Government proposals demand leadership and a culture change

The Waterhouse report on the widespread abuse of children in care in north Wales from 1974 has focused attention on the issue of how vulnerable such children are to abuse.1 But these children are vulnerable in many ways, not least in terms of their health care, and they are often let down by those who are meant to serve them. The government has been making attempts to improve their overall care and welfare and is currently consulting on improved arrangements for health care.

In December 1999 the English Department of Health issued proposed new guidance on the health care of looked after children.2 “Looked after” is the term introduced by the Children Act 1989 to cover all children in public care, including those in foster or residential homes and those still with their own parents but subject to care orders. The new guidance on health care is one of a series of publications that include a revised edition of Working Together to Safeguard Children, 3 which updates the guide to interagency working to promote children's welfare and protect them from abuse, and a new Framework for …