More Money, More Problems? Addressing the Funding Conditions Required for Rights-Based Child Welfare Services in England

Round 1

Reviewer 1 Report

This is a well designed, well executed study with important implications for public policy. 

Literature review

The author provides a nice review of what is currently known about public financial support for children’s services and service availability and outcomes.  The author sets up the study nicely with the background information provided.

The research questions are quite interesting.

Methods

The methods are clearly laid out.  The author provides sufficient detail about the source and context of the data used in the study.

Findings

The findings are clearly laid out and well documented.  A fine analysis.

Discussion

The author clearly translates his findings into important take aways for the reader.  The study has important implications for public policy in England.

 

Author Response

Thank you to the reviewer for their kind comments on the article. 

Reviewer 2 Report

a good topic and well researched- however is looking at funding without comparing to specific outcome measures enough?  Money  spent should be linked to population health metrics.  Also there are non governmental sources of funding and can that be tracked. 

Tracking funding itself is useful and publishable but more cogent would be connecting to some sentinel metrics

Author Response

Thank you to the reviewer for their suggestions. I have included two additions to the article to attempt to address the points raised.

 

Firstly, while I believe the relationship between funding and health outcomes is outside of the scope of this paper and would not be possible to include in the space available, I have extended the discussion of a related study by Bennett, et al. which found that inequalities between more deprived and less deprived local authorities in a key outcome for children’s services — the rate of children ‘looked after’ (in the care system) — have been increasing since the onset of the austerity policies and during the period of analysis covered in this paper, where the reduced equity of funding of children’s services has been established. This addition has been made on page 18. Unfortunately, England does not have a measure of substantiated child abuse and neglect comparable to other countries which is often used as the most relevant health metric for child welfare services, so the rate of children who are looked after is often used as the closest equivalent as the overwhelming majority of children who are looked after are looked after due to concerns about neglect and/or abuse.

 

Further, the limitations section has been extended to explain why the association between other commonly used child welfare metrics in England (Children in Need rates and Child Protection Plans) and children’s services funding should not be used to assess funding inevitability. This is due to the fact that these measures of welfare are derived from children’s services themselves, and that it has been well-established that they depend to some extent on ‘demand management’ and rationing which is intrinsically linked to funding. An explanation has been added to page 21 as well as references to key literature on demand management and threshold rationing in England.

 

Lastly, an addition has been made to the limitations section to address the potential implications of not including other sources of funding that may nonetheless provide services related to children’s welfare and wellbeing. This addition can be found on page 21.

Round 2

Reviewer 2 Report

a very useful study-  but was there ever any commitment with the Children's Act to commit adequate funding and have it be based on the changing data about need?  Certainly in the US, there is no relationship to actual need and funding is based on political realities and lobbying