Hostname: page-component-669899f699-tzmfd Total loading time: 0 Render date: 2025-05-06T21:58:34.351Z Has data issue: false hasContentIssue false
  • English
  • Français

Families ‘At Risk’ and the Family Nurse Partnership: The Intrusion of Risk into Social Exclusion Policy

Published online by Cambridge University Press:  01 July 2009

ANNELIESE DODDS
ANNELIESE DODDS*
Affiliation:
Institute for the Study of Public Policy, King's College London email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

This article considers why the family nurse partnership (FNP) has been promoted as a means of tackling social exclusion in the UK. The FNP consists in a programme of visits by nurses to low-income first-time mothers, both while the mothers are pregnant and for the first two years following birth. The FNP is focused on both teaching parenthood and encouraging mothers back into education and/or into employment. Although the FNP marks a considerable discontinuity with previous approaches to family health, it is congruent with an emerging new approach to social exclusion. This new approach maintains that the most important task of social policy is to identify quickly the most ‘at-risk’ households, individuals and children so that interventions can be targeted more effectively at those ‘at risk’, either to themselves or to others. The article illustrates this new approach by analysing a succession of reports by the Social Exclusion Unit. It indicates that there is a considerable amount of ambiguity about the relationship between specific risk-factors and being ‘at risk of social exclusion’. Nonetheless, this new approach helps to explain why British policy-makers may have chosen to promote the new FNP now.

Type
Article
Information
Journal of Social Policy , Volume 38 , Issue 3 , July 2009 , pp. 499 - 514
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Armacost, M., Laracy, M. and Phillips, J. (2001), ‘Foreword’, in Blank, R. M. and Haskins, R. (eds.), The New World of Welfare, Washington, DC: Brookings Institution Press.Google Scholar
Armstrong, H. (2006), ‘Interview for Epolitix’, www.epolitix.com/EN/Interviews/200609/131229c8-3dae-4e53-9bfb-f35795c82787.htm, accessed 14 January 2007.Google Scholar
BBC News (2006), ‘“Problem families” scheme set out: Mr Blair wants to prevent teenage criminality’, BBC News, 5 September.Google Scholar
Beck, U. (1992), Risk Society: Towards a New Modernity, London: Sage.Google Scholar
Bradshaw, J. and Holmes, H. (1989), Living on the Edge: A Study of the Living Standards of Families on Benefit in Tyne and Wear, Tyneside Child Poverty Action Group, London: Child Poverty Action Group.Google Scholar
Cabinet Office (2008), ‘Context for social exclusion work’, Social Exclusion Task Force web site, London, accessed January 2009.Google Scholar
Child Poverty Action Group (2001), Poverty Bites: Food, Health and Poor Families, London: Child Poverty Action Group.Google Scholar
Community Care (2006), ‘Time for Armstrong to deliver’, 14 September, www.communitycare.co.uk/Articles/2006/09/14/55697/Time+for+Armstrong+to+deliver.html, accessed 14 January 2007.Google Scholar
Davison, C., Frankel, S. and Smith, G. D. (1992), ‘“To hell with tomorrow”: coronary heart disease risk and the ethnography of fatalism’, in Scott, S., Williams, G., Platt, S. and Thomas, H. (eds.), Private Risks and Public Dangers, Aldershot: Avebury.Google Scholar
Esping-Andersen, G. (1990), The Three Worlds of Welfare Capitalism, Cambridge: Polity Press.Google Scholar
Family First Health (2006), ‘Nurse–family partnership’, www.familyfirsthealth.org/nfp2.html, accessed 14 January 2007.Google Scholar
Ferguson, H. (2003), ‘Welfare, social exclusion and reflexivity: the case of child and woman protection’, Journal of Social Policy, 32: 2, 199–216.CrossRefGoogle Scholar
Freeman, R. (1992), ‘The idea of prevention: a critical view’, in Scott, S., Williams, G., Platt, S. and Thomas, H. (eds.), Private Risks and Public Dangers, Aldershot: Avebury.Google Scholar
Gallie, D., Marsh, C. and Vogler, C. (1994), Social Change and the Experience of Unemployment, Oxford: Oxford University Press.CrossRefGoogle Scholar
Giddens, A. (1994), Beyond Left and Right: The Future of Radical Politics, Stanford, California: Stanford University Press.Google Scholar
Giddens, A. (1998), The Third Way: The Renewal of Social Democracy, Oxford: Polity Press.Google Scholar
Hacker, J. (2004), ‘Privatizing risk without privatizing the welfare state: the hidden politics of social policy retrenchment in the United States’, American Political Science Review, 98: 2, 243–60.CrossRefGoogle Scholar
Her Majesty's Government (2006a), ‘Tackling deep-seated social exclusion: Hilary Armstrong announces next steps and new arrangements in government’, Cabinet press release, Social Exclusion Task Force, 13 June, CAB/035/06.Google Scholar
Her Majesty's Government (2006b), ‘Cabinet Office announces new Head for Social’, press release, Exclusion Task Force, 22 November, CAB/068/06.Google Scholar
Jupp, V. and Norris, N. (1993), ‘Traditions in documentary analysis’, in Hammersley, M. (ed.), Social Research: Philosophy, Politics and Practice, London: Sage.Google Scholar
Kemshall, H. (2002), Risk, Social Policy and Welfare, Buckingham: Open University Press.Google Scholar
Klein, R. and Millar, J. (1995), ‘Do-it-yourself social policy: searching for a new paradigm?’, Social Policy and Administration, 29: 4, 303–16.CrossRefGoogle Scholar
Layard, R. (1997), What Labour Can Do, London: Warner Books.Google Scholar
Levitas, R. (1998), The Inclusive Society? Social Exclusion and New Labour, London: Palgrave Macmillan.Google Scholar
Moran, M. (2003), The British Regulatory State: High Modernism and Hyper-Innovation, Oxford: Oxford University Press.CrossRefGoogle Scholar
Moynihan, D. P. (1968), The Negro Family – The Case for National Action, Office of Planning and Research, Washington, DC: US Department of Labor.Google Scholar
Murray, C. (1996), Charles Murray and the Underclass: The Developing Debate, London: IEA Health and Welfare Unit in association with The Sunday Times.Google Scholar
Newman, K. S. (2000), No Shame in my Game: The Working Poor in the Inner City, New York: Vintage Books.Google Scholar
O'Brien, R. (2005), ‘Translating a research intervention into community practice: the Nurse Family Partnership’, Journal of Primary Prevention, 26: 3, 241–57.CrossRefGoogle ScholarPubMed
O'Connor, A. (2001), Poverty Knowledge: Social Science, Social Policy and the Poor in Twentieth-Century US History, Princeton and Oxford: Princeton University Press.CrossRefGoogle Scholar
Olds, D. (1996), ‘Review of “Starting Right”: how America neglects its youngest children and what we can do about it’, Social Service Review, 70: 4.CrossRefGoogle Scholar
Olds, D. L., Robinson, J., O'Brien, R., Luckey, D. W., Pettitt, L. M., Henderson, C. R., Ng, R. K., Sheff, K. L., Korfmacher, J., Hiatt, S. and Talmi, A. (2002), ‘Home visiting by paraprofessionals and by nurses: a randomized, controlled trial’, Pediatrics, 110: 486–96.CrossRefGoogle ScholarPubMed
Olds, D. L., Kitzman, H., Hanks, C., Cole, R., Anson, E., Sidora-Arcoleo, K., Luckey, D. W., Henderson, C. R., Holmberg, J., Tutt, R. A., Stevenson, A. J. and Bondy, J. (2007), ‘Effects of nurse home visiting on maternal and child functioning: age-9’, Pediatrics, 120: 832–45.CrossRefGoogle ScholarPubMed
Parton, N., Thorpe, D. and Wattam, C. (1997), Child Protection: Risk and the Moral Order, Basingstoke: Macmillan.CrossRefGoogle Scholar
Powell, M. (2000), ‘New labour and the third way in the British welfare state: a new and distinctive approach?’, Criticial Social Policy, 20: 1, 39–60.CrossRefGoogle Scholar
Prideaux, S. (2005), Not So New Labour: A Sociological Critique of New Labour's Policy and Practice, Bristol: Policy Press.Google Scholar
Richardson, L. and Le Grand, J. (2002), ‘Outsider and insider expertise: the response of residents of deprived neighbourhoods to an academic definition of social exclusion’, CASE Paper, Centre for the Analysis of Social Exclusion, London: London School of Economics.CrossRefGoogle Scholar
Robinson, F. and Gregson, N. (1992), ‘The underclass – a class apart?’, Critical Social Policy, 34: 38–51.CrossRefGoogle Scholar
Scott, S. and Williams, G. (1992), ‘Introduction’, in Scott, S., Williams, G., Platt, S. and Thomas, H. (eds.), Private Risks and Public Dangers, Aldershot: Avebury.Google Scholar
Skocpol, T. (1992), Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States, Cambridge, MA: Belknap Press of Harvard University Press.CrossRefGoogle Scholar
Smith, C. (2006), ‘Mom school: fixing children's services is only half the battle’, New York Metro, 20 February.Google Scholar
SEU (Social Exclusion Unit) (1998), Rough Sleeping – Report by the Social Exclusion Unit, London: Social Exclusion Unit.Google Scholar
SEU (1999a), Teenage Pregnancy, London: Social Exclusion Unit.Google Scholar
SEU (1999b), Bridging the Gap – New Opportunities for 16–18 Year Olds not in Education, Employment or Training London: Social Exclusion Unit.Google Scholar
SEU (1999c), A Review of the Social Exclusion Unit, London: Social Exclusion Unit.Google Scholar
SEU (1999d), PAT 01 – Jobs for all Policy Action Team, report 1, London: Social Exclusion Unit.Google Scholar
SEU (1999e), PAT 02 – Skills, London: Social Exclusion Unit.Google Scholar
SEU (1999f), PAT 03 – Enterprise and Social Exclusion, London: Social Exclusion Unit.Google Scholar
SEU (1999g), PAT 07 – Unpopular Housing, London: Social Exclusion Unit.Google Scholar
SEU (1999h), PAT 11 – Schools Plus: Building Learning Communities, London: Social Exclusion Unit.Google Scholar
SEU (1999i), PAT 13 – Improving Shopping Access for People Living in Deprived Neighbourhoods, London: Social Exclusion Unit.Google Scholar
SEU (2000a), PAT 12 – Young People, London: Social Exclusion Unit.Google Scholar
SEU (2000b), PAT 16 – Learning Lessons, London: Social Exclusion Unit.Google Scholar
SEU (2000c), PAT 08 – Anti-social Behaviour, London: Social Exclusion Unit.Google Scholar
SEU (2000d), PAT 18 – Better Information, London: Social Exclusion Unit.Google Scholar
SEU (2000e), PAT Report Summaries: A Compendium, London: Social Exclusion Unit.Google Scholar
SEU (2001a), A New Commitment to Neighbourhood Renewal National Strategy Action Plan, London: Social Exclusion Unit.Google Scholar
SEU (2001b), Consultation on Young Runaways, London: Social Exclusion Unit.Google Scholar
SEU (2001c), PAT Audit – National Strategy for Neighbourhood Renewal, London: Social Exclusion Unit.Google Scholar
SEU (2001d), Preventing Social Exclusion, London: Social Exclusion Unit.Google Scholar
SEU (2002a), Making the Connections: Transport and Social Exclusion, interim findings, London: Social Exclusion Unit.Google Scholar
SEU (2002b), Inclusion 2, London: Social Exclusion Unit.Google Scholar
SEU (2002c), Young Runaways Report, London: Social Exclusion Unit.Google Scholar
SEU (2003), Inclusion 6, London: Social Exclusion Unit.Google Scholar
SEU (2004a), Action on Debt, factpack produced by the Social Exclusion Unit short studies team, London: Social Exclusion Unit.Google Scholar
SEU (2004b), Mental Health and Social Exclusion, final report, London: Social Exclusion Unit.Google Scholar
SEU (2004c), Inclusion 10, London: Social Exclusion Unit.Google Scholar
SEU (2004d), Breaking the Cycle – Taking Stock of Progress and Priorities for the Future, summary report, London: Social Exclusion Unit.Google Scholar
SEU (2004e), Jobs and Enterprise in Deprived Areas, London: Social Exclusion Unit.Google Scholar
SEU (2004f), Low Income and Multiple Disadvantage 1991–2001: Analysis of the British Household Panel Survey, main report, London: Social Exclusion Unit.Google Scholar
SEU (2004g), The Impact of Government Policy on Social Exclusion among Children Aged 0–13 and Their Families: A Review of the Literature for the Social Exclusion Unit in the Breaking the Cycle Series, main report, London: Social Exclusion Unit.Google Scholar
SEU (2004h), Project Scoping Note: Better Service Delivery for Disadvantaged People who Move Frequently, final version, London: Social Exclusion Unit.Google Scholar
SEU (2004i), Jobs and Enterprise in Deprived Areas, summary report, London: Social Exclusion Unit.Google Scholar
SEU (2005a), Improving Services, Improving Lives: Evidence and Key Themes, interim report, London: Social Exclusion Unit.Google Scholar
SEU (2005b), Inclusion through Innovation – Summary of Questionnaire Responses, London: Social Exclusion Unit.Google Scholar
SEU (2005c), Transitions, interim report on young adults, London: Social Exclusion Unit.Google Scholar
SEU (2005d), Transitions: Young Adults with Complex Needs, London: Social Exclusion Unit.Google Scholar
SEU (2005e), Better Government for Older People, summary of report, London: Social Exclusion Unit.Google Scholar
SEU (2006a), Reaching Out: An Action Plan on Social Exclusion, London: Social Exclusion Unit.Google Scholar
SEU (2006b), A Sure Start to Later Life: Ending Inequalities for Older People Summary, London: Social Exclusion Unit.Google Scholar
SEU Undated, PAT 10 – Arts & Sport, London: Social Exclusion Unit.Google Scholar
Soss, J. (2005), ‘Making clients and citizens: welfare policy as a source of status, belief and action’, in Schneider, A. and Ingram, H. (eds.), Deserving and Entitled: Social Constructions and Public Policy, Albany, New York: State University of New York Press.Google Scholar
Taylor-Gooby, P. (ed.) (2000), Risk, Trust and Welfare, London: Macmillan.Google Scholar
Taylor-Gooby, P. and Dean, H. (1992), Dependency Culture: The Explosion of a Myth, London: Harvester Wheatsheaf.Google Scholar
Valios, N. (2007), ‘The earlier the better’, Community Care, 26 July, reprinted as ‘US project to improve child health and welfare rolled out in UK’, http://www.communitycare.co.uk/Articles/2007/07/25/105242/us-project-to-improve-child-health-and-welfare-rolled-out-in-uk.html, accessed January 2009.Google Scholar
Ward, L. (2007), ‘Q&A: Nurse Family Partnership programme’, Guardian Unlimited, 16 May.Google Scholar
Wilkinson, R. (2005), The Impact of Inequality: How to Make Sick Societies Healthier, London: Routledge.Google Scholar
Witcher, S. (2003), Reviewing the Terms of Inclusion: Transactional Processes, Currencies and Context, CASE Paper, Centre for the Analysis of Social Exclusion, London: London School of Economics.Google Scholar