A number of barriers prevent children from visiting a GP. These include lack of trust in children’s social care services, GPs not trusting children’s social care, and a focus on the relationship between parent and child. Further, the role of universal services is questioned. Listed below are some of the barriers to child health care in general practice. To address these issues, more GPs are adopting direct responses to maltreatment concerns.
Barriers to gp for children
A recent study of barriers to GP visits among New Zealand children showed that Maori and Pacific children had higher odds of hospitalisation than other children. Compared with New Zealand European children, Maori and Pacific children had twice the risk of being admitted to hospital. This difference is particularly significant for those who have difficulties obtaining an appointment at their GP. A study of GP visits among New Zealand children in New Zealand identified three main types of barriers to seeing a GP.
The findings suggest that barriers are largely a matter of affordability and convenience. Children from low-income families are particularly at risk of not accessing a GP because of costs and availability of time off. In addition, some barriers can be explained by social determinants of health such as racism. Still, barriers may be more complicated by other factors such as the cost of transport or having to arrange after-hour care for dependent children.
GPs don’t trust children’s social care
One report found that GPs don’t trust children”s social care services. The authors based their conclusions on three studies – two randomised controlled trials and one qualitative study. The latter described the direct response as ‘case-holding’ where the GP’s relationship with the parents was key to the child’s welfare. One qualitative study noted that GPs did not report referral thresholds, which could result in a false perception of the severity of a child’s situation.
The research found that GPs don’t trust children”s social care services, with some exceptions. Until recently, referrals to children’s’ social care were only made after GPs had been convinced that a child was the victim of physical abuse. However, many GPs now collaborate with children’s’ social care teams, despite the lack of trust between the two groups.
GPs focus on relationship with parent
The GPs’ focus on the relationship with the parent for children is in line with guidelines for child health, which describe the normal development of children during their first five years. The guidance also urges GPs to discuss broader family issues with parents during child health consultations. However, the GPs’ focus on the relationship with the parent for children is not systematically evaluated or trained. Instead, this guidance aims to help them identify the kinds of support that parents need.
Participants in the study were given detailed information, including the study’s objective and methodology. Written informed consent was obtained from all participants. The study was approved by the Medical Ethics Committee of Maastricht University Medical Centre. The focus groups were conducted from July to September 2013. The focus group guide was developed with the help of existing literature and a priori expert discussions. The questions focused on different aspects of the GP consultation with the parent and included both the parent’s perspective and the GPs’ perspective.
GPs record information for case-finding
This study aimed to explore whether GPs consistently record information for case-finding for children with acute infections. In this study, GPs recorded vital signs of a sample of children aged 5 years or younger more often than they did for children aged older than this. The results revealed a marked improvement in the recording rate of vital signs for children who were ‘well’. The findings were in line with existing literature, although some limitations may have prevented detailed documentation.
Most parents who call the MPS don’t have their children permanently with them and may want to check on antibiotic allergies. Sometimes, however, the father needs information for case-finding while the child is with their ex-partner. It is also possible that the child’s mother is living with another partner and the father wants to track her down. Alternatively, the father might want to get the mother’s address to contact her. The GP for children should be able to provide these details if it is appropriate.