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The aim of this report is to highlight the duty that health care personnel have to inform child welfare services when they are concerned about a child.

We have done this by summarizing available knowledge from statistics, research and investigations, and from the experience we have gained from supervision.

Health care personnel have an indivi­dual duty to inform child welfare services if they have reason to believe that a child is being mistreated in the home, or being seriously inadequately cared for in other ways. When we reviewed our supervision cases, we found few cases about health care personnel not informing child welfare services about their concern for a child. Most of the cases sent to the supervision authorities related to concern that health care personnel were in breach of their duty of confidentiality by sending a report to the child welfare services.

A review of the supervision reports showed that the majority of the services we have investigated had no manage­ment system for ensuring that the staff are given adequate training regarding the legislation, their duty to report and their duty of confidentiality.

There is a large amount of research literature on child abuse and inadequate care. This shows that these are two of the most serious risk factors for many types of physical and mental disorders and problems among children. 

However, we have little knowledge about the way in which health care personnel meet their duty to inform child welfare services.

Our summary shows that health care personnel and others should be more alert about possible child abuse and inadequate care, and that they should have a lower threshold for contacting the child welfare services. The problem is: “You don’t see what you don’t believe”.