Thousands of professionals dealing with cases of suspected child abuse rely on the principle, enshrined in the Children Act 1989, that the welfare of the child should be paramount at all times.
So many could have been worried by the potential conflict created by recent legal action taken by parents wrongly accused of abuse, who attempted to establish that health and local authorities were also liable for their welfare in such cases.
However, last week the House of Lords ruled in favour of the health authorities in East Berkshire, Dewsbury and Oldham, and Kirklees Metropolitan Council (Children Now, 27 April-3 May).
They argued that if social workers and doctors owed a duty of care to parents, this could compromise their duty to the child and increase the risk of abuse.
Relief across the sector
There has been a palpable sense of relief among social workers and paediatricians following the ruling.
John Coughlan, who chairs the Association of Directors of Social Services' children and families committee, is typical of many: "We have sympathy with any parent who feels they haven't been treated fairly. But we can't afford for children's professionals to compromise their decisions around protecting children."
Bertie Leigh, senior partner at Hempsons and the solicitor who conducted the case for the NHS trusts, says winning the case will provide a much-needed boost to the morale of paediatricians, which has been dented by negative publicity surrounding the wrongful conviction of a series of mothers based on evidence by paediatrician Professor Sir Roy Meadow.
Leigh says: "If it had gone the other way it would have been very damaging. It would have been a further discouragement to go into the area, with the law further prompting a society that does not rate child protection very highly."
Nevertheless, the cases of the three families involved make for difficult reading.
The first claim was brought by a mother diagnosed by both the paediatrician Professor David Southall, and a subsequent doctor, as having Munchausen's Syndrome by Proxy. Her son was put on the child protection register but was later diagnosed as having severe allergies.
In the second case, a father was accused of sexually abusing his nine-year-old daughter. Twelve days later, doctors accepted there was no abuse after diagnosing a rare skin condition.
A doctor involved in the third case, where a baby girl was diagnosed with an inflicted injury, failed to carry out a test for brittle bone disease despite being asked to do so by his local council.
The five judges were faced with the choice of ruling in favour of local authorities having a duty of care to the child, to the parent, or to the child with a limited duty to the parent.
Four sided with the first option, deciding that the defence of this general principle outweighed the "legitimate grievances of parents" no longer suspected of abuse.
But one, Lord Bingham, argued that the case should go to trial.
When the Lords strike out a case, they take the facts at face value.
As they have not been proved, effectively they are no more than allegations.
Bingham argued that liability to parents - and children - could not be decided by the Lords before the facts of the cases had been fully explored and verified in a court.
He was also sceptical of claims that paediatricians were likely to be swayed by parental pressure.
Accountability is still important
Liz Goldthorpe, chair of the Association of Lawyers for Children, disagrees with that. "If the system is constantly having to look over its shoulder it will drive a coach and horses through child protection," she says.
However, she believes professionals need to be held accountable if they fail to discharge their professional duty. "If they are just struck off by the General Medical Council it does not provide sufficient compensation to a child who's been separated for eight months from their parents."
She also says the lack of attention that agencies pay to listening to parents needs to be tackled, pointing to comments on cases by Mr Justice Munby of the High Court Family Division.
"In one case he talked about a 'mindset culture that militates against hearing properly'," she says. "There are some local authorities who do listen but many don't."
Leigh says paediatricians will inevitably make mistakes when diagnosing cases of child abuse because the role is investigative but, unlike other diagnoses, they are not able to manage the whole process themselves.
"They are not investigators. Their job is to put forward a single piece of the jigsaw, so they will frequently raise suspicions when it's wrong. But as the Climbie case showed, you must communicate first and never wait for the full diagram."
KEY QUOTES FROM THE JUDGMENT
- Lord Nicholls: "The best interests of a child and his parent normally march hand in hand. But when considering whether something does not feel 'quite right' a doctor must act single-mindedly in the interests of the child"
- Lord Bingham: "If the authority is to be made liable in damages for a negligent decision to remove a child ... there would be a substantial temptation to postpone making such a decision until further inquiries have been made in the hope of getting concrete facts"
