Teachers, GPs and paediatricians have no confidence in the ability of social services to make a difference to their lives and fear the child’s plight will be made worse if he or she is taken into care and placed in a foster family, they say.
A series of papers published today by the Lancet medical journal in collaboration with the Royal College of Paediatrics and Child Health paints a grim picture of the unseen sufferings of an estimated 1 million children a year in the UK.
Between 4 and 16% of children suffer physical abuse, such as hitting, punching, beating and burning, according to a paper by Ruth Gilbert and colleagues from University College London’s Institute of Child Health. The figures come from research in high-income countries, including the UK, which is not thought to differ from the average.
Some 5-10% of girls and 1-5% of boys have been subjected to penetrative sex, usually by a family friend or relative. If sexual abuse is defined more widely – as anything from being shown pornographic magazines to rape – it is estimated that it will include at least 15% of girls and 5% of boys.
Around 10% of children suffer emotional abuse every year, the paper says, which includes persistently being made to feel worthless, unwanted or scared. More still – up to 15% a year – suffer neglect, defined as the failure of their parents or carers to meet the child’s basic emotional or physical needs or ensure their safety.
Those like Baby P who are picked up by the social services and placed on the at-risk register are only the tip of the iceberg. The plight of fewer than one in 10 maltreated children is investigated and substantiated by child protection services.
The experts underline a key finding from the case of Baby P – that professionals are not communicating and sharing their suspicions.
Lancet editor Richard Horton said the findings, which had taken a year to reach publication, had “huge significance for considering an appropriate and measured response to the findings around Baby P”.
He added: “What this report does emphasise is the extent of the risk factors and consequences of child maltreatment, which are of such complexity that any reflex attempt to apportion blame or think there is a simple solution to this issue is to completely misrepresent the extent and depth of the problem.”
The papers also expose the paucity of evidence behind the decisions taken by health professionals and social workers. Far more research is needed into finding out what will prevent a child being abused. “We don’t know how effective existing practice is,” said Jane Barlow, professor of public health in the early years at Warwick University, co-author of the paper on interventions. “These are some of the most vulnerable children out there in society.”
In a Lancet commentary, Dr Horton says the series “will unfortunately not halt the blight of child abuse, because the phenomenon is too common, too surreptitious and too deeply rooted in deprivation and other social ills – but we nonetheless hope to raise awareness of the scientific evidence that is available, and indeed essential, to guide paediatricians and other professionals in their practice with children who might have been abused and to help bring a new logic and clarity to public debate about this contentious area.”