A crisis of confidence is developing between the General Medical Council (GMC) and paediatricians. Some assert that the GMC does not adequately understand the unique nature of child protection work,1 which the GMC refutes.2 We argue that this reflects a fundamental confusion in doctors’ duties regarding child protection, the consequences of which are exacerbated by the GMC’s fitness to practise procedures.

Child protection guidance in the United Kingdom is underpinned by the 1989 Children Act. It introduced the “principle of paramountcy” of the child’s welfare over all other competing considerations, to which UK child protection and paediatric guidance now refers. However, this principle only applies to the courts’ criteria for deciding the outcome of cases under that act,3 not to doctors, whose medical and legal duties in child protection are governed by the usual body of medical law.

Medical law states that a doctor’s duty to the (non-competent) child is owed to the parent, whose consent is …