Hidden on the ward: the abuse of children in hospitals

Abstract

Hidden on the ward: the abuse of children in hospitals While there have been a small number of high profile cases of the abuse of children by hospital staff, there has been relatively little attention paid to the child protection issues for children staying in hospitals. Drawing on a conceptual framework from work on institutional abuse, we identify three types of abuse: physical and sexual abuse; programme abuse; and system abuse. Physical and sexual abuse can be perpetrated by medical professionals and hospital workers, it can be perpetrated by other children, or it can be perpetrated by the child's own parent(s). Research evidence from the United States of America (USA) suggests that the rate of abuse in hospitals is higher than in the family home. Programme abuse occurs when treatment and care falls below normally accepted standards. Recently, a tragic case of programme abuse concerned the unacceptably high death rate of babies undergoing heart surgery at Bristol Royal Infirmary. System abuse is the most difficult to define but concerns the way in which child health services fail to meet the needs of children. Recent reports have highlighted inadequate services for children and young people, lack of priority given to children's services, and geographical inequalities in the provision of services. Three crucial aspects in safeguarding children from abuse are highlighted: listening to children; the selection support and training of staff; and external systems of inspection, monitoring and standards. The recent British government agenda which has placed quality at the centre of National Health Service (NHS) developments are discussed. Only by addressing the abuse of children in hospital openly and honestly will effective child protection be possible.

Interdisciplinary child protection team work in a hospital setting

“…The low detection rates could also be related to the fact that children find it difficult to report maltreatment or abuse to other people and that the medical. staff is often inadequately educated in this area [20,34]. Detailed education plans [23,28] for doctors and nurses or for improving screening strategies by standardising minimum criteria for reporting child abuse [3,19,26,27] have been shown to be effective in improving the detection and reporting of maltreatment cases.…”

The use of physical restraints on children: practices and attitudes of paediatric nurses in Turkey

“…Both health organizations and health professionals have to remember that they must work under both ‘non‐maleficence’/‘beneficence’ ethics regulations and take the principle of ‘first, do no harm’ into consideration. Kendrick & Taylor (2000) defined any harm as either emotional or physical abuse of children.…”

Telling tales: a qualitative exploration of how children's nurses interpret work with unaccompanied hospitalized children

“…The National Commission of Inquiry into the Prevention of Child Abuse (1996) noted that hospitals were amongst institutions that pose significant risk factors for harm to children through systems abuse. Kendrick and Taylor (2000) agree. Evidence of systems abuse in the United Kingdom includes a shortage of appropriately qualified staff to meet the needs of children admitted to hospital, the admission of children to adult wards, failure to meet the needs of adolescents, inadequate intensive care facilities for children (House of Commons Select Committee 1997) and the under treatment of pain in children (Twycross 1997).…”