Nobody knows how many children are in care in Switzerland. And differences in local organisational structures and standards for placements have meant that much needed reform of the foster care system is advancing at an uneven pace.
“We have children who have been through every imaginable kind of hardship. They have suffered neglect, hunger, physical and sexual abuse. What they need is security; instead they are delivered into a system with inbuilt discontinuity.”
Those are the words of children’s advocate and former foster child Urs Kaltenrieder, co-founder of Integration, a reputable foster placement organisation and support network in Emmental. Many of the children referred to his organisation have been through several previous placements. (see below)
How is it that Switzerland, one of the world’s most highly developed societies, has not been able to deliver best-practice care to its most vulnerable children?
It’s almost a decade since a government-commissioned report looking into the improvement of the Swiss foster care system was completed, but some of the key recommendations have yet to be implemented.
The 2005 reportexternal link, ‘The foster care system in Switzerland’, found that the basic data required to effectively manage the system was missing and called for investment in research. Yet experts today are still relying on extrapolated estimates from the 2002 census which put the figure at 15,000.
“The basic data must be regularly collected (number of foster children, number of children in homes, the progression of the placements), the different models and forms of organisation must be recorded, investigated and evaluated,” the report’s author Barbara Kathrin Zatti wrote.
Zatti also said that a central monitoring office should be set up “as quickly as possible“ to collect and analyse the essential information. Neither goal has been achieved.
What has happened is the introduction of new child and adult protection legislation. Separately, the government issued regulations covering the supervision of foster care and children’s homes. The new law, in force since 2013, includes a requirement for each canton to set up multidisciplinary and regionally organised child protection authorities.
This process is under way and, it is hoped, will soon end the practice of child protection issues being resolved on a micro level by communes, with lay people rather than professionals making the decisions.
The 2005 report also referred to “problematic, questionable or completely unregulated areas … such as the lack of supervision of organisations offering foster care places [family placement organisations]” and called for regulations.
Zatti no longer specialises in the area of foster care and could not comment on developments in the sector. Andrea Keller of Integrasexternal link, a professional association for social and special needs education primarily for children in care, is not satisfied with the level of progress since 2005. Integras, whose membership includes care institutions, offers a quality-control label to placement organisations.
“Under the new foster care regulations, family placement organisations must now register with the canton to say they are doing this work. But the problem is there is still no requirement for a permit. The cantons must in some way recognise these organisations und oversee them but there is nothing in the law about quality,” Keller told swissinfo.ch.
To date only five cantons have taken the initiative to require these organisations to meet conditions for a permit.
“The pressure on the side of the authorities is increasing very slowly. Awareness is high particularly in Bern, Zurich, Solothurn, Zug and Graubünden. Elsewhere it is much slower than we hoped,” Keller said.
Filling the gap
Placement organisations first emerged in the 1990s in response to a shortfall of foster places and a lack of state help for foster families.
An estimated 60 organisations are still filling the gap in expertise and personnel around Switzerland, engaged by communes or cantons. They receive up to CHF250 per child placed per day. Part of the money is passed on to the foster family, the rest may be used to provide support, training or special therapies.
“These organisations have by and large brought an improvement in the quality of care,” Stefan Blülle of Basel’s child protection office told swissinfo.ch.
“But the quality varies. We now we have an estimated 2,000 such places in Switzerland and the difficulty is that there are very different approaches to supervision, the division of roles, and the philosophy of the regulation,” he added.
Part of the problem is the high turnover of staff in social services. “There’s a very high loss of know-how due to high personnel turnover in child protection services. They are under pressure, faced with lots of cases and delegate work to the family placement organisations,” Keller said.
Blülle cites examples of organisations that provide excellent support for foster families, but with the requirement for financial transparency not yet being universally enforced by the authorities, he agrees it is has been possible for less altruistic operators to put too much emphasis on profit.
In recent years, Swiss media reports have cast doubt on the credentials and operating methods of several family placement organisations.
Graubünden in eastern Switzerland took a lead in regulating this area, introducing its own cantonal foster care laws in 2007, under the leadership of the head of Graubünden’s social services department Andrea Ferroni.
“We were the first canton to regulate the family placement organisations. We realised that the structures to place children who couldn’t live with their parents had significantly diversified and the law had to catch up,” Ferroni told swissinfo.ch.
“The question of whether an organisation does its job properly arises in all categories of care. When you’re placing a foster child it is not enough to have a free bed and a good heart. Quality norms have to be set down,” he added.
The stakes are high for children in care who have already been through difficulties at home.
“One in three children in care has changed placements at least once,” Blülle explained. “We know from research into attachment that babies and small children suffer negative consequences from broken relationships with their main carers. The effects on older children and adolescents have hardly been researched.”
“These are children who have often been through very difficult experiences. We have to give the foster families support, they can’t be expected to rely on intuition to deal with serious problems,” he added.
The good models show that providing the right kind of support works. Blülle refers to Kaltenrieder’s Integration foundationexternal link in Emmental, a placement organisation for children with learning and behavioural problems which also provides remedial teaching and therapies.
“Families with Integration can call 24 hours a day if they need to, are encouraged to report problems, identity problems early and solve conflicts,” Blülle said.
Of more than 100 children placed by Integration over 15 years, there were only four cases where the relationship with the foster family broke down.
That Switzerland with its highly federalist structure has a patchwork of services covering children in care is not surprising. Health, education and social welfare are cantonal matters and different models have developed in different cantons.
Ferroni believes that the implementation by the cantons of the new foster care regulations, as well as the new Adult and Child Protection Law will be sufficient to raise standards nationwide to a good level within five years.
“These legal instruments were urgently needed and I assume that the cantons are taking it seriously and implementing the regulations as soon as possible for the wellbeing of the children and their development chances,” he said.