LOUDOUN TRUST

 

SYMPOSIUM NOVEMBER 12^th 2015

“Mandatory Reporting”

A Loudoun Trust Commentary.

(This summary is of the views of some thirty persons with expert knowledge in the area of child sex abuse.)

In general the symposium spent some time considering whether there was a genuine need for something to be done about the reporting of child sex abuse.

There was an overwhelming opinion that something needed to be done.

Several participants outlined distressing cases from their experience. One remarked on the difficulties within the present system when  there had to be a balance struck between the potential pain to the victim and taking action against the perpetrator.

There was discussion about whether mandatory reporting was the real question for the symposium – or whether discussion to cover all areas of child sex abuse.

Everyone agreed that there was a problem that needed to be solved and restriction of the discussion to a single topic was not the best way forward.

Areas for discussion were listed. Beyond mandatory reporting, resources was perhaps the most commonly discussed subject.

Some victims, it was said, could not report abuse because they could not find anyone to report to.

There were other aspects of failure – effectively “passing the buck”, or complacency. Perhaps worse was institutional cover-up. It was said that some people feel that child sex abuse is something to hide – not something to bring out into the open.

Furthermore, such allegations within a school could cause the school to fall in the league tables – this had reputational and financial consequences, particularly to private schools.

Most agreed that that  prevention of child sex abuse and the protection of our children is the key to success in this area and that this should be the main focus of the discussion.

GUIDELINES

Discussion began with consideration of the guidelines issued by the General Medical Council regarding  the reporting of suspected child sex abuse. The guidelines outline a system in which the physician must carefully weigh the possible harm to a third party, must consult with a colleague and then keep the decision under review – writing down the rationale for the decision,  in particular with regard to risk assessment.

Several members considered this to be a good system.

However, one member saw advantages of mandatory reporting to supplement this, for she thought the situation at the moment was far too confusing. She was of the opinion that many psychiatrists and other professionals have high standards – but there was poor practice as well. With such people the GMC guidelines were not enough.

Some claimed that many members in the professions were not clear about the GMC guidelines. One reason was that the guidelines actually clash with practical experience in the workplace – and that people do not therefore adhere to the guidelines. Better training was needed.

Other clinicians did not like the guidelines because they are forced by them to rely upon their own judgement. This means that they are therefore subject later, in perhaps more calm or settled circumstances, to the opinions and judgments of their peers.

However, it was thought that if there were better training, the GMC guidelines could be followed and that there was no need for a change in the law.

One person suggested that some of the wording in professional guidelines is ambivalent. As an example, he mentioned that much of the guidelines depended on the meaning of the word “act”.

To illustrate the point,  he quoted patients who may have been looking at the internet for many years, but who never commit child sex abuse - even though they have long term psychological problems in that area. Is watching pornography an “act” – or does it only apply to actual contact with children?

The question of resources was frequently mentioned- and one contributor thought that this was the main reason why the guidelines were not working. There could be no in-depth training, because the budgets were shrinking.  However, she added that training itself might not be enough – because medical staff were already drowning in the amount of training they needed to do. Too much is demanded of such staff. They never read the guidelines - even though they are available.  She agreed that some words in the GMC guidelines are ambivalent, or nuanced.

Further, she claimed that doctors could not quote the guidelines. They concentrate on good medical practice, not on how to report suspicions of child sex abuse. 

There was a general feeling that some clarification is needed if there is to be adequate discussion on this subject.

An experienced psychiatrist pointed out that the term “child sex abuse” was relatively new. When he had started his career the term was unheard of. These days however, the profession was inundated with such cases. He thought that the profession was  going in the right direction to deal with such cases, but there was always  tendency to swing too far in one direction only to then reverse and swing too far in the other direction. He thought that the main way forward was to listen more to the children themselves.

A paediatric registrar agreed.  She said that that the guidelines in  her profession only used  the word “abuse”, not “sex abuse”. Although she had prosecuted many cases of abuse she wondered how many cases had been missed because “child sex abuse” was not mentioned.

SUPPORT FOR MANDATORY REPORTING.

There was some support for universal mandatory reporting as discussed in the Lords in 2014  – i.e. that everyone should come under the law, but that some areas, such as the medical profession, might be granted some temporary exemption.

One participant mentioned the DBS, the Disclosure and Barring Service. This is the body which replaced the Criminal Records Bureau and the Independent Safeguarding Authority in checking the suitability of persons wishing to gain employment.

He claimed that the DBS will take no action on a report from, for example,  social services -   unless it has already been reported to the police. He claimed that this ‘link in the chain’ was quite broken and put children into danger.

He thought that the entire system needs to be addressed because it is not working. One might conclude that if one wished to devise a system that would fail, one could not do better than what we have.

He thought that many around the table might not know the prevalence rate of established cases in Britain. He said it is a ‘paltry’ five per cent.  One area to consider was the paucity of prosecution of professionals. He added that he was not suggesting that reports must necessarily go to the police – for there is already a framework for reporting to the Local Authority Designated Officers.

He pointed to research done in Australia where there is mandatory reporting in one form or another in the states and territories. He considered that the difference in the degree of child safety which was introduced by mandatory reporting was quite significant.

He said that the number of reports to various agencies substantially dropped below the numbers in the period before mandatory reporting. The number of substantiations of reports has risen, but the number of reports has dropped. This had put less strain on the resources.

A legislator said that the government’s  financial resources meant that all the plans that used resources were unlikely to succeed – whereas mandatory reporting might succeed in one sense. She quoted the legislation on FGM -  female genital  mutilation -  saying that it had drawn attention to the problem and got the message across. Mandatory reporting of child sex abuse might have a similar effect.

A retired police officer said that he knew of at least five charities which went  into schools and talked  about FGM. This was getting the message across on  the ground floor. Such visits had resulted from the FGM legislation.

CONTRARY OPINION.

The question was then put whether mandatory reporting would mean that people would not seek help. The general feeling was that such was the case.

A psychiatrist asserted that that there is a reason for patient-clinician confidentiality. The courts, he said,  have often said that breaching such confidentiality is an important matter. He thought that the public harm that can be caused by breeching confidentiality is very great. He said that the harm to the public should be balanced against any benefits that mandatory reporting might bring. In his opinion,  mandatory reporting would  it tip the balance sufficiently to cause harm.

He questioned some of the disruption that such mandatory reporting might bring to a family.  And he added that he thought that patients might disappear if there were mandatory reporting.  

A lady thought that this was a major point against mandatory reporting. She thought it important that people believe that they can get help. She thought that if there are indeed a large number of people who have these tendencies,  but never act upon them, it is important that they can go to seek help.

Another contributor thought that that one of the advantages of mandatory reporting is that is takes the pressure off children who are abused.  Against this however, he thought that the great problem with mandatory reporting is that children have no control over what happens to them under such a system. All control is taken away from them.

One participant said he would like to comment on evidence that mandatory reporting will increase the number of cases. He thought that it would not improve the safeguarding of children. The risk would be that you have less safeguarding because you have a lot of reporting. He thought we needed more research and numbers before reaching a decision. He said that latest official research shows that if children are aware that anything they say will be passed on to children’s services, then they won’t say anything at all.

However, he thought it interesting to hear that in Australia, when mandatory reporting was introduced, that the number of substantiated cases increased. He thought that aspect should be explored.

THE SCOPE OF MANDATORY REPORTING, IF INTRODUCED.

Given that mandatory reporting was being considered, but that few around the table considered it should be universal, discussion turned to what the scope of any mandatory reporting might be.

In defining scope, one participant suggested that there were two areas for discussion. The first was the scope of what they were discussing – i.e. the areas in which mandatory reporting might be introduced; the second area of discussion would be the effectiveness of mandatory reporting in those areas.

Another member suggested categories for areas where mandatory reporting might be introduced. They were

(i) professional bodies,

(ii) institutions dealing with children and

(iii) anyone not in the above who worked with children.

She said that there was experience in Canada of mandatory reporting in these three areas, as well as universal reporting.

A psychiatrist pointed to another aspect of scope – the “paedophilic level” of patients or potential offenders. She termed some as  ‘paedophilic failures’ who were not lifelong paedophiles. Others have fleeting sexual interests,  or might be drawn to child pornography at times of a mental breakdown  - but  then recover. Should mandatory reporting, with all its consequences, apply to them?

She pointed out that paedophilia is not a crime - it is a mental health disorder. There are people who have long term paedophilic interests but who never commit child sex abuse.

She thought that rather than reporting such people,  they should be investigated closely because it is crucial that we understand what it is that drives child sexual abuse..

A psychologist added to this. She thought there was a misconception that child sexual abuse is always perpetrated by people who are lifelong paedophiles,  predatory, who are simply  looking for an opportunity to re-offend. This is not so. She considered that this mistake underpins the idea that we must report such people immediately. In fact, she said, people who work in the field know that there is not a dichotomous divide between paedophiles and everybody else.

Another contributor, who works with young people, made an allied point relating to age.  She thought that there is a division -  a difference between information coming from a mature person and a teenager. She thought that there was a greater duty to report with younger people. The younger the person, usually the greater the protection that is needed. In her experience, mandatory reporting might help in certain age groups.

She was also of the opinion that there was a divide between reporting  suspicions in a professional context and mandatory reporting resulting from observation of the consequences of child sex abuse.

Another contributor thought that we should take into account real differences between mandatory reporting,  which remains solely within  an institution or a special area, and reporting which  leads in the end to  criminal proceedings. 

Another psychologist pointed to yet another area of “paedophilic level” – use of the internet.  Should someone who mentions that they are watching internet child pornography be reported  - when actual children are not involved?

Another participant thought it wrong in principle to be criminalising professionals who had a therapeutic relationship with a child. The question of  the right not to report is different between children and adults. Adults are allowed in such circumstances to consider if they are ready for the consequences before a report is made to the police. This is not so with children, so the clinician must decide what is best for the child. Of course, she added, if the child is at risk, one should report. – but that decision is a matter for professional judgement.

A third participant added to this. There was a question of the length of time that abuse took place. Is there a difference between a fleeting encounter which is not predicated on emotional psychological issues? To exemplify this mentioned the situation of a nurse in A&E dealing with an injured or sick child. Such a nurse might touch a child on parts of the body which would be classified elsewhere as sexual assault.

Someone else thought that we must take into account the environment in which society may place young people. She cited the situation in prisons where a teenage girl might be put in close proximity to a predatory adult. This was unfair to both.

In summary therefore, the symposium raised several areas where reporting might be made, and  which deserved different consideration to the others.

Any introduction of mandatory reporting should take into account

(i)                 the environment in which society places children ( hospitals, prisons etc) –where guidelines apply.

(ii) the psychological make-up of the person to be reported (fleeting     encounters etc)

(ii)              whether the report is of a suspicion or an actual observation.

(iii)            whether a child is actually physically involved (internet)

These four categories were also affected by the three divisions of:

(i)                 Professional bodies that deal with children.

(ii)              Institutions that look after children

(iii)            Others outside the above two categories.

EXPERIENCE FROM OTHER JURISDICTIONS.

Various members had experience in other jurisdictions. In addition to the experience of Australia – mentioned elsewhere -  there was experience from Canada and the United States.

Canada

There is  universal mandatory reporting over all Canadian provinces and territories. It applies to everyone – even  down to the person on the street.

A member who had researched the Canadian system thought it a complete ‘dead letter’. She said that studies have discovered that there is widespread disregard of the law.

She said that Canadian clinicians in general decide that they should put their duty to their patient above the demands of the law.  There is a conflict of interests in that decision. They rely upon their professional judgement as to whether it is in the best interests of the child – even it they are in danger of facing a potential criminal prosecution.

She said that it has been held in Canada that the ‘good faith’ immunity provision protects the practitioner from a complaint by the alleged abuser being taken to the GMC as well as immunity from prosecution by the legal authorities. As for UK legislation, she thought that there should be immunity, in all aspects, for anyone reporting suspicion of child sex abuse – when it is  “in good faith”.

Her experience in Canada led her to the conclusion that the biggest thing we could do in the UK is to have notices about child sex abuse  in every school and every doctor’s surgery. These notices would state that reporting could be ‘good faith’ reporting – and be immune from legal liability

UNITED STATES

Most states in the USA have mandatory reporting for the professions and such institutions.  There are exemptions for some professions.

One member of the symposium said that research in the United States shows that there is a fall-off in children attending sexual health clinics because they know that they are mandatory reporters.

Another contributor noted that the experience from America is that people don’t seem to notice the signs. They assume that bed wetting is the problem – they don’t go on to think that it might be because of child sex abuse.  She thought there needed to be greater understanding of the problem. She emphasised the need to listen to children.

AUSTRALIA.

Australia has a variety of different laws and systems on  mandatory reporting in its nine states and territories.

Australia was mentioned several times in the symposium. Reference was made to a document on the internet at: http://core.ac.uk/download/files/310/10881440.pdf

One contributor recommended that all should read this document.

This contributor claimed that research about to be published indicated that after the introduction of mandatory reporting:

(i) the number of reports to various agencies has now substantially dropped to below pre-mandatory reporting days.

(ii) the number of substantiations of reports has risen

(iv) mandatory reporting put less strain on the resources.

Allied report on general experience

One contributor made a general comment about systems designed to deal with problems.

He had some twenty years experience in banking management. (He is now an executive in a global organisation which attempts to improve business leadership through education and the exchange of ideas.)

He said that in his experience “control management” is the least effective form of management.

He expanded this by saying that most of the successful companies in the world provide training in order to give the individuals within the company the ability to form and use  their own judgement. They are encouraged to drive their company forward by using their own knowledge and their own best judgment.

He said that if you impose your will on people, they will pass the buck. If something goes wrong, they will say ‘ But I followed the procedure’. That, to them, is enough.

Such an attitude does not stop poor behaviour or performance.  He thought that if a company has such a  problem, it must change the culture and empower people to make their own decisions.

He thought, as an outside observer, that this was relevant to the present discussions.

 THE FAMILY.

There was frequent reference throughout the symposium of the effect that mandatory reporting might have on families.

One member thought that there was a fundamental point to make which is that, by looking at mandatory reporting, its advantages and disadvantages, the symposium was not addressing the main point of the issue of child sex abuse. She thought that it is better to intervene at the beginning of such abuse rather than approach it from the end with a punitive approach. She said that family therapy was the key. The problem today is how to create channels of approach, education and support in order to intervene in families where children are being sexually abused.

Another contributor reported that the NSPCC has done a lot of work on mandatory reporting in which they mentioned ‘family centred’ intervention.

Another member said  that it was important to remember that  mandatory reporting, as suggested, does not apply to the family setting – it only applies to institutions and such. 

A social worker said that her view was that if a young person reported that he or she was being abused by a members, or members of her family (something the contributor thought to be common) then there was a greater duty to report this in order to protect the young person. In such circumstances, she thought mandatory reporting would help.

Another member of the symposium mentioned children who are without family and cast out into the world.  In terms of putting children first, should they not have priority in some fashion?

THE LAW.

A participant spoke about the principles of law. He outlined the differences between common law and statute law. Under common law the court decides on a case involving a clinician on the basis of whether other such clinicians would act in like manner. This brings  professional duties and ethics into the decision. Professionals have a duty to protect confidentiality, but also the protection of the public – two aims which are often at odds. In common law therefore it is a matter of personal judgement and professional guidelines.

The current proposal is to shift disclosure from common law to statute law. This is a crucial decision -  because the right to confidentiality can become obscured.

He added that there is also, in common law, a duty of care which professionals must be careful to ensure.  If disclosure of suspected child sex abuse became mandatory, there would be a profound change in the relationship between clinicians and the general public.

Another member of the symposium said she considered that the law is not clear to practitioners.

A lawyer in the room remarked that there is often a knee-jerk reaction to events  - which is to introduce a new criminal offence. This was not a good idea – particularly since mandatory reporting was aimed at professionals. She said that it is one thing to ensure that professionals stick to the guidelines, but to make not sticking to them that a criminal offence would be disastrous.  She pointed out that  it would be impossible to distinguish between  the professions which deal with child sex abuse  - with their guidelines and management structure -  and the institutions which deal with child abuse  - with their guidelines and management structure. They would be largely the same people with possibly two different sets of guidlines. Would failure to report to both together, to one and not the other, merit prosecution?

She then turned to discussing “criminalisation by association”  She recounted a case she had defended (successfully). It concerned a Muslim wife whose husband had committed acts of terrorism. The wife was completely ignorant of her husband’s activities, yet she had been accused of complicity.

Mandatory reporting would be particularly bad if it were to lead to  ‘criminalisation by association’  of a professional who is actually trying to help someone. If that happened, nothing would ever make things right.

She concluded that mandatory reporting, prosecuting the  non-reporting of  a criminal offence, could make things worse than they are at present.  It was, in her opinion, a diversion from the real issues.

Turning discussion to Articles 3 and 12  of the United Nations Convention on the Rights of the Child (UNCRC), she commented that there was already some difficulty in the law.  Article 3 says that we must take decisions in the best interests of the child – but article 12  says that children should have a say in decisions taken about them.

She added however that members might have a look at the United Nations Convention on the Rights of the Child. We should consider  whether we should incorporate the Convention into domestic legislation. She thought that this would be a more useful change  than mandatory reporting in protecting children.

A member with experience of other jurisdictions stated that perhaps the only advantage of mandatory reporting, as she saw it in other jurisdictions, is that they all contain immunity from liability in statutory reporting, in “good-faith” reporting. She added that some jurisdictions have immunity to all reports, other confine themselves to ‘good-faith’ reporting, because there is a lot of malicious reporting.

Another participant, exploring the idea of limited mandatory reporting, suggested that in terms of institutional abuse,  criminalisation could centre on  evidence of a cover-up rather than simple non-reporting.   By adopting this principle, the state could go after churches which have covered up priests and schools which have covered up paedophile teachers. This would be a form of limited criminalisation.

Someone else remarked that there are already terrorism laws when one must report suspicions - and section 3 of the Proceeds of Crime Act says that if there is suspicion of money laundering, people are supposed to report or they will be in trouble.

Another participant reiterated the point that mandatory reporting could be criminalising professionals for exercising their professional judgement. She pointed out that this may well be a different situation from that of an institution which cares for children.

With institutions, the decision not to report might not necessarily be that it is best for the child. There is the reputation of the institution to consider. Mandatory reporting might be preferable in an institution where the institution itself has a vested interest in a cover up. This was particularly so with independent schools where the reputational damage of such a report might be very great.

Various other legal points were raised, based on experience. One member referred to people watching child pornography on the internet. He said that only about ten per cent of cases he knew about would be termed “illegal” and would need to be reported. That this number is so low has it caused changes in his modus operandi in dealing with internet pornography crime. What happens now is that researchers pro-actively go looking for it rather than waiting for reports. That would seem to be a more effective of dealing with it. However, with relevance to mandatory reporting, it is a pre-reporting stage.

He agreed with others that creating a new criminal offence is not the way to go. He said that, on principle, we should always be extremely careful about creating a new criminal offence.

A psychologist pointed to a difficulty with the idea of mandatory reporting of suspicions of child sex abuse. She said that there may well be various non-specific indicators leading to the raising of suspicion to a threshold where mandatory reporting should take place – but who makes that assessment. How do you define “suspected”? 

Another participant added that, in general,  the criminal justice system is not child friendly. She was aware of lots of people who have suffered abuse who will not go to the police because they do not think will get the answers that they want.

She thought that there was a fundamental point here about prosecution and justice in this matter.

A psychologist added an ancillary point with a hypothetical example. He spoke of a person who was inclined towards paedophilia, but who did not wish to offend. This person, if mandatory reporting were brought in, would know, or at least suspect,  that should he go to a psychiatrist for help, there may be a report which could lead to prosecution. He could be taken out of his family, even if only as a precautionary measure.

Meanwhile, and in contrast however, his next door neighbour might be doing the same thing. However, because he is not seeking help, nothing happens to him.

The man wishing to do the right thing might be punished, the offender might not. This is not justice.

RESOURCES.

Almost every aspect of discussion ended with either a complaint or comment on the lack of resources. Those with experience in legislature made it clear that there was little hope of getting increased resources. Nevertheless not all the matters raised concerned increase in resources. Some were about where the current resources could be better employed.

A social worker said that in spite of the training there was often a lack of experience in teachers and educational staff about child sex abuse.  She complained further that the training that is done does not include how to spot child abuse, nor how to  spot the changes in young people's behaviour which might suggest it. 

Another participant reported that she had met  many people who claimed that there had been delay in making their disclosure  - simply because there was nobody to disclose to. 

Nevertheless many people around the table spoke of a lack of sufficient resources.

A member who had medical qualifications said that without doubt  there were professionals with high standards, but this was merely the tip of the iceberg – she worked with children who were under the water and something had to be done to help them.

Another spoke about people who work in situations of emergency where they have little time. Placed in intense situations, with little time,  they sometimes  have a tendency to ‘close down’ conversations. So the first hints of sex abuse might be easily ignored.

Another participant said that there are huge numbers of children who do not get the kind of therapy that they need. She quoted a case of two children, aged five and seven, whose father had been abusing them and who was convicted of grooming children. They were given a new home in Scotland, but had never subsequently had therapy. Those children remain at risk as adults because they have not had any therapy.

She said that we have seen many stories over the past few years in different sectors of society where children have been failed.   What is coming out is that we haven’t taken this matter seriously. That, she thought,  is what we should really be looking at. We would not be overwhelming the whole system if we did that.

Against this, another participant said that if all reporting was mandatory to the local authority there would be a massive increase in reporting. She thought there would be a massive increase of reports of incest – and, at the moment,  the local authorities will not intervene in such cases.  

Even when the resources were present there could be problems in determining who had responsibility to take action. A probation officer reported that a system that they had used to report (48,000 cases a year) had failed because the social services had not acted upon the reports, thinking that the probation service was dealing with them.  In turn, the probation officers had thought that the reports had been dealt with. They  had begun to consider that risk to the child was the job of someone else, not of their service.

POLICE.

Mandatory reporting, as it was suggested in 2014, would have meant that reports would be made either to the Local Authority Designated Officers (LADOs) or the police.  Much was said at the symposium concerning the resources needed by both of these organisations in order for them to deal with reports. Lengthy, complicated and potentially hurtful investigations by the police were of particular concern.

One retired police present officer thought that everything should be cleared up before there was any approach to the police.  This should happen, he thought,  even if mandatory reporting were introduced.  His reasons for this were that  the Crown Prosecution Service require the police to submit evidence on every case and the police in turn need the cooperation of everyone to get the evidence. This takes up time and resources.

He considered that if others did not want the victims involved because they were children, the police would get nowhere with gathering evidence so it would all be a waste of time. He pointed out that  the police cannot force people to give evidence.

A psychotherapist sympathised with this opinion. She said that if everybody reported the slightest suspicion to the police, the police  could never investigate anything.  She thought that there was nothing that will make things right suddenly in cases of child sex abuse. She considered that more training and resources for people with children in their care would make things better.

The retired police officer thought that there should be a body of people where one might get advice as to whether a certain matter should be reported. He again questioned whether a case should ever be reported to the police since there was no guarantee that even more stress might not be put upon the victim.

From his own experience he knew that such investigations could be damaging. And this was not just in questioning the victim. He said he had frequently had to go to the victims and their families in order  explain why there is to be no prosecution.

Another participant wondered if reports to the police were necessary at all. She wondered if  local authorities could do the job – or perhaps  other safeguarding offices?

She also spoke about the level of suspicion which would require intervention. She pointed out that last year’s amendment, as it was written,  said that reports don't all have to go to the police. She pointed out that there are many statutes that, when breached, do not require reports to go to the police.  They do not have a criminal tariff attached to them if they are breached.  Why should non-reporting not be placed in this classification?

She considered that the general view around the table was that a suspicion should go to a guidance panel, not necessarily to the police.

Another  former police officer agreed that  mandatory reporting would create a real problem for the police if the victim did not want the case to go forward. Nonetheless, the police would have to investigate the allegation.

However, he considered that, in general,  the system actually works – a person is innocent until proved guilty – not guilty until proved innocent. So an allegation is only an allegation and may not  lead to an investigation.

He felt that where we are going wrong lies in the fact that the police need to rely on the Crown Prosecution Service to decide whether there is enough evidence or not. This takes time. He felt that in the process  the child is the one who suffers.

On the other hand, he pointed out that  young police officers today are not as naïve as he had been in his younger days. They knew better how to listen to children. To support this view that our perceptions and concerns had changed, he pointed out that  in the eighties there would not have been a symposium such as this. Such things did not happen.

Another participant summarised, saying that  if it is true at the moment that only a small percentage of cases come to the attention of the authorities, we must note that police forces are being cut every year.  The CPS is, of course, being cut likewise. She thought that with mandatory reporting, the police and the CPS would be inundated.

This would lead to a different problem. She thought that they  would fail to give the service that the general public expect. An unwarranted expectation would be created.

SUMMARY

The general view was that reform is necessary, but it must be made with due consideration of the resources already at the disposal of the authorities, rather than seeking more resources. This, despite a strong view expressed by some,  that protecting children from sex abuse -  sometimes overlooked or ill-defined in the past -  was necessary at any price.

Systems from other jurisdictions, particularly Australia and Canada were attractive. The research done on mandatory reporting in Australia was considered worthy of study. The idea of “good faith” reporting,  giving immunity to those reporting,  was serious consideration should mandatory reporting be introduced.

There was a strong body of opinion that mandatory reporting conflicted with the code of confidentiality between patients and clinicians. Several examples of the possible deleterious effect on the medical professions were mentioned.

There was also a strong body of opinion about the principles involving law if mandatory reporting were introduced. One such was the comment that mandatory reporting was directed not at the victim, nor at the perpetrator, but at a professional who was working within professional guidelines that were approved by the government.  

The general view was that statutory changes should not be made, but that all professional bodies and all institutions which care for children should have clear guidelines, understandable to all,  which are approved by government. Current training should incorporate sessions on such guidelines.

Since this reform would not cover a third category of area of child sex abuse – i.e. instances outside the professions and institutions – there was a suggestion that an accessible office should be set up to which all, including possible victims,  might go to get advice about where they might report suspicions.