Introduction
Ensure a medical examination is conducted in all cases of alleged or suspected physical or sexual abuse or severe neglect unless there is a compelling rationale not to.
A decision not to conduct a forensic medical examination where any of these circumstances apply must be made in consultation with the team manager or practice leader and must be endorsed by the Deputy Area Operations Manager or above. A detailed rationale for the decision must be documented on CRIS in a case note.
Wherever possible, parents should be involved in decision making and supporting their child through the examination process.
For additional information see Medical and forensic examinations - advice.
Procedure
Case practitioner tasks
- Consult your supervisor about the need for a medical examination with reference to:
- the presenting issues, possible seriousness and urgency
- the appropriate service to conduct the examination
- the child’s views and wishes
- the parents’ known or likely views
- the legal status of the child
- the role of police.
- Inform, consult and seek the consent of the child’s parents where possible unless this would be contrary to the child’s best interests.
Wherever possible, parents will be informed, consulted and appropriately involved in any medical examination or treatment planned for their child. Usual practice is to seek parental consent for examination and treatment regardless of whether the legislation requires consent or not.
Where a child with sufficient maturity and understanding may provide consent, parental consultation is required if the child is not subject to a care to Secretary or long-term care order (or any order specifying a relevant condition).
- In all cases of alleged or suspected physical or sexual abuse or severe neglect, adhere to the requirement of the protocol with Victoria Police. See Police protocol.
- See Consent for medical examination and treatment for the procedure regarding obtaining consent for medical examination or treatment.
- If the child is in the care of a parent, obtain parental consent for the examination or consult your supervisor about seeking a court order to enable the examination to proceed. Refer to Temporary assessment order (without notice).
- If the child is living in out-of-home care, inform and consult with the child’s parents where possible. If the placement is managed by a community service, consult with the community service care manager.
- In all cases, consult the child if they have sufficient maturity to consent to the examination. The examination will not proceed where a competent child expresses that they do not consent.
- Consult the team manager and your legal representative or the Child Protection Litigation Office (CPLO), if adhering to the child’s stated wishes will pose a significant risk to their health.
- Seek written approval for the examination from the team manager if the child is living in out-of-home care subject to an interim accommodation, family reunification, care by Secretary or long-term care order or a therapeutic treatment (placement) order, and requires an examination to determine their medical, physical, intellectual or mental condition.
- For a forensic medical examination, contact the Victorian Forensic Paediatric Medical Service (VFPMS) to arrange the appointment. Refer to VFPMS website at: Victorian Forensic Paediatric Medical Service (VFPMS).
- If Victoria Police is involved, discuss with police who will take the lead in arranging the examination.
- If you cannot access the VFPMS, contact the Royal Children's Hospital (9345 4299) or Monash Medical Centre (9594 2155).
- If an examination is required outside normal business hours, contact the VFPMS central number (1300 661 142) to confirm which hospital will undertake the examination.
- If the child is outside metropolitan Melbourne, refer to the VFPMS website and consult your supervisor about appropriate local medical services.
- Provide the examining medical practitioner with information about the:
- role of Child Protection
- purpose of the examination
- requirement for a written report and photographs
- potential for the medical practitioner to give evidence in court at a future date.
- Accompany the child or arrange for a suitable support person to attend the examination with the child.
- Attend the examination to provide information and receive immediate feedback if the outcome may lead to urgent protective intervention.
- If an urgent forensic medical examination is required, request an initial provisional opinion report and any clinical photographs on completion of the examination. Following phone contact, make all further requests for documentation in writing.
- Follow up recommended medical assessments or interventions arising from the examination in discussion with the family.
- If Victoria Police is involved, ensure all reports arising from the examination are made available to police.
- Update the essential information categories with information or evidence that is obtained from the medical assessment.
- Undertake a risk assessment or review risk assessment where a risk assessment has been completed.
- Ensure there is a comprehensive record in CRIS, including the parents’ and child’s views, legal or other consultations, summary information arising from the examination, recommendations, decisions and approvals and the rationales for these.
Supervisor tasks
- Provide ongoing supervision and support.
Team manager tasks
- Approve medical examination and treatment where required.
- Endorse the risk assessment.
Deputy area operations manager
- Engage in discussions with team manager/practice leader when it has been recommended not to conduct a forensic medical examination when there is an alleged or suspected physical or sexual abuse or severe neglect.
- Endorse this decision (where appropriate) and record a detailed rationale on CRIS for this decision.
Area executive director or director, child protection task
- Approve the medical treatment against a parent’s wishes when in the best interests of the child.