Protecting children, supporting professionals
Archive for the ‘Opinion’ Category.
PACA supports whistle blower paediatrician Dr Kim Holt.
If those of you who follow the link to Andrew Gilligan’s blog want to know more, perhaps you could read the NHSL (National Health Service for London) report on this matter at this link:
PACA Press release - Failure of Medical Regulation - time for an inquiry into the integrity of the GMC after David Southall’s appeal win.
PACA is delighted that justice has been achieved in the case of David Southall, with the Court of Appeal today overturning the decision of the GMC’s Fitness to Practise (FtP) Panel in December 2007 to erase his name from the medical register.
The Appeal Court determined that the GMC Panel had been prejudiced by an inappropriate view that David Southall should not have undertaken an interview of a mother to investigate the death of her child. The three judges considered the Panel’s approach “was not one based on evidence”. PACA always considered the finding of the FtP Panel perverse and another example of the GMC’s harassment of leading child protection doctors. […]
Download the full press release as PDF: Failure of Medical Regulation - time for an inquiry into the integrity of the GMC after David Southall’s appeal win
In the UK, on June 1st 2009, there was a Panorama TV programme about Dr David Southall entitled “a very dangerous doctor”.
Soon after the broadcast a complaint about the programme was made to Ofcom.
Ofcom’s response is published in the Ofcom broadcast bulletin issue 148 on page 138 and on. (see link below).
Needless to say the complaint was not upheld.
Ofcom is The Office of Communications, a government body.
Link:
http://www.ofcom.org.uk/tv/obb/prog_cb/obb148/Issue148.pdf
PACA has been supporting a Consultant Paediatrician who worked in Haringey before Baby P died.
This is a link to an article on the Sunday Telegraph website:
http://www.telegraph.co.uk/news/uknews/baby-p/6739202/If-Great-Ormond-Street-had-listened-to-me-Baby-Peter-would-still-be-alive-says-consultant.html
On reading this article PACA has released the following press statement:
6/12/2009
STATEMENT BY PACA: DR KIM HOLT SHOULD BE THANKED AND REINSTATED
For immediate release:
PACA (Professionals Against Child Abuse) wishes to express its support for Dr Kim Holt, Consultant Paediatrician, following the publication of information about concerns she and others raised in 2006 about the management of children’s health services in Haringey.[1]
Dr. Holt was one of four Consultant Paediatricians who wrote to their managers listing numerous concerns which they had raised for at least two years at that stage.[2] Many of these were the same as factors identified by the Care Quality Commission when it reviewed the death of Baby P.[3] Only one of the four Consultants is currently in post.
PACA notes with concern the fact that Dr Holt has been excluded from her job for over two years, is currently on a temporary secondment, with no long term job security and that she has always been clear that she wanted to return to her original post. PACA notes that Dr. Holt stated that considerable efforts were made to have her removed.
It appears that Dr. Holt is yet another NHS whistleblower who has been badly treated by the NHS after raising legitimate concerns. This is unacceptable. Following the Stafford scandal, health ministers repeatedly stated that whistleblowers enjoy full legal protection from the Public Interest Disclosure Act 1998.4 If this were truly the case, Dr. Holt would not have suffered these detriments. We would welcome a statement from a minister on this matter now.
PACA suggests that Dr. Holt should be thanked by her employer, Great Ormond Street Hospital for Children NHS Trust, which should also offer her a public apology. It should reinstate her and supply the necessary resources to allow her to do her job. It should also compensate her for the unnecessary costs she has incurred, including those relating to unnecessary legal costs and maintaining her skills whilst excluded from the workplace. We do not see that any other course of action is in the interests of vulnerable children, the wider community, and the NHS.
We note that Great Ormond Street’s spokesperson finds it “difficult to comment until an independent investigation is completed.” We understand that the report from the investigation was supposed to have been published in September 2009. Ongoing delay appears to prevent Great Ormond Street from addressing important issues. We believe that it is in the public interest for that report to be published. When it is, PACA members will study the report to see what implications it may have for other individuals involved.
John Bridson Chair PACA
—
Notes
1 BMA News Review, front page headline, 21 November 2009; Sunday Telegraph, 6 December 2009.
2 A. Gilligan, Doctors raised alarm over ‘high risk’ at Baby P clinic, Evening Standard 12th May 2009
3 CQC, Review of the involvement and action taken by health bodies in relation to the case of Baby P, 2009 [Draws on previous independent investigation] http://www.cqc.org.uk/_db/_documents/Baby_P.pdf
4 See, for example, Ben Bradshaw MP, Minister of State for Health, House of Commons Hansard 18 May 2009.col 1227W.
Information about PACA: Children are the most vulnerable members of society. Sometimes the very people who are expected to protect them place them at risk. It is then that professionals who work with children have a duty to protect them. PACA believes that vulnerable children need dedicated paediatricians, nurses, social workers, teachers and the law to protect them. PACA was formed in response to high profile cases against paediatricians at the General Medical Council at which it became clear that the present regulatory systems did not protect children and were open to abuse by those who sought to discredit professionals who stood up publicly for children’s rights. PACA advocates for children’s rights by campaigning for regulatory organisations to be trained in child protection, for the interests of the child to be paramount, and for professionals who stand up for children to receive fair treatment.
Dr Southall was struck off the medical register by the GMC pending an Appeal.The Appeal was heard and a judgment published in May 2009.
This confirmed the GMC decision to strike him off, there was just one more chance, a short two hour verbal appeal to be held in October 2009.
“Although very disappointed with this judgment, I intend to seek leave for a further Appeal.
“I wish to make it clear that I completely deny the accusation made by Mrs M who has been supported in pursuing her false allegations by Mrs Penny Mellor, the leader of a long-standing campaign against my child protection work.
“The version of what happened in that interview with Mrs M as part of a section 47 child protection inquiry requested of me by the Family Court was exactly as described by the Team Leader in Social Work for the case who was present throughout.
“This Social Worker had been qualified for 10 years, possessed a number of higher professional qualifications in child protection and had met me along with her supervisor on only one occasion prior to and not at all after the interview.
“In her report prepared for the GMC hearing, she stated “I am certain that Professor Southall did not make such an allegation during that interview.”
“I find it difficult now to understand how any doctor in the UK can undertake a sensitive discussion or perform an intimate examination in the presence of an appropriate chaperone and be safe from false allegations.”
The Law Commission Consultation Paper on Expert Witnesses contains some mythology. PACA member David Murray penned this excellent response.
We have learnt over the last few years that no one and no profession is infallible. Some people can see the myths, but others are blind to them and are led by their prejudices.
Link to the Law Commission Consultation Paper on Expert Witnesses (PDF)
Text of the response by David Murray:
“You invite comments on the Consultation Paper.
PACA, is a group of Consultant Paediatricians and doctors together with lawyers, social workers and psychologists involved directly in Child Protection, or indirectly in the defence of doctors maligned in the media and punished by the General Medical Council for acting for the abused child against the abusers. May we ask you to consider the points made in the attached letter? We would be delighted to offer advice on the medical and forensic implications of working in this difficult field where our duty to children now requires us to defend ourselves against unfounded and often malicious commentary.
The Paper itself uses inaccurate evidence to illustrate poor medical and scientific expertise. It would make more sense to have used as an example of misleading expert evidence, not the Clark case, but a case in which such evidence had been shown conclusively to be in error, and for that error to have lead directly and materially to an unjust conviction, rather than to pick a case where the finding of murder was based on convincing medical and forensic argument remote from the supposed failings of expert witnesses, and then use that imagined failing to claim that such events are a problem. There is no “dogma that holds that two or more unexplained infant deaths should lead inexorably to the conclusion that a murder has been committed”, nor do Meadow or any other paediatricians cleave to it as the commissioners hold. There is no evidence that, “multiple cot deaths in a family could have underlying genetic causes”, nor can it be reliably stated that the occurrence of a second cot death is “usually from natural causes” when all, some, or none of such cases might be murder. How are we to reach sound conclusions as to the merits of procedures designed to protect against misleading opinion when the examples used to adduce such a necessity are so flawed that they discredit the real experts and take their lessons from the opportunist incompetent?
Meadow is not an example of flawed expertise but an expert traduced for being too astute and prescient. It was he who first realised that his ally in the comforting and treating of the sick child, its mother, may be the agent of its distress. Is it not odd that the country’s most distinguished expert in the misfortunes and murder of children should be the focus of an inquiry into flawed medical expertise? Is it not ironic that the wrong target has been selected with the expert of great value to the Court confused with the inexpert ‘expert’ who makes clinically implausible suggestions of a cause of death that are just sufficient to persuade the Court that there is a real dilemma and that justice is best served by prevarication?
Those who deserve scrutiny are not the leading figures in paediatric and forensic medicine but those whose imaginative diagnoses serve their purpose in Court but would be lethally dangerous if made at the bedside of a critically ill child: the retired haematologist who thinks Victoria Climbié died of a rare disease that inflicted marks on her body that seemed, to all but him, the indentation of the bicycle chain used to beat her, the retired biochemist with the first ever case of a novel syndrome to explain a child dying full of salt, the microbiologist who added to a dead baby’s list of injuries, typical of violent suffocating assault, the clinically unsound diagnosis of an infection of such ferocity that it overwhelmed the child in its bouncy chair in no more than ten minutes, the doctor flown in to say that dreadful injuries could have been caused by epilepsy rather than brutal contact with a banister rail. Constructive advocacy acts in the interest of clients but seldom for truth or the protection of vulnerable children. A great injustice has been done to Sir Roy Meadow and to the murdered children and should not be added to.”
Following the erasure of Dr David Southall from the GMC medical register.
PACA is saddened to learn that David Southall’s appeal in the High Court
today was unsuccessful in overturning the decision of the GMC’s Fitness to
Practise Committee to erase him from the medical register in December 2007.
The GMC have held three Fitness to Practise Hearings against David Southall:
in 2004, 2006-7 and in 2008. Only in the 2007 Hearing did the outcome lead
to a permanent restriction on David Southall’s ability to practise medicine.
PACA believes the GMC have acted inappropriately and have been improperly
influenced by a skilful and hostile media campaign by parents involved in
alleged child protection cases and their advocates. PACA is now concerned
that today’s result will have further serious and negative effects on the
willingness with which doctors will engage in child protection.
Internationally acclaimed and eminent paediatricians involved in child
protection have sustained repeated harassment in recent years, including
from the GMC. PACA considers that the GMC preliminary assessment procedures
have been ignorant of the nature of child protection procedures in the
Family Courts and that this case should never have been brought against
David Southall; that he has always given honestly held opinions, based on
extensive experience in complex child protection cases and solely with the
purpose of protecting children has never been questioned.
The disciplinary actions of the GMC, today supported by the High Court, will
be a further deterrent to paediatricians and other health professionals from
engagement in child protection work. Last year, the Royal College of
Paediatrics and Child Health voted overwhelmingly to express their grave
concerns about the GMC’s actions in the cases of both Professor Meadow and
David Southall. PACA considers today’s action will be a disservice to
children. The GMC should act only to encourage doctors to report child
protection concerns and engage in child protection work, by making them feel
safe from disciplinary actions, unless the doctor has been shown to have
acted incompetently or with malice.
We will provide full comment when we have read the full judgement.
[Update - the full judgement can be read here: Final_Southall_22_05_09.pdf (236 kb)]
We think the Laming terms of ref. give PACA adequate scope to contribute to his review. We still do not have an address for his review but note that the ministers letter says he will provide all necessary resources. We have sent our submission to the DCSF expecting them to forward it…
The ongoing deaths of young children as a result of abuse should signal the fact that the current system of investigation and care still has shortcomings. Perhaps the processes of classifying abuse and the investigation of abuse need reflection. These two papers might help with a reassessment of the process.
