Friday, July 11, 2014

SylviaAnnHewlett. Child neglect in rich nations. UNICEF. 1993. 05. Some successful initiatives.

Some successful initiatives

Prenatal and postnatal care: Netherlands
Perinatal care, consisting of the services provided for mothers before, during and immediately after childbirth, is particularly effective and comprehensive in the Netherlands. Central to this country’s policies is the principle that giving birth is a natural process rather than an affliction and that it should, if possible, be based at home. From this principle has grown ‘maternity home care’, a support service that combines medical care with practical assistance to the mother and her family, run by the Dutch Cross Society. (55)
Current maternity care practice in the Netherlands developed in response to a high perinatal death rate of about 35 per cent at the turn of the century. Early attempts to train professionals to assist in home deliveries were inadequate and disorganized, and resulted in the creation of a government-appointed maternity care committee, which published a landmark report in 1943. The report led to significant changes, the most important being the training of maternity care assistants in centres run by fully qualified specialist nurses. At the high point, there were 16 such schools.
In recent years, budget cuts, growing pressure from the medical establishment for care assistants to receive broader training, and declining birth rates have led to the closing of these residential schools. In their place are two new training courses: one offered by secondary schools; the other, a three-year full-time course that qualifies care assistants in a range of related fields, including perinatal care, family welfare, and care for the elderly and the physically handicapped.
The Dutch Cross Society admits that the move away from specialists has meant some small loss in the quality of care. Nevertheless, the rights and benefits available to pregnant women in the Netherlands are still impressive. At the heart of the system are the midwife, a major player in maternity care throughout Europe, and the home visit, a source of preventive care and parent education. (56)
The system operates in the following way: A pregnant woman first contacts her general practitioner and then decides whether to continue with the doctor or transfer to a privately practising midwife, who in the Netherlands is office- rather than hospital-based. High-risk pregnancies are referred to an obstetrician, which is one of the main reasons why home delivery is regarded as a safe alternative and is officially endorsed. (The health insurance fund will not pay for care by an obstetrician unless medical indications require it.)
Prenatal care provided by the Cross Society encompasses health care education in group sessions, gymnastic classes and home visits. Prenatal health education groups, open to women and their partners, are often organized in collaboration with midwives. They concentrate on providing information on such subjects as the growth and development of the foetus, diet, labour and caring for the new baby. The sessions operate as support networks for expectant mothers and complement home visits, which offer guidance of a more individual kind. Home visits aim to prepare parents for the psychological impact of birth and the lifestyle changes it entails, as well as to inform them of the services available, from the loan of nursing equipment to the health screening of babies and children up to the age of four. A 1987 survey indicated that pregnant women in the Netherlands are visited at least once before birth, and postnatal visits are made on a daily basis for 8 hours a day, up to a maximum of 10 days. (57)
The Cross Society’s prenatal gymnastic classes are popular and over-subscribed. In 1988, 45 per cent of all pregnant women in the Netherlands took part. Over the course of 8 to 10 sessions, a physiotherapist prepares women for the rigours of delivery, emphasizing a woman’s active role in what happens to her and teaching breathing and relaxation techniques that will help diminish her fear and stress. Classes aimed at restoring the functions of a woman’s body after birth are also offered by many of the local branches of the Cross Society, but not all, because postnatal gymnastic classes are not paid for by the health insurance fund.
A surge in the popularity of hospital births during the 1970s — 57 per cent of births took place at home in 1970, but by 1989 the figure had dropped to 33 per cent — led to the establishment of the ‘golden mean’ of polyclinic delivery. This means that a woman gives birth in hospital, without a formal admission and usually under the supervision of a midwife. If all goes well, she returns home after 36 hours (or even 24 hours), unless there is a medical reason for her to remain in hospital, such as a premature or Caesarean birth. The mother then receives a level of maternity home care determined by her choice and financial considerations, since families have to pay 300 guilders (approximately US$ 150) for 8 to 10 days of full home care. Without the benefit of Cross Society membership or private insurance, costs can be much higher.
Contributions, at an average of less than US$20 per year, cover one fifth of the cost of most of the Society’s services; the rest comes from the insurance moneys levied by the tax authorities. The exception is maternity care, which to a large extent is financed through the national health care insurance fund. The fund provides 70 per cent of the Dutch population with free care by general practitioners and specialists including midwives, free dentistry, free medication and nursing care in either general or psychiatric hospitals. Contributions are mandatory for workers below a certain income level (about US$21,000). The fund provides not only for employees paying the premium but also for their families, nonworking students and the disabled. The remaining 30 per cent of the population holds private medical insurance policies.
On a home visit, a maternity care assistant typically checks on the baby’s physical condition, gives practical help with breastfeeding, advises on birth control, looks after older siblings and helps out with household chores such as shopping, cleaning and cooking. One mother may decide she needs maternity care visits for only one hour twice a day, while another may opt for the full eight hours. Whatever level is chosen, the new mother is also visited by the midwife or general practitioner who attended her delivery. He or she offers counselling on infant care and follows up on the mother’s health and physical condition after the birth. At four weeks, 90 per cent of new babies attend a well-baby clinic, one of 3,000 organized and run by the Cross Society. During the first year of life, a baby attends a clinic an average of 10 times.
The maternity care provided in the Netherlands by the Dutch Cross Society seems hard to fault. It is sensitive to the needs of the new mother and has the additional advantage of being low cost, because expensive obstetricians are used only in complicated or risky cases. However, highquality home care accessible to all is an ideal that has been affected by recent budget cuts. The provision of 10 days of home care is no longer automatic but “tailored to the individual situation of the family.” (58) Since 1987, a 10 per cent cut-back in mandated services has been accompanied by calls for a greater reliance on the private market. Recently, the Minister of Public Health suggested that the maximum period of home care should be cut to five days. (59)
Despite these worrisome developments, perinatal care in the Netherlands still attains an extremely high standard. Strictly in terms of health, Dutch babies do very well (the neonatal mortality rate in 1989 was 3.8 per 1,000 live births, which places it at the low end of the European scale). What’s more, the system of home births and/or care at home after delivery underpins and supports the family in the critical post-partum period, and in so doing plays a role in preventing the development of a broad range of problems.
Experts at the Dutch Cross Society are convinced that a qualified maternity care assistant operating in a home can both detect incipient problems and help resolve them in areas as diverse as dental care, birth control and child abuse. Especially with young children, prevention is so much better than cure, and home visits are a good example of how government can help create the conditions that allow mothers and babies to flourish, rather than wait until families are already in crisis and offer damage control.

Parenting leave: Sweden
Sweden has one of the most liberal parenting leave policies in the developed world. New parents are now entitled to 450 days (approximately 15 months) of paid leave when a child is born. Not only is Swedish policy particularly generous in the amount of time given to new parents, it also avoids the discriminatory aspects of the more standard maternity leave policies. Because parenting leave is equally available to both men and women, it is hard for employers to use it as an excuse to fail to hire or promote mothers.
Parenting leave is the most important component of parental insurance, which is part of Sweden’s social insurance system and comes under the National Insurance Act. The first maternity benefits were established in 1937 and combined a cash grant with a job guarantee. In 1974, Sweden shifted from maternity to ‘parenting benefits’, creating a six-month paid parenting leave for both mothers and fathers. This was extended to 360 days in 1980 and to 450 days in 1989. Both natural and adopted children are included. Parenting leave has gradually expanded as increasing numbers of Swedish women have entered the labour force — today, 80 per cent of all Swedish women with children under the age of seven are employed full or part time. (60)
Parenting leave can be used entirely by one parent or shared between them. In the latter case, parents decide how to divide up the 450 days, since only one can receive compensation at a time. Leave can be used to stay at home full time or it can be combined with part-time employment, in which case the parent receives a combination of salary from the employer and benefits from the insurance system. The 450 days can be taken until a child’s eighth birthday. For the first 360 days, parenting leave is paid at 90 per cent of the parent’s gross income. For the final 90 days, a fixed reimbursement rate of 60 kroner (about US$8) per day is paid. An extension of this benefit to 18 months at 90 per cent of income for the entire period was scheduled to go into effect in 1991, but has been abandoned.
When parenting leave was first introduced in 1974, only 3 per cent of fathers took advantage of it; in 1986, 23 per cent of those drawing this benefit were fathers; in 1990, 26.1 per cent were. (61) It seems that if a government creates a parenting entitlement that is both generous and available to both sexes, sexual stereotypes do begin to break down. A quarter of Swedish employers are now tolerating, even supporting, ‘daddies on velvet.’
Sweden is one of only two countries to have established male rights to parenting leave on a large scale. Interestingly, the other country is Australia. As of July 1990, Australian male employees with 12 months of continuous service are entitled to 52 weeks of unpaid leave in order to become the primary caregiver of a newborn child. Because this is unpaid leave, no one expects the ‘take up’ rate to be very significant. However, this new entitlement does advance the cause of equal parenting. (62)
A second component of the parental insurance system in Sweden is the ‘10-day benefit’, which entitles the father to a special paid leave of up to 10 days for childbirth. A father is entitled to this leave even if the mother is receiving parenting benefits for the same child at the same time. In 1990, the benefit was used by 109,000 men, 86 per cent of all fathers of children born that year.
A third component is the ‘temporary child-care benefit’, which reimburses parents for the loss of income involved when one of them stays home to care for a child—their own child or an adopted child, foster child or stepchild. This benefit is payable for up to 90 days per child annually and occasionally can be extended to 120 days. Situations qualifying for the benefit are: when a child falls ill; when the person who looks after the child falls ill; when one parent needs to look after a child at home while the other parent takes another child to a doctor or hospital. Compensation is 80 per cent of income for the first 14 days and 90 per cent thereafter.
A fourth component of parental insurance is a ‘contact days benefit’, which entitles parents with children between the ages of 4 and 12 to take two days off work per child each year to visit the child’s preschool, leisure centre or school. Parents are fully compensated for loss of income incurred on these days. In 1990, contact days were paid for 29 per cent of all children in the 4- to 12-year-old age group.
And last, a ‘pregnancy cash benefit’ is payable to expectant mothers who are unable to continue with their normal tasks during the latter stages of pregnancy and who cannot be assigned more suitable work. The pregnancy cash benefit is paid at the same rate as the parenting benefit and is payable for a maximum of 50 days during the last two months of pregnancy. In 1990 the average number of benefit days per pregnancy was 39. (63)
To non-Swedish eyes, this list of parental benefits seems astonishingly generous, even profligate, and yet government officials justify the policies on economic grounds. “Swedish employers want productive employees,” according to Bo Adolfsson, labour counsellor at the Swedish Embassy in Washington, D.C. “Women in America go back to work, and they aren’t good on the job because they are worried about their child. Turnover is high. The main reason is not low wages but, more likely, bad child care.” (64)
It is important to remember that over the last several decades Swedish social benefits have gone hand in hand with successful economic growth: GNP per capita is now US$25,490, the third highest in the world, and above the per capita figure for the United States, which stands at US$22,560. (65)

Child care: France
France has the most comprehensive child-care system in Western Europe. Responsibility for the provision and control of child-care services is shared between the Ministry of Social Affairs, which works through local authorities and covers nursery and child-minding facilities for children under the age of three, and the Ministry of Education, which provides preschools for children of ages two to six. Today, almost every French child between the age of three and six and nearly half of all children aged two to two and a half attend some form of preschool. Preschool care, while not compulsory, not only supports maternal employment, but also provides a vital first step in the socialization and development of French children. (66)
For reasons ranging from increased female employment to trade union pressure and pronatalist sentiment, child care in France has been defined for some time as a public responsibility. Increasingly, extended periods of maternity, paternity or child-care leave mean that many of the youngest children in France are in their parents’ care. Nevertheless, 33 per cent of those under age three are in day care, including 10 per cent of those under two. Most provision for this type of care is made by local authorities, or is otherwise publicly funded. (67)
France boasts a long tradition of out-of-home care. As early as 1771, Jean-Frédéric Oberlin, a Protestant pastor, set up infant schools in remote villages in the Alsace mountains so women could work in the local timber industry. In the 19th century, crèches were established by philanthropic agencies with the aim of reducing poverty and infant mortality among the working classes by freeing mothers to work outside the home. In the postwar era, crèches and écoles maternelles (publicly funded preschools), have become an integral part of the French social security and family support system. Once considered welfare institutions for the poor, creches are now in great demand by middle-class working parents. Today, all crèches take children up to the age of three and are partially subsidized by the State.
Crèches collectives are essentially crèches that offer full-day care, 8 to 12 hours per day for children under three. Places are restricted to children of working mothers. Eighty per cent of the crèches collectives are for use by residents of a particular neighbourhood; the remaining 20 per cent are attached to workplaces — mainly hospitals — with opening hours designed to suit employee needs. The average facility accommodates 50 children, divided into either two or three age groups. Older children are organized in groups of 10 to 12 with an éducatrice (instructor) for part of the day. In France, 85,000 children (4 per cent of the underthrees) attend crèches collectives. About 6,600 children are looked after in mini-crèches, which take fewer than 16 children and are usually situated in apartments or houses.
The fees for crèches collectives are income-related and range from 15 to 85 French francs (about US$3 to US$ 17) per day. In 1987,26 per cent of the cost was borne by parents. The remaining costs were divided between local authorities (54 per cent) and regional family allowance offices known as caisses des allocations familiales (20 per cent). (68) These offices, funded by employee contributions, were originally set up to give cash benefits to needy families with children, but since the 1970s they have subsidized child-care services, thus allowing local authorities to expand services for children under age three. (Expenditure by the caisses rose by 41 per cent between 1984 and 1987.) Their objective is to increase the quality as well as the quantity of child-care places, both by reducing the size of nursery classes and by providing a greater diversity of services. Their recommendation is that child-care costs should be around 12 per cent of family income.
With the number of working mothers growing rapidly, the few available creches have long waiting lists. Large cities such as Paris, Lyons, Marseilles and Orleans have more creches than poor rural districts. For example, nearly half of all available places in nurseries are in the Ile-de- France region around Paris, although this area has less than one fifth of the French population.
Crèches familiales (family day care) is based in the home of an assistante matemeUe or nonrrice, both child-minders, and staffed by caregivers who are supposed to be registered and approved by the authorities, but frequently operate without a licence. Each caregiver takes responsibility for a maximum of three children, including her own. The public agency that enrols and supervises the assi-statttes ma tern dies is headed by a paediatrics nurse, who organizes medical examinations and collects parental fees, which are income-related; pays caregivers; and provides equipment and assistance. A statute passed in 1977 gave the axsistantes matemeUes legal entitlements including rights to a minimum wage, social insurance and paid holidays; but many still resist registration because it makes them liable for income taxes.
A crèche familiale costs less than a crèche collective because in the former, the children are taken care of in a private home, where operating costs are typically about 30 per cent lower than those of centre care. In 1987, there were 46,400 places in this type of day care (2 per cent of the children under age three); 38 per cent of the costs were paid by parents, 42 per cent by local authorities and 20 per cent by the caisses.
Haltes-garderies are part-time nurseries offering 41,400 places for children up to the age of six, though most attending are under three. Originally intended to care a few hours each week for the children of nonworking mothers while they went shopping or pursued other interests, haltes-garderies are gradually turning into part-time mini-nurseries, in response to the growth in part-time employment.
And finally, there are private child-minders — about 138,000 who are registered care for approximately 200,000 children under age three (about 9 per cent of the total). An additional number who are unregistered look after atleast 130,000 children under age three. The latter, like the assistantes maternelles above, resist registration because once their activity becomes official, they are liable for income taxes. However, in 1981, France introduced tax relief on day-care expenses incurred by families, and this has encouraged registration.
The French écoles maternelles (publicly funded preschools), were established in the 1950s. Today, the schools are so popular that places for two-year-olds are invariably oversubscribed. Preference is given to children of working parents. There is more space available for older children, however: Only 60 per cent of mothers with children aged three to five are in the workforce, yet more than 95 per cent of children in this age group participate in the preschool system. Hours are generally from 8.30 a.m. to 4.30 p.m. But outside school hours, when working parents need a complementary child-care facility, service periscolaire is available in recreation centres that are generally attached to the preschools and open at 7.30 a.m. and close at 6.30 p.m. The ecole maternelle itself usually adjoins a primary school, but has its own director and exists as a separate entity.
There are three levels within preschool: ages two to three and a half (called les tout-petits, the little ones); ages three and a half to five (les moyens, the middle ones); and ages five to six (les grands, the big ones). Emphasis is placed on encouraging children to develop confidence and self-esteem, as well as on learning how to learn, in preparation for primary school. Research has found that French children who do not attend the preschool programme are likely to be at a disadvantage when they begin regular school.
From 20 to 30 per cent of the cost of the ecoles maternelles is paid for by the central Government, the rest is underwritten by the local authorities. Tuition is free, but parents do pay income-related fees for meals, before- and after-school care, and Wednesday afternoon programmes (when French schools are closed).
Throughout the 1980s, there was a steady increase in the provision of publicly funded child care in France. The rise in the proportion of young mothers joining the labour force has undoubtedly been a major spur to the development of such an impressive system, but that is only part of the story. Recent Governments have all recognized that proper preschool care and education are an investment in the nation’s future citizens. (69) Olga Baudelot of the National Institute of Pedagogical Research in Paris makes a cost-benefit case for publicly funded day care. “Child care,” she says, “has freed a million women to work and allowed 500,000 others to make a living out of child care. These women are consumers and taxpayers.” (70)

Child care and child rights: United Kingdom
Interestingly, the United Kingdom, a nation that publicly funds a mere 2 per cent of its day-care places, has produced some of the most finegrained research on the costs and benefits of child care. Two reports, both published in 1991, demonstrate convincingly that creating a comprehensive child-care service in the United Kingdom would boost the economy as well as strengthen the financial and educational circumstances of British children.
In one of the reports, for the National Children’s Bureau, Sally Holtermann estimated that it would cost £550 million (SI = US$1.50, 1 September 1993) to improve and expand existing child-care services sufficiently to accommodate an extra 2 million children. That would allow the percentage of women with a child under 11 who are in paid employment to rise to 70 per cent, from 50 per cent in 1989. One and a quarter million ‘extra’ parents at work would boost the national economy by approximately £12 billion. In the Holtermann study, the positive effects of expanded subsidized child care were wide-ranging and included the creation of about 350,000 jobs in child care and the lifting out of poverty of 500,000 children in families currently dependent on income support. (71)
The second study, published by the Institute of Public Policy Research,  has estimated that up to half a million children could be lifted out of poverty if high-quality, affordable child-care services freed their mothers to work. (72) In this study, the direct rate of return to the Government for moneys invested in child care ranges from 5 per cent to 51 per cent over a 13-year period, depending on how intensively parents use child-care services. And the social rate of return — which includes the economic gain for the household (enhanced earnings) as well as flowback to the Government (taxes) — ranges from 24 per cent to 84 per cent.
Recently, children’s rights in the United Kingdom have also gained attention through the Children Act (1989), which came into force on 14 October 1991. The Act has been described by the Lord Chancellor, Lord Mackay, as “the most comprehensive and far-reaching reform of child law... in living memory.” (73) That may be an exaggerated claim for an Act that has yet to have much effect on children, but many of its limitations are due to funding shortfalls. In the sphere of principle, the Children Act is on the cutting edge of attempts to make legal systems more responsive to the needs and rights of children.
A systematic review of laws relating to children was launched in the 1980s after a House of Commons Select Committee report described existing legislation as complex, confusing and unsatisfactory. (74) The Act was also, in part, a response to the debate following inquiries into the child-abuse related deaths of three children: Jasmine Beckford (1985), Tyra Henry (1987) and Kimberly Carlisle (1987). The inquiry into Kimberly’s death concluded that the law had failed the social workers in their primary task of protecting the child because no legal mechanism had been available to allow them access to her or to ensure that she had a medical examination. (75)
The Act brings together legislation from both private and public law. Items covered under private law include, for example, disputes between divorcing parents about the future of their children. Public law, on the other hand, deals with public policy issues such as the duties and powers of local authorities. A central thrust of the Act is that the welfare of children should be ‘paramount’ in all of these legal contexts. A basic recommendation is that children should be brought up within their own families whenever possible. They should be taken into care only when it is absolutely necessary, because the best place for a child to be is in his or her own home.
The language of the Act represents a distinct change of emphasis. The words ‘parents’ rights’, ‘custody’ and ‘access’ are replaced by ‘parental responsibility’, ‘partnership’ and ‘contact’. Parents still have rights, but the emphasis now is on responsibilities — how a parent can best safeguard the well-being of a child, how best to take into account a child’s wishes and needs. In fact, the Act attempts to give new priority to children in divorce proceedings, stating that “never again will parents in separation or divorce battles be able to lay claim to their children as if they were property.”
The Children Act is also a step forward for fathers, as it encourages divorcing parents to negotiate shared responsibility for their children. At least for married individuals, parental responsibility is now for life. (In the case of unmarried fathers, parental responsibility is not automatic, but can be acquired if the mother agrees, or the court rules, that he should have it.)
Should parents be unable to agree on how to distribute parental responsibility in the wake of separation or divorce, the court can pass a variety of Section 8 orders. Examples are a Resident Order, which stipulates where the child should live; a Contact Order, which may require the parent with whom the child is living to allow telephone calls, visits and overnight stays with the other parent; or a Specific Issue Order, which settles a particular area of dispute, such as the choice of a school. Indeed, anyone concerned about the welfare of the child may apply for a Section 8 order. Grandparents, for example, may contest an adoption order and ask that the child come to live with them.
Many of these new regulations need adequate funding if they are to be properly implemented. For example, budget cuts in the 1980s undermined a non-custodial parent’s financial responsibility for a child by reducing the number of social security staff devoted to collecting child maintenance. The result was 9 per cent less child maintenance collected from 1988 to 1989 than from 1981 to 1982.
Regulations under the Children Act that mandate a certain level of local authorities’ services have already run into severe funding constraints. These new regulations cover disparate matters, from the rules governing private foster-care arrangements, to the registration and inspection of child-minders and children’s homes.
Many professionals believe that the resources necessary to implement the Act — whether for regulation, inspection or training — are simply not there. For example, they argue that the £3.5 million available nationally for training is nowhere near enough. Brian Doughty, head of Strategy and Development for the region of North Tyneside, has complained that the resources are totally inadequate and have to be “massively topped up from the local authorities’ existing budgets. If central government really wishes to promote the welfare of young children and ensure they have access to the range of services of the Children Act... they should ensure adequate finances are made available.” (76) The Association of County Councils estimates that implementation of the Act will cost as much as £150 million nationwide.
Clearly, many of the Act’s good intentions will come to naught without proper funding, and they might even have undesirable consequences. One example is the proposal to expand the registration scheme for child-minders to include all those caring for children up to the age of eight. (Current provision is limited to under the age of five.) Local authorities must not only re-register and inspect every child-minder already on their books — more than 100,000 in England and Wales — but they must also register and inspect new child-minders and check them for appropriate attitudes to children’s cultural, religious and dietary needs.
Most local authorities despair of meeting the Act’s demands. For example, in the town of Sutton, insufficient resources and staff have created such a backlog that the authority is unable to register any new child-minders at all, leaving the field wide open for people to work outside the law — the very danger the Act was designed to combat. Another problem concerns high fees. Registration fees of£100 and inspection fees of £75 for nurseries and playgroups may signal the end for small, informal programmes that survive on a shoestring budget.
The Children Act sets high standards for the United Kingdom, and yet at present, the Government seems unwilling to provide the resources necessary to meet those standards. (77) Children with special needs are a case in point. The Act requires local authorities to provide support for disabled children and latchkey children. But without central government support, how can financially strapped local authorities provide afterschool programmes or special schooling? This paradoxical situation compromises many of the recent reforms in education and health care, which are bound to fail because there has been no commensurate increase in the size of budgets. Indeed, in some critical areas — such as industrial training — budgets are actually shrinking.

Family allowances: Belgium
Family allowances, sometimes referred to as ‘child benefits’ or ‘child allowances’, were first adopted in Europe in the 1930s to combat falling birth rates and to supplement family income at a time of high unemployment. Initially financed by an employer payroll tax, many European countries gradually moved towards family allowances financed from general government revenue. In the 1950s and 1960s, these allowances were permitted to erode in value, but this trend was reversed in the late 1960s, when governments became concerned once more about poverty in large families and the rise in the number of single-parent families. Then, in the late 1970s, the allowances declined again. In most European countries, family allowances have dwindled over time as a proportion of family income, although they remain important to lowincome families.
There are striking similarities in the pattern of benefits. Throughout the European Community, member States pay family allowances through their social security systems, targeting the mother as the recipient of the benefit. Most pay more for larger families and older children, and design the family allowance as a universal rather than a meanstested benefit.
In a recent report using data from 1990, Belgium emerged as having the most generous system of family allowances in Europe administered by a powerful Ministry for the Family.
As is the case in some other European countries, family support policy in Belgium was once tied to a strong pronatalist approach, designed to encourage families to have more children. Thus, the payment gradient is steep—the rate for the third child being three times the rate for the first. (Rates range from approximately US$70 a month for the first child to US$220 a month for the third child.) The rate per child also rises with the age of the child. The Belgian family allowance is not means-tested and is payable until the child reaches the age of 18 or completes full-time education. In practice, many families collect until age 25.
In Belgium, the family allowance is referred to as an ‘indirect wage’, and it is a significant source of economic security for families. However, it has not been immune to the spending cuts of the 1980s. The family allowance as a percentage of a family’s after-tax income diminished from 3.8 per cent in 1980 to 3.2 per cent in 1986. In recent years, the allowance has lagged behind the rise in wages, and as a result, families with children have fallen behind.
There are calls in Belgium for the child, rather than the mother or the father, to become the ‘entitled person’. (This is often seen as a solution to problems raised by changing caretakers, which occurs with divorce or remarriage.) There are also new pressures for higher family allowances, coming from Belgium’s strong ‘family movement’, which is conservative in orientation. The movement, which has particular currency among the Catholic population, stresses that higher allowances would enable more women to stay out of the paid labour force, thus preserving the traditional division of labour between men and women.
Outside the European Community, the leading country in family allowances is Sweden, which adopted them in the 1930s. Sweden’s family benefits were not inspired by pronatalism. Rather, they have aimed at redistributing resources in favour of families with children and at providing better employment opportunities for women with children.
A European Community survey in 1990 found that the level of family allowance was not a key factor in influencing a person’s decision to have a baby; it ranked seventh on the list. Economic prospects, availability of housing, the existence of child-care facilities and the strength of the marital relationship were all more important determinants. It seems that pronatalism is no longer the dominant force behind this benefit. Instead, family allowances are part of a general commitment in Europe to family and child welfare, a commitment that has been sadly lacking in other rich nations.

Divorce reform: France, Sweden, United States (Wisconsin)
The adverse consequences of divorce for children seem to be particularly severe in the United States and the United Kingdom. This is because, more so than in other countries, reformist energies in the 1970s and 1980s were directed towards maximizing adult rights to freedom and equality rather than towards providing a safety net for children. As Mary Ann Glendon has noted, those Anglo-American countries are unique in the degree to which they have accepted no-fault, no-responsibility divorce, and in their “relative carelessness about assuring either public or private responsibility” for children. (78)
The divorce reform movement produced two models in Western Europe: a ‘traditional’ model (found in France and Italy), which emphasizes private responsibility and the financial obligation of the former provider; and a ‘Nordic’ model (in Sweden and Norway), which relies on elaborate programmes of public support for single parents with children.
France liberalized its divorce laws in 1975, but was careful to continue to protect the economic interests of women and children. All assets acquired during marriage are now divided equally, and the spouse with the higher income (nearly always the husband) is required to make payments to the other “to compensate... for the disparity which the disruption of the marriage creates in the conditions of their respective lives.” (79) In addition, child support awards are generous, and if the non-custodial parent fails to pay, the State rather than the custodial parent absorbs the risk. This means that if there is a default in child support payments, all the custodial parent needs to do is apply to a State agency. The agency then tries to collect from the non-custodial parent, but in the meantime it advances the amount of child support owed, up to a limit set by law.
Cases of unilateral no-fault divorce are governed by a particularly strict set of rules in France. The plaintiff must not only wait six years for a divorce, but “remains completely bound to the duty” of supporting his wife and children in their current lifestyle. (80) All of these safeguards help ensure a reasonable standard of living for children in the case of divorce.
Sweden protects its children in other ways. Like France, child support is guaranteed by the State, but instead of relying on alimony or other support for a divorced spouse to maintain a certain standard of living, child support is backed with “the most comprehensive and generous package of benefits for one-parent families in the world.” (81) As one divorcee explained, “Everyone knows that divorced parents need more money and more social support because of the additional pressures involved in raising children as a single parent ... So, as soon as I got divorced my income went up: Both the local and national Government increased maternal benefits, my tax rate dropped drastically ... It also helped to have the possibility of 24-hour day care.” (82)
In the United States, a few states are beginning to move in a ‘European’ direction in order to better protect the interests of children. For example, in 1987, the state of Wisconsin drew up guidelines for child support awards. The new standards are generous—ITpercentof the noncustodial parent’s income for one child, rising to 35 per cent for five or more children — and they have dramatically increased the monetary value of child support. At the same time, Wisconsin instituted a system of routinely withholding child support from the salaries of non-custodial parents, and this has brought delinquency rates down. The net result: Custodial parents are granted much larger child support awards, and the awards are much more likely to be paid.
Wisconsin has also increased the coverage of child support awards by treating never-married fathers (where it is possible to establish paternity) in exactly the same way as divorced fathers, using identical guidelines and collection procedures. State officials estimate that eventually 40 per cent of never-married fathers will be forced to contribute child support. (83)
A powerful feature of the Wisconsin initiative is that it sets a ‘socially assured minimum benefit’; if the non-custodial parent’s child support payments are lower than this benefit, the state steps in and pays the difference.
But is the Wisconsin model enough? Easing financial hardship is an extremely important goal, but it does not heal the psychological wounds of divorce. The research evidence seems overwhelming: No matter how prosperous their environment, abandoned children still yearn for their fathers and underperform in school.
If governments decide that a father’s presence, as well as a father’s salary, is important to the welfare of children, policy-making becomes a great deal more complicated. The State can no longer ‘fix’ the divorce problem by simply producing bigger and more reliable child support payments. It needs to venture into more difficult territory. Bringing divorce rates down and, when the breakup cannot be avoided, maximizing contact between the non-custodial parent and the child both become targets for legislation.
Despite the United Kingdom’s dismal performance on the child support front (with payments actually shrinking in the 1980s), the United Kingdom is taking these non-economic issues seriously. Early in 1992, Lord Mackay, the Lord Chancellor, rejected proposals made by the Law Commission to further liberalize the divorce laws on the grounds that they would undermine families with children even more. Lord Mackay has spoken eloquently about the problem: “The Law Commission did not recognize sufficiently clearly the need to strengthen the institution of marriage.” (84) It seems likely that the United Kingdom will move towards making divorce more difficult. Lord Mackay is thought to favour a longer waiting period for contested divorces, along the lines of French practice.

Family-friendly workplaces: United Kingdom, United States
Over the last decade the United Kingdom and the United States have seen a fivefold increase in the number of companies offering a package of family-friendly benefits to working mothers and fathers. This dramatic development has been prompted by two powerful trends: a massive deterioration in the life circumstances of children and the looming skill shortages of the 1990s.
Throughout the advanced industrial world, corporate executives warn of a “widening skills gap.” (85) In Australia and Canada, business leaders worry about an “employment crisis,” (86) while in the United States analysts talk about a “monumental mismatch” between jobs and the ability of workers to do them. (87) Across countries and across economic sectors, corporations are caught in a bind as far as human resources are concerned and face growing competition for a limited, skilled workforce.
The human capital deficit seems to be considerably worse in the United Kingdom and the United States than elsewhere, because in those countries the emerging shortfall in skills has been exacerbated by public policy. While most other nations have enacted elaborate family benefits, in the United Kingdom and the United States, public policy has tended to undermine rather than bolster fragile family structures, leaving to the private sector the unenviable task of picking up the pieces. This works best when companies can prove that family-friendly workplaces are good for the bottom line.
In the United States, an impressive body of evidence now exists to show that in-house programmes of family support can improve corporate profitability. One large national survey reports the following ‘payoffs’ to family benefits: improved recruitment (cited by 85 per cent of respondents), reduced turnover (65 per cent), reduced absenteeism (53 per cent), increased productivity (49 per cent) and enhanced company image (85 per cent). (88) Over the last three years, several high profile companies, including investment banking firms, such as Goldman Sachs and Bankers Trust, have sponsored on-site day-care centres in their efforts to capture these ‘payoffs’.
A few companies have analysed in detail the costs and benefits of specific family support policies. For example, the Union Bank in California has shown that on-site child care dramatically reduces labour turnover among working mothers (from 9.5 per cent to 2.2 per cent a year), producing significant savings for the company. (89) Honeywell, a computer manufacturer based in Minnesota, has introduced a sick-child-care programme that has cut back on absenteeism and reduced labour costs. (90) And Merck, the large pharmaceutical firm, has demonstrated impressive returns from its parenting leave policy. The price tag attached to replacing an employee at Merck is US$50,000. By permitting a new parent to take a generous six-month child-care leave (cost: US$38,000, which includes partial pay, benefits and other indirect costs), the company succeeds in retaining almost all of its new mothers, thereby achieving a net savings of US$12,000 per employee. (91)
J. Douglas Phillips, Senior Director of Corporate Planning at Merck, stresses the large cost savings inherent in bringing attrition rates down. In an analysis of turnover costs — duplicated in other companies with similar results — he showed that turnover costs average 1.5 times annual salary costs. According to Phillips, few companies are aware of how expensive it is to replace workers, but in most firms, “avoiding turnover for just a few employees will yield excellent paybacks.” (92) His research shows that while other programmes are capable of reducing attrition rates, parenting leave and other family benefits have the greatest impact on turnover. He believes that Merck’s family support package helps account for the company’s low annual turnover of 5.5 per cent, compared with the American average of more than 12 per cent.
The United Kingdom shares with the United States a dearth of public policies on the family support front and, as is the case in the United States, British companies have been drawn in to fill the vacuum. For example, the Midland Bank has set up 300 on-site day-care centres in an attempt to stop large numbers of women from permanently leaving the bank after they have children. According to one senior executive at Midland, “The value of the women who leave is incalculable because of their experience and training.” (93)
Company-sponsored day care or parenting leave is obviously much less needed in countries where there are well-developed public policies in these areas. In France, for example, there are relatively few unmet needs on the child-care front, and therefore little incentive for corporations to step in with their own programmes.
It is important to emphasize that working parents need time as well as benefits. Companies at the cutting edge of family policy have found flexible hours, compressed work weeks, part-time work with benefits, job-sharing, career-sequencing, extended parenting leave and home-based employment opportunities particularly popular among employees.
Corporations as different as IBM (200,000 employees) and NCNB Corporation, a Charlotte, North Carolina-based bank holding company (13,000 employees), have found it possible to create a more fluid, less rigid workplace that gives workers with family responsibilities significant discretion over how they structure their careers, how many hours they work each week, and when and where work is performed. For example, IBM employees can now take a three-year break from full-time employment, with an option of working part time in the second and third year, to take care of young children or elderly relatives. With the exception of the part-time component, this ‘career break’ is unpaid, but health and retirement benefits continue while workers are on leave, and IBM guarantees a full-time job at the end of the three years.
This ‘gift of time’ has proved immensely popular and has remained in place as a key employee benefit, despite the cut-backs at IBM over the last year. (94) In hard-pressed dual-income American households, many parents are desperate for such relief on the scheduling front.

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