Here are just some of the issues raised by the plans for the NT. Unfortunately, I’m not sure that the Federal Government has given much thought to them as yet …
1. “Compulsory health check” for under 16-year-olds sounds as though it might be code for “s-xual abuse health check”. Unfortunately, no such thing is available to health workers. One can test for s-xually transmitted infections (STIs) with swabs and ur-ne tests, as well as blood tests, but these will only pick up those with an infection, and would obviously miss any who had been s-xually abused but did not have an infection. Furthermore, no test is perfect, and sometimes a test will come up positive when in fact no infection is present. To complicate matters, although an STI in a pre-pubertal child will nearly always indicate some s-xual abuse, it is not 100% true, especially with very young children (under three years old) who may acquire some STIs (such as chl-mydia) from their mother at the time of birth. These infections may stay for some years before spontaneously resolving. In adolescents, STIs may be evidence of consensual s-xual activity with another adolescent of the same or similar age. Currently in Qld, s-xual activity under the age of 16 is illegal, so screening large numbers of under-16-year-olds for s-xual activity may end up criminalising adolescents who are having healthy, consensual s-x.
2. If no STIs are found in an individual child or adolescent, this, of course, does not rule out s-xual abuse having taken place. There are generally no reliable signs to be found on examining an adolescent (and many young children) that would allow a diagnosis of s-xual abuse to be made with any confidence.
3. Who is going to carry out these compulsory health checks? Doctors, nurses, and child safety officers are already in very short supply throughout northern and central Australia, and many positions are already currently unfilled. To find the hundreds of workers necessary to make any long-term difference will be almost impossible. Also, many health workers would feel very uncomfortable with carrying out “compulsory” health checks on any young person. What if a 15-year-old girl or boy does not consent to be examined? How will they be “forced” to do so? What if parents do not consent? Will the health worker, with the assistance of the police and/or military, ride roughshod over the parent’s wishes and force an adolescent to submit to an intimate examination? How many of us would like such an approach for our children, in our communities?
4. If a diagnosis of s-xual abuse is made, who is going to look after these children? Will they remain in a dysfunctional, and possibly abusive, family situation, or be removed from their community to live possibly hundreds of kilometres away, away from family, supports, and all they have ever known? Shades of the Stolen Generation …
5. How will the legal system cope with an influx of dozens, or possibly hundreds of charges, of s-xual abuse, in remote areas, often among people whose knowledge of English and the legal system is rudimentary?
And Simon Chapman, professor of public health at the University of Sydney, writes:
Those wanting more of an idea of what’s involved in investigating s-xual abuse should check out this expert report, which sets out in huge detail, gold standard guidelines for paediatricians and other health workers seeking to investigate whether s-xual abuse has occurred, using principles of scientifically
evidence-based, caring, consultative and ethical medical practice.
Try to then mentally match even a fraction of these considerations with possibilities likely to be involved with the army, police and strike-force doctors model. If good is to come out of this, the welcome political will in Canberra needs urgent tempering with the what we all trust will be many willing and wise voices around the country whose experience will not allow it to degenerate into a tragic fiasco.