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Community child health in crisis

Commentary on the leading article by Mather (see pp 697–704)

In her personal view, Dr Mather has hit the nail on the head when she describes the world as currently viewed by many community paediatricians.1 On the one hand, most paediatricians who hold a post with the word “community” somewhere in their title or job description would talk enthusiastically about the uniquely varied, challenging, and frequently rewarding nature of their clinical work. However, they will also readily identify and expand on the frustrations, anxieties, and challenges identified within the paper.

Community child health does appear to have somewhat of an image problem. It can be difficult to describe in a few sentences to a layperson what it is exactly that community paediatricians do. Colleagues in other braches of child health would have no difficulties in this respect and would accurately convey an easily understood image of their profession by saying “I look after sick newborn babies” or “I am a children’s doctor who specialises in diseases of the nervous system”. I challenge any community colleague to summarise their work in a similar fashion without resorting to such jargon as “social paediatrics”, “health promotion”, or “child advocacy”, terms which, though admirable in their own right, do not easily lend to an appreciation of who community paediatricians are or of their unique contribution to child health and welfare. This confusion may not be limited to the public. I remember some years ago referring a child with chronic nephrotic syndrome to a tertiary …