Professionals Against Child Abuse

Dr David Southall was erased from the medical register in December 2007 by the GMC. As it turns out this action was against the GMC’s own rules about erasure and he has subsequently been restored to the register pending appeal. In response to this volte face PACA issued the following press release outlining the issues facing the GMC in their case against Southall.

PACA has had major concerns about the General Medical Council’s Fitness to Practice procedures in high profile cases of paediatricians who have led the way in child protection work. PACA considers the GMC’s actions have reduced the willingness with which paediatricians will report suspicions of child abuse and engage in child protection work, including acting as expert witnesses. PACA has attempted to engage with the GMC, but Professor Catto, President of the GMC, and Finlay Scott, CEO, have responded that PACA is “painting a misleading picture, thus adding to the very problem they say they wish to resolve”.
 
However, last week, PACA’s concerns were overwhelmingly supported by a motion at the Annual General Meeting of the Royal College of Paediatrics and Child Health. The motion listed the areas of concern (see below) and called for the GMC to review the Fitness to Practice procedures as a matter of urgency. They recommended involvement of the RCPCH, the Department of Health, Department for Children, Schools and Families, Social Services Inspectorate and National Children’s Bureau. Unlike the GMC, these bodies better understand the relevant legislation and practice.

PACA is now further disturbed by the announcement today that the GMC failed to comply with its own regulations when they applied an immediate sanction against Professor Southall, resulting in his inability to work as a doctor. The GMC’s sanction led to Professor Southall’s immediate suspension from clinical and charity work, including his honorary medical directorship of the aid agency Childhealth Advocacy International (CAI).  This sanction was applied in the absence of evidence that his clinical or CAI work had caused any harm and had in fact brought enormous benefits to patients.  As a direct result of this sanction, Professor Southall had resigned from his consultant post at the University Hospital of North Staffordshire. Furthermore, the actions of the GMC against him have seriously impaired CAI’s ability to raise funds for its humanitarian aid work.

At least the GMC’s have conceded that they had made an error, resulting in cancellation of the suspension. However, it compounds their existing inability to regulate judiciously in cases involving leading child protection professionals. Given the GMC’s inability to recognise their error in erasing Professor Sir Roy Meadow from the medical register, described by a high court judge as approaching the irrational, and apologise to him, we have little expectation that the GMC will move forward with an urgent review of its procedures, as voted for at the RCPCH AGM. It is now time that the GMC reviewed the sanctions and erasure that they applied to Professor Southall’s cases in 2004 and 2007 respectively. In the view of PACA, they were both incorrect judgements.

Currently the GMC will receive complaints from anyone (having no vexatious complaints policy) - it then investigates and prosecutes these complaints, sits in judgement on its own investigation and finally decides what penalty should be applied. This is hardly a fair or balanced process and certainly not one that fulfils a doctor’s right to a fair hearing under Article 6 of the European Convention. Our experience of the GMC responses to its errors lead us only to conclude that it is incompetent and disingenuous in the way it attempts to defend the indefensible.

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Motion for RCPCH AGM – York University, April 2008

The College has grave concerns about the actions of the GMC relating to proceedings involving child protection work directly or indirectly. These actions include:

1. The GMC erased from the register one paediatrician acting as an expert witness in a case where two children had died and where the mother was tried for murder. The erasure was quashed by the High Court, but the GMC have not acknowledged that the erasure decision was wrong and have not satisfactorily explained why they consider it is not related to the child protection field. As a consequence, paediatricians have been deterred from acting as expert witnesses in cases involving child injury or death, many of which would be classified as possible child protection cases.

2. The GMC sanctioned a paediatrician for reporting concerns to the statutory authorities for child protection and, describing the doctors’ behaviour as “precipitate” and criticising his evidence-based opinion given in good faith, found him guilty of serious professional misconduct and suspended him from further child protection work. This contravenes the stated professional and public duty to report child protection concerns and the latest guidance issued by the GMC itself. As a consequence, paediatricians now feel less certain of the correct way to proceed and may therefore be less likely to report child protection concerns.

3. The GMC erased from the register a paediatrician who was exploring with a parent the mechanism of death of their child at the request of social services in the context of care proceedings. The parent alleged that the paediatrician had accused her of murder, despite evidence to the contrary from the senior social worker present who along with the paediatrician took notes throughout the interview. As a consequence, many paediatricians are now more reluctant to participate in child death reviews or indeed explore with parents possible mechanisms for sudden death.

4. The GMC have repeatedly relied on an expert witness known to have opposing views to the doctor being investigated and who had advised contrary to that doctor in the first of the above cases. This raises serious questions about the impartiality of this expert, particularly as the GMC did not use any other expert evidence. As a consequence, paediatricians feel that GMC hearings in the field of child protection have not had the benefit of truly impartial advice representing current mainstream professional practice.

5. The GMC have undertaken a number of investigations on paediatricians who have already been the subject of investigations by other bodies and have been exonerated. The GMC have not inquired about such investigations, or have failed to take account of these previous investigations. We consider that this represents double jeopardy and demonstrates an unfair and incomplete process. As a consequence, paediatricians have become less willing to be involved in child protection work, knowing it may result in multiple complaints and investigations.

6. GMC registered doctors working in other specialities, who were convicted of various crimes, including assaults on children and viewing child pornography (offences which would render them unemployable as paediatricians) have been reinstated to the register. As a consequence, paediatricians feel treated more harshly than other specialities by the GMC.

7. The GMC does not automatically inform the doctor when it decides not to proceed with a complaint. College members know that complaints in child protection are rising and are under extreme and often public stress when they receive such a complaint. As a consequence, paediatricians are poorly informed by the GMC of progress in their own personal case.

8. The GMC is unwilling to state whether it has received multiple complaints from the same person(s) acting as part of a campaign against factitious and induced illness, quoting data protection legislation. Paediatricians have been asking the GMC to develop a policy for dealing with vexatious complaints and serial complainants. As a consequence, paediatricians feel the GMC is not taking their concerns on board.

For the above reasons, the College continues to have grave concerns over current GMC procedures for dealing with cases related to child protection. We call upon the GMC to review these procedures as a matter of urgency and involve in the review this College and other bodies such as the Department of Health, Department for Children, Schools and Families, Social Services Inspectorate and National Children’s Bureau, who have an understanding of the relevant legislation and practice, in order to support continued quality work by paediatricians in this field to the ultimate benefit of children and their families.