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Doctors for children in public care.
  1. SUREKHA PRABHU,
  2. CLIONA NI BHROLCHAIN
  1. Northampton General Hospital
  2. UK

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    Doctors for children in public care. M Mather. (£14.95; paperback). British Agencies for Adoption & Fostering, 2000. ISBN 1873868812

    This is the first book in recent times to deal with the health services needed for children looked after in public care. We are all aware of the authors' key role in highlighting the plight of this forgotten group of children. The outcome in terms of their current health is a severe indictment of the lack of care they receive. Their risk of mental illness is four times that of their peers. One in six girls that leave care has already been pregnant or become pregnant within a year. Social outcomes are no better. Only one in six go on to higher education, compared with two thirds of their peers. Over a third of young prisoners have been in care.

    The book gives a review of the wide ranging issues. For those already working as medical advisers, the information will not be new. However, it provides a valuable resource in one volume to those community paediatricians, in permanent posts and in higher specialist training, who would otherwise have to spend much time accumulating the same information from a variety of sources. It should be essential reading for those embarking on the medical adviser role for the first time.

    The book deals with the history of medical advisers, issues relating to adult health and primary care, the diverse health needs of this vulnerable group of children together with chapters on young people's own views and on medical records and confidentiality. For the medical managers amongst us, there are invaluable service specifications and practice standards including model job descriptions for advisers in adoption and “looked after children”. A suggestion of the sessional requirement needed to do justice to these roles would have been a useful addition.

    The back of the book contains several teaching exercises for medical advisers. They are intended to provide a framework for group discussion. We thought these very helpful for higher specialist trainees as well. Simpler exercises aimed at SHO, “core registrars” and GP principals could usefully be added. Model answers might be helpful for non-specialist trainers although the resources needed (mostly British Association of Adoption and Fostering guidance and practice notes) are listed for each exercise.

    With the advent of the “quality protects initiative” to improve the care of children in public care, this book is a timely reminder of what we as paediatricians can do to advocate for this vulnerable group of children. Our SpR will be offered the book as he starts his adoption and fostering module later in the year. We are also likely to use some of the training exercises in our own continuing professional development programme.

    The “starfish story” of the late David Baum is an apposite reminder of the plight of children looked after in public care. He presented a starfish to BACCH, as the chairman's badge of office, as a constant reminder of the importance of the individual child in community child health services. The authors have used the story as their frontispiece. Read it when you buy the book.

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