On 22nd May, ‘Joint Working Guidance’ on Age Assessment was published by the government, branded with the logos of the Home Office and ADCS. More guidance on age assessment is promised in the near future.
‘Age assessment’ is the misnomer commonly used for a process whereby social workers allocate a date of birth to potential service users. BASW has last week published a position statement which questions the use of the term, but more importantly warns against social workers undertaking the exercise alone.
BASW is hosting a twitter debate on this on Monday 8th June between 6-8pm. Here (that would be below, after the background section), I want to set out why I think it is indeed a nonsense for social workers to carry out single-agency age assessments.
Three key pieces of reading for those unfamiliar with this territory:
- Here’s an overview of the numbers and the key findings from them from the Refugee Council @refugeecouncil (March 2015).
- Here’s an excellent guide published by the United Nations, ‘The Heart of the Matter: Assessing Credibility when Children Apply for Asylum in the European Union‘ (December 2014).
- Here’s a guide to the legal maze in this country from @coram.
In summary, the reality is that it is invariably immigrants, frequently unaccompanied asylum seeking children (‘UASC’s’ for short), who have a date of birth allocated to them because they are ‘age-disputed’ which means they haven’t got satisfactory proof of age, and the age they claim to be is not accepted. Why is it not accepted? Cynics on the one side say people who are plainly adults claim to be children in order to access the superior support available to children. There is a lot of truth in the idea that superior support is available to immigrant children compared to immigrant adults:
- for children, the primary responsibility lies with social services to provide support; for adults, social services only owe a duty to those who have community care needs (this is a terse summary of a great series of case I once summarised in ‘Destitution at Mornington Crescent‘, and of the retreat from those cases following the decision of the House of Lords in Slough, ‘Sick asylum seekers: Somebody Else’s Problem‘);
- immigrant children are generally not returned to their country of origin until they reach adulthood. The reasoning is basically this: an adult can be returned to a country that will accept them, but a child has to be returned into the care of someone who will accept responsibility for the child. This is much more difficult so generally children get to stay while they remain children.
- also, an adult who has been a ‘looked after child’ will have additional rights to social services support after turning 18.
Cynics on the other hand point to the same facts to point out not the incentive to claim you are a child, but the cost to the State if you are. The – now dated – report of the Immigration Law Practitioners Association ‘When is a child not a child?’ refers to social workers being “put under pressure by managers to assess children as being over rather than under 16 or 18 years of age”.
The nonsense of single agency assessment
Now, coming to the question of why on earth social workers should be allocating dates of birth, I want to talk about one court case in particular. There have been many important cases, some more recent, and from higher courts, than the one I want to look at. But I think that the case of A v London Borough of Croydon  EWHC 939 (Admin) (08 May 2009) explains a lot about how we got where we are, and how little sense it makes for social workers to have responsibility for this process.
The case concerned two doctors who between them had cornered a somewhat niche market in providing medical reports in age dispute cases, such reports being generally provided on the instruction of the representatives of the age disputed individuals. Unsurprisingly, the reports tended to provide medical opinions suggesting the individuals in question were younger than social services said they were. The question in the case was, whether the medical reports were in fact built on sound science:
- the clear starting point was that the received medical wisdom was that age cannot be accurately assessed by medical means. The opinion of the Royal College of Paediatrics and Child Health was that the margin of error was 5 years either way (paragraph 15).
- given the unreliability, the Royal College “urged caution” upon doctors asked to give an opinion. “an age assessment should only be done in the context of a holistic examination of the child” (paragraph 15).
The doctor whose reports were subject to particular scrutiny (the other doctor was said to have poorer practice, see paragraph 24) said she had taken account of the Royal College guidance. She did not attempt to accurately determine age, nor suggest it was possible. Instead, she used a statistical technique:
Having considered all the data obtained and applied the average levels, she reaches a conclusion within a standard deviation of 2.1 years. She asserts that the standard deviation is ‘taken from published sources which are generally accepted as the professional standards within each area considered. Standard deviations and centiles for weight, height and physical parameters from the CDC are used when race specific ones are not present as recommended by the WHO.’ Her centile values are based on the principle of 50% of the population having values equal to or less than the 50th centile and hence 50% of the population having values between the 25th and 75th centile… She asserts that by taking a number of different parameters it is possible to reach a satisfactory conclusion since the margins of error inherent in each individual parameter will be reduced so that there is, as she puts it, a regression towards the mean. (paragraph 28).
Some social workers practising in the area of child protection will be aware of the concept of “linear reasoning”, where we eliminate all the possibilities in order save the last one, which because it is the last left standing is the option we go for. And the courts have said, unsurprisingly, that linear reasoning is flawed because it means that the last solution left standing is not subjected to the same critical scrutiny (see paragraph 51 of G (A Child)  EWCA Civ 965 (30 July 2013)).
That, in my opinion, is what is wrong with social workers doing age assessments on our own. The alternatives have been systematically demolished. We agree that there is no accurate medical assessment possible. Statistical modelling has been slammed by the court. Holistic multi-agency assessment is agreed to be the best approach, but other professionals are backing away from contributing to a flawed process. Social workers doing it on their own is the last option left standing. But the last solution left standing is not being subject to the same level of critical scrutiny. If medical assessment is hugely unreliable, if statistical modelling is unreliable, who seriously thinks that a social work model could be any more valid, or have any chance of surviving if ever made subject to the same level of critical scrutiny?
The truth is, social work is not having the courage to reject a role it ought to be rejecting. At least, I hope that’s the truth. I never forget the powerful words of Beth Humphries in ‘An Unacceptable Role for Social Work: Implementing Immigration Policy‘, which hint at an even less palatable possible truth:
Research that has been done suggests that social workers or their unions have protested little about the new expectations imposed on them to monitor immigration policy… teams were operating well below the standards seen as acceptable for UK citizens… social workers ‘will volunteer to do the ‘‘dirty work’’ of social policy, even when this involves intentional and systematic deprivation by official agencies, of the means of dignified existence’.
Allan Norman (@CelticKnotTweet) is an independent social worker at Celtic Knot. Between 2006-13 Celtic Knot was also his law firm. Allan now works at the British Association of Social Workers, leading on Policy, Ethics and Human Rights, including International issues. This blog is maintained in a personal capacity and does not necessarily represent the views of the British Association of Social Workers.