Proposed system to detect child abuse could deter parents from seeking treatment, pressure group says

BMJ 2012; 345 doi: (Published 28 December 2012) Cite this as: BMJ 2012;345:e8705
  1. Nigel Hawkes
  1. 1London

Children who visit emergency departments or have out of hours GP consultations are to have their details logged on a national computer system in a bid to detect child abuse.

Dan Poulter, health minister for England, said he hoped the new system, to be rolled out from 2015, would prevent cases such as those of Victoria Climbié and Baby P, two children who died as a result of abuse.

Poulter told the Times: “Doctors and nurses are often the first people to see children who are victims of abuse. Up until now, it has been hard for frontline healthcare professionals to know if a child is already listed as being at risk or if children have been repeatedly seen in different emergency departments or urgent care centres with suspicious injuries or complaints which may indicate abuse.

“Providing instant access to that information means vulnerable and abused children will be identified much more quickly—which can save lives.”

The proposal is more modest and manageable than ContactPoint, a database of all children under the age of 18 created by the last government in response to the Bichard Report into the death of Victoria Climbié. It cost £224m to set up and £4m a year to run and was accessible to 330 000 users. Strongly criticised by privacy and security experts, it was closed down by the Coalition Government in August 2010.

The new Child Protection Information System will link up existing at risk registers run by local authorities and bring together records from all emergency services. Doctors and nurses using it will be able to see if the children they treat are subject to a child protection plan or are being looked after by the local authority, or have often attended emergency departments or urgent care centres over a period of time. A budget of £8.6m has been allocated for its development.

Simon Eccles, an accident and emergency consultant who is medical director of NHS Connecting for Health, told the Times that he had no doubt clinicians treating Victoria Climbié would have behaved differently if they had been able to access such a system.

Amanda Thomas, of the Royal College of Paediatrics and Child Health, said: “The college has been involved from an early stage and will continue to work with the Department of Health to ensure it is introduced effectively, integrates well with the existing practices of NHS staff and makes a genuine contribution to improving child protection practice.”

However, some experts question whether a lack of information was instrumental in the failure of health and social services to protect Victoria Climbié. A report for the think tank Demos1 argued that what happened to Victoria “was staring people in the face.” While information-sharing systems were important, the over-reliance on such systems could actually reduce the capacity of child protection practitioners to identify and manage the risks to children.

The Manifesto Club, which has campaigned against the use of disproportionate surveillance in child protection, warned today that the new database might have the perverse incentive of discouraging parents and carers from taking children for treatment for fear of being identified as abusers.

Dolan Cummings, spokesman for the group, said: “There is certainly a danger that such a system will discourage parents from taking their children to hospital, and not only those parents guilty of abuse, but even those embarrassed by frequent minor injuries, who will be more inclined to treat them at home rather than risk an interrogation at the hospital.

“Bureaucratic checks cannot guarantee children’s safety, and can have unintended consequences, like institutionalising a climate of suspicion rather than one of spontaneous care, with human judgment about what really is suspicious.”


Cite this as: BMJ 2012;345:e8705


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