|
|
By Nick Triggle
Health reporter, BBC News
|
Child protection work is back in the spotlight after the case of Baby P who died after suffering months of abuse.
Doctors play a key role in this process giving expert opinion on injuries as well as treating them. But as one leading paediatrician explains, it is a very challenging job.
Paediatricians have to collect evidence as well as treat
|
The last 24 hours for paediatrician Rosalyn Proops are pretty typical.
As well as fulfilling her role on the wards of the Norfolk and Norwich Hospital, she is part of a six-strong team that see children when abuse is suspected.
First in was a baby boy who had been brought in by a health visitor with unexplained bruises.
Later on, police handed over a girl who they had suspected had been sexually abused.
And before the day was out the consultant was examining a boy with learning difficulties who had cigarette burns on his body.
Dr Proops has been doing child protection work since the 1970s and spends the equivalent of over a day a week dealing with such cases.
She says: "Not only do we have to treat these children as clinicians, but our role is to work with other agencies to find out what has happened.
"This may include collecting forensic evidence or talking to them about how they have got the injuries."
Guidelines state that paediatricians hold meetings with the police, social services and the other agencies involved within 24 hours of the alarm being raised.
'Not so simple'
"We have to act immediately," she says. "We share evidence and decide what should happen.
"There are a number of cases where it turns out that the injuries were accidental or related to some other illness.
"The most common tend to be where abuse has happened, but it is not always so simple.
"Most parents love and care for their children, but sometimes something inexplicable happens.
"These are very hard to deal with and there are no straightforward answers.
"Children are generally better off with their parents and carers, and sometimes we need to work with families to support them."
When assessing children she says there are several tell-tale signs that the injuries are not accidental.
"You have to consider the context. If an immobile baby has a broken leg you would automatically be concerned.
"But a four-year-old who broke a limb on the sports field - that is a different matter.
"You also listen to what the parents say. If it is an accident, they will generally know what the child was doing, when it happened. They will know the details.
"If they are vague and change their story, again you get suspicious."
But she also says the views of the other agencies are essential in the process.
"You need to know what evidence everyone else has. Social services may be familiar with the family.
"They may know of other children who have been harmed or that mum and dad have drink or mental health problems.
"You have to piece everything together and that is why working together is so important."
'Not perfect'
She acknowledges the system failed in the Baby P case - a doctor had seen the unnamed boy but missed a broken back - but says that does not mean the whole system is failing apart.
"You will always get cases that are not picked up, it is not perfect. But I do think the system is under-resourced."
She says one of the most important procedures to adopt is to work in teams and discuss cases and share evidence with colleagues.
"You must never work alone. You need other doctors' input and that is what is happening now."
But speaking about the Baby P case, she is clear.
"Missing major injuries should not happen. It is that straightforward. I think in this case people were too ready to believe the parents.
"We have to think the unthinkable."
|
One-Minute World News
E-mail this to a friend
Printable version
In this job we have to think the unthinkable
BBC News
Bookmark with:
What are these?