Social workers, foster carers and parents are all needed for the adoption process, says Tim Walker

Adoption can be a complex business, as Madonna has discovered. While the current media focus is on adoption from abroad, adoption workers continue to work tirelessly to place the countless children in need of new homes here in the UK. And with national adoption week upon us, much of the field remains understaffed, underpaid and overworked.

But while the rewards are not financial, the hard work nevertheless pays off, says Giuliana Montixi, children's services manager for Barnardo's Newcastle adoption project. "The reward comes in being part of making a family complete, and a child secure and happy."

Montixi took the accepted route to her current position with Barnardo's, beginning by gaining a social work qualification. "I qualified as a social worker in 1990," she explains. "Then I worked with 'looked-after children', who are in the care of the local authority; I worked with children who had behavioural and educational issues, and later in child protection. Then I went to a fostering team."

Montixi spent eight years working in adoption for a local authority before joining Barnardo's, a voluntary adoption agency. "It's important for any adoption worker to have a range of experience of children and families," she says. "You need a good understanding of the feelings of loss and separation that affect a child undergoing adoption."

There is a severe national shortage of social workers, who require three years of experience before specialising in family placement, meaning it is increasingly difficult for local authorities to find people with the right expertise to work in adoption.

Those who do find that today the majority of adoptions come through the care system, and that very few of the children are newborn babies. Last year the average age of an adopted child was four years and two months, and while 75 per cent of children are under the age of seven when they are adopted, they can be as old as 18. Many have serious medical conditions that their parents have been unable to cope with. Others have been subject to abuse or neglect and suffer mental health problems as a result. Often, a group of siblings need to be adopted together. Adopters may need to modify their expectations of the adoption process.

"The training and initiation for adopters shows them what a challenging task they are probably going to have," explains Barbara Hutchinson, deputy chief executive of the British Association for Adoption and Fostering. "Often those who want only a new baby to adopt are likely to drop out of the programme when they see the realities."

Jonathan Ewen, director of Barnardo's North East, agrees. "Adoption assessment workers need the right intellectual and analytical abilities," he says. "Adopters will try to present the best possible impression, and they can have the misconception that these children 'just need a bit of love'. Well, some children have very profound problems that need a lot of care and attention."

One of the major frustrations for us is that there aren't enough adopters out there, says Giuliana Montixi. When a local authority has a problem placing a child with a family from the same area, they may turn to a nationwide voluntary agency like Barnardo's. "For example, in the North East," says Jonathan Ewen, "there aren't many ethnic minority families looking to adopt, so Barnardo's find families elsewhere in the country for ethnic minority children. We also organise more difficult adoptions such as those of older children, with more complex problems than the youngest."

Adoption begins with a social worker intervening in the life of a family and ends with the child either returning to their home, or being found a new one. In the interim, while the child's future is in the hands of convoluted court proceedings, they will be put in the care of a foster family.

Avril Head and her husband have been foster carers for 22 years. They have three grown-up birth children, and have adopted two of their former foster children. Currently, they are caring for a further two foster children.

"We started off looking after children with disabilities," Avril explains. "When we were young, we both had experiences of people with disabled children who had absolutely no support. We thought we could do something to help. Now it's come full circle because two of the children we have are disabled and we're looking for help ourselves!"

A recent green paper set out proposals for better pay and a national qualifications framework for foster carers. For now, however, the Heads are volunteers, with no benefits and no pension. "We worked out that we get £1.78 an hour," says Avril. "We think of ourselves as professional foster carers, though it's not yet recognised as a career. You can really help children overcome the issues they have before they leave you."