Working Together or Pulling Apart?

By Carol Lupton, Nancy North and Parves
The Policy Press
ISBN 1 86134 244 6

This useful book debates how the NHS positions
itself within formal child protection networks. NHS policy makers
see life through NHS-tinted spectacles, through which the external
world is viewed quizzically and with detachment, and their
relationship with other policy communities is parallel rather than
engaged. It also means that child protection has had little
priority for the NHS.

For a national service commanded and
controlled by Whitehall, it has had little impact on key issues
such as the involvement of GPs in child protection work. Successive
failures to establish a genuine inter-agency or cross-cutting local
service environment are catalogued, and the reasons succinctly

The authors discuss why certain health
professionals, like paediatricians and health visitors, work more
closely within the child protection system than others, although
specialists like psychiatrists and dentists need to be just as able
to recognise child abuse. Collegiality rather than professional
autonomy is needed within the health service to promote effective
joint-working, and this well-argued book demonstrates the gulf
between rhetoric and reality. However, like many books written from
a policy perspective, it is stronger on analysis than

Anthony Douglas is executive director,
community services, Havering Council.


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