Recommendations will work only with professional and managerial commitment

In his report on the torture, starvation, and eventual murder of Victoria Climbié, Lord Laming noted that any case of deliberate harm to a child is a serious and potentially fatal condition that deserves the same quality of diagnosis and treatment as a brain tumour or heart disease.1 His report includes a long list of recommendations. He stresses the importance of accurate written records, discharge plans, and better information systems. His support for a “commissioner for children” is welcome.2 The proposed new national and local managerial structures should improve supervision, coordination, and accountability. But the key question is not who will be accountable for the next child abuse tragedy3 but how much the better reporting arrangements will contribute to preventing one.

The answer is, probably not a lot, unless there is also professional and managerial commitment to other, and arguably more important, changes. Prevention depends on collaboration, as emphasised in the publication Working Together from the Department of Health.3 But it is not just organisations, committees, and boards that must work together. …