I am a consultant paediatrician* (I am writing under a pseudonym to protect family, colleagues and patients) with over 20 years experience. I work with parents, many of whom have problems with mental health, substance misuse or learning difficulties. My job is to help protect their children and prevent them from following a similar life path.
I know what the effects of the Health and Social Care Bill will be because I can see it happening already. Looking after vulnerable children who are at risk of harm is becoming much more difficult because of the needless reconfiguration of services, whilst simultaneously attempting to make unprecedented savings. We must stop this Bill now or risk catastrophic breakdown of services for the most vulnerable children in society.
Let me illustrate the issues I face. It is a Saturday afternoon earlier this month, I am on call, and I have just spoken to the emergency duty social worker who explains that NSPCC received a call from a nursery worker who was extremely concerned about sisters aged four and six. The younger one confided that her father is sexually abusing her. Initial enquiries reveal a family history of abuse. The father has a criminal record for violent sexual offences and drug dealing. On week days I would be able to telephone the child’s GP for help with this family. But out of hours care is now provided by a Consortium of GPs and they cannot access primary care records. Not helpful for these children right now.
There is no doubt in my mind that these girls are at risk of harm. They need protection. It’s urgent. Normally the Police are excellent, but today there is no Child Abuse Investigation Team (CAIT) available locally, so there is no person from the police with the skills to interview young children about suspected sexual offences. Contracts are being renegotiated and cross-cover arrangements for weekends have yet to be finalised.
The duty social worker cannot access previous social care electronic case files because the IT contract is with a private provider who does not provide technical support during weekends. So no further information is available.
The child protection system is only as good as its weakest link. On balance the best option was to wait till Monday when normal service will be restored. But I worry about these children over the weekend.
Are you worried yet?
I don’t think this Bill will improve child protection services and the vast majority of my colleagues agree. Since free market competition-based health care systems are more expensive, less efficient and associated with gross inequities, this doesn’t feel like good clinical practice, nor safe and effective care for maltreated children.
The Health and Social Care Bill will increase bureaucracy because the number of statutory organisations will increase from 163 to 521. These are supposed to be co-ordinated through Health and Well-Being Boards (HWBB), but without all the child safeguarding organisations present on these Boards, it sounds like a formula for “not in my budget”.
Children have the right to grow up in a society where they are valued, where high-quality services are easily accessible, where the best interests of children come before commercial and political interests. Fragmentation of services has already started and will only get worse Children deserve better than this Bill. I am worried that more children will be abused and die. You should be too.
The Health and Social Care Bill signals the downfall of the NHS as the most equitable health service in the world. It will lose Liberal Democrats both credibility and votes.
Do not let this Bill pass. Only you can protect the NHS now.
“Dr Thomas Jones” is a pseudonym. The author is a Consultant Paediatrician and Designated Doctor for Safeguarding Children and has asked for professional reasons to publish this article under a pseudonym. Their identity has, however, been verified by the site’s editorial team.
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