Cross-Agency Analytic Tools to Flag Infants Brought to Hospitals with Repeated Unexplained Injuries
Mr Abdul Muhaimin Abdul Malik asked the Minister for Social and Family Development in relation to the infant who died in September 2024 after prolonged parental abuse (a) whether the infant was assessed for or enrolled in KK Women's and Children's Hospital's Anchor programme; (b) if not, why earlier hospital presentations did not trigger a referral to Anchor or the Protective Service despite existing coordination; and (c) whether cross-agency analytic tools will flag infants with repeated unexplained injuries.
Answer:
The passing of Trevor Neo is a tragic incident. KK Women’s and Children’s Hospital’s (KKH) Anchor Programme supports children aged three and below with suspected abuse or neglect concerns who are assessed to have moderate to high needs. Referrals may be made by KKH, the Ministry of Social and Family Development (MSF) Protective Service or Child Protection Specialist Centres. Under the programme, a multi-disciplinary team of paediatricians, psychiatrists, psychologists, medical social workers and home visitors supports the child and family mainly through regular home visits. This support includes developmental and health screenings, guidance to strengthen parenting and the parent-child relationship, caregiver mental health screening and support, and coordination of care with other agencies.
2. When Trevor was first presented to KKH, the clinicians performed a detailed physical examination, a brain scan, eye examination and whole-body X-rays. There were no signs of any bruises, fractures, nor abnormal findings from the physical examination and imaging tests. KKH also interviewed the parents, who gave explanations on Trevor’s conditions.
3. The physical findings, together with the parents’ accounts, did not indicate any concern that the child had been a victim of abuse, but suggested that the parents might face common challenges coping with a young child. The hospital therefore did not refer the case to the Anchor Programme, and instead facilitated care arrangements and made referrals to parenting and child development support following Trevor’s discharge.
4. It is not always easy to detect abuse. Although doctors are trained to look for clues suggesting child abuse had taken place, they are not always evident, particularly if parents and caregivers avoid providing any information to the hospital staff to raise their suspicions. While in hindsight, we wish we had somehow detected the case, KKH could only act based on the information available to them at the time.
5. We must continue to learn from serious cases and try to make detection sharper and more accurate. Cross-agency analytic tools may provide us with a more holistic view of the families that may be at risk. MSF is looking into incorporating relevant information from healthcare agencies into Sensemaking Alerts for Frontline Engagement and Response (SAFER) to provide a fuller picture of families who may be at risk. However, we recognise that patient and medical information are highly sensitive. Any inclusion of such information would need to be proportionate and subject to appropriate data governance safeguards. The presence of a healthcare encounter or other link identified by SAFER may not, upon assessment, indicate that further action is required.