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Collections under which this article appears: Abuse (child, partner, elder)

BMJ 2003;326:180 ( 25 January )

News

Paediatrician calls for shake up in handling child abuse cases

Lynn Eaton, London

A radical shake up is needed in the way child protection cases are tackled, with a harder line being taken when professionals suspect premeditated abuse, argue UK paediatricians in two articles in the latest issue of Archives of Disease in Childhood (2003;88:101-4, 105-7).

The authors of the two papers are consultant paediatricians Professor David Southall and Dr Martin Samuels of North Staffordshire, Stoke on Trent, and Michael Golden, emeritus professor of medicine, University of Aberdeen.

Professor Southall and Dr Samuels attracted controversy when they were suspended in 1999 following allegations that they conducted a clinical trial on children without parental consent. They were also accused of harassing parents whom they suspected of child abuse (BMJ 2001;323:885)[Free Full Text]. They were reinstated in 2001 after an inquiry found that the allegations were unjustified (BMJ 2002;325:1054)[Free Full Text].

In the two articles Professor Southall and colleagues propose that instead of the current arrangement, whereby multidisciplinary child protection teams handle all cases of alleged child abuse, and social workers are trained to work with the parents, there needs to be a tougher approach to handling cases where there is suspicion of deliberate, premeditated child abuse by the parent or carer for gain.

They propose a new, three point classification of suspected child abuse cases:

• Category A: deliberate, premeditated child abuse undertaken for gain (where the abuser enjoys inflicting pain)

   

• Category B: impulsive ill treatment resulting from adverse societal and personal pressures (where a parent is under great stress and lacks support)

   

• Category C: mild ill treatment universal in all societies (such as smacking a badly behaved child).

   

All suspected category A cases should be handled by a newly established special interagency task force led by the police, say the authors. Parents suspected of category B child abuse would be referred to the more traditional child protection team. Category C abuse should be tackled through education.

Professor Southall told the BMJ that the report into the death of Victoria Climbié (which is currently with ministers) is just one example of how the current arrangements are failing children whose carers are deliberately harming them.

Working with parents in the category A group had proved incredibly difficult for professionals. Professor Southall said: "These people are very threatening. One of the ways they manage to succeed is to frighten professionals."

(Credit: PA PHOTOS)   Victoria Climbié: the inquiry into her death is with ministers

© 2003 BMJ Publishing Group Ltd

Rapid responses:

Read all Rapid responses

Child Abuse

Selwyn D'Costa

bmj.com, 23 Jan 2003 [Full text]

Home goal?

Lisa C Blakemore-Brown

bmj.com, 24 Jan 2003 [Full text]

A useful distinction

David M Foreman

bmj.com, 26 Jan 2003 [Full text]

Public Anxiety

Michael D Innis

bmj.com, 29 Jan 2003 [Full text]

PDF of this article Email this article to a friend Respond to this article Read responses to this article PubMed citation Related articles in PubMed Download to Citation Manager Search Medline for articles by: Eaton, L. Alert me when: New articles cite this article

Collections under which this article appears: Abuse (child, partner, elder)

© 2003 BMJ Publishing Group Ltd

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