Doctors who suspect children are being abused or neglected must tell parents and the young people themselves as soon as possible about their concerns and what action they will take, according to new draft guidance from the GMC.
The guidance also proposes that all doctors have a duty to act to protect children from abuse and make sure they receive the support they need to keep them safe, even when the doctor is only treating the adults.
The new guidance has been developed by a working group (1) chaired by the Rt. Hon. Lord Justice Thorpe and including paediatricians, a GP, a psychiatrist, social care professionals and advocates for children and young people. The group was asked to develop clear standards for all doctors, including those who do not routinely treat children.
Among its recommendations is a requirement that every doctor should be able to spot signs that a child could be at risk at an early stage, for example if a parent misuses drugs or alcohol.
Evidence presented to the group from both doctors and parents suggested that open and early communication can help reduce the distress and confusion that parents and children often experience after concerns are raised (2).
The group was set up following concerns by paediatricians and others involved in child protection about the difficulties of working in this area. These include knowing when to share confidential information and the risk of complaints being made by parents about the doctor’s decisions.
The GMC is holding a public consultation on the draft guidance, which asks doctors, other professionals, parents and children to give their views on a number of key issues, including how doctors should update a patient’s records when concerns of abuse are unsubstantiated.
Niall Dickson, the Chief Executive of the General Medical Council, said:
“We recognise that taking action to protect children from abuse can be challenging and distressing for everyone involved. This is a complex area of practice, but we believe this new guidance will provide greater clarity about what doctors need to do to protect children, even if they are uncertain about the risks involved. We hope it will also help give doctors confidence to make these extremely difficult decisions.”
A foreword to the guidance reassures doctors that when they act reasonably in response to concerns about abuse or neglect, following the principles in this guidance, they will not be subject to censure by the GMC.
Key issues emerging during the development of the guidance included the importance of working closely and effectively with other professionals involved in child protection and the benefits of good and constructive communication with parents and carers. The guidance covers these and other areas including giving evidence in court, communicating with children and parents and sharing confidential information.
The GMC has also published further analysis of the involvement of paediatricians in the GMC’s fitness to practise procedures (3) which shows that paediatricians are no more likely than other doctors to have their cases referred to a public hearing.
Over a five year period, paediatricians received proportionately fewer complaints on average than other specialties including general practice and surgery. The analysis also indicates that complaints about paediatricians are more likely to be investigated, but are also more likely to be closed following an investigation with no further action than complaints about other doctors. This may be because paediatricians can be involved in contentious areas of practice that raise serious concerns, which may not always be borne out on investigation.
Since April 2006 the GMC has held seventeen fitness to practise hearings involving paediatricians and only two were concerned with paediatricians involved in child protection (4).
The consultation runs from 27 June to 14 October 2011. To take part in the consultation, please visit www.gmc-uk.org/childprotection
Notes to Editors:
For further information please contact the Media Relations Office on 020 7189 5454, out of hours 020 7189 5444/ 07920 461497, email press@gmc-uk.org, website http://www.gmc-uk.org/.
(1) Membership of the Working Group:
The Rt. Hon. Lord Justice Thorpe (Chair), Deputy Chair of the Family Justice Council, Lord Justice of Appeal (Family Division)
Dr Keith Brent, Consultant Paediatrician
Ms Anne Goymer, Barnardo’s Strategic Lead Health and Housing
Dr Danya Glaser, Consultant Child & Adolescent Psychiatrist
Dr Diane Hart, Principal Officer, National Children’s Bureau
Dr Kathleen Lessells, Retired General Practitioner
Ms Bridget Lindley, Deputy Chief Executive and Legal Adviser,
Family Rights Group
Baroness McIntosh, House of Lords
Dr Heather Payne, Consultant Paediatrician
Dr Rosalyn Proops, Consultant Paediatrician
GMC Council members:
Dr John Jenkins
Ms Ros Levenson
Professor Terence Stephenson
(2) When developing the draft guidance, the Working Group considered what it had learnt through 244 written responses to an initial call for evidence and 24 oral evidence sessions involving organisations and individuals representing the views of doctors, other health professionals, children and parents.
(3) The analysis of fitness to practise data covers April 2006- December 2010 and is available on the GMC website: www.gmc-uk.org/childprotection.
(4) These figures have been updated following the completion of the GMC's Annual Fitness to Practise statistics for 2010.
The General Medical Council registers and licenses doctors to practise medicine in the UK.
The law gives us four main functions:
- keeping up-to-date registers of qualified doctors
- fostering good medical practice
- promoting high standards of medical education and training
- dealing firmly and fairly with doctors whose fitness to practise is in doubt
