Child health expert urges mandatory reporting of neglect or abuse

A child health expert has called for reporting child abuse to be made mandatory as he led a debate which divided doctors.

Professor Andrew Rowland wants to see it become a legal requirement for professionals such as doctors and teachers to report any reasonable suspicion of child abuse or neglect.

Currently doctors may not report it if they believe doing so could put the child at risk of further harm, with fears that a change in the law could see them be punished if it appears they have failed to act.

Prof Rowland has previously spoken of how the recommendations he made in a report into the issue could reduce the “likelihood of another Rotherham occurring in the future”.

“The abuse that has been suffered by children is appalling in its own right, but tragically, children have been ignored and in some cases even blamed for the abuse that has happened to them,” he told delegates at the British Medical Association’s (BMA) annual representatives conference in Liverpool today.

“The world is a dangerous place to live in, not because of those people who do terrible things but because of those people who don’t do anything about them,” he added.

“There is no doubt that communities need to do more to support and to protect children. But alongside that, we as professionals need to do more.”

He was supported by consultant paediatrician Dr Keith Brent, of the BMA’s Central Southern branch, who said “mandatory reporting is the way to go”.

“You might think that that sounds very big brother, and I suppose in a way it is. But I think as a society we must be big brothers to little children,” he added.

“I actually think it would make the job of everyone easier.

“We must all realise that what we’re doing currently doesn’t work.”

But London-based GP Dr Penelope Jarrett said that while the current guidelines are “clear and nuanced”, mandatory reporting “cannot be nuanced”.

“Who is to determine the point at which concerns about behaviour becomes concern about abuse?” she asked.

“We do need resources to help these families, we do need to be able to access social workers when we have concerns.

“We do not need to be punished.”

Ayrshire GP Dr Haldane Maxwell said he was also against the move as it could lead to patients fearing visiting the doctor and to “potential problems if something that we don’t think appropriate to report, in retrospect, was deemed to be an early sign of abuse”.

“Would the courts punish us?” he asked.

Dr John Chisholm, the BMA’s medical ethics committee chairman, said the BMA has argued against mandatory reporting, along with the Royal College of Paediatrics and Child Health, the NSPCC and the General Medical Council.

He said: “Whilst reporting will usually be the right thing to do – the appropriate, the professional duty – there needs to be scope for professional discretion and flexibility not to report in the rare circumstances where reporting would not be in the interests of the child or young person.”

Prof Rowland, a consultant paediatrician in emergency medicine at Pennine Acute Hospitals NHS Trust, put forward a motion in support of an evaluation of the benefits of mandatory reporting legislation.

Doctors narrowly voted in favour, with 56% agreeing to the move.

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