Latest News
Significant Harm: the health effects of detention of
children seeking asylum (10th Dec 2009)
The Royal Colleges of Paediatrics and Child Health, General
Practitioners and Psychiatrists and the UK Faculty of Public Health
have published a policy statement and recommendations on the harms
to the physical and mental health of children and young people in
the UK who are subjected to administrative immigration detention.
Significant
Harm Intercollegiate policy statement
New GMC guidance on confidentiality for
doctors
The GMC has launched new guidance on confidentitality for
doctors. Confidentiality is central to the trust between patient
and doctor but the guidance explains some occasional exceptions to
this important rule.
Listen to the podcast which explores when a doctor can tell
police if a patient presents with a suspicious knife or gunshot
wound. Dr Tunji Lasoye, lead consultant at King's College Hospital
emergency department talks about his experiences treating knife
wounds and how the new guidance will help his work.
College statement on the role of paediatricians
in the age assessment of unaccompanied young people seeking asylum
(24th February 2009)
The Royal College of Paediatrics and Child Health
recognises that there are significant difficulties when
young people claim asylum who may not have documentation or even
knowledge of their age. We consider that paediatricians have
a valuable contribution to make in the assessment of these young
people. There are important dimensions of age assessment,
where the training and expertise of paediatricians is central. We
reiterate the view stated in the 1999 College guideline in relation
to age assessment that "there is no single reliable method for
making precise estimates. The most appropriate approach is to
use a holistic evaluation, incorporating narrative accounts,
physical assessment of puberty and growth, and cognitive,
behavioural and emotional assessments." A paediatric
assessment is an integral part of such a holistic evaluation.
The College recognises the importance of up-to-date
evidence to inform best practice. We have been asked to review the
evidence and are currently considering the means by which we will
undertake this work.
In addition, below is the college response to the BMJ news
coverage of the subsequent test case judgement:
Age Assessment of Asylum
Seekers
22 May 2009
Claire Dyer reports* that a high court judge has ruled that
doctors are no better than trained social workers at assessing
whether an asylum seeker is younger than 18. This view has caused
concern amongst many of those dealing with refugee children. We
think that it is important that the judgment is carefully studied
so that the right conclusions are drawn.
In the cases of A v London Borough of Croydon and WK v Secretary
of State for the Home Department and Kent County Council, Mr
Justice Collins was critical of the standard of age assessment by
paediatricians and concluded that local authorities were entitled
to prefer a social worker's assessment to that of a
paediatrician.
We accept that age assessment based on physical examination is
not precise. We have previously given the margin of error as
anything up to plus or minus five years. In the context of the age
assessment of a young person seeking asylum, this is impractically
large. We also accept that an interview carried out by a trained
social worker is an important part of a holistic assessment of
age.
There is a danger however that this judgment may be seen as
saying that a social worker's view should always take precedence or
that the views of paediatricians should no longer be sought. The
judgment makes it clear that, "flawed though they are",
paediatricians' reports must not be ignored and should be
considered because they "may identify something which could and
occasionally should lead to a different conclusion". We would have
preferred to see a stronger endorsement of medical evidence and
some acknowledgment of the impartiality that a clinician can bring.
There is no doubt however that paediatricians' reports still have
an important part to play.
The judgment also points to a number of things that RCPCH need
to do urgently. First, we must take on board the criticism that age
assessments have been inconsistent and produce better guidance that
will strengthen the evidence-base and reliability of assessments.
Second, we need to develop training in this area to ensure a
greater uniformity of approach. Both of these will require funding,
which we are actively seeking. Finally, we need to work more
closely with social workers to provide the best assessment of age
possible. Ideally our assessments should complement, not
contradict, each other. Paediatricians, like Social Workers, want
to ensure that vulnerable children are protected.
Len Tyler, Chief Executive
Dr David Vickers, Registrar
Royal College of Paediatrics and Child Health (RCPCH)
* Clare Dyer, News: Doctors no better at assessing young people's
age than experienced social workers (19 May) BMJ
2009;338:b2056
Competing interests: None declared
College Position Statements
The College issues position statements
relating to RCPCH and Government policy, consultation responses and
court judgements. For statements see:
Annual Report
The RCPCH
Annual Report
covers many areas of the College's current work and policy.