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• Mandatory Reporting of Child Abuse: all that glitters is not gold
  Minoo Irani
  Published on: 8 May 2009

• Published on: 8 May 2009

  Mandatory Reporting of Child Abuse: all that glitters is not gold

  • Minoo Irani, Consultant Community Paediatrician

  The leading article on child protection by Ben Matthews et al (1) starts with a promising review of the difficulties experienced by UK Paediatricians with child protection work. However, their argument that low substantiated cases of abuse and neglect in UK represent the reluctance of paediatricians in England to engage in the business of child protection is not supported by their statistics. Also, their approach of comp...

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  The leading article on child protection by Ben Matthews et al (1) starts with a promising review of the difficulties experienced by UK Paediatricians with child protection work. However, their argument that low substantiated cases of abuse and neglect in UK represent the reluctance of paediatricians in England to engage in the business of child protection is not supported by their statistics. Also, their approach of comparing substantiation rates across different child protection systems and processes is flawed. The authors introduce the concept of mandatory reporting laws for child abuse. These have a limited evidence base for truly improving outcomes for children, but have a potential for personal penalties for professionals who may not have reported child abuse for any reason and also introduce a risk of complacency about child protection work in the future.

  At face value, the substantiation rates of child abuse and neglect in USA (12.1 per thousand children) appear significantly more than England (3 per thousand children). An analysis of the data from the Child Maltreatment Report (USA, 2007) (2) confirms that the national rate of referral was 43 per 1000 children. Comparing this with 538,500 child protection referrals made in England (3) and a child population of approximately 11.66 million (4), shows that the referral figures for England are in fact slightly more than USA. Hence it cannot be concluded that lack of reporting laws in England contributes to the lower substantiation rates.

  Also, child protection procedures in England (5) may not be directly comparable to other societies with similar child welfare standards. Initial assessments by children’s social care in England (319,900 in 2008) could result in a ‘child in need’ conclusion with a plan for service provision for supporting the child and family. A proportion of the initial assessments require core assessments (105,100 in 2008) for a more in-depth assessment of the child’s needs and parental capacity to respond to these needs. There may be substantiated concerns that a child has suffered significant harm, but a plan for ensuring the child’s future safety and welfare can be developed and implemented without having a child protection conference or a child protection plan. Hence substantiation rate comparison across countries may have less meaning unless similar procedures are followed everywhere.

  Legislative immunity for reporting professionals is an attractive concept. However, it is unlikely to exist in isolation of mandatory reporting laws. Such mandatory reporting laws bring up a whole range of problems which the authors touch upon in one paragraph towards the end of their report. A significant majority of paediatricians would agree that child protection services in some parts of England appear overwhelmed by the volume of work they face to safeguard children within the current processes. Overburdening these systems with many more unsubstantiated notifications (as would arise from mandatory reporting) would not only be time consuming and costly, but also risk diverting attention and resources from those children at real risk of abuse.

  Mandatory reporting does carry a sting in its tail for professionals too; failure to report carries a range of personal penalties for non- reporting (6). The default position of being ‘safe than sorry’ will have implications for service efficiency and cost. More importantly, if future generations of professionals have a sense of ‘legislative security’, there remains a real risk that knowledge, skills and training in child protection could be adversely affected.

  There is no doubt about the fact that paediatricians’ confidence in child protection work needs to be urgently restored in the UK. The article by Matthews et al takes a bold first step towards addressing some of the barriers to this. There is, however, unlikely to be a single solution to a complex problem like this.

  References

  1. Mathews B, Payne H, Bonnet C, Chadwick D. A way to restore British paediatricians’ engagement with child protection. Arch Dis Child 2009; 94: 329-331

  2. Administration for Children and Families. Child Maltreatment 2007. Reports. Chapter 2 http://www.acf.hhs.gov/programs/cb/pubs/cm07/chapter2.htm#screen

  3. Department for Children, Schools and Families. Referrals, Assessments and Children and Young People who are the subject of a Child Protection Plan, England- year ending 31 Mar 2008 http://www.dcsf.gov.uk/rsgateway/DB/SFR/s000811/index.shtml

  4. Office of National Statistics http://www.statistics.gov.uk/statbase/Product.asp?vlnk=15106

  5. Working Together to Safeguard Children. 2006. London

  6. Mandatory Reporting of Child Abuse and Neglect: State Statutes and Professional Ethics http://www.ndaa.org/pdf/mandatory_reporting_state_statutes.pdf

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  Conflict of Interest:
  None declared.

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