Injection of clarity needed?

The legal status of children who stay in hospital for three months or longer gives rise to considerable confusion among managers in social services and social work departments. And the number of young people affected is significant. NHS statistics for the year ending 31 March 2000 suggest that in England around 2,800 children aged 0-19 on admission were discharged after spending more than two months in hospital, as were more than 500 children in Scotland. (A small number of these would have been discharged as adults.) A two-year study, commissioned by the Joseph Rowntree Foundation1 and carried out by the universities of Stirling, Durham, Newcastle and York, investigated the numbers, characteristics and circumstances of children and young people with complex needs who spend long periods in health care settings. Interviews were conducted in England and Scotland with 11 social services or health managers responsible for these children. The findings show a worrying degree of uncertainty about the position of young people who find themselves in a hospital or other health care setting for at least three months. One social services manager believed such children become looked after under the terms of the Children Act 1989. Another said children are not formally looked after but nevertheless receive the same services and safeguards as those who are. One Scottish social work manager did not know whether children going into health care settings for short-term (respite) care are looked after or not. And discussion with the research team's advisory group indicated that the confusion is not confined to our fieldwork areas