Doctor's plea: We must widen the net

Photo / Natalie Slade

Child abuse expert Dr Patrick Kelly wants the law changed so health workers have to "shoulder some of the responsibility for keeping children safe".

The Starship Hospital paediatrician deals with the aftermath of child abuse every day, and wrote a hard-hitting letter to the incoming Health Minister Tony Ryall in December 2008.

The letter, obtained under the Official Information Act, said risk assessment in child protection was a "notoriously unreliable science".

"The sole absolutely reliable risk factor for abuse is abuse itself," Dr Kelly wrote.

"The family most likely to abuse or neglect a child, is the family which has done so already." .

Recognising abuse and neglect, then stopping it immediately, would "have an enormous impact on the health of New Zealand" said Dr Kelly.

Almost 1800 children whose abuse or neglect was detected by social workers in 2008 were re-abused within six months, often by the same parents or family members.

Dr Kelly's letter said it was "remarkable" that professionals other than CYF and the police were not enrolled in the "front line" of child protection.

"While lip service has been paid to the role of health and education in child protection, it has focused only on the provision of information to the statutory authorities.

"As a consequence, health professionals as a group have been able to avoid taking responsibility for child protection.

"Unlike some other countries, no legislation in New Zealand requires health professionals to shoulder some of the responsibility for keeping children safe."

The numbers of children diagnosed with abusive injuries were the "tip of the iceberg" said Dr Kelly and many had already been seen by doctors or nurses who did not recognise the signs.

He proposed that every district health board establish a child protection team with a paediatrician, a specialist nurse, a social worker, a mental health worker and administrative support.

Dr Kelly told the Herald that police and CYF should not be the only ones responsible for protecting children.

"It takes the whole community, including health workers."

GRIM NUMBERS

* 130 children admitted to Starship Hospital with injuries from "definite or probable" child abuse between July 2005 and July 2010.

* 17 children have died