Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Intended for Healthcare Professionals
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
  • Subscribe BJGP on YouTube
Intended for Healthcare Professionals
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
The Back Pages

How to protect general practice from child protection

Mike Fitzpatrick
British Journal of General Practice 2011; 61 (585): 299. DOI: https://doi.org/10.3399/bjgp11X567315
Mike Fitzpatrick
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info
  • eLetters
  • PDF
Loading

The tragic deaths of Victoria Climbie and Peter Connelly (Baby P) and the ensuing moral panics have driven the world of child protection into a spiral of defensiveness, posturing, and bureaucratic box-ticking that is now threatening to engulf general practice – to the detriment of both doctors and any children who might need safeguarding.1

Over the past month I have received requests from local child protection authorities for reports on 18 children. These follow a standard form, opening with a request for ‘specific medical history’ and proceeding to solicit further information under a number of headings: the ‘developmental needs of the child’ (with five subheadings); the ‘capacities of parent/carer to respond appropriately to those needs’ (six categories); the ‘impact of family and environmental factors on parenting capacity and the child’ (six categories); and, finally, ‘any other relevant information’. The letter emphasises the need to complete ‘promptly’ this comprehensive assessment of the medical, social, psychological, and cultural disposition of the child and its family, ‘within 48 hours’ (bold type in original). There is no mention of issues of consent or confidentiality and no indication of why any of this information is required.

The most striking feature of the reports peremptorily demanded by social services is that they reflect a profound misunderstanding of the nature of general practice. We tend to see children episodically, infrequently and in brief consultations when they are ill, and usually accompanied by parents devoted to their welfare. Our job is to attempt to diagnose and treat them. We lack the time and the expertise (and in my case, the inclination) to adopt the roles of social worker, psychologist, policeman, or priest in relation to the intimate personal lives of the children and families who come to our surgeries seeking respite from illness.

We are currently sinking under the weight of guidelines (arriving at the rate of one every 12 months for the past 5 years) and unreadable minutes of case conferences (in which any useful information is buried in pages of politically correct declarations).2

Every inquiry into the death of a child leads to a renewed chorus of demands that GPs should be compelled to attend case conferences (organised at short notice during surgery hours), endure compulsory ‘training’ in child protection (of the sort that has failed to make any difference in the past) and attend weekly meetings with health visitors (who have generally been redeployed in locations remote from GP surgeries). The sheer impracticality of these proposals – reflected in the increasing strident rhetoric with which they are promoted – suggests that a radical rethink is overdue.

It is time to acknowledge the simple fact that, because issues of child abuse come up only rarely in general practice, GPs have little role to play in child protection. My modest proposal is that all contacts between GP surgeries and child protection authorities should be suspended and any concerns should be mediated through local community paediatricians. A brief phone call is all that is necessary to share essential background information, avoiding reports, meetings and case conferences in all but the most exceptional circumstances.

Of course, under such a system – as under past arrangements (and indeed under the system currently being imposed on general practice) – some cases of abuse will be missed. But it would provide better protection for cases that are recognised without bringing the whole of primary health care to a halt under the burden of paper and irrational expectations.

  • © British Journal of General Practice, April 2011

REFERENCES

  1. ↵
    1. Department of Health
    Achieving equity and excellence for children: how liberating the NHS will help us meet the needs of children and young people (DoH), 16 Sep, 2010. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_119490.pdf (accessed 11 March 2011).
  2. ↵
    1. Learner S
    (2011) After Baby P: can GPs follow child protection guidance? BMJ 342:d707.
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 61 (585)
British Journal of General Practice
Vol. 61, Issue 585
April 2011
  • Table of Contents
  • Index by author
Download PDF
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
How to protect general practice from child protection
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
How to protect general practice from child protection
Mike Fitzpatrick
British Journal of General Practice 2011; 61 (585): 299. DOI: 10.3399/bjgp11X567315

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
How to protect general practice from child protection
Mike Fitzpatrick
British Journal of General Practice 2011; 61 (585): 299. DOI: 10.3399/bjgp11X567315
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • REFERENCES
  • Info
  • eLetters
  • PDF

More in this TOC Section

The Back Pages

  • The ethics of listening and responding to patients' narratives: implications for practice
  • How big is your society?
  • Evidence-based medicine and Web 2.0: friend or foe?
Show more The Back Pages

Series

  • Working with vulnerable families in deprived areas
  • Tips for GP trainees working in obstetrics and gynaecology
Show more Series

Related Articles

Cited By...

Intended for Healthcare Professionals

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2023 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242