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GPs criticised for child protection failings

OnMedica staff

Friday, 13 March 2009

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The Laming Inquiry into the Baby P tragedy has sparked an urgent shake-up of child protection services in England to ensure better protection for some 200,000 children living in homes where there is a high risk of abuse.

Health Secretary Alan Johnson and ministerial colleagues in other departments have accepted all 58 of Lord Laming's recommendations to prevent a repeat of the tragic circumstances in which Baby P died in August 2007 in the London borough of Haringey.

In the month preceding his death, NHS professionals had eight opportunities to spot that the 17 month old was being seriously abused.

While the main thrust of The Protection of Children in England: a progress report, focuses on remedying failures in social care, Lord Laming, who led the watershed 2003 inquiry into the murder of Victoria Climbie in the same borough, was also critical of health services.

In particular he was  critical of engagement of GPs, in Children's Trust, Local Safeguarding Children Boards and other multi-agency forums for safeguarding children.

"A common concern raised during the production of this report is the difficulty in attracting 'designated' and 'named' health professionals, both in primary and secondary care, with responsibility for child protection. It appears that the safeguarding of vulnerable children is often not viewed as a priority for GPs in some areas."

Lord Laming adds that this is spite of the fact that a range of measures have been introduced, by the Royal College of General Practitioners, The Royal College of Paediatrics and Child Health and by the Department of Health through the Care Services Partnership including a toolkit for GPs developed in partnership with the NSPCC.

"However more needs to be done to ensure GPs are proactive in doing all they can to keep children safe. There needs to be suitable rigour in the child protection training of each GP which enables them to contribute effectively to the multi-agency approach to the well-being of children. This should include appropriate referral and information sharing training."

Turning to hospital care he stressed that where medical staff suspect an injury is non-accidental they must ensure social services and the child's GP are notified as soon as possible. Having asked parents permission, they should arrange for a more thorough medical examination to identify any additional injuries or concerns. Full notes should be taken and medical staff must notify children's social care services and the child's GP of any refusal.

Lord Laming also recommended that the Department of Health and the Department for Children, Schools and Families strengthen current guidance and put in place systems and training so that Accident and Emergency departments are able to tell if a child has recently presented to A&E and if the child is subject to a chid protection plan.

"If there is any cause for concern staff must act accordingly, contacting other professionals, conducting further medical examinations of the child as appropriate and necessary and ensuring no child is discharged whilst concerns for their safety or well-being remain."

He also recommends establishing a new national safeguarding delivery unit to support public services and councils in doing this and changing the way social workers and health visitors are recruited and trained.

Hours after publication of the Laming report Alan Johnson ordered a review of health visiting.

Mr Johnson said: "Lord Laming reinforces the key role of the health visitor and their contribution to child protection. I have today asked the chief nursing officer to lead a programme of action on health visiting. This programme will be developed and delivered in partnership with the Community Practitioner Health Visitor Association, other key stakeholders and NHS experts across the country.

"It will ensure the key roles of health visitors are defined and delivered, that health visitors are supported in their vital work and that career opportunities and numbers of health visitors are increased."

Education secretary Ed Balls has already agreed to establish the national safeguarding delivery unit and the government has committed itself to responding to Lord Laming's 57 other recommendations by the end of April.

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