Intended for healthcare professionals


Complaints against doctors in child protection work have increased fivefold

BMJ 2004; 328 doi: (Published 11 March 2004) Cite this as: BMJ 2004;328:601
  1. Zosia Kmietowicz
  1. London

    The threat of complaints and ruined reputations is driving paediatricians away from fulfilling their role in child protection, leaving vulnerable children at risk of abuse, says the Royal College of Paediatrics and Child Health.

    A survey of college members, to which almost 80% of the country's 6072 paediatricians replied, has shown that the number of complaints made against doctors involved in child protection has risen fivefold in the last seven years.

    And while complaints have risen, paediatricians have turned their backs on child protection work. Currently 30% of posts where paediatricians take a lead in child protection are unfilled.

    The catalyst for the increase in complaints has been the publicity surrounding two high profile cases, said Professor Neil McIntosh, vice president of science and research at the college. The first was that of paediatrician Professor David Southall, who was suspended in 1999 while North Staffordshire Hospital NHS Trust investigated complaints about his research and child protection work (BMJ 2000;320: 9) but was reinstated two years later after no evidence was found against him (BMJ 2001;323: 885). The second was that of an accused mother, Sally Clarke, who was convicted of smothering her two infants in 1999 but was freed by the Court of Appeal last year (BMJ 2003;326: 304).

    Professor McIntosh said: “The incredible response rate to the survey reflects how agonised paediatricians feel about this issue. The fact is that paediatricians are ducking out of child protection because of the flak they get from the media.”

    Between 1995 and 2003 the number of complaints against paediatricians rose from 20 a year to 100 a year, the survey shows. Seventy eight of the 732 complaints detailed are still ongoing, but of the remainder only 3% have been upheld.

    However, the effect of the publicity has eroded the public's confidence in the profession and led to a reluctance among paediatricians to take a lead role in cases of suspected child abuse, said Dr McIntosh.

    “Complaints in such cases are hot news, but the doctor involved cannot comment both because of issues of patient confidentiality and because the case is sub judice,” said Dr McIntosh. “This not does not prevent comment by family or the media. By the time the complaint has been shown worthless the reputation of the paediatrician has been damaged; the issue is no longer newsworthy. Retractions and apologies are almost unknown.”

    The college plans to examine a sample of the complaints more closely to see what they were for and how they were dealt with. Dr McIntosh hopes this will help to identify the problem areas of child protection work so that the college can develop supportive measures to encourage paediatricians to take on responsibilities for children at risk. However, this is likely to take at least nine months, he said.

    Penny Mellor, a campaigner who supported parents in recent high-profile cases including that of Angela Cannings, said there was no orchestrated campaign against paediatricians. “There are a really small handful of five paediatricians that we have concerns about,” she said on BBC Radio's Today programme.

    “As to the rest of the world of paediatrics, we do not have any concerns with their work.”

    A Department of Health spokesperson said they recognised child protection work could be extremely stressful for staff.

    “Paediatricians play an essential role in child protection. A consultant has a clear responsibility to make a referral to social services in any case where he or she has “reasonable cause to suspect that a child is suffering or likely to suffer significant harm'.”