Viewpoint - Don't fear child safety role

Dr Minoo Irani explains why he believes that GP consortia will be in a good position to oversee child protection.

Dr Irani: GPs are well placed to act on concerns for a child’s wellbeing (Photograph: Charlie MacDonald)
Dr Irani: GPs are well placed to act on concerns for a child’s wellbeing (Photograph: Charlie MacDonald)

In Achieving Equity and Excellence for Children the DoH proposes that PCTs' responsibilities for safeguarding children should pass to GP consortia when they become fully operational in April 2013.

It makes sense for consortia to take this on, but first we must banish our anxieties about high-profile failures in safeguarding children and the negative experiences of those held accountable for such failures. Then we can think rationally about the current contribution of GPs and, in future, of consortia to safeguarding.

The benefits to children, families and partner agencies of greater primary care involvement will far outweigh the risks to GP consortia.

Section 11 of the Children Act 2004 places a statutory duty on a range of services, including the NHS to make arrangements to safeguard and promote the welfare of children.

PCTs currently discharge a number of responsibilities as commissioners of local health services. Local authorities (LAs) also have responsibilities for this, as do the police and voluntary and private organisations.

The NHS will always be expected to play a part in commissioning (and providing) local services to safeguard children.

If GP consortia are expected to commission the range of services for children and families, they will also be accountable for ensuring that high quality and effective services are available for vulnerable children.

While some functions could be shared with LAs - and joint commissioning would certainly be a first step towards strengthening partnership working - it is unlikely that GP consortia will be able to relinquish all accountability for child protection.

The NHS Commissioning Board as currently proposed may be too removed from local processes to effectively commission safeguarding on behalf of consortia.

GPs and their teams sit at the centre of NHS healthcare and are uniquely placed to recognise and act on concerns for children's wellbeing.

They are closely involved with safeguarding children in their clinical practice and their collective knowledge about the needs of children and families is unmatched by any other professional group in the NHS.

It is inconceivable that GPs lack strong views about improving safeguarding services.

However, current organisational structure, pressure on clinical time and general apprehension probably limit greater primary care involvement.

The advantages of more primary care involvement will not only be realised by children (improving quality and effectiveness of services would make them safer) and families (primary care-based support for the family). They will also improve links and understanding between primary care and children's social care.

It could also bring safeguarding processes out of the shadows of complexity and mystery, into the light of common sense and front line clinical practice.

 Visit our GP Commissioning resource centre

Dr Irani is a consultant community paediatrician in Berkshire and NHS Alliance specialists network lead

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