Morning Call: pick of the comment

The ten must-read pieces from this morning's papers

1. Brown may have survived. But the coup was a success (Guardian)

Seumas Milne argues that although the Hoon/Hewitt coup failed to oust Gordon Brown it succeeded in changing Labour's political direction. Thanks to the Blairites, the government's "crablike shift" towards a more social-democratic stance has come to a halt.

2. Bankers are just bonus-snaffling Marxists (Times)

Anatole Kaletsky says that, as with Yugoslav workers' co-operatives, the problem with the banks was that managers paid out all the revenues in wages and allowed their capital to disappear.

3. Crunch time for reforming banks (Daily Telegraph)

The launch of the Financial Crisis Inquiry Commission in the US is the last chance to shame a banking industry into change, says Adrian Michaels.

4. Iris Robinson is not a sinner. She's a heroine (Times)

Robinson may be "fairly ghastly" but she deserves to be celebrated for breaking free from decades of suffocating Presbyterianism, argues Melanie Reid.

5. Ranting against Iran won't help reform (Independent)

Declaring Iran a pariah state and imposing new sanctions will not help the country's dissidents, warns Adrian Hamilton. Western protesters must remember that change will come only from within the country, not without.

6. The biggest loser from this election will be positive politics (Independent)

John Rentoul says that, with the Tories nowhere near as popular as New Labour was in 1997, we can expect a dismal anti-politics election, with no party able to offer a clean break.

7. Will Google stand up to France and Italy, too? (Guardian)

Rebecca MacKinnon praises Google's stand against Chinese censorship, but questions whether the internet giant will be willing to challenge France's and Italy's efforts to restrict web privacy and freedom.

8. The crusade against faith schools is an attack on our freedom (Daily Telegraph)

Ed Balls's attempt to control the admissions policies of faith schools is illiberal and unjust, argues Benedict Brogan.

9. Haiti's earthquake (Times)

A leader says that the US has allowed Haiti, a country on its doorstep, to become a failed state. The Obama administration must lead the way in mounting an effective aid operation.

10. Media-savvy designer Islamists must not distract us from the real danger (Guardian)

Timothy Garton Ash warns that steps to ban Islam4UK and other extremist groups once again risk reducing liberty without increasing security.


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Testing migrant children’s teeth for their age is not only immoral – it doesn’t work

Ministers have flirted with this idea for over a decade. It’s bad policy, as well as poor ethics.

This week, the Home Office finally ruled out the use of x-rays to establish the age of childhood migrants.

It’s welcome news, but this story predates the dispersal of the Calais “Jungle” camp. 

For over ten years, ministers in Conservative and Labour governments have flirted with these tests. And it’s been up to us – the practitioners who’d be expected to administer them – to pick holes in a policy that’s a great way of securing headlines, but simply cannot deliver on the claims made by its cheerleaders.

It goes without saying dentists are health professionals, not border guards. But our objections run deeper than that. And it’s worth revisiting the arguments, just in case future governments start grasping for silver bullets.

It’s ineffective

We can talk about philosophy later, but let’s start with a pretty fundamental objection: dental x-rays are simply not a reliable way of establishing age.

No two mouths are alike. I’ll add my own to that list, as I still sport two of my baby teeth.

Children and young people mature at different rates, so the level of accuracy in these tests changes with time. And these x-rays can estimate age in younger children much more accurately than in adolescents. So as children mature at different rates, the potential margin of error gets ever larger with age.

For example, the third molars, commonly known as wisdom teeth – the last permanent teeth to develop – can form any time between the ages of 16 and 23, and a small proportion of individuals never develop third molars at all (I’ll have to pop my name to that list too).

A 2010 study of 300 young people aged between 11 and 25, whose age was determined based on dental x-rays, showed this method of testing consistently over- or under-estimated age, with a two-year average difference between dental and known age.

So if you are searching for a litmus test that will tell you whether a subject is 17 or 19 years old you won’t find it here.

It’s inappropriate

A few MPs and pundits have found it hard to acknowledge the codes health practitioners sign up to, which make this test a no go.

We must always act in the best interest of our patients when providing a medical procedure. And it is beyond question that the process of radiography is a medical procedure that should be carried out only for medical purposes, and where the patient stands to benefit.

Now many people might not consider this test an invasive procedure. However, x-rays do carry a small risk of possible long-term physical impact, and current best practice in this area dictates that exposure to radiation should be kept as low as reasonably possible over a lifetime. They should be carried out sparingly and where there is a well-defined potential clinical benefit, which must always outweigh the potential clinical harm.

As taking x-rays to determine the age of an individual carries no clinical benefit, it frankly isn’t appropriate to expose a patient to the potential clinical harm it can cause.

It’s unethical

Our lawmakers cannot simply dispense with fundamentals like consent to show they are “taking action”.

It is a legal principle that before practitioners carry out any medical procedure, the recipient – or someone who can consent on their behalf – must be given a full understanding of the nature of the procedure, its significance, impact and potential consequences before signing up to it.

For the children arriving from Calais, this would be a difficult task without English as a first language. Consent may also be required from a suitable adult. Yes, these children may be unaccompanied, but it does not mean the need for valid consent and protecting the child’s best interests can simply be ignored.

The letter of the law might be inconvenient, but it is a requirement that can only be compromised where the urgency and necessity of the circumstances demand rapid action in a patient’s best interests. And even in these circumstances the validity of treatment has sometimes ended up being challenged in the courts.

Given that taking x-rays in order to determine age is not medically justifiable in the first place, the urgency justification really doesn’t come into play. And that means dental colleagues – in the absence of valid consent – could find themselves performing an act that constitutes a criminal battery.


In the past, ministers have debated whether there is a credible “public interest” case that might override these little legal or philosophical objections. But these practical and ethical concerns can’t really be separated.

But why bother constructing a case for a test that frankly isn’t much cop? Dentists can only hope the latest message from the Home Office marks the beginning of a consensus, which draws a line under a decade of wishful thinking.

Judith Husband, Chair of the British Dental Association’s Education, Ethics and the Dental Team Working Group.