Child safeguarding: the National Health Service (NHS) can do much better

By John Tingle

Our children are our future and we need to look after them well. There is however a lot of evidence to suggest that we are failing our children in a number of key health areas. UNICEF in a report put the UK in 16th position – below Slovenia, the Czech Republic and Portugal – in a league table of child well-being in the world’s richest countries. The report considers five dimensions of children’s lives – material well-being, health and safety, education, behaviours and risks, and housing and environment – as well as children’s subjective well-being.

There are a number of health and other child well-being challenges for the UK to meet. The UNICEF report provides some useful context from which to view the recently published Care Quality Commission (CQC) report on the arrangements for child safeguarding and healthcare for looked after children in England.The CQC is the independent regulator of health and social care in England.Whilst the report does contain some positive findings, when read as a whole, these seem subsumed by the large number of negative findings, some of which are very worrying.

This is a report for every organisation and person who comes into contact with children including staff in health services who, the report states, are in a strong position to assess children’s, health, welfare and safeguarding concerns. Everybody who comes into contact with children are now facing a number of serious challenges as society has changed dramatically over the years. These challenges have been brought about with advances in technology, the internet, and global mobility. The challenges are very cogently described in the report:

“Children are groomed for sexual exploitation and radicalization on social media, and young people from certain communities can be at risk of trafficking and female genital mutilation. The number of children identified as having been abused or exploited is only the tip of the iceberg – many more are suffering in silence. (p.6)

It’s clear from reading this report that the NHS in England needs to urgently do more for children at risk of harm. Unfortunately, this is an area where history has not served the NHS and other related public services well. The report points to a lot of other reports and activities over many years and there are still today well documented gaps:

This report is an important wake up call for all those services who deal with children including the health service. It is very concerning to read that health services are not consistently protecting and promoting the health and welfare of our children. This does not bode well for the future of our society. Our children are our future. The fact that there is unwarranted variability in the system is an acute cause for concern.The report is very clearly written and contains lots of very useful information. It provides an important agenda for change.  It is clear that our most vulnerable children and young people are not all getting the proper help when and where they need it.

John Tingle

John Tingle is a regular contributor to the Bill of Health blog. I am a Lecturer in Law, Birmingham Law School, University of Birmingham, UK; and a Visiting Professor of Law, Loyola University Chicago, School of Law. I was a Visiting Scholar at Harvard Law School in November 2018 and formerly Associate Professor at Nottingham Law School, Nottingham Trent University in the UK. I have a fortnightly magazine column in the British Journal of Nursing where I focus on patient safety and the legal aspects of nursing and medicine. I have published over 500 articles and a number of leading texts in patient safety and nursing law. My current research interests are in global patient safety, policy and practice, particularly in African health care systems. My most recent publication is: "Global Patient-Safety Law Policy and Practice," edited by John Tingle, Clayton O'Neill, and Morgan Shimwell, Routledge 2018.

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