The misguided notion that child abuse is pervasive in society

Some paediatricians have promoted the notion that abuse is pervasive in society. We are now suffering the consequences, writes Michael Fitzpatrick

The decision of the General Medical Council to appoint the campaigner Penny Mellor to its working group on guidelines for paediatricians working in child protection has provoked a furore.

Given Mellor’s leading role in the campaigns against prominent paediatricians Roy Meadow and David Southall, who have now been restored to the medical register after the claims against them have been discredited, it is not surprising that child protection doctors should object to her inclusion in the GMC committee. In 2002 Mellor was convicted on criminal charges of conspiracy to abduct a child and served a prison sentence; she has since made numerous allegations against professionals involved in child protection cases.

While Mellor’s inclusion in the GMC committee is unlikely to improve the reputation of the GMC or bring clarity to the troubled world of child protection, professionals in this field – including health visitors, social workers, practice nurses and GPs as well as paediatricians – need to question the wider assumptions that have driven the dramatic increase in the profile of child abuse over recent years and have contributed to the prevailing climate of irrationality.

Whereas the family was once regarded as a refuge for adults from the cares of the world and as a safe haven for children, it has come to be regarded as a hidden realm in which abusive relationships thrive. Paediatricians used to see occasional cases of “non-accidental injury”; now they encounter an epidemic of children suffering a wide range of forms of abuse. Rare cases of incest have been replaced by common allegations of sexual abuse. An obsession with abuse has been promoted by therapeutic entrepreneurs in the medical and social work professions and by voluntary organisations in the spheres of domestic violence and child care. This misanthropic outlook on intimate relationships has found a responsive audience in a cultural climate in which themes of child abuse and sexual violence have become staples of novels, newspaper reports, television features, dramas and soap operas.

It appears that the popularisation, by paediatricians such as Meadow and Southall among others, of the notion that the abuse of children is a pervasive feature of society, contributed to the false convictions of a number of parents on charges of killing their children. Though these convictions (which were overturned on appeal) were a rare occurrence, the prevailing obsession with abuse that helped to secure them has had much wider consequences.

It has also contributed to a series of miscarriages of justice affecting parents and care workers which have generally received much less publicity than the cases involving high profile paediatricians. These include the cases of the Shieldfield nursery workers in Newcastle and the care workers involved in the Welsh children’s homes scandal.

While it is important that professionals remain vigilant in seeking to protect children, it is also important that they do not see abuse everywhere – in particular, where it does not exist. The proliferation of codes of conduct governing all interactions between adults and children reflects prevailing anxieties and institutionalises distrust between parents and professionals.

Parents have become fearful about taking their children to GPs’ surgeries or hospital accident and emergency departments lest their symptoms be interpreted as manifestations of abuse. Many adults have become reluctant to engage in any form of social activity with children – such as sports coaching, music or drama – because of the inevitable suspicion aroused by their involvement. Whether or not Penny Mellor stays on the GMC working party, the key problem is the wider obsession with abuse which remains unchallenged.

Michael Fitzpatrick is a GP in Hackney, east London

This article is published in the 12 August 2010 edition of Community Care under the headline “How has the family turned from safe haven into a den of abuse?”