The most common dilemma for doctors who think a child may be being neglected or abused is whether to disclose confidential information and to whom.
Around 200 GPs, practice staff and hospital doctors sought advice from the Medical Defence Union (MDU) during 2011 on the subject and although this is a small proportion of the nearly 10,000 files opened by the MDU to assist members during the year, this area can be one of the most difficult dilemmas faced by doctors.
The MDU, which indemnifies over 50% of GPs and hospital doctors, said along with queries about disclosing information (45), other common reasons for members to seek advice included receiving a complaint from the parent or carer because they had raised concerns about a child (35) and advice on appearing as a witness or providing a statement in connection with criminal investigations or inquests (33).
Dr Catherine Wills, MDU medico-legal adviser, said:
"Child abuse is an emotive, sensitive and often very difficult issue for doctors to deal with.
"Our advice to them is that their first responsibility is to the child and the child’s interests should take precedence over those of parents or carers.
"Doctors who call the MDU are often concerned that they are raising valid concerns to the appropriate agency. The new guidance from the GMC acknowledges that doctors taking action will be justified, even if it turns out that the child isn’t being abused or neglected, as long as their concerns are honestly held and reasonable and they take action through appropriate channels.”
The MDU advice for doctors on child protection issues includes:
- Familiarise yourself with the new GMC guidance, which applies to all doctors, including those who only treat adults. Be aware of local procedures and national guidance on the issue.
- You have a duty to act on any concerns you have that a child may be at risk.
- Your duty of confidentiality means that you should ask for consent to share information unless there is a compelling reason not to do so. But, if you cannot get consent, you should weigh up the possible harms. If a child or young person is at risk or is suffering abuse or neglect, it will usually be in their best interests to disclose information.
- Concerns should be raised through the appropriate channels. For example, the local designated person for child protection eg. a doctor or nurse at the PCT.
- If in any doubt about whether to share information, you should seek advice from an experienced colleague, a named or designated doctor for child protection or your medical defence organisation.
Related link:
The Medical Defence Union
Protecting children and young people: The responsibilities of all doctors