The government has announced details of a proposed shake up in children's services in an attempt to avert another case of avoidable child death such as that of Victoria Climbié, the child who was murdered by her great aunt in February 2000.
In its consultation paper, Every Child Matters, the government proposes much closer working between primary healthcare services and local authority children's services, which are to be radically overhauled.
By 2006, the government wants to see all children's services, including children's health services, integrated into children's trusts, to be run by local authorities. The trusts would include community and acute health services, such as community paediatrics, teenage pregnancy coordinators, child and adolescent mental health services, and speech and language therapy.
The trusts would be headed by a director of children's services, accountable for both education and social services within a local authority.
Primary care trusts would be expected to agree relevant sections of their delivery plans with the director of children's services and would be encouraged to delegate responsibility for commissioning these services to the children's trust.
The green paper also proposes appointing an independent children's commissioner to champion children's views in England, a proposal which met with approval from the National Society of Cruelty to Children, the BMA, and the Royal College of Paediatrics and Child Health, all of whom have been lobbying for such an official for some time.
“The children's commissioner is something we have been pressing for for some time,” said a spokesperson from the royal college. “We are very pleased indeed.”
Wales has had a children's commissioner since 2001, and Scotland passed legislation earlier this year for such an official. Northern Ireland has a children's commissioner, Nigel Williams, appointed in June 2003.
The government also proposes that local authorities hold computerised details of every child's name, address, date of birth, school attended, and GP. These data would be attached to an identification number, such as the child's NHS number, and would also indicate whether a child is known to education welfare services, social services, or police or youth offending teams. If more than one agency were involved the lead agency for that child would be shown. Where a professional was concerned about a child they could indicate this on the system, for other professionals to see.
It also intends to place a new responsibility on health services and the police to join “local safeguarding children boards.”
Victoria Climbié died in February 2000 at the hands of her carers, Marie-Therese Kouao and Carl Manning, despite having had contact with four social services departments, three housing departments, two specialist child protection teams of the Metropolitan Police, two hospitals, and a families centre managed by the children's society the NSPCC.
The government's consultation paper, published on Monday, follows a report by Lord Laming into the child's death (BMJ 2003. ;326: 23912560255).
Professor Alan Craft, president of the Royal College of Paediatrics and Child Health, said the proposed changes would make a huge difference to social care and education for children. “But there is a real potential that it is going to be difficult for them to join up health,” he warned.
Every Child Matters is available at www.dfes.gov.uk/everychildmatters