Medics 'under-report child abuse'

Worry about getting it wrong, the repercussions for thechild and family and possible legal action were reasons given for notreporting their concerns.

Of the 419 medical staff polled, 60% had seen a child with signs of abuse, but less than half reported it.

The Belfast-based study is published in the Journal of Advanced Nursing.

Fear

About three-quarters of the healthcare professionalsquestioned said they were aware of how to report child physical abuse,but more than eight out of 10 said they would like further information.

Community nurses showed the highest level of awareness, followed by doctors and dentists.

Virtually all of the respondents said there should bemore training for staff on how to recognise and report child physicalabuse.

More than a fifth of the respondents were worried aboutgetting it wrong, and many were also concerned about confronting thefamily involved.

The staff said they would want to remain anonymous ifthey did report a case and feared hostility and damage to theirrelationships with the families.

GPs were particularly concerned that reporting might trigger a formal complaint, a disciplinary hearing or even litigation.

Litigation

High profile court cases such as that of Professor SirRoy Meadow, the paediatrician who was struck off after giving flawedevidence at Sally Clark's 1999 trial for the murder of her sons, mayhave added to medics' anxieties, say the study authors.

Other barriers to reporting included workload pressures,red tape and hierarchy, reporting procedures and lack of sensitivityand support from social services and colleagues.

Lead researcher Dr Anne Lazenbatt, from the School ofNursing and Midwifery at Queen's University Belfast, said medical stafffaced a tough challenge and needed support when making such harddecisions.

"Although the consequences of failing to identify childphysical abuse can be catastrophic, it is also essential thatprofessionals are educated to recognise conditions that mightinadvertently be mistaken as abuse so that unnecessary distress can beavoided.

"Healthcare professionals can play an essential role inrecognising and reporting abuse, but only if they receive the educationand support they need to make informed decisions."

Maureen Scott of the Royal College of Nursing said: "Thereport validates what we have been saying for some time - that nursesand other health care professionals require much better training andeducation about child abuse as they play such an essential role inrecognising and reporting incidents."

Chris Cloke of the NSPCC said: "Parents need to have the confidence that their children are in safe hands.

"Reporting concerns is a vital part of child protectionwork and everyone whose work involves contact with children should atleast have a basic level of child protection awareness."