Medical and forensic services for victims of sexual assault have been shown to have wide discrepancies in services, according to a UK study.
A study published in the latest issue of the Journal of Clinical Forensic Medicine examined the availability of Sexual Assault Referral Centres (SARCs) in the UK and compared their services with each other and with non-SARC police victim examination suites. A SARC is a model service established to address the forensic and therapeutic needs arising following sexual assault.
The study was set up by Mary Pillai, a Consultant Gynaecologist and Forensic Sexual Assault Examiner at Cheltenham General Hospital, and Sheila Paul, a Forensic Physician for Thames Valley Police and general practitioner, after learning from concerned colleagues that services to complainants were becoming increasingly disparate across the UK. The organisation of a forensic medical examination following a complaint of sexual assault has traditionally been a police responsibility with the main focus being the forensic element and varied attention given to the medical needs arising for complainants. There are however, other therapeutic considerations at the initial examination and subsequently, if physical and psychological sequelae are to be minimised and recovery facilitated.
The results of the study showed that complainants of sexual assault in the UK, especially children, face wide differences in forensic and medical services between SARCs and non-SARC facilities. It also revealed that there is a severe shortage of experienced doctors willing to do this work, and in many no, some areas only male doctors are available. Some areas, including those served by SARCs, have so few doctors that they cannot provide a rota, or 24/7 cover for examinations, resulting in long waits for an examination. For children identified acutely following a sexual assault there is virtually no service available.
Although there was some variation in services between SARCs, all offered better all-round services to complainants than non-SARC facilities, providing attendees with all the forensic and medical care they need, under one roof in most cases or being able to easily refer on for such care if not In the non-SARC services, lack of co-operative working with local health services, lack of equipment, and lack of formal medical follow up arrangements is the norm The lack of health funding and facilities to address the health consequences of sexual crime is most extreme in the non-SARC services, with many areas relying on the good will of a small number of doctors to provide a comprehensive service under less than ideal circumstances, often with great difficulty and often without a rota.
Ideally, any complainant would be served by a SARC offering 24/7, full holistic forensic and medical care, working closely with the forensic medical examiner and the police. Nevertheless, in 2005 there were only 13 SARCs in England and Wales for more than 60,000 sexual offences recorded by police, of which 14,000 were offences of rape.