It was New Year's Day 2008 when Martin Narey finally received the letter he had been waiting for. Inside were the names of 63 HIV-positive children and their families who had at last received a reprieve from the British Government and no longer faced deportation back to Malawi and Rwanda and to almost certain death.
In a candid interview before he steps down as chief executive of the children's charity Barnardo's, Mr Narey told The Independent that receiving the letter was the proudest moment of his professional life.
The 54-year-old former head of the prison service had fought long and hard to keep the children in this country, lobbying Tony Blair to argue that it would be "cruel and inhumane" to return them to die when anti-retroviral treatment in the UK could give them a normal life expectancy.
"On a visit to one of our services in Manchester I met Josephine, a mum whose appeal against a decision not to grant her asylum had just been rejected. Josephine and her son Michael, then 14, were about to be deported to Malawi," he said.
"Both Josephine and her son were HIV positive. The clinical evidence I was subsequently able to read indicated that without anti-retroviral treatment in Malawi, both would die within months, whereas Josephine's life expectancy here was considerable and Michael's was essentially that of any other 14-year-old.
"What most shocked, upset and moved me about Josephine was not her quiet acceptance about her own death, but her abject fear over the reality that because she had a radically lower blood count she would die first and leave Michael to die on his own a few weeks or months after her.
"I went straight from there to the Labour conference where I was speaking in a Fabian Debate and I spoke very frankly about what I'd seen. That got me in front of the All Party Parliamentary Group on HIV. That got questions asked at PM's Questions. That got me a meeting with Tony Blair and eventually – and to his enormous credit – a list of more than 60 children, all HIV positive, and their families were given indefinite leave to remain.
"The reprieve list, which was sent to me on New Year's Eve and I opened on New Year's Day 2008, was, and I suspect always will be, the best moment of my professional life."
Mr Narey also revealed new research showing that six out of 10 children who are returned to their birth parents after being in care are abused or neglected again within two years. He argues that this bolsters the case for removing more children with abusive backgrounds from their families and transforming their lives by having them adopted.
"I think that we as a society try for too long [to keep children with their birth parents]. I think we probably need more children in care than the 60,000 we have now. I'm not saying we should sweep in without giving parents a chance. But we shouldn't put the child at long-term risk," he said.
Mr Narey, who is to leave Barnardo's in January, called for new national targets to increase the number of children in care being adopted. Adoptions increased after Mr Blair introduced targets in 2000 for a 50 per cent rise by 2006. But the targets were quietly shelved in 2008 after protests that the policy was encouraging social workers to remove children from their parents in order to meet the targets.
Mr Narey said: "Tony Blair brought some personal passions to the office of Prime Minister. One of them was the wish to see greater numbers of adoptions. Since his sponsorship has disappeared they have fallen right back and very, very few babies are now adopted. The research is absolutely clear. Adoption, particularly of babies, can be transformational."
The government-commissioned research, by Professor Elaine Farmer of Bristol University, found that 59 per cent of children who had returned home after being in care had then been abused or neglected. The study of 138 children found that social workers often waited for a "trigger incident of physical or sexual abuse or severe domestic violence" before taking decisive action. In more than half of cases, the parents' problems had not been addressed while their children were in care – including drug abuse and mental health problems.
The researchers also judged that three in 10 children had been left too long with their parents in adverse circumstances before care proceedings were initiated. "After I last spoke out about needing more children in care, an academic wrote to me saying I was forgetting about the need to balance the needs of the child with the rights of the parents. But there is no balance, there is only the one thing to be taken into account and that's the welfare of the child," Mr Narey said. "The legislation is clear but the practice is not. Before Baby Peter, if you look at the vilification social workers have historically faced for taking children into care, no wonder some of them back away."
He also warned that the care system was under increasing pressure. The children and family court advisory and support service Cafcass reported a 43 per cent rise in care applications between 2008 and 2009, but the number of qualified social workers rose by just 13 per cent during the same period.
An extra £250m is needed to ensure the safe and efficient running of the service, Narey says, describing the £23m for additional social workers announced by the Government as "a drop in the ocean". "There's far greater danger in the UK now of children being left in circumstances of abject neglect than there are of children being taken away from decent families. I think most people would be pretty alarmed at the conditions in which social workers have to leave a lot of children," he said.
Mr Narey joined Barnardo's after 23 years as a career civil servant in the prison service and is credited with giving children's causes a higher profile. When he accepted the role, he said he wanted the charity to "be brave" – and has often kept to his word.
Mr Narey, who lives in Whitby, north Yorkshire, and is married with two grown-up children, said he will not miss the weekly commute which sees him catching the 6.30am train from York to London every Monday and not returning home until the end of the week.
"It's been fine," he said. "But I just did not want to go on doing it forever. I've done this job longer than any other job. By the time I leave this I'll have done five and a half years. I'm really pleased with the way things have gone, but I think that's quite a long enough stint in a job like this. I think the organisation will thrive with someone new coming in. I have had a lot of big jobs and I just look forward to the possibility of doing a few other things."
Some names have been changed to protect the identities of those featured in the article
Deadly virus: HIV in Africa
*One in three children born with the HIV virus who do not receive treatment will die before their first birthday
22m people in Sub-Saharan Africa have HIV. In Malawi the rates of childhood HIV and Aids are among the highest in the worldReuse content