New plan for GPs to trace bashers

By MONIQUE DEVEREUX

Doctors will be required to ask all women patients whether they are being abused at home, if health officials have their way.

In advice to Health Minister Annette King, the officials say a "culture change" is needed to ensure that GPs report abuse.

Their briefing paper was compiled in response to the Commissioner for Children's report into the death of James Whakaruru, the Hawkes Bay 4-year-old beaten to death by his stepfather.

The boy was seen by GPs nearly 40 times because of injuries.

Opinion was divided yesterday over the call for women patients to be routinely asked about domestic abuse regardless of their reason for visiting the doctor.

Women's Refuge praised the idea, but some GPs said it would be insulting and inappropriate.

The ministry says American research shows that directly questioning women about abuse produces a higher disclosure rate than less direct inquiries.

It recommends that questions about abuse be put to all women, not just those who have injuries that could come from domestic violence.

"A policy of asking about violence only when there are other reasons to suspect it misses a substantial proportion of women in violent relationships," it says.

The suggestion follows a study completed by the American Association of Paediatrics last year.

Over three months, US doctors asked 92 per cent of mothers they saw through a childcare scheme if they were being beaten at home.

A third said they had been abused at some stage, and 17 per cent said they had been abused within the past two years.

The American Medical Association recommends a series of three questions, including "are you, or have you been, in a relationship where you have been harmed or you are afraid of your partner?"

The Health Ministry's chief adviser, child and youth, Dr Pat Tuohy, said asking women if they were in abusive relationships was now acceptable, because abuse had become a widely recognised part of life.

While it was only a suggestion, doctors could include the questioning as part of seeing a new patient.

Dr Tuohy said doctors would need training so they would know how to refer women for help if they identified cases of abuse.

He said doctors could ask patients about their relationships "from time to time," but conceded that asking every female patient at every appointment would not be ideal.

Women's Refuge chief executive Merepeka Raukawa-Tait said having doctors ask female patients about abuse was relevant and the ministry was "on the right track."

She said she recently attended a health professionals conference where a nurse had told of her own history of abuse.

The nurse had said that in all the years she kept going to the doctor with bruises and broken bones, no one asked outright if she was being abused.

"She said that if one doctor had asked just once, 'are you safe at home?' she would have revealed everything and probably would have got help a lot quicker. That's a nurse saying that, so surely that gives a lot of credit to the idea."

But some GPs say questioning patients would be a waste of time, and is a suggestion from people "so far from the coal face it's silly."

Hamilton GP Leo Revell said he certainly would not be asking all of his female patients if they were abused because "I trust that I know my patients well enough to know if there is some trouble at home or their injuries reflect that."

He said questioning everyone was "crazy" because only a small percentage of women were abused and asking those who were "obviously confident and poised and happy would be an incredible insult."

Royal College of General Practitioners chairman Ralph Wiles said most doctors would feel uncomfortable asking such direct questions of all their patients.

Annette King would not comment on the briefing paper, except to say she would like to see GPs taking a positive role in tackling issues surrounding domestic violence and child abuse.

Herald Online feature: violence at home

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