London: Doctors are being given new backing to report suspected child abuse after paediatricians voiced fears that high-profile cases such as Baby P had deterred some doctors from acting on their suspicions.
Guidance being issued to the UK’s 230,000 doctors by the General Medical Council (GMC) makes clear that those who act on honestly-held fears about a child’s welfare and follow the correct procedures will receive the regulator’s support even if parents lodge a complaint.
Paediatricians welcomed the move, which they said would give doctors greater confidence to help protect patients in one of the most charged and difficult areas of medical practice and remove the threat posed by vexatious complaints.
In future, doctors who trigger an investigation by reporting their suspicions will not face any sanctions even if their concern turns out to be groundless, as long as they have followed the GMC’s guidance.
The guidance, which will come into effect on 3 September, states: “It is vital that all doctors have the confidence to act if they believe that a child or young person may be being abused or neglected. Taking action will be justified, even if it turns out that the child or young person is not at risk of, or suffering, abuse or neglect, as long as the concerns are honestly-held and reasonable, and the doctor takes action through appropriate channels.”
It adds: “Doctors who make decisions based on the principles in this guidance will be able to justify their decisions and actions if we receive a complaint about their practice.”
Niall Dickson, the GMC’s chief executive, said: “Child protection is a complex and emotionally challenging area of practice for any professional, and doctors in particular can find themselves having to make difficult and delicate judgements in a charged atmosphere. The decisions made or not made as a result can have far-reaching consequences.”
For example, doctors seeing an adult patient who has mental health or substance misuse problems, or who lives in a home where domestic violence occurs, should consider if a child is suffering abuse or neglect. If they do, they should tell the adult of their concerns and act upon them, by seeking advice from the designated lead official in child protection in their area or speaking to social services.
Dr Tom Allport, a consultant community paediatrician in Bristol, said: “Child protection is part of the job with the highest emotion and highest pressure. You are potentially recommending that children get removed from parents, putting yourself in court and opening yourself up to criticism. It is really helpful that the GMC is setting out what its expectations are of doctors in undertaking child protection work. This should allow doctors to feel confident that if they work taking account of the guidance, then their livelihood shouldn’t be at risk.”
He added: “I hope the GMC will have strong mechanisms for detecting and responding quickly and appropriately to malicious or vexatious complaints. It is terribly easy for articulate parents to put doctors though fitness-to-practice procedures at the GMC. Colleagues are angry how undiscerning the GMC has been about doctors working in child protection. I hope that paediatricians can trust the GMC to treat us fairly in doing difficult work.”
Applications to the courts by local councils to take a child into care are at an all-time high, which is believed to be linked to increased risk aversion among social workers following the death in 2007 of Peter Connelly, the 17-month-old who became known as Baby P.
They soared after the court case in September 2009 in which his killers were convicted and the subsequent media furore which led to the dismissal of Sharon Shoesmith, the director of children’s services in the north London borough of Haringey.
There were 1,727 applications in April and May in England alone 14.1 per cent higher than the same months in 2011 and an all-time high of 972 in May alone.
Home Office statistics show that on average at least one child in England and Wales is killed every week at the hands of another person.
Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, said: “No amount of guidance will completely eliminate child abuse, but with an average of one child dying every week because of abuse, we need guidance like this to make sure doctors do everything in their power to lower that figure.”
Andrew Flanagan, chief executive of the NSPCC, added: “Doctors play a critical role in child protection as they are often in the best position to spot crucial evidence of abuse. It is vital that they are able to use their professional judgement without the fear of repercussions.”