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Long years of hand-wringing have not improved New Zealand’s high rate of child abuse. The problem is the lack of a joined-up response to reports of harm, writes Frances Matthews.
This story is an early online publication from the 14 December issue
Child protection workers were vilified in the media as home-wreckers who stole children away from their parents, yet simultaneously did not do enough to prevent child abuse
As an emergency room doctor in hospitals in the UK and Canada in the 1980s and ’90s, I saw a good deal of child abuse. Once or twice a year, on my shift, I dealt with a child who despite our best efforts would die after an assault by carers.
About every couple of years, I saw children who had suffered serious sexual assaults and would require resuscitation and surgery that night just to save their lives, and who would endure years of reconstructive surgery to repair the damage to bladder, bowel and genitalia.
Once or twice a year, I saw a child with life-changing injuries as a result of a serious assault. Every week I saw children with injuries that were not life threatening but had been inflicted by others. All the time I saw children who were hungry and neglected, whose families were well known to us, to social workers, paediatricians and police. It was a depressing experience.
In Canada, I sat on child protection committees made up of social workers, doctors, nurses and designated police officers. We met regularly. Sometimes there was not much to discuss, but it established relationships of trust between us. We knew who to turn to. We had our differences, especially over the issue of privacy, but most people understood that the right to privacy did not extend to a right to abuse children in private.
We had all been staggered by the reports of the abuse of children in the care of the State and in the care of the church. Reporting was mandatory in most provinces in Canada, but the mechanism of response was evolving, and we saw that it involved collaborative and cooperative relationships. Child protection was still depressing, but less so. I don’t know what is happening now; it is many years since I left.
There is ongoing discussion about whether there should be mandatory reporting of child abuse in this country. The arguments are raised every few years after another catastrophic child protection failure, most recently the murder of five-year-old Malachi Subecz.
Most professionals would have no difficulty with the idea of mandatory reporting: Professional bodies and employers already expect it. The difficulty is not mandatory reporting, it is the lack of timely and effective response to the report.
Some years ago, while working as a GP in a city in New Zealand, I tried to make a report, but the phone rang and rang and no one picked up. The practice nurse tried for most of the morning, still with no response. After 5pm, I managed to speak to the on-call social worker, who told me it wasn’t an emergency and I should ring again in the morning. I was hardly uplifted by his response.
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I started working in adult protection and noticed that some of the social workers I encountered had stopped working in child protection because it was so deeply disheartening. Child protection was under resourced and overstretched. Child protection workers were themselves subject to abuse by individuals, and to vilification in the media as home-wreckers who stole children away from their parents, yet simultaneously did not do enough to prevent child abuse.
The lack of resourcing, lack of understanding of child (and adult) abuse and the complete lack of joined-up thinking between government departments has had a chilling effect on child protection over the years.
Social workers and lawyers don’t want to be involved with Oranga Tamariki. The work is hard and thankless, it sullies reputations and tarnishes the best intentions. The pay isn’t great. The burden of moral injury among those who’d like to make a difference but simply can’t is too enormous.
We need to do better. Most families of children who suffer abuse are well known to social workers, doctors, nurses, police, early childhood educators and the Department of Corrections. They are among the poorest and least privileged members of society. Working collaboratively across government departments to at least lift these families out of poverty, and give fairer access to housing, employment, education and healthcare, would go a long way to addressing the issue of both child and adult abuse. We are reaping what has been sown for generations, and it isn’t pretty.
Some years ago, I went to a meeting in the Beehive where the then Minister for Children’s Issues solemnly told us New Zealand led the world in child abuse. Yes, we led the world in child abuse, and we’re still up there, but not in a good way. We need to foster collaborative relationships between a whole network of individuals, organisations and government departments and we need to work on equity in health, education and housing as well as child protection. We don’t need more reports, but we do need some joined-up thinking, and some joined-up responding.
Canterbury-based Frances Matthews is a doctor in general practice and a medicolegal advisor
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