Welfare staff urged to shun child abuse unit

Safety fears: Call for a review of hospital's covert video surveillance

Social workers have been warned not to send children to a Midland child abuse investigation unit which operates a controversial surveillance system unless given guarantees for their safety.

The Independent has learnt that parents managed to injure their babies before nurses at North Staffordshire Hospital NHS Trust, in Stoke-on-Trent, who were watching on a secret closed-circuit television link, could summon help. One child's arm was broken and there were several cases of attempted suffocation.

Writing in this month's Journal of Medical Ethics, Donald Evans, director of the Centre for Philosophy and Health Care at Swansea University, warned that children who are secretly filmed under covert video surveillance (CVS) at North Staffordshire are at "heightened risk of physical assault and injury, including fractured limbs, poisoning, suffocation, physical attack with implements and finally emotional abuse."

Babies sent to the hospital for child abuse investigations are deliberately left alone with their suspected abusers in order to obtain videotaped evidence of an anticipated assault for court proceedings. Video cameras in the CVS suite are hidden and parents are unaware they are being filmed. No more than 10 seconds should elapse before intervention is initiated and no more than a further 15 seconds before a nurse arrives to protect the child. In September 1992 - two months after CVS was set up at the hospital - a mother broke her baby's arm before staff could intervene.

The month-old baby was under surveillance because the mother was suspected of causing repeated apnoea attacks, or breathing fits. The defence claimed the mother was suffering from post-natal depression. She was given an 18-month custodial sentence.

When told that there was confirmation of a child having had its arm broken, Dr Evans warned social services departments that they should "obtain guarantees as to the safety of children they send to North Staffordshire Hospital now that the risks were known, or they will be culpable".

CVS, which is practised in about 10 hospitals around Britain, has been the subject of fierce debate in the Journal of Medical Ethics. Its critics claim that CVS breaches the spirit of the Children Act 1989, is a forensic operation that should be left to the police, and that the interests of innocent parents are inadequately protected.

The Royal College of Nursing has voiced "concerns" about the practice , although it accepts that in some cases it could be considered "necessary".

A spokeswoman said: "The RCN believes that if the purpose is solely to provide evidence for the prosecution of the perpetrator, whilst it may be ethically defensible for covert video surveillance to be carried out, the actual video monitoring and behaviour interpretation should not be a nursing activity."

Dr Martin Samuels, consultant paediatrician at North Staffordshire, said that CVS had been used about 40 times and in "the vast majority of cases" abuse had been detected. It was only used as a last resort, and after a case conference which included representatives from the police and social services. "Ideally this should be a police activity but Staffordshire Police were not willing to undertake it," he said.

However, Brian Waller, of the Association of Directors of Social Services said: "CVS is a relatively new technique and a clinical review of its effectiveness might now be appropriate."