Parents whose children have more than 10 accidents before they turn 5 will be investigated for child abuse the next time they seek medical treatment for the child.

The decision follows ACC's discovery of 236 children who have each been the subject of claims for treatment for more than 10 accidental injuries in the past five years.

In the most disturbing case, there were 52 claims for one child.

Such cases will now be referred to the Children, Young Persons and their Families Service for investigation.

The move to exchange information between Government agencies is part of a surge of initiatives to fight child abuse after several highly publicised deaths.

The report into the death of 4-year-old James Whakaruru by the Commissioner for Children prompted ACC to search its records last month for multiple claims.

In future ACC will notify CYFS if more than 10 claims are made before a child is 5.

Another horrific case of child abuse was marked in Carterton yesterday when several hundred people marched through the Wairarapa town in memory of Hinewaoriki Karaitiana-Matiaha, or Lillybing, who died in July.

A homicide inquiry was launched after an autopsy revealed that she had been bashed, scalded and sexually violated. No one has been arrested for her murder.

In Auckland, Xena, Warrior Princess star Lucy Lawless and TVNZ newsreader Liz Gunn have joined other mothers to form an action group to fight child abuse.

The yet-to-be-named group will endorse the Starship hospital's Safe and Sound appeal.

The appeal will raise money to set up New Zealand's first multi-agency "Cares" - Child and Adolescent Recovery, Empowerment and Safety - centre near the Starship.

CYFS general manager service delivery Ken Rand said the service would this week start looking into the 236 cases identified by ACC, although 20 per cent of them involved children already known to it. One case was already the subject of a full investigation.

Mr Rand said that while the initial inquiries into each case would stretch the service, a real staff problem would begin only if a high proportion of the ACC cases involved genuine child abuse.

"Not all of these cases will be child abuse. Some of them are quite historic. Also, you know kids will be kids, and kids have accidental injuries all the time."

The service is also negotiating with the Royal College of General Practitioners to set up a similar link that may help identify child abuse cases. Other organisations with access to children, such as the Education Review Office, are also being targeted as potential sources of information to identify abuse.

Children's Commissioner Roger McClay said the new protocol linking ACC and CYFS was an excellent step, and he felt "quite chuffed" that the move had stemmed from his James Whakaruru report.

"Someone has sprung into action - little James Whakaruru's life has amounted to something after all."

But Mr McClay criticised doctors who have treated children suffering signs of abuse and failed to notify anyone of their concerns.

James Whakaruru had seen doctors 40 times before he was finally killed by his stepfather.

"How can you repeatedly treat the wounds of a child that are suspiciously non-accidental, then remember to claim ACC for your work, but forget to tell anyone that there is possibly a child in trouble?" Mr McClay asked.

"If you claimed insurance for your car 40 times in five years, the insurance company would be asking you a few questions. Why shouldn't doctors?"

Minister of Social Services Steve Maharey said that while it was difficult for doctors always to recognise the signs of child abuse, there came a point after treating accident after accident where doctors should take some action.

"That is what this system between ACC and CYFS is based on, a trigger point. Doctors are clearly in the frontline of dealing with children, and they need to find their own trigger point."

However, the chairwoman of the Medical Association, Dr Pippa MacKay, said she doubted whether any doctor suspecting child abuse would fail to report it.

* To donate to the Safe and Sound Appeal ring 0800 946 010.

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