BMA recommends doctors detain suspected abused children

Doctors should detain a child if they suspect abuse and alert the relevant agencies, according to new guidance on child protection published today by the British Medical Association (BMA).

The BMA's guidance is designed to help doctors and their teams to deal with suspected cases of abuse or neglect and assist them when faced with child protection issues.

GPs are often the first professionals to come into contact with children at risk and they, together with all members of the local primary health care team, should be fully aware of how to act in child protection matters, says the guidance.

The BMA Child Protection Tool Kit states that doctors working in emergency departments and other hospital departments, who come into contact with children at risk, must inquire about any previous hospital admissions and gain access to all relevant notes and records if possible.

The guidance advises that any child considered at risk must be thoroughly examined within 24 hours of admission to hospital and should not be discharged unless a discussion has taken place with local social services. Weekend admissions should not be allowed to interfere with emergency protection proceedings, the guidance adds.

Chairman of the BMA's Medical Ethics Committee, Dr Tony Calland, said: "What is important for doctors to remember is that if they have concerns about a child or children who may be at risk of abuse or neglect, they need to act immediately - the best interests of the child or children must dictate all their actions.

"There is always a degree of risk when dealing with child protection issues, at one end there is the danger of leaving a child for too long in a dangerous situation and on the other the risk of removing a child unnecessarily from its family. We hope this tool kit will help doctors weigh up the risks and reassure them that they are not alone and that support is available to help them make these difficult decisions."

The Child Protection Tool Kit advises doctors to be alert to physical and emotional signs of potential abuse. Physical signs include broken bones, bruise marks shaped like hands, fingers or belts, cigarette burns, human bite marks and evidence of internal bleeding.

Emotional indicators of potential abuse or serious neglect can include a baby or child who cries constantly, a baby or child who fails to thrive normally without clinical explanation, a child who is often very dirty or smelly, a child who is often left at home alone or a child who is left in unsafe situations.

It is essential, says the guidance, that doctors listen to the views of children and if at all possible involve them in the decisions being made on their behalf.

However critics say that doctors would already conduct a full examination and, if necessary, contact social services if they thought a child was possibly being abused or neglected.

Writing in The Times today, journalist Camilla Cavendish raised her concerns that the new guidelines will encourage over reporting and lead to parents not taking their children to their GP or hospital because they fear a doctor might wrongly believe their child is abused and contact social services.