Speech delivered in Madrid, 7 July 2017: Medical neutrality in times of conflict and protecting fundamental human rights | Brexit and the European Medical Profession.

<CHECK AGAINST DELIVERY>

 

Señor Presidente, señor Vice-Presidente, señor Coordinator de la Journada, distinguidos invitados.

 

Buenos dias, good morning, buongiorno, bonjour y bom dia.

 

Soy el profesor Andrew Rowland, de la Asociación Médica Británica.

 

Espero que me perdone por continuar el resto de mi discurso en inglés, pero creo que mi español no es muy bueno puede que no entienda si continúo en español.

 

I’m here to talk to you about the impact of Brexit upon the European medical profession.

 

Brexit means that the UK is leaving the European Union – the EU, a political entity. It clearly does not mean that the UK is leaving Europe.

 

We’re still European and still only 33km over the English Channel from you all.

 

Before I outline the challenges that Brexit poses to our profession and the patients we serve, I’d like to provide some context about the referendum result and the BMA.

 

The BMA is an apolitical organisation representing over 160,000 doctors and medical students from across the United Kingdom’s 4 nations – 2 of which, Northern Ireland and Scotland, voted to remain within the EU. The votes from Wales and England – with the bulk of the UK population residing there – were decisive and this resulted in the referendum result to leave the EU.

 

We did not advise our members how they should vote in the referendum as our political neutrality had to be maintained during the referendum campaign.

 

Instead, we provided our members with an objective analysis of the significant (and hugely positive in my personal view) impact that the EU has upon them and the health of the nation.

 

The enormous amount of feedback received from members since the referendum validated this analysis as we’ve heard countless examples of how Brexit will, and indeed already is, threatening our members’ ability to provide healthcare to patients.

 

For comparison, we have genuinely only heard of one potential benefit from Brexit: the UK will be able to implement “traffic light labelling” – on food and drinks in an effort to improve dietary choices.

 

I’ll leave it up to you to decide whether this warrants our departure… but the reality of the position we are in is that the UK public – by a very slim majority – have voted to leave the EU and it is those departure negotiations that have just begun.

 

So, how does Brexit threaten our profession and our patients?

 

Most obviously, it threatens the rights of the 300,000 plus UK citizens living in Spain and the 129,000 Spanish citizens in the UK to access healthcare and other social services.

 

The same concerns apply to the 200,000 plus Italians, 170,000 French and 132,000 Portuguese currently residing in the UK, as well as the 65,000 UK citizens in Italy, 185,000 UK citizens in France and 18,000 UK citizens in Portugal.

 

It also threatens in excess of 30,000 EEA qualified doctors registered in the UK who provide invaluable healthcare.

 

Simply put, our current National Health Service – the NHS – couldn’t function without the 2,400 Italian, 1300 Spanish or hundreds of French and Portuguese doctors currently working in the UK.

 

The issues at play are complex, whether they are residency rights; access to the labour market, pension or social security rights; or access to education.

 

We know that a significant number of European Economic Area doctors working in the NHS are considering leaving the UK in the light of the “Brexit” referendum, and if this occurs it would seriously impact patient care across the UK and only increase what are often already unacceptable delays for treatment.

 

Restrictions on their free movement and ability to practise, via the mutual recognition of professional qualifications, won’t just damage the UK but the whole of Europe.

 

This cross-fertilisation of ideas and skills and professional development opportunities provide related benefits to the European medical profession and, axiomatically, the patients it serves.

 

We know of, for example, a Spanish general practice trainee who works in the East of England who chose to do postgraduate training in the UK partly to learn from the British model of family medicine, which is very different from the system she had previously trained within in Spain.

 

In addition to broadening her experience of primary care ahead of a planned eventual return to Spain, her ability to speak with Spanish citizens in the UK in their native language is massively beneficial to all concerned.

 

This is, of course, just one example but it is useful reminder that the potential adverse effects of Brexit are bidirectional and not simply a matter for the UK or other individual European Countries.

 

“Brexit” may slow, but will not reverse, such pan-European professional migration.

 

Accordingly, it cannot be allowed to threaten the progress of patient safety measures like the European alert mechanism – an early warning system which advises all European regulators when a doctor is banned or their ability to practise is restricted – or ongoing efforts to ensure that minimum standards in medical education and training are met.

 

Comparable levels of pan-European professional migration also exist in the medical research and innovation sector with 15% of all academic staff at UK universities originating from other EU member states.

 

An end of free movement and related domiciliary rights will not only imperil high quality medical research in our own country but also in the EU as a whole.

 

Such pan-European collaboration has led to a quarter of the world’s top 100 prescription medicines being discovered and developed in the UK as well as the development of the largest pipeline of biotechnology products in Europe.

 

The importance of such pan-European collaboration to this sector, and to our respective economies, is all too clear.

 

You will be aware that the EU has played a key role in both the protection and improvement of population health through the development of cross-national strategies, collaborative working and the implementation of legislation.

 

You will also know that, as a member state, the UK has actively supported this as a priority policy area and played a key, cooperative role in the amelioration of Europe’s public health.

 

The UK’s departure from the EU cannot be allowed to threaten such existing pan-European cooperation as it becomes ever more vital in promoting the rights of vulnerable people in society, tackling health inequalities and chronic diseases, driving the development of progressive public health standards and in the protection against serious health threats.

 

Such challenges will be amplified in Northern Ireland, given its unique situation of sharing a land border – the EU’s future external frontier – with the Republic of Ireland.

 

We are particularly concerned with the challenges that colleagues will face with regards to cross border health services as many doctors, particularly those working in areas bordering the Republic of Ireland, deliver healthcare on an all island basis.

 

The most striking examples are perhaps the new Radiotherapy Unit in Altnagelvin Hospital in Derry, in Northern Ireland, which will provide access to radiotherapy services to over half a million people living in both Northern Ireland and the Republic of Ireland and the cross-border cardiology services operating in the same hospital which saved 27 lives in its first nine months of operation.

 

We’re doctors so we don’t just diagnose problems, we seek to manage symptoms, cure conditions and play an active partnership role, in resolution of problems that are identified.

 

However, resolving these challenges isn’t just about the Divorce settlement between the UK and the EU but about working to ensure that our future relationship, and the transitional period in between, protects the medical profession and, crucially, our patients.

 

In order to achieve this outcome, we need to ensure that all sides of the negotiating table – that is to say the European Parliament, Commission and EU 27 member state governments as well as the UK government – prioritise resolution of our common objectives.

 

The good news is that, with the invaluable support of our European colleagues – many of whom are today – we’ve been able to secure their prioritisation by the EU.

 

Indeed, the European Commission’s working paper “Essential Principles on Citizens’ Rights” states that “EU 27 citizens or UK nationals who resided legally respectively in the UK or EU27 at the date of entry into force of the Withdrawal Agreement should be considered legally resident even if they do not hold a residence document evidencing that right” and that it “should ensure, in the UK and in EU27, the protection…of recognised professional qualifications (diplomas, certificates and other evidence of formal qualification) obtained in any of the EU28 Member States before that date.”

 

The European Council’s recognition “of the unique circumstances on the island of Ireland” and “that flexible and imaginative solutions will be required” is also to be welcomed.

 

Most significantly though, and reflective of the unique nature of our profession, was Michel Barnier’s, the EU’s Chief Brexit negotiator, recognition of the European “nurses and doctors who contribute to the quality of healthcare in the United Kingdom” and the need for their status to be resolved as a priority.

 

The prioritisation of these mutual concerns would not have been possible without your support at both national and European level. For this assistance, you have our sincere thanks.

 

Whilst this is welcome, it is not the “beginning of the end” but very much the “end of the beginning” as negotiations will take years to complete and powerful, well-funded, sectors are also working to secure their interests.

 

The European medical profession must continue to work as one to ensure that its interests, and those of the patients it serves, remain at the top of the negotiators’ list of priorities and are dealt with as such during what will be a period of unprecedented peace-time political activity.

 

These are some of the most important features of that ‘cloud with a silver lining’ that señor Coordinator de la Journada talked about at the very start of today’s meeting. Señor Presidente, agradezco a mi estimado colega de Portugal por estimular el debate sobre las futras oportunidades que esperan la profesión médica europea.

 

Je souhaite echo à ce que mon estimé collègue Le Presidente d’order médecins français à dit… c’est les coeurs et les esprits. En ce moment c’est les coeurs et les esprits de la population en Europe qui pourrait être affectée par Brexit et donce les coeurs et les esprits des négociateurs.

 

Y me complace mucho el entusiasmo de señor Presidente consejo general de colegios oficiales de medicos de permanecer unido con la Asociación Médica Británica para afrontar los retos de Brexit.

 

Señor Presidente, recent discussions between the UK government and the EU have indicated that the “Brexit” negotiations may be carried out in a robust manner, albeit between longstanding allies.

 

Accordingly, we would ask for your ongoing support in ensuring that the principles of medical neutrality in times of conflict and of protecting fundamental human rights – guiding principles of our civilisation – continue to be applied during negotiations to ensure that “Brexit” does not result in any collateral damage to our patients’ health.

 

Señor Presidente obrigado, merci bien, muchos gracias, grazie y thank you very much.

 

Professor Andrew Rowland

Head of the UK Delegation to the European Union of Medical Specialists

Children, Young People, Young Adults & Families #Manchester I❤️MCR

My utmost respect goes to the members of the public and professionals who voluntarily joined us, who offered assistance to us whenever they could, and who worked tirelessly with us throughout the night in support of other human beings.
An atrocity targeting children, young people, young adults and their families.
A community that has selflessly pulled together with efficiency and genuine compassion for victims and families, in the light of last night’s events. Countless acts of kindness and altruism for the public benefit.
Some of you may know people who were there; some of you may know people who were affected; some of you may be affected.
Here is something that Children and Young People might find useful as they think about what happened last night:
Follow https://twitter.com/gmpolice for updates and information about what you can do to help.
My thoughts and condolences go to the victims, and their families and friends, involved in this terrible incident.
#Manchester I❤️MCR

Safeguarding the health of patients across Europe: Speech given at the Council of the European Union of Medical Specialists, Tel Aviv, April 2017

SPEECH

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Mr President, colleagues, members of Council,

At the last Council meeting I had the opportunity to talk about the exit of the United Kingdom from the European Union – a decision taken by a majority of those people who voted in the referendum.

That speech I gave was one that I did not ever think I would have to give and we live now in difficult times; unprecedented times; extra-ordinary times with many traps, dangers and hurdles ahead.

No one at UEMS Council knows exactly what will happen over the course of the next two years of negotiations as the UK prepares to leave the European Union; no one at UEMS Council knows exactly what difficulties or indeed opportunities may lie ahead; and absolutely no one at UEMS Council knows exactly what the future will look like without the UK in the EU.

But what we cannot do at UEMS Council is to allow “Brexit” to damage the relationships between members of the UEMS family.

Whilst, of course, the “Brexit” negotiations will be carried out between our respective governments, not people in this room, and between long-standing allies, the same principle should be applied here to the medical profession in order to ensure that the UK’s withdrawal from the EU does not result in any collateral damage to our patients’ health.

Thanks to the support of UEMS and numerous other European Medical Organisations, the EU’s Chief Negotiator, Michel Barnier, has prioritised securing the rights of the European “nurses and doctors who contribute to the quality of healthcare in the United Kingdom” and British citizens resident in other EU member states and who benefit from healthcare under the same conditions as their hosts.

The EU also recognises that “flexible and imaginative solutions” are required to secure the existing provision of cross-border healthcare in Ireland. Whilst this is welcome, it is not the “beginning of the end” but very much the “end of the beginning” as powerful, well-funded, sectors are also working to secure their interests.

The European medical profession must continue to work as one to ensure that its interests, and those of the patients it serves, remain at the top of the negotiators’ list of priorities.

For example, whilst macro-level health issues are very much on Michel Barnier’s radar, ensuring that the specifics of UEMS’ concerns are equally well understood continues to require additional engagement.

Removing the uncertainty created by the UK’s decision to leave the European Union must receive the focus of the negotiators. For example, this uncertainty includes:

  • The Polish students who have access to British universities under the same conditions as British students;
  • The British pensioners who are resident in Spain and who benefit from healthcare under the same conditions as Spanish pensioners;
  • The doctors and nurses from, for example, Romania, Spain and The Netherlands who contribute to the quality of healthcare in the United Kingdom;
  • The doctors from multiple countries including, for example, Greece who come across to the United Kingdom to contribute to World-Class medical research and training;
  • Or the engineers from Italy, Germany or elsewhere who choose to work in the United Kingdom, just like the thousands of British people who have made the same choice to work or live in Berlin, Barcelona, Rome or Vienna.

Michel Barnier has said that guaranteeing European citizens rights will be an absolute priority.

The issues at play are complex, whether they are residency rights; access to the labour market, pension or social security rights; or access to education. We know that a significant number of European Economic Area doctors working in the NHS are considering leaving the UK in the light of the “Brexit” referendum, and if this occurs it would seriously impact patient care across the UK and only increase what are often already unacceptable delays for treatment.

Over 30000 registered doctors in the UK gained their primary medical qualification in another European Economic Area state and over 150000 EU citizens work in the UK’s health and social care sphere – with free movement playing a crucial role in both professional development and in meeting varying health and social care, including medical, workforce requirements across Europe.

Comparable levels of pan-European professional migration also exist in the medical research and innovation sector with 15% of all academic staff at UK universities originating from other European Union member States. With medical research becoming increasingly international in focus and integral to tackling the main current and future societal challenges, it is imperative that solutions are found to secure researcher mobility and the provision of clear long-term frameworks in a “post-Brexit” European Union.

Very recently within UK cross-party MPs have said that it is imperative that health and social care providers can continue to retain and recruit the brightest and best from all parts of the globe and that it is important to prioritise and resolve reciprocal health care agreements at the earliest opportunity to end the uncertainty for both EU citizens in the UK and UK citizens living in the EU.

Mr President; members of Council; by continuing to work together as a family of European Medical Organisations and within the UEMS family itself, then I am confident that both the UK’s exit deal as well as the arrangements concerning our future relationship with the European Union 27 will recognise, and reflect, the fact that the medical profession is unique and must be elevated above simple politics.

Colleagues, whatever happens politically; whatever happens in the media; and whatever happens to public opinions regarding “Brexit” I’m am pleased to reaffirm the UK delegation’s commitment to working with our European Partners to safeguard the future of the European Medical Profession and, crucially, the patients we serve.

 

Professor Andrew Rowland BMedSci(Hons)  BMBS(Hons)  MFMLM  MAcadMEd  FRCEM  FRCPCH  FRSA

Head of the UK Delegation to the European Union of Medical Specialists

The Feel Happy Series: Fixing Child Sexual Exploitation (#CSE) by @FixersUK

Fixers needs YOU on Wednesday 26 April 2017 in London.

fixers

 

Young people who have experienced child sexual exploitation – including abuse, coercion and grooming – are putting their heads together to make childhood safer and society more responsive for future generations.

 

 

With the support of Fixers – the campaign that gives young people a voice – and the health research charity, Wellcome Trust, more than a dozen young people with insight into one of the most pressing issues of today will come up with proposals that reflect the sharp edge of their experience.

 

They’ll be discussing, and then proposing action, in three main areas:

  • child sexual abuse [from family and trusted adults]; and
  • coercion into unwanted sexual behaviour, including sexting [especially in school];and
  • sexual grooming [especially online].

 

The young people will explain what went wrong for them, how responsible adults and their peers reacted, their treatment by professionals, and the effect on their mental and physical wellbeing. They will then define what they wanted from those around them, either to stop or prevent the abuse … or to respond in the best possible way when it happens.

 

Their efforts will culminate in a conference in central London, where an invited audience will hear from the young people in an open plenary and subject-specific sessions. The conference is open to health, education and social support professionals, as well as the police and other law enforcement agencies.

 

Fixers is calling for academics and researchers – in health, social policy, law and sociology – to participate in this conference by helping to lead discussion groups and workshops with survivors to assist them in turning their voices into policy proposals. Fixers would like to hear from anyone with an academic background in Child Sexual Exploitation (CSE) and who would be interested in taking part in this excellent opportunity to generate primary research into a relevant and high profile issue. 

 

fixers-1

 

Contributors are expected to include …

Siobhan Pyburn [25] – whose father was jailed for her childhood abuse in 2007 – and who, with the help of Fixers, has become a prominent and articulate campaigner for better reporting of and support for child sexual abuse victims, ‘Lisa’ [20] who was coerced and exploited by a group of Asian men in Manchester in the early 2010s, and ‘Rebecca’ [19] who was groomed online by an older man when she was 14.

 

‘Fixing Child Sexual Exploitation’ is part of the Feel Happy Fix Series which brings together young people who already campaign on issues that affect their well-being, to share their insight and the lessons they have learnt. Established in 2008, Fixers is a national charity and ‘movement’ that has already enabled around 20000 young people [16-25] to ‘use their past to fix the future’ by tackling issues that matter to them.

 

For further details or to RSVP, please contact Chris Podszus at: chrispodszus@fixers.org.uk

 

Supported by:

welcome

 

Revised statutory definition of Child Sexual Exploitation (CSE)

Earlier this week the new government definition of Child Sexual Exploitation (CSE) was launched along with new “Working together” advice on CSE.

 

The revised definition is detailed below: 

 

Revised statutory definition of child sexual exploitation

Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.

 

The new “Working together” advice on CSE and the new definition can be found here:

https://www.gov.uk/government/publications/child-sexual-exploitation-definition-and-guide-for-practitioners

 

A progress report detailing the government’s work in this area along with forward commitment can be found here:

https://www.gov.uk/government/publications/tackling-child-sexual-exploitation-progress-report

 

Here is a link to the extended version of the document that Bedfordshire University wrote with Research in Practice which unpacks some of the issues in greater depth:

https://www.beds.ac.uk/__data/assets/pdf_file/0009/536175/UOB-RIP-CSE-GuidanceFeb2017.pdf

PRESS RELEASE: #CYPAdv

advocacy-house-web

Children and young people get together to discuss a possible ‘Children’s Advocacy House’ for the North West of England.

PROFESSOR Andrew Rowland, paediatric emergency medicine consultant from The Pennine Acute Hospitals NHS Trust, was joined by young people, aged 11-14 years, and some key individuals yesterday (08 November 2016)  to discuss the possibility of setting up a new Children’s Advocacy House for the North West of England.

The idea was first put forward by Professor Rowland in his Churchill Fellowship report (Living on a Railway Line – a major report to improve the safeguarding of vulnerable children in the UK and beyond[1]), and thanks to support from a network of individuals and events, a group of over 50 children and young people, together with key individuals, were brought together yesterday at MediaCityUK to discuss whether an Advocacy House[2] is something children and young people in Greater Manchester might want.

The highly successful event was attended by over 50 children and young people, the Roald Dahl’s Marvellous Children’s Charity[3], the office of the Children’s Commissioner for England, Public Health England, Tony Lloyd (Interim Mayor of Manchester), Ann Coffey MP, Councillor Karen Garrido (Ceremonial Mayor of Salford), key individuals from the NHS and other invited guests. The entire focus of the day was on the young people with the adults attending to learn from the young people present.

During the day, the event, which was live-Tweeted using #CYPAdv, was trending in second place on Twitter with only the USA #Election2016 ahead in first place.

The day included remarks from Professor Rowland, the Ceremonial Mayor of Salford, Councillor Karen Garrido, Ann Coffey MP and Tony Lloyd as well as the young people telling the adults present about the idea of an Advocacy House, what might happen there and how they might use it.

The question and answer session with the Interim Mayor of Manchester, Tony Lloyd, provided the opportunity for a two-way conversation for the children and young people to imagine and explain their thoughts about a potential advocacy centre.

Jake, a young person attending yesterday’s event, said it was important to, “forget the bad things and look forward to the good things.”

Harvey, a young person attending yesterday’s event, said it was important to, “have confidence in yourself.”

James, a young person attending yesterday’s event, said it was about, “catching bad dreams, keeping good ones and raising spirits.”

Neve, a young person attending yesterday’s event, summarised the aim of the Children’s Advocacy House as, “you speak, we listen, everyone cares.”

Professor Andrew Rowland, Consultant in Paediatric Emergency Medicine at The Pennine Acute Hospitals NHS Trust and Honorary Professor at Salford University said:

“The unique work that the children and young people have produced will be the starting point for professionals in the region to consider ways in which they can improve engagement with young people facing adversity and difficulties. The principles of co-design and co-production of services with children and young people should be an over-arching concept within the North West region where we now have a unique opportunity to put these design principles at the very heart of the strategic values of organisations working with children, young people and families. I am excited to see how organisations within the North West, and beyond, respond to the fantastic ideas that the children and young people have come up with during this Children’s Advocacy Centre event, and how those organisations will now work with children and young people to hopefully lead to the creation of a brand new Advocacy House for them in our region.”

Dr Joan Livesley, Senior Lecturer in Multi Professional Postgraduate Studies at the University of Salford, said:

“This was a fantastic day with children and young people, identifying unmet need and getting some great ideas from them about how to resolve these problems.”

Dr Mary Ryan, Consultant and Director of Medicine at Alder Hey Children’s NHS Foundation Trust in Liverpool, said:

“The need for a Child Advocacy Centre in the North West has been something we have thought about for a while now. This need was confirmed and highlighted by the children we spoke to during this event. We owe it to them to listen, and work harder to make this dream a reality.”

The outputs of yesterday’s event will be written into a report to be released in mid-2017.

The event was funded by NHS England (North Region) and organised by Dr Joan Livesley, Senior Lecturer in Multi Professional Postgraduate Studies at the University of Salford, in conjunction with Professor Rowland and a group of professionals working with children, young people and families.

NOTES TO EDITORS

The concept of a Children’s Advocacy Centre in the United Kingdom (UK), and the North West of England specifically, was put forward by Professor Rowland in his Churchill Fellowship report (Living on a Railway Line – a major report to improve the safeguarding of vulnerable children in the UK and beyond[4]).

A Children’s Advocacy Centre is a relatively new idea in the UK although well established in the United States of America (USA). In the USA Children’s Advocacy Centres often focus on the provision of a multi-disciplinary team approach to responding and preventing child abuse. They provide programmes and support services for child victims and their families enabling them to heal emotionally and physically.  They often provide a single place where children can be interviewed, examined, have therapy etc.

The aim of the project in the UK is to seek support to establish a Children’s Advocacy Centre in the North West of England but one that is co-designed and co-produced by children and young people and provides services that extend outside of child abuse. The proposal would be to incorporate programmes and support services for children and families experiencing all types of different problems as well as providing education and awareness to prevent problems becoming established. The services would be provided by professionals and volunteers from a range of different disciplines depending on what consultation events highlight as being the key issues that would be served by a Children’s Advocacy Centre.  Services would fall into 4 categories, aligned with the four public health stages of intervention: support to prevent problems happening; support to help problems in their early stages; support for problems that won’t go away; support for dealing with the after effect of major life events or trauma.

The purpose of the day was to find out what children and young people think of the idea of an Advocacy House for the North West of England. The term “Advocacy House” was used to differentiate the concept from the advocacy centres in the USA.

Aims of the day

  1. To seek the views of children and young people on the development of a Children’s Advocacy House in North West England
  2. To determine how children and young people could be involved in the design and evaluation of a Children’s Advocacy House if the concept is taken forwards.

Objectives

  1. To explore children and young people’s understanding and meaning of the term advocacy
  2. To establish in what circumstances they may contact such a centre
  3. To establish what such a centre may look like, how it may be accessed and what should be provided to ensure that it is acceptable to children and young people.
  4. To establish the facilitators and barriers in children and young people accessing such and advocacy centre.

Closing remarks

Professor Andrew Rowland, Consultant in Paediatric Emergency Medicine, closed yesterday’s event by saying:

“That was an amazing day! We have all learned loads about the kind of region that children and young people want us to have. I’ve heard very clearly from you today that it is about inclusivity; mutual respect; diversity and valuing people as individuals. All of us who are here today as the adults learning from you, believe in the value that children and young people play in our society.

“I’m convinced that our best days are still ahead of us if we listen to children and young people and we reach for those days together, in partnership. We all have a role to play in building a stronger, fairer, more inclusive region for children and young people with healthy children and young people at the heart of that society.

“We deserve it to young people to work our hardest to make life better for you and your families. I know that some of you have told us about difficult things today and that has shown great courage. You have told us these things because you have trusted us. You have done that because you didn’t necessarily have to tell us your name.

“I want you all to remember that there are people you can talk to whatever it is that might be concerning you – these people include your teachers, doctors, nurses and other professionals, some of whom are here today. People will not judge you ; we won’t always get it right but everyone here will try our best for you.

“Now, what do we do about moving these ideas forwards? Today is, of course, just the start. What we now need is other organisations to take up these ideas and develop them into a reality.

“We will be producing a report of today and, together, we hope to encourage other organisations to respond positively to the outcomes of today and to move forward with the concept you have all devised for us today.

“By valuing the input of children and young people and by recognising that your opinions, thoughts and dreams are important, together we can make a brighter future for us all.

“Working with children and young people has never been as important as it is now, and this has to be our mission together:

“To give every child and young person every chance of happiness, every chance of good health and every chance of protection from harm.

“As I’ve been going around the groups today I’ve tried to prepare a summary of the discussions you have been having but I’ve realised that there is no need for me to do this. There is no need for me to try and summarise in just a few words all of the amazing work you have been doing today – that wouldn’t do justice to the effort you have all put in to today and it wouldn’t be able to adequately reflect the key things you’ve told us. We’ll save those ideas for the report and, instead, I’m going to leave you with some really striking messages that you have generated.”

“Forget the bad things and look forward to the good things.” Well said, Jake.

“Have confidence in yourself.” I couldn’t agree more, Harvey.

It is about “catching bad dreams, keeping good ones and raising spirits.” Absolutely, James.

“You speak, we listen, everyone cares.” What a great way to end today, Neve.

“Thank you all very much.”

[1] http://www.wcmt.org.uk/fellows/reports/living-railway-line-turning-tide-child-abuse-exploitation-uk-overseas

[2] A Children’s Advocacy Centre

[3] http://www.roalddahl.com/charity

[4] http://www.wcmt.org.uk/fellows/reports/living-railway-line-turning-tide-child-abuse-exploitation-uk-overseas