G620(P) The need for mandatory reporting legislation

Abstract

The Children’s Commissioner, in 2015, estimates that: 1.3 million children and young people will be sexually abused by their 18th birthday, only one in eight children and young people receives a statutory response to sexual abuse, the statutory response is largely disclosure–led. Aims To restore the medical diagnosis of child sexual abuse for doctors to report concerns, based on symptoms and signs, to the Statutory agency. The medical diagnosis of child sexual abuse was removed from doctors for political reasons. Method Two doctors made a medical diagnosis of child sexual abuse in 121 children. These children belonged to a larger number of 157 children where the medical diagnosis of child sexual abuse was considered. Of the 157 children, 82 children saw the doctor in the usual way and are referred to as index children. The doctor requested the other 75 children to be seen because they were related to or associated with index children. Of the 82 index children, 42 children saw the doctor with an existing concern of child sexual abuse (Group A). 40 children saw the doctor with a health problem and relied on the doctor to initiate concern about child sexual abuse (Group B). Results The figure for correct diagnoses, or of cases justifying further investigation most often cited by the professionals who were closely involved put it at around 70%–75%. If the figure of 70%–75% of correct diagnoses was true, it could clearly be contrary to general public understanding of the accuracy of the diagnoses. In professional terms, it would still be necessary to raise the question that if 25%–30% of the Consultants’ diagnoses were false positives does this constitute professional incompetence? This raises fundamental questions about the accuracy of diagnoses in other fields of medicine where the proportion might be considerably lower for an initial or ‘working’ diagnosis. Conclusion Group B children need doctors to be protected with Mandatory Reporting Legislation to increase the number of children receiving a Statutory response for suspected child sexual abuse.