'Missed chances' to help boy

Deputy Prime Minister Nick Clegg said the Government must ensure abused children like Daniel Pelka "do not fall in between the cracks of the system again".

Mr Clegg told ITV News it was "absolutely heartbreaking" that Daniel had been neglected and abused "in the most unimaginable way".

"The whole nation was shocked to our core when we saw what happened to this little poor boy," he added.

Home Secretary Theresa May said there are "lessons to be learnt" from the case of Daniel Pelka, the four-year-old boy who was beaten and starved to death.

Ms May said: "I'm pleased the Government enables these reviews now to be published so we can actually see where issues arise. We can genuinely learn the lessons.

"I think all the agencies have recognised that they need to look at how information is shared between people.

"One of the issues that the Daniel Pelka case raises is that when people are looking into issues of domestic violence, making sure we look at how those incidents affect children."

Prior to Daniel Pelka's death in March 2012, the four-year-old came in contact with a number of professionals who either noticed or treated him for injuries, or saw changes in his weight and eating behaviour.

The Serious Case Review found there were a number of opportunities to protect Daniel that were missed:

Read: Daniel suffered 22 different injuries across his body

Children's Minister Edward Timpson has ruled out Government support for a so-called "Daniel's Law" that would place a legal duty on social workers, doctors and school teachers to report child abuse.

Mr Timpson has instead written to the Coventry Safeguarding Children Board, which published today's report, urging them to "dig deeper" into the reasons why mistakes were made in the case of Daniel Pelka.

He said: "Mandatory reporting is not the answer. Guidance is already crystal clear that professionals should refer immediately to social care when they are concerned about a child.

"Other countries have tried mandatory reporting and there is no evidence to show that it is a better system for protecting children. In fact there is evidence to show it can make children less safe."

Daniel Clews, who was headteacher of Little Heath Primary at the time Daniel Pelka attended, said he has asked himself "many times if I could have done more."

Mr Clews said the school's concerns about Daniel "were based on the limited information available to us and were passed on to the relevant agencies that we thought were best placed to help".

He continued: "I believe that my staff and I followed all the procedures we felt were appropriate to take given what we knew during the six months that Daniel was with us.

“During that time, his teachers and I did raise concerns with his mother and believed we were working together to get to the bottom of these issues.

"Had we doubted for an instant that his mother was not the concerned parent she professed to be, we would, of course, have acted very differently."

The Coventry and Warwickshire Partnership NHS Trust has looked at "a number of actions" that it needed to take following the death of four-year-old Daniel Pelka, medical director Dr Sharon Binyon said.

Dr Binyon told ITV News: "We know that the number of health visitors in Coventry was one of the lowest in the country, so we have been working with NHS England.

"Since the time of Daniel's death we have doubled the number of health visitors and they will be trebled by 2015."

The Trust has also implemented a new system "whereby when there is a child in the house and domestic violence is reported then automatic reporting goes to school nurses and health visitors as appropriate, but it's also kept electronically on their records."

Prof Eileen Munro told ITV News the Serious Case Review into Daniel Pelka's death is "very frustrating".

Prof Munro, who conducted a review into high-profile abuse cases including the death of Baby P, said the new report "tells you what happened, but it gives you very little idea of why".

She continued: "These were clearly professionals who were concerned about Daniel, they were very actively trying to help him and they failed.

"And I don't get a sense from the review of why they failed - what it looked like, how they were misled, why they didn't see the sadistic torture that was going on - so I find I cannot clearly see what lessons you can draw from it."

The chair of the Coventry Safeguarding Children Board, which published the Serious Case Review into Daniel Pelka's death, said it found there were "missed opportunities" and "other things should and could have been done".

Amy Weir told Daybreak, "However, it is not the purpose of this review to identify who was responsible, or what could have been done differently by particular individuals."

Gill Mulhall, the current headteacher of the school Daniel Pelka attended, said if his teachers had been aware of his suffering then they would have "acted very differently".

Ms Mulhall said: "What was proven in the criminal trial is that his mother was a convincing manipulator who fooled many professional bodies over a long period of time by producing a convincing act as a caring parent.

"If we had been aware of the bigger picture of Daniel's life, or had any doubts about his mother, then we would of course have acted very differently.

"What we want to see now are changes where schools are aware of concerns from other agencies which affect our pupils to try and ensure that nothing can ever happen again."