A paediatrician who has helped to cut child abuse in Hawkes Bay by two-thirds has been given the chance to tackle the problem on a national scale as the country's new Children's Commissioner.

Dr Russell Wills, a community paediatrician for the Hawkes Bay District Health Board, was a surprise choice for Children's Commissioner, given his outspoken role as spokesman for the Paediatric Society's campaign to keep smacking as a criminal offence in the 2009 referendum.

But Napier MP Chris Tremain, who approached him about the role on behalf of Social Development Minister Paula Bennett, says he was chosen because he had developed solutions to child abuse and neglect.

Eastern Institute of Technology professor Kay Morris Matthews, who has evaluated Hawkes Bay's collaborative approach to "B4 School" health checks which Dr Wills leads, says the programme is helping families to resolve health and parenting issues before children reach school.

"His skilled chairpersonship and his human way of communicating with professionals are just very effective," she says.

"He is just totally passionate and committed to children and to improving their health and wellbeing."

Dr Wills, 47, grew up in Hawkes Bay and left a job as Plunket's national paediatrician to go home to Hastings as a community paediatrician 11 years ago.

In an unprecedented move, Ms Bennett has agreed to let him keep up his clinical work in Hastings half the time, commuting to the commissioner's office in Wellington for the other half of each week during his five-year term.

Dr Wills says he did not want to move his wife and two sons aged 11 and 14 because the boys were settled in their schools.

He also wants to keep up his clinical work because it "keeps me grounded".

Hawkes Bay children are among the country's poorest. Half the region's babies are Maori and 56 per cent are born into the most deprived 30 per cent of families. Three-quarters of the children admitted to the region's hospitals are Maori or Pacific and three-quarters are from the poorest three deciles.

"My particular numbers, because I do a lot of child protection and behaviour work, are even higher," Dr Wills says.

Mr Tremain says Dr Wills is "empathetic across a raft of different situations".

"He's very good with his te reo, he speaks well on the marae," he says.

Dr Wills arrived back in Hastings as the region was reeling from the 1999 murder of 3-year-old James Whakaruru.

He introduced a programme, since adopted nationwide, which trained all the region's health professionals to look out for signs of abuse and to take action.

"What that means is that if you are in a violent relationship and go into a hospital anywhere in the country, you can talk to your paediatrician or nurse or midwife and they will be trained to talk to you sensitively, assess your risk and do things that will keep you safe," he says.

NZ Child and Youth Epidemiology Service statistics show that hospital admissions of children for assault, neglect or maltreatment in Hawkes Bay plunged by two-thirds from 37 for every 100,000 children in 1998-99 to just 12 in 2008, while the national average was static at around 20.

Ngati Kahungunu iwi head Ngahiwi Tomoana says the health board now consults the iwi "on a weekly basis, if not more frequently" over every case of child abuse or family violence involving an iwi family.

The head of the iwi's healthy whanau strategy, Jenny Smith, says Dr Wills pulled together police, health agencies and all other agencies working with families.

"He has seen the raw edge. He will be real," she says.

He took a similar cross-sectoral approach when "B4 School" checks for all 4-year-olds were introduced in 2008. Dr Wills led a clinical advisory group which has overseen the training of more than 100 nurses in doctors' clinics, Maori and other health services to reach all 4-year-olds, conduct the checks and refer children for help where needed.

The first 10 months of the new service up to January last year reached 75 per cent of 4-year-olds in the poorest fifth of families and 84 per cent of all 4-year-olds.

The latest data show that the service will reach 80 per cent of those in the poorest fifth of families by the end of next month.

About half of all 4-year-olds, and almost 70 per cent of those from the poorest fifth of families, are referred for help to dentists, eye or ear specialists or other health services, or to social agencies and Special Education services for parenting and behavioural issues.

Unusually, in Hawkes Bay all referrals are managed by a "triage group" of health, education and social services who meet fortnightly to agree on who should take each child and to track every child's subsequent appointments.

"The idea is that no child falls through the cracks," says Professor Morris Matthews.

In his new national job, Dr Wills will have a key role advising on a "green paper" due to be published in August on child protection, including tracking at-risk children, possible mandatory reporting of child abuse, more use of schools for after-school activities and reviewing the whanau-first placement policy for children in state care.

Dr Wills sees his priorities in the job as "the priorities we all have - child poverty, parenting, family violence, child abuse, the educational tail, and teenage suicide, motor vehicle accidents and pregnancy".

"What I bring is an approach to these things, the ability to bring people and ideas together to a common purpose," he says.