Row over Glasgow parenting programme deepens

An author of an independent report that evaluated the effectiveness of the Triple P – Positive Parenting Programme in Glasgow has raised serious questions about the health board’s decision to commit millions of pounds of public funds to the programme.

The report, which was published earlier this month, found that the flagship programme did not improve the social and emotional functioning of children and concluded that “the overall lack of efficacy leads us to recommend that Glasgow should not commit to further investment in Triple P training or materials”. It also suggests that the particularly high drop-out rate amongst families from the most deprived areas could contribute to a widening of health inequalities in Glasgow.

However, at the time Director of Public Health at NHS Greater Glasgow and Clyde, Dr Linda de Caestecker, who has championed the programme, issued a statement rejecting the report “due to its lack of robustness” and further claimed that is “lacks credibility as a position as it betrays a basic lack of understanding of the way people live their lives.”

In a letter to NHS GGC chief executive Robert Calderwood - which has also been copied to new Health Secretary Shona Robison, Social Justice Secretary Alex Neil, BMA Scotland and Unison Scotland - GP and visiting professor at the University of Glasgow, Dr Philip Wilson asserts that there was at the time of its introduction in 2009, and continues to be, “no reliable evidence that Triple P is effective as a public health intervention”. He has therefore written to Calderwood to ask why the board was able to bypass normal competitive procurement procedures before awarding the lucrative contract to Triple P, despite having been repeatedly briefed in advance that the evidence base was “flawed, being at best weak and at worst dishonest.”

Wilson writes that in a news story published in Holyrood magazine in 2010, which reported that the board was being called upon to commit to an independent evaluation of the programme, a spokesperson for NHS GGC is quoted as saying that the Triple P programme was selected as it was the “best fit” for Glasgow’s requirements and met the exemption to tender due to its “unique nature.”

In response to queries about the depth of consultation that took place prior to its selection, the spokesperson also told Holyrood at the time that Triple P was adopted as the main parenting programme in Glasgow following discussion and agreement at appropriate forum and groups, and that following a “detailed analysis” of the published evidence for parenting programmes by the Public Health and Health Improvement Directorate, Triple P was found to be the “only” programme that has taken a full population public health approach, incorporating an evidence-based universal component with an existing media and information campaign.

However, Wilson writes: “This statement appears to have little validity given that a document was circulated publicly in 2008 proposing an alternative system involving multiple parenting programmes tailored to need. There is thus little doubt that alternative providers or consortia of providers could have submitted strong tenders.” 

He also disputes the Board’s claim that the overall cost of the programme since 2010 has been around £4m, and suggests that the true total of public funds committed to date, when the cost of staff time has been factored in, will now be at least £12m.

In addition, he asks why senior officers of the board, including de Caestecker, have been allowed to reject the findings of the independent evaluation and calls the health board's press statement was "deliberately misleading, demonstrably inaccurate and insulting to the research team."

In an interview with Holyrood magazine shortly after the roll out of the programme in Glasgow, head of international programme dissemination, Triple P International, Dr Majella Murphy- Brennan, said a unique aspect of the multi-level programme is that it treats parenting as a public health issue, so is suitable for every parent.

“It suits the parent with a family with minimal problems that just needs a little bit of information about parenting, even if it is just to confirm that they are on track. But it is also suited to families that have quite severe problems with their children, and also parents who have problems as well in terms of marriage conflict, depression, stress and anxiety, all of the issues associated with raising a child.”

NHS GGC has stated that the programme has supported more than 30,000 families since its introduction in 2009 and “is making a positive difference to the lives of thousands of families.”