• By Kevin Mount
  • Posted on Friday 18th February, 2011

Well-being is all very well – but what does it mean exactly?

Most social policy for children in most countries has been rooted in a safety-net strategy, of catching the most disadvantaged before they hit the floor. Now several European countries are taking a divergent approach by trying to improve the well-being of all children.Who could disagree with the idea of improving the well-being of all children? Few in the prevention world, for sure. But as Nick Axford's new book Exploring Concepts of Child Well-being explains, most governments have at best a hazy idea about what they are trying to achieve.Well-being is a relatively new idea. And for the most part it has been welded on to policies based on old ideas. In the UK, for example, Axford finds that policies for children are underpinned by theories about meeting needs, upholding rights, tackling poverty and combating social exclusion, as well as enhancing quality of life.All very well if the ideas are congruent. But on several grounds they are not. Take just two of the concepts.A needs-led health policy might focus on the mobility, absence of pain, and mood required to lead an ordinary life. The rights perspective on health is more concerned about access to services and mainstream society, regardless of ill-health or its consequences.And are the children whose health needs remain unmet the same as those whose rights are scanted? Sometimes, yes, but mostly no.In the disadvantaged communities Axford studied, 39% of children were in need and 42% were judged to have had their rights violated, but only 20% of the children were in need as well as having scanted rights.Most policy makers are concerned with the best interests of children. But they seldom recognize that their 'take' on those interests might clash with their colleagues', or that the children they are concerned about are different from those of their colleagues.Even in practical terms, this state of affairs is problematic. Decisions about whether to target children who meet specified thresholds or live in disadvantaged communities or to support those who appeal against their treatment have a critical bearing on who gets help, and whether children get help that can improve their lives.Anyone reading Axford's book will come down in favor of one of the five approaches he examines. He argues that all are useful lenses through which to view well-being but, if pushed, says that he would decide in favor of need. I would disagree. But that's not the point.While policy makers have been adding to their repertoire of ideas, often in a haphazard way, children's well-being has suffered on several counts. Research from the UK Institute of Psychiatry suggests a thirty-year decline in emotional health and behavior of British children. My own work for UNICEF consistently places the UK bottom or next to bottom on a range on indicators of children's well-being. The chances of the UK meeting its ambitious and critically important targets for reducing child poverty are diminishing rapidly.It is not for want of ideas. As Axford's book shows, we have lots of them. It is not for want of activity. In the UK at least every idea spawns some kind of policy, service or program, much of it framed in terms of prevention.But there is a lack of clear thinking, of working out the relative advantages of contrasting approaches, working out strong compromise positions and taking a genuine interest in their effectiveness.We are all for well-being. We just have to work out what it is.• Nick Axford's Exploring Concepts of Child Well-being: Implications for children's services is published by The Policy Press.

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