Cutting and learning

Innovation involves testing a method or idea. In children’s services it is usually about implementing a new policy or programme. But what about working out what would happen if a policy, programme or some other intervention in children’s lives was removed?

To find out if a new idea is effective, we subject it to a randomised controlled trial. Half the eligible children, selected at random, get the innovation and half do not. We compare outcomes for the two groups.
 
Might we do that in reverse to test whether current interventions are making a difference to children’s lives? Would it be possible to remove the intervention from half of the eligible children, again selected at random, let the other half carry on as before and compare outcomes for the two groups?
 
Such a strategy might make it possible to do something about policies or programmes that are thought by children’s services to be potentially ineffective, or less effective than alternatives.
 
During the next few years children’s services will shrink. Huge cuts in public expenditure are forecast in most economic developed nations. The easy route will be to lop a percentage off every sector of children’s services. An outcomes based approach like the one just described would be more ambitious.
 
The first step might be to make a list of policies, programmes or other interventions that are suspected of having little beneficial impact. In each case, instead of an across the board cut, half the eligible children woud be directed to other interventions. Outcomes could be compared with those that stay with the programme. If the consequences for children’s health and development were negative, then the intervention would be saved. If child outcomes stayed the same or improved, then cuts coud be made with confidence.
 
Maybe we should give this idea a fancy name to help it catch on. How about 'evidence based de-commissioning'? Of course, there woud be ethical implications. The prosepct of taking services away from children in the interests of knowledge will raise eyebrows. But in the economic climate looming the only alternative might only be swingeing, ill-considered cuts.