulnerable families where children and babies may be at risk of neglect and disadvantaged by their social circumstances in accessing appropriate, preventative support services. I will describe the Strengthening Families Program located in the Social Work Department of the Royal Children's Hospital, which provides a model for interdisciplinary and intersectoral (welfare and health) collaboration. The Program offers care management to individual families and is working towards systemic changes in the hospital's response to these families. Finally, I will illustrate aspects of the work of the Royal Children's Hospital Strengthening Families Program with a case study wherein a recent history of domestic violence impacted on the family's capacity to access health and welfare services for both mother and children.

I was recently challenged by a colleague to think about the sticky question of what social work, as a discipline, has achieved over the last 40–50 years. Being challenged about the efficacy of social work and the discipline's capacity for lasting impacts is hardly a new experience. Many social workers will have confronted the opinions of clients, managers, family members and the public about the contributions or otherwise that they perceive social workers to offer. I have had these experiences too, but there are particular times when such comments remain in one's memories. After the elapse of many years I do not claim to have total accuracy of recall, but perhaps the first time I was shaken by a challenge to my noble presumptions was when Dr John Paterson, Secretary of the Department of Health and Community Services, Victoria, spoke at a meeting of child protection workers around 1989–90. He declared that he thought a mature accountant could do as well in the role. As others have recalled, Dr Paterson ‘did not blush to ignore traditional codes on the role of public servants in the policy process and overtly sought to participate in normative statements about policy’ (Barraclough & Smith, 1994, p. 16). He was known for making offensive remarks. He described disability advocacy bodies as ‘piss and wind’ groups, denigrating them as people more interested in talk than getting their hands dirty delivering services (Milburn, 1993, p. 1). He precipitated great angst amongst public servants.

The use of e-technology as a way of improving communication and collaboration across services in child welfare has generated significant interest in recent years. The Information Sharing and Assessment (ISA) is an e-technology initiative that has been introduced by the British Government as an attempt to promote better information sharing between professionals, early identification and multi-professional interventions. This article looks at one aspect of ISA, the introduction of the Common Assessment Framework (CAF). It considers some of the issues relating to the introduction and use of the CAF, and discusses some of the ways in which systems of child welfare may learn from the English experience. While acknowledging the potential for e-technology to strengthen practice developments in child welfare, it emphasises the need for careful scrutiny of new developments to ensure that they do not have negative, unintended consequences.

We are in agreement with some of the points made in the recent article by Tregeagle, ‘Weighing up the evidence and local experience of residential care’ (Children Australia, 42(4), 240–247). For example, there can be no dispute about the high costs of residential placements or that achieving a stable residential environment is very challenging. Table 1 provides a three state cost comparison of residential placements (Ainsworth, 2017).

A recent study which investigated the relationship between a range of measures of psychological well-being and stress in a group of 109 Melbourne mothers (Rodd, 1992), unearthed some surprising but not unexpected findings. In fact, the research into maternal stress was initiated following many years of working with parents, running parent support and education programs and discussions with a range of professionals who provide services for families. The end result of the examination of this observational and anecdotal evidence pointed to the fact that mothers of young children are stressed - not just slightly or moderately stressed - but experiencing extreme levels of emotional stress in relation to their parenting role!

Among the plethora of minor parties fielding candidates in Australia's 2016 federal election was a relative newcomer called Sustainable Australia. Formed in 2010 and campaigning with the slogan ‘Better, not bigger’, the party's policy centrepiece calls for Australia to slow its population growth through a combination of lower immigration, changes to family payments, and the withdrawal of government agencies from proactive population growth strategies (Sustainable Australia, n.d.). At a global level, the party also calls for Australia to increase foreign aid with a focus on supporting women's health, reproductive rights and education. Like most minor parties, its candidates polled poorly, attracting too few votes to secure seats in the Senate. But in the ensuing months, the South Australian branch of The Greens broke from the national party platform by proposing the aim of stabilising South Australia's population within a generation (The Greens SA, 2017). Just this August, Australian business entrepreneur Dick Smith launched a ‘Fair Go’ manifesto, similarly calling for reductions in Australia's population growth to address rising economic inequality and a “decline in living standards” (Dick Smith Fair Go Group, 2017).