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Safeguarding children is everyone’s responsibility: UK government statement on the duties of doctors
  1. Terence Stephenson
  1. Professor Terence Stephenson, Academic Division of Child Health, School of Human Development, Nottingham University, Queen’s Medical Centre, Nottingham NG7 2UH, UK; terence.stephenson{at}

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The first duty of the paediatrician is to the child or young person

Over the past few years, some paediatricians have faced legal action as a result of their involvement in child protection cases. Others have had vexatious complaints of which only a tiny minority have been upheld.1 2 A survey of members of the Royal College of Paediatrics and Child Health (RCPCH) found that 13.8% of over 4500 respondents had been subject to a total of 786 complaints about child protection and that the number of complaints per year had increased from less than 20 in 1995 to over 100 in 2003.3 Of those complaints resolved at trust or NHS level (including the NHS Ombudsman), less than 3% were upheld. Of 87 referrals to the UK General Medical Council (GMC), only that against Dr David Southall was upheld. The GMC extended the 2004 ban against him working on child abuse cases by a further 12 months on 23 July 2007.

As a result of these factors, many paediatricians have been deterred from giving expert evidence in suspected child abuse cases, adding further delays to a slow system4 and resulting in the Chief Medical Officer’s consultation document Bearing good witness.5 This is against a backdrop of some health professionals describing a reluctance to report suspected child abuse,6 a worrying situation and potentially taking us back to the days before Henry Kempe’s seminal work on non-accidental injury.7 A stratified random sample of 979 nurses, doctors and dentists working in primary care in Northern Ireland were sent a postal questionnaire; 419 responded, giving a 43% response rate. The data were collected in 2002–2003. In their working lives, 60% (251) said that they had seen a …

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  • Competing interests: Terence Stephenson is a non-executive director of an NHS trust and Vice-President of the Royal College of Paediatrics and Child Health. The views expressed in this article are personal views and not necessarily the views of those organisations.

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