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None of the agencies involved in Victoria Climbie's case are spared criticism in Lord Laming's report into her death.

"Not one of the agencies empowered by parliament to protect children in positions similar to Victoria's - funded from the public purse - emerge from this inquiry with much credit," he says in his report.

While the majority of recommendations relate to social care, Laming also highlights the need for significant improvements for police and health care professionals over the next two years.


Starting with the police, three main deficits emerge: resources, training and priority given to child protection teams.

Both child protection teams (CPTs) involved in Victoria's case, Brent and Haringey, were based in poor accommodation with "cramped conditions, poor heating systems and difficult access".

"Police vehicles were scarce, computer equipment was outdated and inadequate, and offices were poorly decorated and equipped," demonstrating the low priority the service was given, says the report.

The lead officer on child protection for the Association of Chief Police Officers, Terry Grange, says a review of CPTs across the service would reveal that child protection is seen as a marginal activity. "Funding and resources are always a struggle. If you are on the margins, you are on the margins in that struggle."

Although Laming found no direct link between Haringey CPT's standard of service offered to Victoria and the adequacy of resources, he said it would be wrong to discount the "corrosive effect that a long period of neglect and under-resourcing" can have on the morale and effectiveness of such a team.

Two recommendations call for an effective child protection database and IT management system as well as ensuring CPTs are not "disadvantaged in terms of accommodation, equipment or resources".

Closely linked is the low status attributed to CPTs. Evidence given to the inquiry described CPTs as "cardigan squads" and the "Cinderella" of the force.

"Strong efforts must be made throughout the police force to raise the profile and status of child protection work to a level that its importance deserves, thereby encouraging high-calibre officers to apply," Laming says.

Any suggestion that child protection policing is of a lower status should be eradicated with government taking the lead, the report says. The neglect of CPTs, at least in London, "may be due to the lack of prominence given to such policing by central government".

It calls for the Home Office to ensure that child protection policing is included in the list of ministerial priorities for the police and for chief constables to give child protection investigations a high priority in their policing plans.

Yet the first national policing plan mentioned child protection just once (news, page 6, 28 November). Grange said he could not find the word "child" once in the draft plan, but the final document says "appropriate priority" should be given to child protection.

"But how do you define appropriate? The Home Office should be more specific," he says.

Other police recommendations focus on training. Despite the volume of evidence given in the inquiry, "it remains unclear exactly what training was available".

Laming's report recommends that the Home Office should implement a national training curriculum for child protection officers and specific child protection training should be added to the syllabus for the strategic command course.

Grange contends that the Metropolitan Police has "responded magnificently" to what happened. In June 2000, a new child protection command unit, SO5, was established, instigated by the Serious Crime Group and headed by commander Carole Howlett (now deputy assistant commissioner). This centralised all London CPTs.

This was the "turning point" and "whole working practices changed", according to detective inspector Michael McDonagh, who heads Camden child protection unit. He adds that officers attending the inquiry gave feedback on issues raised, so many of the recommendations have been pre-empted.

About £230,000 has been spent on new accommodation for the Camden team. There has been an increase in officers and McDonagh says "morale is high". A new child protection IT package called Protect has been introduced and this will be superseded this year by the pan-Met system, Merlin.


Training in child protection has also increased from non-existence to the introduction this year of a four-week course.

"Since June 2000, there has been a huge commitment from the Home Office, the Metropolitan Police Authority and Metropolitan Police Service to put child protection in the forefront of everyone's mind," McDonagh adds.

Some of the police recommendations are echoed for the health service. Laming believes that "GPs are an extremely important element of the child protection framework".

Victoria was registered with two GPs, Dr Indravadan Patel in June 1999 and Dr Wasantha Gooneratne in November 1999, but these records amount to two registration cards containing basic information.

Laming calls for the Royal College of General Practitioners to explore the feasibility of extending the process of new child patient registration to include information such as living conditions and school attendance.

Had Patel asked these questions in Victoria's registration he would have established Victoria was not attending school and was living in a potentially unsuitable hostel, and would then have considered Victoria to be a child in need of careful monitoring.

GPs also need to ensure that all members of their practice staff are aware of who to contact in local health agencies, social services and the police.

But chairperson of the British Medical Association's community care committee, Dr Andrew Dearden, said he would be disappointed if most GPs did not know a contact at social services or could not find out relatively quickly.

Dearden calls for electronic centralised records, "so even if the staff are not consistent, the information is". But this is unlikely to be introduced for at least five years, he warns, and raises data protection issues.

However, in his general recommendations, Laming urges the government to issue guidance on the Data Protection Act 1998, the Human Rights Act 1998 and common law rules on confidentiality and their impact on information sharing between professionals when there are welfare concerns about children. And he again raises training. "I was surprised to hear that an experienced GP such as Dr Patel had never received any training or guidance in child protection matters, particularly in the recognition of possible deliberate harm."

He says all GPs should receive training in the recognition of deliberate harm to children and in the multi-disciplinary aspects of a child protection investigation. The Department of Health should look at introducing training in these areas for all general practice staff and other primary health care staff.

The Royal College "strongly supports" these recommendations. "We believe that the concept that the needs of children are paramount must be made explicit in the undergraduate and postgraduate education and training of doctors and other health care professionals."

Dearden agrees, but warns if GPs have to train in one specific area every three years as suggested, it would have a "knock-on effect" on other medical areas. Also, GPs are not always best placed to spot abuse, as abusers are more likely to take an injured child to casualty where there are no records, he says.

"What is needed is more training, more time and more awareness," he says, adding that with more time with a patient, a GP is more likely to detect other problems.

"Ideally, where there is sufficient staff and funding, I would like the vast majority of the recommendations to be implemented. But in a situation where there is not enough staff or funds, my fear is only the minority will be implemented," he warns.

- For more background information on the Victoria Climbie Report see www.communitycare.co.uk/climbie