If we look at child sexual abuse as a major heath problem for children which is where I started off, and if we consider that we are pretty conservative in the uk and most people would say that its more than well over 10% of children are affected by this - but as I say we are conservative and so I keep it to 10% for the audiences I speak to because if you put it up higher than 10% most people shut off and cease to listen to you. It affects all social strata and cultural groups, has serious long term morbidity particularly in mental health problems and serious implications for society in general. As I understand it from colleagues in the States and the UK it seems that early intervention with abuse specific programmes of therapy is likely to be cost effective and have beneficial effects for children and their families. So why is it that in the face of that evidence we seem to have difficulties in getting health authorities to put money into this kind of work.
I just thought thorough - where is it that we get our money for the health service in the UK - and public opinion - we elect our democratic government and the government then apportions money to the National Health Executive and in Scotland there is a Scottish executive and then that is divided up and given to health boards. The real controllers of the money that we have in our health trust which is a combined health trust combining community health services for children with hospital based services - the director of public health and his public health physicians control where the money goes and they also have a great deal of control about how that money is distributed to local services.
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