Reporting abuse (par 27)
Aspects of this new duty are uncertain. They do, however, go significantly beyond the duties imposed under sections 151, 152, 195 and 195A of the Crimes Act 1961 (introduced in March 2012) to take steps to protect a child or vulnerable adult. For example, s151 provides that everyone who has actual care or charge of a person who is a vulnerable adult and who is unable to provide himself or herself with necessaries is under a legal duty to take reasonable steps to protect that person from injury.
By reference to the Crimes Act, “vulnerable patients” will likely be interpreted as including “vulnerable children” (those under the age of 18 as established by s152) and “vulnerable adults” (defined in s2 as meaning “a person unable, by reason of detention, age, sickness, mental impairment, or any other cause, to withdraw himself or herself from the care or charge of another person”).
There is no definition in GMP of “vulnerable patients” or “abuse or neglect”. There is tremendous scope for confusion for doctors in applying, and thus complying, with this standard, particularly in circumstances were there will inevitably be a number of competing and potentially inherently incompatible considerations and interests.
Nor does GMP provide any guidance on what the “appropriate authorities” might be. In some circumstances doctors might regard a clinical Child Protection Team as more appropriate than the police or child, youth and family.
The term “without delay” could also be subject to differing interpretations. If a doctor notifies too quickly without obtaining and/or checking relevant facts, they could equally be subject of later criticism. In a criminal context, “without delay” has been interpreted as being not synonymous with “immediately”; and that it is a matter of what is reasonable in each case (Elliott v Police HC Dunedin AP15/97, 16 April 1997).
The new duty is also potentially confusing about a doctor’s duty where the reporting of abuse might cause danger. It states: “You should inform the patient, and if the patient is under the care of another person, his or her caregivers of your intention to report your concerns, taking into account that such action might endanger you or the patient.”