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3.2.8 Medical or dental treatment - including immunisations

Last Modified: 24-Mar-2022 Review Date: 29-Oct-2010

 ‭(Hidden)‬ Legislation

Overview

The CEO has delegated the authority to child protection workers to approve medical/dental treatment and examinations (including immunisations), where anaesthetic consent and/or an operative procedure is not required for a child for whom the CEO has parental responsibility under s.24 and 25 of the Children and Community Services Act 2004 (the Act).

If a child in the CEO's care is seriously injured and needs urgent medical treatment to address their injuries or save their lives, the doctors/surgeons do not need consent to provide emergency treatment. 

Medical and dental examination and treatment includes:

    • any dental examination and treatment (including dental fillings) that includes local anaesthetic only

    • a medical examination and/or treatment that does not include an anaesthetic, including twilight anaesthesia, or operative procedure, and

    • an immunisation.

Medical and dental practitioners seek parental consent as necessary. If ongoing examination or treatment is required, consent is usually sought at the initial visit. The practitioner will request additional consent as required.  

You must advise practitioners of the child's known medical history, including any medications  being taken, prior to the child receiving  treatment.

 

Rules
  • You must determine who has parental responsibility for the child and thus holds the authority to consent on behalf of the child.  Refer to the In the CEO’s Care - Parental Responsibility Chart.

  Child subject to section of the Act

    "Child in CEO's care"

Does CEO have parental responsibility?

​s.29

Provisional protection

​Yes

Yes (to limited extent)

Subject to any interim order in respect of the child, the CEO has responsibility for the day to day care, welfare and development of the child, including responsibility for making decisions about any medical or dental examination, treatment or procedure in respect of the child. Responsibility for the long term care, welfare and development of the child otherwise remains with the parents.

​s.47-53

Protection order (supervision)

​No

​No

Parental responsibility remains with the parents.  Conditions placed on parents by the Court.

​s.54-56

Protection order (time limited)

​Yes

​Yes

​s.60-66

Protection order (until 18)

​Yes

​Yes

​s.74-77

Negotiated placement agreement

​Yes

​No

Parental responsibility essentially remains with the parents EXCEPT where the NPA agreement specifically authorises the CEO to do so, and is signed by the CEO and the parents. Cannot be used where there are child protection concerns

​s.32(1)(a)

Placement service

​Yes

​No

Parental responsibility remains with the parents. (Note: It is Department policy that a placement service must not be used where there are child protection concerns).


You must check each negotiated placement agreement (NPA) to ascertain if it expressly authorises the CEO to consent to medical or dental treatment and immunisations in lieu of the parents. 
 

Written consent for treatment and immunisation must be obtained from parents where:

  • The child's NPA does not authorise the CEO to consent to medical or dental treatment and immunisations, and
  • where the child has been provided with a placement service under s.32(1)(a) and is therefore in the CEO's care but the parents retain parental responsibility and approval cannot be provided by the CEO.

You must keep parents included, informed and updated about appointments or treatments for their children.

Process Maps

Not applicable

Information and Instructions

  • Authority and delegations for consent
  • Parental involvement
  • Medical checks
  • Dental treatment at a public dental clinic
  • Immunisation
  • Recording
  • Authority and delegations for consent

    Section 127 of the Act authorises the CEO to give consent (in lieu of a parent) for a child to undergo medical or dental treatment, including immunisations, where that child is:

    • in provisional protection and care
    • the subject of a protection order (time-limited) or protection order (until 18)
    • the subject of a negotiated placement agreement, only if the agreement authorises the CEO to do so.

    In situations where a child requires surgery or anaesthetic (other than local anaesthetic for dental treatment), follow the procedures set out in Chapter 3.2 Operative procedures and anaesthetic consent.

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    Parental involvement

    Where it is possible and appropriate, talk to the parents about the planned medical or dental treatment to allow them to express their views and wishes and see if they have any additional information that will help with the planning.

    If the parents disagree and the matter is contentious, you must discuss this with your team leader. The best interests of the child should be the determining factor (s.7 of the Act).

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    Medical checks

    As part of the health care planning process, when a child first comes into the CEO's care they will have a general medical examination followed by a health and development assessment. The child will then have a health and development assessment on an annual basis before the care plan review. You arrange and provide consent for the medical check and health assessment. For details, refer to Chapter 3.4 Health care planning

    A carer can take a child to see a medical practitioner for a medical check, short-term illness (such as influenza) or emergency treatment (e.g., a broken bone), without your consent, but the carer must inform you as soon as possible afterwards. 
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    Dental treatment at a public dental clinic

    If a child needs a dental check and/or treatment (and it cannot be provided through the School Dental Service for school age children), they can be seen at a public dental clinic.

    Dental Health Services prioritise referrals for children in the CEO's care and apply the 100% subsidy rate.  

    1.  Call Dental Health Services on (09) 9313 0555 for information on the closest public dental clinic or view the Dental Health website under the Adult Dental Service heading and choose clinic locations.

    2.  Complete the following forms and provide at the appointment:

    If a child requires a dental procedure that involves a general anaesthetic, then a submission for anaesthetic consent is required. Refer to Chapter 3.2 Operative procedures and anaesthetic consent.

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    Immunisation

     

    All children in the CEO's care must have all necessary vaccinations according to the WA Health Childhood Immunisation Schedule, unless there are contraindications on medical advice.

    The Department's policy is in line with WA Health and the National Immunisation Program, which aims to reduce the number of cases of diseases that are preventable by vaccination in Australia.

    You must make sure that children and young people in the CEO's care are immunised, unless there is an exemption fro medical reasons from a doctor or immunisation provider.  

    Children and young people in the CEO's care must have all their required immunisations for carers to receive child care fee assistance and Family Tax Benefit Part A.  If carers receive a payment for a child in the CEO's care, this can affect  their eligibility for these payments.

    Vaccines recommended by the National Health and Medical Research Council (NHMRC) for children are funded by the Australian Government and provided free of charge. Immunisations can be obtained from Community Health Clinics, general practitioners (GPs), Regional Public Health Units, some Local Government Councils and Aboriginal Community Health Services. Note that GPs may charge a consultation fee.

    School-based vaccination program 

    The Year 7 school-based vaccination program is provided free of charge. GPs can offer this vaccination for students who did not or could not access it through the school program.

    Immunisation providers will seek consent for immunisations as required. If an immunisation provider requests written consent, complete Form 589 Immunisation Consent Form. The form must be signed and forwarded to the immunisation provider directly, or given to the carer or support person who will attend the appointment with the child. 

    If the carer is taking the child to the appointment, you should remind them to take the Child Health Passport so it can be updated by the immunisation provider.

    The Childhood Immunisation Schedule (funded by the National Immunisation Program) lists the vaccines recommended for all children from birth to 5 years of age.  For information about immunisation providers and/or for appointment bookings:

    • visit the WA Department of Health website - Where can I get immunised? 

    • call the Central Immunisation Clinic in West Perth on (08) 9321 1312

    • call the local Public Health Unit in your region.

    Influenza vaccinations

    Unless there are contraindications on medical advice, you must make sure that all children in provisional protection and care and children under a protection order (until 18) and protection order (time limited) over the age of 6 months receive the influenza (flu) vaccine each year.

    WA Health advice is that the only reason for a child not to have the flu vaccine is following a severe (anaphylaxis) reaction to a previous dose of flu vaccine, or to any component of any vaccine. Allergic reactions to the flu vaccine are rare. If unsure, you should seek advice from the child's GP.

    The following groups are eligible to receive free government funded flu vaccinations:

    • Children aged 6 months to less than 5 years
    • Aboriginal people 6 months and older
    • Children 6 months and older with certain medical conditions that put them at risk of severe flu, including:
      • heart and kidney disease
      • chronic respiratory conditions
      • chronic illnesses that required regular medical attention or hospitalisation in the previous year
      • chronic neurological conditions
      • impaired immunity
      • children aged 6 months to 10 years receiving long-term aspirin therapy.

    Further information about the flu vaccine for children can be found on the website Healthy WA.

    COVID-19 vaccination

    The Department supports the COVID-19 vaccination program as prescribed by the federal and state governments and the WA Department of Health. Vaccinations are free of charge at COVID-19 vaccination community clinics with an appointment, pharmacies, or through a GP.

    Staff should check the Department's COVID-19 vaccination page and the Healthy WA website for the latest information on the vaccination roll out program: Government COVID-19 vaccination roll-out information (SharePoint).  The Healthy WA website also provides further information relating to the COVID-19 vaccine and can be accessed here

    Children aged 5 and older can receive a COVID-19 vaccine. To confirm if a child or young person in the CEO's care is eligible, or to learn more about underlying medical conditions, use the Vaccine Eligibility Checker (link also in related resources).  Where required, complete Form 589 Immunisation Consent Form.

    Where the young person is assessed by a medical practitioner or health professional as being a mature minor as per the Gillick Principle, the young person must provide informed consent to receive the COVID-19 vaccination. For young people assessed as Gillick Competent, or those over 16 years of age, additional consent from the Department is not usually required.

    Consider a GP consultation if: 

    • the child or young person has, or may have, an underlying medical condition, or

    • the young person or their family have concerns and would prefer to speak to a doctor before the vaccination.

    The same delegations apply for the COVID-19 vaccine as for other immunisations. Child protection workers should sign Form 589 (in related resources) and give this to the vaccination provider before the vaccine is administered.

    If you have any concerns about the decisions a child in the CEO's care makes about COVID-19 vaccinations, consult with your team leader. 


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    Recording

    Store all medical reports, dental reports, and immunisation records in the Child History Folder, after you have scanned a copy to the Child History File. 

    A copy of medical reports or information from reports may be provided to relevant parties (for example, a copy may be provided to parents and/or carers if appropriate). 

    You must update the Quarterly Care Review in Assist and th eChild Health Passport to include any new health information.

     

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