Tuesday, December 15, 1998 Published at 15:07 GMT
West case that haunts NHS staff
25 Cromwell Street - scene of the Wests' murders
The NHS in Gloucestershire has been criticised for failing to improve its child protection service in the wake of the Fred and Rosemary West case.
It adds that many health professionals are unfamiliar with the guidance, that care agencies specialising in child protection are not working well together and that most health workers have not been trained in how to spot and care for child sex abuse victims.
Only one in four had attended training in recognising the signs of child sex abuse and only one in eight had finished the full course.
The report by a team led by barrister David Spicer says: "It is clear that arrangements for child protection have not been given the status and consideration during recent years that the government expects."
The West case
Care agencies were slammed following the West inquiry for failing to intervene despite numerous signs that Fred and Rosemary West were abusing children over a period of more than 25 years.
The Spicer review makes 34 recommendations on issues including improved training for health staff in child protection.
The health authority says it has drawn up an action plan to implement the recommendations, but adds that it has made some progress since the review started last year.
But Charles Lomas, regional representative of the Community Practitioners' and Health Visitors' Association, said the problem was one of resources.
"If proper investment and care had been made to ensure professionals were able to carry out their work on child protection we would not have the report that Spicer has produced showing the many deficiencies that have occurred," he said.
He added that social services in Gloucestershire had been "severely underfunded" for many years and the NHS had been forced to "take up the slack".
There had also been cutbacks in health visitors which had left vulnerable people at risk, he said.
"The work carried out by Spicer should have been considered before any decisions on cutbacks were taken," he said, adding that people had "gone back to sleep" after the West case and needed to put more attention into child protection.
The health authority is planning to make £100,000 of cuts in health visiting by next April.