Key messages

  • Vulnerable children exposed to child abuse and neglect need protection and support so they have the best chance in life.
  • Health services and health professionals have a responsibility to protect and promote the safety and wellbeing of vulnerable children.
  • Legislation requires health services staff to report suspected child abuse.
  • Health services should ensure that organisational systems are in place to support vulnerable children in line with the departmental quality framework Health Care that Counts.
  • The Department of Health & Human Services has a range of educational tools and resources to help health professionals understand their responsibility to vulnerable children including an e-learning portal – Children at risk.
  • The department has several specialist health programs and priority access health services targeted to children who have experienced child abuse and neglect.

The Victorian Government funds a range of health services for children and young people in Victoria. It aims to improve outcomes for vulnerable children and their families.

Victoria's vulnerable children – Our shared responsibility strategy 2013-2022

The strategy outlines collaborative governance arrangements and a performance and accountability framework that provides a set of goals, key outcomes and indicators that aim to reduce the incidence of vulnerability.

Child health guidelines

The Victorian Government’s Community Health Program provides state funding for organisations to deliver primary health and community-based support services to meet local needs. The Community Health Program provides over one million service hours of allied health, counselling and nursing each year. The child health guidelines set out what is expected of child health services provided through the Community Health Program.

Children at risk learning portal

This e-learning portal supports health professionals in their early identification of and response to children at risk of child abuse and neglect. It is widely used across the health and welfare sectors, and the Department of Health & Human Services continues to build resources on the portal.

At the portal, Health professionals working together to keep children safe is an online resource  available at no cost, for health professionals working in Victorian health settings.

This resource helps all health professionals to:

  • identify vulnerable children
  • respond to suspected abuse or neglect
  • understand the child protection and family services system.

Vulnerable babies, children and young people at risk of child abuse and neglect

The current framework applying to acute health services is the Vulnerable babies, children and young people at risk of child abuse and neglect: best practice framework for acute health services 2006. This framework is being revised and expanded to include all health services in Victoria and will be known as Health Care That Counts: A framework for improving care for vulnerable children. It is expected that this framework will be available by the end of 2015.

The Vulnerable babies, children and young people at risk of harm: An intervention guide is available to provide a short step by step guide for health professionals to assess and act where there is a suspicion of non-accidental harm to a child.

All Victorian children need a nurturing and supportive family and community, to achieve their full potential. For vulnerable children exposed to child abuse and neglect, our health system must be responsive, knowledgeable and proactive in identifying and responding to children where there is suspected child abuse and neglect.

Working within a health setting, we must all watch out for vulnerable children. When working with any family, health professionals should be open to the possibility that any child could be vulnerable to abuse or neglect.

  • Be mindful of situations and behaviours that suggest a child’s vulnerability.
  • Consider the impact of any parental incapacity on dependent children.
  • Be calm in situations of suspected abuse or neglect.
  • Seek the advice of a senior staff member.
  • Act promptly.

Resources and information for health professionals

Children at Risk Learning Portal

This e-learning portal supports health professionals in their early identification of and response to children at risk of child abuse and neglect. It is widely used, and the Department of Health & Human Services continues to build resources on the portal.

At the portal, Health professionals working together to keep children safe is an online resource for health professionals working in Victorian health settings.

This resource helps all health professionals to:

  • better identify vulnerable children
  • better respond to suspected abuse or neglect
  • better understand the child protection and family services system.

Legislative responsibilities for health staff

Mandatory reporting of suspected child physical or sexual abuse

Doctors, nurses, teachers and police must report suspected child physical or sexual abuse to the child protection service. This mandated obligation is set out in s184 of the Children, Youth and Families Act 2005.

Professionals are mandated to report child abuse

  • when they form a belief on reasonable grounds that a child needs protection from physical injury or sexual abuse
  • where they form this belief while practising a mandated profession
  • each time they become aware of any further reasonable grounds for this belief.

'Forming a belief' is the process of asking whether you are more or less likely to believe the child faces significant harm based on the information available. It does not mean you have to prove the abuse has occurred or is likely to occur.

The children at risk e-learning portal provides resources for mandated reporters

Failure To Disclose Sexual Offence On A Child Under 16 Years

A new criminal offence imposing a legal duty on all adults to provide information to the police regarding child sexual abuse became law in Victoria in October 2014. This criminal offence is found in the Crimes Amendment (Protection of Children) Act 2014 ss 327 -330 and will include all adults working within Victorian health settings.

The Act requires that any adult who forms a reasonable belief that a sexual offence has been committed by an adult against a child under 16 has an obligation to report that information to police. Failure to disclose the information to police is a criminal offence.

Visit the Department of Justice website for more information and a downloadable factsheet

Reporting multiple deaths

A death must be reviewed by the Victorian Coroner when it is a second or subsequent death of a child under the age of 18 within the one family. 

Children who are stillborn or children who lived their entire lives in hospital are not considered reviewable deaths, unless otherwise determined by a coroner. Medical practitioners must tell the Coroner when they identify a reviewable death.

For more information, please go to the Coroners Court of Victoria website. 

Protecting vulnerable babies, children and young people is everyone's business

Health care that counts: A framework for improving care for vulnerable children in Victorian Health Services sets out what all Victorian health services, need to do to identify, protect and support vulnerable children and families.

The framework specifies principles and action areas to guide health providers and health professionals to identify, respond early and support vulnerable children, to protect them from harm and to improve the quality of health service provision.

The Action Areas provide a quality assurance mechanism for health providers. 

The five action areas to make health care count for vulnerable children and their families are:

  • Action area 1: Governance for safe, high quality healthcare for vulnerable children and families
  • Action area 2: Access for vulnerable children and families
  • Action area 3: Family sensitive and inclusive practice
  • Action area 4: Working together
  • Action area 5: Effective communication and information sharing

Timeframe for finalisation of the framework

The framework is currently being finalised and will be available to health services by the end of 2015. The framework is being expanded to include health settings such as community health, mental health, drug and alcohol services as well as acute health services. Under the annual departmental funding and policy guidelines for health services (part 3) an annual report on progress under the framework is required.

Specialist health programs for children at risk

Victorian Forensic Paediatric Medical Service (VFPMS)

VFPMS is a statewide, coordinated specialised paediatric medical service that provides 24-hour forensic clinical examinations and assessments for children under the age of 18 when child abuse is suspected. VFPMS provides assessments for suspected physical abuse, sexual abuse and severe neglect.
Its services include:

  • evaluation of injury
  • specialist expertise for sexual abuse examinations
  • holistic health and developmental assessments for children with complex needs
  • integrated health care with coordinated referral and follow-up
  • comprehensive reports and participation in legal proceedings
  • statewide advice and consultation 24/7
  • education, training and research.

VFPMS only works with children who are referred from Child Protection, Victoria Police or other health professionals. VFPMS provides a comprehensive forensic assessment report and expert evidence in any court proceedings relating to the child. Its service is free and can be accessed at Royal Children’s Hospital or Monash Medical Centre, or via regional hospitals.

Call 1300 66 11 42

Children in Out of Home Care

Pathway to good health

Children residing in the statutory out of home care system have experienced a level of child abuse and neglect that has meant that they are no longer to live safely with their families. These children as well as experiencing significant trauma in their lives also have health outcomes that are much poorer than the general child population.

To ensure that these highly vulnerable children receive the best possible health care to address health deficits, a model of coordinated care and health planning has been developed and funded by the Department known as the Pathway To Good Health. This model has had a phased implementation across Victoria and is currently available within the North and West metropolitan areas of Melbourne and the Gippsland region. The service focusses on all children who enter out of home care for the first time and all young people residing in residential care.

Under the program, these children have access to a coordinated pathway that includes:

  • an intitial health check by a selected general practitioner
  • a priority referral to a specialised clinic led by a paediatrican that provides a multi disciplinary assessment that includes mental health and speech pathology
  • a completed health care management plan with assessments and recommendations for treatment that can be incorporated into ongoing health planning and the child’s statutory case planning process.

A child can only be referred to the Pathway To Good Health by the child protection or out of home care agency working with the child. To see more about the Pathway To Good Health please view a short 5 minute video available at Networking Health Victoria. Log in as non GP and using the log in details:

Username: dhgeneric Password: Health@4527

Priority access to public dental services

Dental health is a vital part of overall child health and for children in out of home care their dental health is prioritised under our public dental system. All children and young people in out of home care are eligible for priority access to public dental services. This means that children can access the next available dental appointment for routine dental care at no cost.

Chief Psychiatrist guidelines - priority access for out of home care

The Chief Psychiatrist guidelines provides priority access for both children within the out-of-home care system and those responsible for caring for the children with access to either primary, secondary or service level consultations via the centralised triage process for mental health.