Learning from Haleigh

THE SPECIAL report on the Haleigh Poutre case released this week isn't as comprehensive as it should be, but running through its recommendations is the message that the state needs to marshal medical expertise to help the Department of Social Services protect children from abuse. Haleigh, 12, was nearly beaten to death last year because, despite repeated DSS interventions and medical consultations, no one removed her from the home where she was being brutalized.

The case is complicated by the DSS decision to ask the courts to remove Haleigh from life support. Haleigh was in better condition than either the DSS, its consulting physicians, or the judges thought. She showed strong signs of life and is now in a rehabilitative hospital.

The three-person commission that wrote the report is right to call for a better system to make decisions to end life support. As it suggests, DSS should get a second opinion from a physician not affiliated with the hospital where the child is being treated. That doctor should come from a panel nominated by the chiefs of pediatric teaching hospitals.

Cases such as Haleigh's are rare, and these procedures should be inexpensive to implement. Based on its past behavior, DSS will have far more difficulty with another recommendation: establishing groups of pediatricians, psychologists, nurses, and other professionals to provide an essential backstop to social workers as they investigate abuse cases.

The commission wants teams to be created at all major pediatric hospitals in the state but doesn't say whether this is enough, who should be on the teams, or how they should interact with DSS. These omissions undercut its most important recommendation.

The teams are essential because Massachusetts contains people with enormous expertise in these areas, but the state lacks the ability to mobilize them in a systematic way. Haleigh lived in Westfield, and, the commission noted, expertise on child abuse is ''seriously lacking in the western region."

People concerned about child welfare have been telling the state to establish these teams for decades, but aside from a brief experiment or two, DSS has never embraced the concept. Florida, a much bigger state, has had great success with its system, which encompasses 22 teams.

Harry Spence, the DSS commissioner, said yesterday that he is committed to implementing the report's recommendations. But they are wide-ranging, and the proposal for teams could easily be whittled down or forgotten.

Spence knows that DSS received bad advice about Haleigh from physicians who could not benefit from the guidance of experienced interdisciplinary professionals. To prevent future tragedies, he needs to make the creation of these teams the capstone of his tenure at DSS.