Sir, - Doctors and nurses have a moral duty to prevent child abuse and to report their concerns. The ISPCC wants reporting of child abuse to be legally mandatory. The majority of professionals (nurses, social workers, doctors, psychologists) who contributed to the Currie Conference on Child Abuse were opposed to mandatory reporting.
My major concerns regarding mandatory reporting are:
It allows for no element of professional judgement.
It would induce a severe loss of confidence in doctors and nurses among many groups of people, especially the deprived. Public health nurses would find many doors closed in their faces.
Those in favour of mandatory reporting have failed to define what they want reported.
Mandatory reporting implies mandatory investigation, mandatory adjudication and presumably mandatory punishment for infringements. Who would do all this?
Mandatory reporting will result in a flood of claims for compensation in the event of unproven allegations. Mr O'Tighernaigh of the ISPCC needs to learn that there are many medical pitfalls in detecting physical child abuse.
Where is the evidence that mandatory reporting prevents child abuse?
The McColgan case was reported. The failures were in communication and in action. All children being used in begging activities are being abused daily - has the law helped them? Would mandatory reporting result in all children of addicts, alcoholics, criminals offenders (who by definition are "at risk") being placed on lists and supervised by the law? The Lancet editorialised in 1996 as follows:
"There is already a consensus that reporting of either sort [voluntary or legal] has to be accompanied by good systems of training and support for those trying to help the family. To impose mandatory reporting where these systems are not yet in place and budgeted for is silly."
A judicial prescription is not a good remedy for social ills. Bad laws do not make for good social order. Most Irish families respect the public health nurse as an ally, friend, helper, and educator. Were she made a conscripted arm of the law, would that love relationship continue?
What is needed in child protection is better education of parents and professionals, early recognition of abuse (physical, sexual, deprivation), prompt intervention, better inter-agency communication, and activation of the Child Care Acts.
Slogans are easy ("stop the hurt"), but solutions are more complex. Inflexible laws could alienate many of those who care for children and already marginalised social groups. The awful media cases: (Kilkenny, Ftizgerald, McColgan) were known to the authorities. Irish children need:
Mandatory reporting? No.
More love? Yes.
Children's ombudsman? Yes.
More money for children's services? Yes. - Yours, etc., Prof Denis G. Gill, Department of Paediatrics, Royal College of Surgeons,
St Stephen's Green,
Dublin 2.