News

The new GP contract, which comes into force in April, includes no less than 1,050 quality indicators. But not one of them covers child protection, prompting fears that family doctors may not play their full part alongside social care professionals and the police in combating child abuse. It has been claimed that under the new contract GP practices will have no incentive to get involved in child protection because of the way they are funded. Cash will be allocated according to how many points practices tot up against each of the quality indicators. The new contract is meant to offer greater scope for joint working with a whole range of agencies including social services. But while some family doctors are likely to offer a wider package of services in order to qualify for extra funding, others may instead choose to provide basic care only. Last year the report into the death of Norfolk six-year-old Lauren Wright suggested GPs lacked training in child protection and tended to rely on other professionals to take on the role. The Laming report stressed child protection was everyone's responsibility.

Bill Badham, development officer, National Youth Agency
"Perhaps the health service needs to take a closer look at Every Child Matters. Section 5.35 states: 'We intend... to place a duty on all relevant local bodies (such as the police and health organisations) in exercising their normal functions, to have regard to safeguarding children, promoting their well-being and working together through local partnership arrangements.' GPs better sort out their indicators to reflect these priorities before the courts do it for them."

Felicity Collier, chief executive, Baaf Adoption and Fostering
"It doesn't make sense to make child protection a statutory requirement on education authorities, introduce a hospital 'standard' following the Victoria Climbie Report's recommendations but then only publish 'guidelines for GPs with special interests'. Baaf's Health Group is very concerned at the continuing lack of priority given to child protection in GP education and workloads. The assessment of risk requires working with hostility, with adults who may wish to deceive, dealing with personal anxiety and understanding how family relationships can compromise a child's safety - and all in a busy GP surgery."

Bob Hudson, professor of partnership studies, Centre for Health Services Management, University of Birmingham
"All of the available evidence shows that involvement of GPs in the child protection network is extremely low. Rewarding them financially is the traditional way of securing their loyalty. But the independent contractor status of GPs makes them weak links in the partnership chain."

Martin Green, chief executive, Counsel and Care
"It is clear from the many enquiries into the issue that the GP has a very important role in protecting children from abuse. The new GP contract should place the protection of all vulnerable people, whatever their age, as a central requirement of doctors and the primary health care system. The new GP contract seems to be another example of where the rhetoric does not match the practice. At the same time as ministers are talking about improving services and protecting children the new contracts allow for out of hours opt-out and do not place protection issues on the agenda."

Julia Ross, social services director, London Borough of Barking and Dagenham
"I doubt if having a child protection indicator is achievable or whether it would make much difference. I do agree something needs to happen or the children's green paper will fail. But it's not just about child protection - it's about children's lives as a whole. Why not have GPSIs - GPs with a special interest - who could be paid to cover a group of practices and support and educate their colleagues? Or how about a lead clinician, who might be a nurse or doctor, in each surgery accountable for delivering good practice in the same way as a hospital lead clinician works?"