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Protecting children from abuse and neglect in primary care
  1. P Ramchandani

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    Edited by Michael J Bannon, Yvonne H Carter. Oxford: Oxford University Press, 2003. £29.50, pp 247. ISBN 0192632760

    The world of child protection is constantly evolving, perhaps now more than ever. The report of the Victoria Climbié inquiry, chaired by Lord Laming, was published last year. As most will know, it details the catalogue of abuse and neglect which this young girl suffered. It also contains 108 recommendations for change. Although the focus of most of these are on social care, police, and paediatric care, there are some specific to the place of GPs and primary care teams, including recommendation 87: “The Department of Health should seek to ensure that all GPs receive training in the recognition of deliberate harm to children, and in the multi-disciplinary aspects of a child protection investigation, as part of their initial vocational training in general practice, and at regular intervals of no less than three years thereafter.”

    A mismatch at the centre of child protection has long been recognised—that the primary care team (including GPs) are often in an excellent position to provide an informed assessment of a families’ abilities and struggles over time. Yet they often remain peripheral to child protection proceedings when they occur, whether through lack of time to attend meetings, or lack of experience in the field of child protection, or myriad other reasons. This book attempts to address part of that mismatch, by providing information about child protection targeted at primary care practitioners. In doing so, it may also fill part of the training gap identified by Lord Laming—even though it was produced before his report.

    A lot is packed into the 256 pages of this book. It is edited by Michael Bannon and Yvonne Carter, a paediatrician and a GP, both with child protection experience. There are 24 other contributors, many of them authorities in their field. A large range of topics is covered, from information about the main types of child abuse and neglect, to less often covered (but important) topics such as domestic violence and adults abused as children. The style, and with it the utility, of the chapters varies. Some are clearly targeted at primary care professionals and written in an easy to read style. Others are more densely written and less orientated to general practice. For most primary care staff there is likely to be much of use within the book. For those more frequently involved in the child protection process, including paediatricians, there may be some useful reminders of things forgotten and some useful updates on key areas of child abuse and neglect.