Turbulence facing the NHS risks having a negative impact on child protection, college says

BMJ 2011; 342 doi: (Published 12 May 2011) Cite this as: BMJ 2011;342:d2991
  1. Helen Mooney
  1. 1London

The future of the NHS and the “huge turbulence” it faces risk having a worryingly negative impact on the protection of vulnerable children, the Royal College of Paediatrics and Child Health (RCPCH) has warned.

After publication of the Munro Review of Child Protection on 10 May the RCPCH said that NHS reforms could pose a major risk to child protection regardless of any proposals on the future of national child protection policy.

A spokeswoman for the RCPCH said that although the Munro review had “answered perfectly well the brief it was set” and was “a good vision for how child protection might work in the future” it had “failed” to acknowledge the “huge turbulence” within the NHS and the impact this will “clearly have” for the protection of children.

“Health professionals such as paediatricians are on the front line of identifying children and families in need and if the government ploughs ahead with the proposed reforms this vision risks evaporating,” she added.

The Munro review, by social policy expert Professor Eileen Munro, calls for targets and red tape to be scrapped and an end to a “tick-box culture,” which has lost the focus on the needs of the child.

The review recommends a chief social worker—similar to a chief medical officer—should be appointed to report directly to government and liaise with the profession and that centrally prescribed time scales for formal procedures, such as social work assessments, should be scrapped.

Professor Munro said that experienced social workers should be kept on the front line even when they become managers so that their experience and skills are not lost.

She was asked by education secretary Michael Gove to review the child protection system in England focusing on whether bureaucracy and targets have been getting in the way of good practice.

In her report she says that: “Helping children is a human process. When the bureaucratic aspects of work become too dominant, the heart of the work is lost.”

She also argues that the system has become preoccupied by individuals “doing things right” rather than “doing the right thing.”

“A one size fits all approach is not the right way for child protection services to operate. Top down government targets and too many forms and procedures are preventing professionals from being able to give children the help they need and assess whether that help has made a difference.”

The report is at


Cite this as: BMJ 2011;342:d2991

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