Any system you have in place is capable of being ignored by individuals within that system if they do not adhere to it

Ann John, former council leader

Ms John told the inquiry into Victoria's death that the professional judgment used in the case by Edward Armstrong, Brent's children's services manager, was found "wanting".

Mr Armstrong, who has been suspended, was singled out for blame by Ms John over the "mistakes" he had made.

Ms John said: "Any system you have in place is capable of being ignored by individuals within that system if they do not adhere to it."

She added that Victoria's death had had a "devastating" effect on the authority as a whole.

Ronald Ludgate: Criticised

Mr Daniel, now Brent council's chief executive, picked out three individuals - all of whom have since "moved on" - for criticism.

They were Mike Boyle, social services director between October 1995 and September 1999, Ronald Ludgate, the acting social services director for six months from April 1999, and Lucille Thomas, the children's social work director.

Mr Daniel said: "I would say there were serious weaknesses at a higher level."

Within six months of him taking office, Mr Daniel said a cull of "under-performing senior managers" was begun as the council, in its attempt to modernise, became "a little intolerant" of them.

The over-stretched children's department was run by two full-time managers and eight or 10 agency staff who were more expensive to employ than full-time workers, he said.

Mike Boyle: Also named as a focus for concern

New social workers were placed on less generous packages than their colleagues in a cost-cutting measure, which saw them working more hours for less pay.

Staff training was saved for full-time rather than locum agency staff, the inquiry was told.

Mr Daniel said that Brent's social services was under-resourced from 1997 to 2000.

But he said reserves had been "raided" and resources redirected towards it, including �420,000 in this financial year.

The hearing was adjourned until 6 November.