Behind the headlines

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?”