Letters Safeguarding children

More effective and proportional systems are needed in primary care to safeguard children

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g6445 (Published 29 October 2014) Cite this as: BMJ 2014;349:g6445
  1. William J Beeby, general practitioner1
  1. 1Parkway Medical Centre, Middlesbrough TS8 0TL, UK
  1. Bill.beeby{at}nhs.net

For the past year I have felt that general practitioners are disadvantaged in their ability to help protect vulnerable children from abuse.1 Other agencies “share concerns” and have lower thresholds for reporting, whereas all the training for GPs seems to focus on “referrals.” Not surprisingly, it is often unclear whether something that we see crosses the threshold for referral, which will precipitate action and potentially jeopardise future relations with the family.

The complexities of presentations in our surgeries need to be matched by a sophisticated system for dealing with our concerns. The separation of health visitors from the primary care team in most areas has deprived GPs of the ability to make soft referrals when they have concerns about a family, although this has never helped with the sexual abuse of older children.

We need more effective and proportional systems in primary care if we are to fulfil our role in genuinely protecting vulnerable children.


Cite this as: BMJ 2014;349:g6445


  • Competing interests: None declared.


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