Bitter pill for the NHS

Once again, the role of the health service in
relation to child protection is under scrutiny. Following the
Carlile review’s sweeping recommendations for change in the way the
NHS in Wales carries out its responsibilities, the report on the
circumstances surrounding the death of six-year-old Lauren Wright
has similarly put the health service under the spotlight.

The Lauren Wright report, commissioned by
Norfolk Health Authority and published last week, reveals an
amateurish approach to child protection bordering on indifference.
Asserting that health professionals must take more responsibility
for child protection, the report catalogues a series of errors and
oversights that resulted in a “failure to safeguard Lauren”. In
particular, it says, there was poor communication, failure to
pursue diagnosis, and over-reliance on other professionals to
act.

Given that a health visitor was also struck
off elsewhere after all but ignoring child protection as an issue
in her caseload of 300 families, March ought to have been a bad
month for the NHS. But such is the status of child protection
within the health service that these events, on a scale which would
have triggered a major bout of soul-searching had they taken place
in an acute sector discipline, have barely caused a ripple.

The impact of health service indifference is
well known in social work. There are notable exceptions, of course,
but many social work professionals have learned to their cost that
the health service is often the weakest link in the child
protection conference and the area child protection committee.

The Lauren Wright report says that child
protection training should no longer be seen as an optional extra
for health professionals. That would be a start. But what is also
needed is concerted action to raise the profile of child protection
among GPs, health visitors and paediatricians, among others. In
Wales, the Carlile review recommended appointing a children’s
services director to take charge of NHS child protection matters,
supported by a specialist child protection service. It also
suggested opening up lines of communication between health and
social services by giving social workers greater access to
children’s medical records. A bitter pill, no doubt, for the health
service to swallow, but probably necessary throughout Britain if it
is to be cured of its habitual complacency.  

A temporary fix

Home Secretary David Blunkett’s emergency fund
for voluntary organisations which face closure because council
funding has been cut is a welcome move. It will save some of them
from closure, at least in the short term.

By setting up the grant, the government has
admitted there is a crisis. But it appears to believe the crisis
will somehow disappear next year. Blunkett was keen to emphasise
that the new pot of £500,000 is a one-off contribution and
that councils must not shirk their responsibilities to the sector
in the future.

It is somewhat naive to believe that councils
which are struggling to meet statutory requirements, claiming
repeated shortfalls in central government funding, will by next
year, be able to raise the priority of voluntary groups on their
overcrowded spending list.

On the one hand the government is eager to
develop the voluntary sector; on the other, it plays its usual game
of shifting funding responsibility from the centre to local
authorities, and blaming them when groups are forced to close. It
seems unwilling to admit that the only solution is to develop a
long-term strategy to fund the sector and ensure that funding is
sustainable.