All children, regardless of their age, gender, ability, race or sexual orientation, have the right to be safe and feel safe.
Any health or hospital-based organisation whose work impacts children and young people now has not just a moral, but a legal responsibility to ensure children and young people are protected from harm.
Easy to do, right?
Wrong. It’s easy to say. But making it happen in practice takes a lot of hard, committed work, right through your organisation. And it has to come from the top. I’ll talk about this more in a moment, but firstly let’s quickly recap this legislation.
NSW (along with Victoria) is leading the way in Australia in a recent set of changes to the law which seek to make children safer than ever in all of the key institutions that work with children — and the health and hospital sector falls squarely within its sights.
To be clear, there have been obligations to implement child safe practice in NSW since 2019. But in November 2021, NSW legislated the requirement for our sector to implement the 10 National Principles of Child Safe Organisations — and it also created an associated enforcement regime. The health and hospital sector is obliged to understand and implement the 10 NSW Child Safe Standards.
This complements the ‘Reportable Conduct Scheme’ that NSW has had in place since 1999, which requires certain types of conduct against children (‘reportable conduct’) committed by adult employees and other adults associated with an organisation to be reported to a centralised oversight body.
So where did these 10 Child Safe Standards come from? These aren’t ‘just another set of regulations’ that were dreamt up by governments. They derive from the recommendations made by the Royal Commission into Institutional Child Sexual Abuse, based on the testimony of thousands and thousands of survivors of child sexual abuse. Child Wise was indeed the original author of the Standards that were taken forward by the Royal Commission and spent years distilling these from our work with children and our experience with the key things that move organisations forward in making themselves safe from child abuse and neglect. The approach to the NSW Child Safe Standards was strongly endorsed by NSW Health, which has made a firm commitment to the implementation of the Standards.
It’s important to remember that you can’t just create “Policies and procedures” to meet the standards and think this will have ticked off compliance. As the NSW Office of the Children’s Guardian says in its NSW Guide to the Child Safe Standards, “Policies and procedures are not enough on their own to protect children from harm.” Don’t get me wrong, policies and procedures are important. Setting up and following good safeguarding policies and procedures means that organisations can more effectively prevent harm to children and young people, are more alert to signs of risk and can more effectively respond should harm occur.
But when organisations in the health and hospital sector engage us to support them with compliance (and to make them more than safe), we often find that the starting place of ‘policies and procedures’ can sometimes be thought of as ‘enough’.
The health and hospital sector across Australia is challenged the most by the vital second standard, that “Children [in your organisation] participate in decisions affecting them and are taken seriously.”
The Royal Commission into Institutional Responses to Child Sexual Abuse was flooded with cases where children tried to communicate horrific things but were silenced. Silenced not just by a refusal to listen, but by subtle actions of adults that indicated to them that a culture existed where no-one wanted to hear them.
It sounds simple. But when it comes down to brass tacks, many health organisations say of their day-to-day practice “how can we really bring the child’s voice and decision making in our everyday work?” Well you can. And you must.
If we are genuinely listening to the voices of children first, we must have a genuine desire to actively listen and observe, not just take a passive, lip service-style approach.
If the children and young people in your organisation aren’t enabled to speak up, challenge and contribute, then adults continue to speak to adults about issues that affect children, their safety and wellbeing.
Empowering children and young people to be active, vocal and confident participants in your organisations is essential if you are to become genuinely ‘child safe’. Listening to children is critical for organisations to understand what they perceive to be a safe environment and who they trust in communicating key messages to them.
Most often, we see the decisions about what is needed to make children feel safe being made as part of a risk or audit framework, decided by adults who govern these areas in an organisation.
In Victoria, one of our clients (the equivalent of a NSW LHD) advocated a small change which speaks volumes; the Victorian Healthcare Experience survey (VHES) is a survey that all Victorian Public health services are required to send to patients on behalf of the state government. Previously when the patient was a child, the survey was addressed to the parent/carer to complete. During consultation regarding changes to the survey, our client advocated strongly for the voice of the child to be captured in these health surveys and now there are specific questions addressing the child’s experience of the health system. These are small but critical steps.
By Natalie Siegel-Brown
First published in Hospital and Healthcare 17 January 2022 - image credit: ©stock.adobe.com/au/Chinnapong
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