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Every doctor has a duty to report suspected child abuse or neglect, says GMC

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e4719 (Published 10 July 2012) Cite this as: BMJ 2012;345:e4719
  1. Clare Dyer
  1. 1BMJ

All doctors have a duty to report concerns that a child may be at risk of abuse or neglect, even if their work is with adult patients, says new guidance from the General Medical Council.1

Niall Dickson, the GMC’s chief executive, said that doctors need not worry that the regulator would “come after them” as long as they followed the guidance and took action through the proper channels.

Paediatricians have shunned child protection work after high profile cases in which some have been hauled up before the regulator after complaints by parents. Two paediatricians with an international reputation, Roy Meadow and David Southall, were ordered to be struck off the medical register but eventually had the decisions quashed on appeal.

The guidance, to be sent to more than 230 000 doctors in the United Kingdom, comes from a working party whose establishment was announced when Southall was restored to the register in May 2010.2 Paediatricians were outraged that one of the group’s members was Penny Mellor, a parents’ advocate they accused of orchestrating a campaign of complaints against child protection doctors, but she stepped down after Southall threatened a High Court challenge to her appointment.3

The GMC’s chairman, Peter Rubin, said that he could see how doctors who worked with adults could overlook child protection concerns. But a patient’s chaotic lifestyle, alcohol or drug misuse, or “serious mental health issues” could lead to worries about the welfare of children in the home.

The guidance outlines the advice doctors should take and how they should raise their concerns with child protection colleagues and agencies. It states, “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.”

Rubin said that many reports on deaths from child abuse over the years—including those on the case of Peter Connelly, who died at the hands of his mother, her boyfriend, and the boyfriend’s brother—had highlighted failures by professionals to communicate with each other.4

Doctors should tell parents of their concerns and ask for their consent to share information unless there is a compelling reason for not doing so, such as increased risk to the child or someone else, the guidance says. But information can be shared without consent if this is justified in the public interest.

Southall said, “This well researched and helpful guidance covers the relevant issues in how doctors should or must participate in the child protection system. However, parents accused rightly or wrongly of abuse almost always become angry, and a referral to the GMC is now a recognised way of airing their concerns.

“At present the default position of the GMC is that they must investigate all complaints. Unfortunately, reassurance that vexatious complaints, especially if part of a campaign, will always be rejected was not given in this guidance. Only time will tell whether the GMC will treat doctors fairly in this respect.”

Amanda Thomas, child protection officer at the Royal College of Paediatrics and Child Health, said that the college was pleased that the guidance was aimed at all doctors, “because whether a doctor has a specific safeguarding role or not, every doctor has a responsibility to protect children.” She added, “What’s crucial now is that the guidance is embedded in practice and the partnership working it promotes across the healthcare profession becomes a reality.”

Notes

Cite this as: BMJ 2012;345:e4719

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