Children with broken bones go to the emergency ward. Children with broken caregivers, like Phoenix Sinclair, go to child welfare. Both systems get overwhelmed at times and, when an error is made, kids can get hurt.
At the inquiry into Sinclair's death Tuesday, two men from very different backgrounds both described the front lines of Winnipeg Child and Family Services as an emergency room.
An executive with a business degree tried "preventative" medicine to reduce its number of "patients." A social worker with decades of experience in the trenches testified he's not sure there is a cure for children at risk -- all child welfare can do is "mitigate risk."
"I was hired for my change-management skills," said Lance Barber, CEO of Winnipeg Child and Family Services from 1997 to 2001. When Sinclair was born in 2000, she became a temporary ward of CFS, and her agency file was opened and closed many times until she died in 2005. Her death wasn't discovered until 2006, and her mother, Samantha Kematch, and stepfather, Karl McKay, were convicted of her murder in 2008. In 2011 the province ordered an inquiry to find out how Phoenix fell through the cracks of the child-welfare system.
She was like many of the kids in care for whom Barber was mining data and strategizing. Most CFS clients were below the poverty level, aboriginal, single-parent females living in social housing, said Barber.
When he took over CFS in 1997, it was split into four geographic regions with some area offices a lot busier than others, he said. The people running the offices didn't co-operate, and some ran programs others didn't, said Barber, who is now director of surgery at St. Boniface Hospital.
To get rid of the slack in the system and move staff where it was needed, CFS got rid of the area offices and switched to program-based offices, said Barber.
They set up community resource centres in social housing areas to work with families and help them keep their kids out of care, said Barber. The workers identified "pillars of the community" as "places of safety" for kids who might otherwise end up in care at a CFS-staffed hotel room.
"We felt the dollar invested in preventative services was a way of ameliorating future workload," said Barber. He compared it to public investments in anti-smoking campaigns paying off now with fewer sick smokers sucking up health-care resources.
Barber said he believed it helped the system, but he still ran a deficit the entire time he was there.
"We were like an emergency department. We had a level of service we needed to provide... We tried to be good stewards."
They couldn't change what was happening outside the agency.
"Child poverty was above the national average, the teen pregnancy rate was above the national average with the number of teens wanting to parent (on the rise)," said Barber.
"Children were coming into the system at younger ages with greater degrees of issues and damage."
Barber's preventative measures didn't cure the system or slow the growing number of kids like Phoenix entering the system, the inquiry heard.
"Intake was, and still is, a very busy place," said Pat Harrison, the intake program manager for Winnipeg CFS from 2003 to 2005.
"I liken it to an emergency room in a hospital," said Harrison, who spent 13 years as a family services worker before moving up in the agency.
"Demand (was) pretty constant. We'd get 15,000 to 16,000 requests for service per year," he said.
Workers had to prioritize cases, "mitigate risk," and move on. The workers who attended Phoenix's home in March 2005 to check on a report her mother was abusing her should not have closed her file without seeing Phoenix, said Harrison.