Date: 27/12/2000
Duty to report at-risk children divides doctors
By Julie Robotham and Geesche Jacobsen

New child protection laws invade the privacy of the doctor-patient relationship and could prevent people from seeking treatment for conditions such as post-natal depression, medical groups have warned.

The NSW legislation, which came into effect last week, requires doctors and other professionals who work with families to report any case where they suspect a child might be harmed, even if there is no evidence of abuse.

But doctors say parents might not seek medical help for themselves or their children if they fear being reported to the Department of Community Services.

The medical secretary of the NSW branch of the Australian Medical Association, Dr Robin Napier, said: "People need to be able to trust their doctor so they can come out with personal concerns without fear of being punished."

The mandatory reporting of suspicion of abuse might also rebound on doctors if they failed to report a family in which abuse was later discovered, he said.

The president of the Royal Australian College of General Practitioners, Dr Paul Hemming, said: "How do you define suspicion? There's all sorts of potential for malicious reports. The doctor-patient relationship needs to be as secure and confidential as any relationship can be.''

A temporary desire to smack a child was "certainly a common feeling with post-natal depression", Dr Hemming said. "If the patient's going to be scared off from reporting that feeling, how's the doctor going to know that or care for them?"

But Dr Sue Packer, a pediatrician who assesses at-risk children at Canberra Hospital and is co-author of the Royal Australian College of Physicians' child protection policy, said mandatory reporting could ease the burden on doctors. They could tell a parent they had no option to make the report, while supporting them through any DOCS investigation.

"You can in a way distance yourself from [the report]," Dr Packer said.

"Sometimes it's a help."

The executive director of children's and family services at DOCS, Ms Carol Peltola, said reporting "doesn't necessarily mean that we are going to see the family or behave in a way that might be intimidating".

The legislation was geared to "get in early and assist families" and was the result of four years of community consultation.

Ms Peltola said the definition of "current concern of risk of harm" was clearly stated in the new law, and was confined to serious physical or psychological harm or neglect.

"We rely on doctors to tell us whether a bruise could have been obtained in normal play," she said. "People need to be reassured that because your child has a bruise doesn't mean we will say this has happened because of things you've done."

But the vulnerability of children meant their interests had to come ahead of doctor-patient confidentiality.

The new law also encourages doctors to report concern for the welfare of unborn children. Although it is the first time child welfare legislation has extended to the unborn, Dr Napier said this was unproblematic because the decision to make a report was at the doctor's discretion.

The chief executive of the Association of Children's Welfare Agencies, Mr Nigel Spence, said: "This is intended not to be a punitive measure to whip babies away from their mothers. The intent of the act is very clearly ... to arrange support services for the mother and her baby to allow her to care adequately for her child."

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