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Re: The Children Act

West Kent Community Paediatricians unreservedly approved the paper by Wynne and Speight.[1] Paediatricians leading District Child Protection Services do not recognise the protected professional described by Dame Barbara Hale viz a viz the social worker.[2] Child protection work is lonely and stressful. It carries a significant vulnerability to malicious complaints for political reasons and media witch-hunts.

Hale refers to the Local Authority’s need to take reasonable steps to protect children from abuse. What does reasonable mean? Work within the Children Act Child Protection framework is hampered by a lack of resources from local authorities to fund this work. The limited professional training social workers receive in child health and development, which assists a proper understanding of Abuse presentations, compounds this. Suspicious bruising is therefore not recognised. Front line Health Visitors' and Paediatricians' concerns may be met with a courteous ignorance or more worrying a cynical disregard at senior managerial level.

The Children Act industry of lawyers and doctors who specialise in defence work has lengthened Court hearings. The defence process now ensures that in Care proceedings, paediatricians DO have to prove beyond reasonable doubt that the child has suffered significant harm. Hale should review the Kent County Court Care proceedings for the past three years.

The medico–legal role bears closer scrutiny. The Department of Health and RCPCH need to clarify the role of the medical expert in cases of Child Abuse. Why are some doctors highly visible as peripatetic defence experts for common Abuse presentations? Why do these doctors seldom agree with the findings of the experienced district paediatrician? There is an overdue need of a proper process of accreditation for this work. This should include a rigorous audit of the defence expert’s findings in the context of the district paediatrician’s grave concerns. The integrity of the medical profession should be above reproach.

Dr G A Evans FRCPCH DCCH, Retired
Formerly Clincal Director Children’s Service
Thamesgateway NHS Trust
Dartford, Kent, UK

References
(1) Speight N, Wynne J. Is the Children Act failing severely abused and neglected children? Arch Dis Child 2000;82:192-6.