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Safeguarding experts have warned that a third of all children’s acute hospital beds in parts of England are being occupied by vulnerable children, who do not need acute medical care but have nowhere else to go.

Doctors have stated that they feel like expensive ‘babysitters’ for vulnerable children, most of which are in care but suffered a placement breakdown due to their self-harming or violent behaviour. Many of the children have severe neurodevelopmental or eating disorders and require specialist care that is not available on ordinary children’s wards.

Dr Emilia Warwrzkowicz, a paediatric consultant who is the assistant officer for child protection at the Royal College of Paediatrics and Child Health (RCPCH) stated “It is estimated that roughly a third of acute hospital beds at the moment are full of these vulnerable young people, many who are subject to child protection plans, or they are already children in care, living in residential placement that is falling apart.”

Police are often called to assist in restraining the children, or to bring them back when they run away. Many paediatricians have stated that they have had to deal with vulnerable children who were not physically ill but displayed such challenging behaviour that they could not be looked after in children’s homes.

Although many of these children are in extreme distress, they often have no diagnosable mental illness and do not qualify for a psychiatric ‘tier four’ bed. Unfortunately, those who do qualify cannot often get one as the beds are so limited.

Dr Vicki Walker, a consultant paediatrician who is the looked after children representative on RCPCH’s safeguarding committee suggested that the detention of vulnerable children on acute wards was a sign of multiple societal failures. She stated “it is the end point of a very traumatic life. We need to look at what has happened in the run-up to see what support they and their family received, this is a while-societal issue, and it ends up with these very vulnerable children feeling that no one else wants them.”

The chair of the National Network of Designated Health Professionals advised that the hospital setting in combination with the police involvement is worsening the situation. He stated “If you sit down, shut the door and keep the police officers out of the way and have a caring, relational approach, then suddenly all the anger disappears and the tears start because they are very, very unhappy, and very tragic characters. And they need all the love and care and support we can give them.”

Statistics from the Children’s Commissioner indicate that there has been a sharp rise in English council’s applying to Court to deprive children of their liberty. In March 2020 327 applications were made, increasing from 215 in March 2019 and 103 in 2018. These applications are often made due to a child requiring a place in a secure children’s placement but none are available.

It is clear that vulnerable children, particularly those within the care system are facing a challenge that involves a lack of resources and funding. It is clear that steps are required from the government to assist the outcry for support. It will be interesting to note whether the recent government announcement regarding the increase in National Insurance Tax will aid in meeting the demand for specialist placements for vulnerable children within social care.


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