Professionals Against Child Abuse

Paediatric Child Protection practice has been seriously hindered by the maltreatment of experts, in particular Roy Meadow and David Southall, both of whom are experts in FII (Fabricated or induced illness ). Politicians, the media, and the GMC have ruined their reputations and careers and worse, left children more vulnerable.

The most recent GMC hearing in August involved David Southall and ended a few days ago. What follows is a series of documents detailing the outcome.

1 – “Transcript of Day 16 of the hearing” this is helpful in putting a balance on the GMC panels self-justifying determination. SouthallDay16_21092011.pdf

2 – “GMC Determination in relation to serious professional misconduct.” Southall-D Not SPM 29 September 2011.pdf

3 – “PACA Press releases version 1″ – used for general distribution. PACA Press Release v1.pdf

4 – “PACA press release version 2″. – used for selective distribution. PACA Press Release v2.pdf

5 – Paca rapid response to Clare Dyer article in BMJ ” Independent Inquiry needed” published BMJ 12/10/11. Independent Inquiry Needed into GMC.pdf

One of PACA’s roles is to try and provide clear information with which readers will be able to make an assessment of the relevance and accuracy of media coverage when we feel that topics are being portrayed in an allegedly unbalanced way.

Currently the topic of Shaken Baby Syndrome is being aired. The following links lead to relevant information. The first document (starting “Yes”) is not in our opinion mainstream; the second comment (starting “No”) mirrors PACA’s stance and reflects mainstream opinion.

Reference: “The triad of retinal haemorrhage, subdural haemorrhage and encephalopathy in an infant unassociated with evidence of physical injury is not the result of shaking, but is most likely to have been caused by a natural disease.”

Link to Article: No – RORKEvSQUIER-No.pdf
by Rorke-Adams LB J Prim Health Care 2011, 3:161-3

Link to Article: Yes – RORKEvSQUIER-Yes.pdf
by Squier W J Prim Health Care 2011, 3:159-161

After viewing the Channel 4 Cutting Edge program on the 12th May, PACA members felt the need to put their comments out as a press release.

PACA Press Release, 14 May 2011 – The Cutting Edge programme on Channel 4 entitled ‘A Very Dangerous Doctor’ (Thursday 12th May) showed yet again how the media approaches the issue of child protection where it has limited factual knowledge of the issues involved, and allows itself to be misled. It repeated the claims made by four sets of parents that Professor David Southall made false allegations of child abuse and was doing this to enable him to research on their children. The programme maker was aware of published evidence that contradicts this in every case, but did not use it. For example, the GMC has already investigated and dismissed the parents’ claims that Professor Southall was accusing them in order to further his research following a detailed investigation by the parents’ own medical expert, who is a Professor of Paediatrics.

Professor Southall has repeatedly expressed how he is unable to defend himself against the mothers’ accusations, as this would place him in contempt of the Family Court in three cases and break the confidences of a social service meeting in the fourth case; in addition, to do so would be potentially damaging to the now “grown-up” children involved.

Because of his pioneering work surrounding child protection, Professor Southall has become the target of those who wish to discredit his work. However, the results of over 20 investigations by authorities such as Professor Southall’s employing NHS Trust, the Regional Health Authority (Griffiths inquiry), three police forces, the Charities Commission, RCPCH, GMC and Attorney General have failed to support the claims in response to complaints made by Mrs Mellor and others in the past 12 years. The numerous investigations have cost the Health Service and the tax payer many millions of pounds to no purpose whatsoever. The complainants are subject to no discipline or sanction, in contrast to the strict professional discipline to which Professor Southall and all the other professionals involved in these issues are subject.

Case 1
The programme incorrectly cited a House of Lords decision (reference: 1), claiming it concerned a false allegation of abuse by Professor Southall. This is quite simply wrong. The case was brought to test whether parents, distressed by an accusation of child abuse, could pursue a doctor for damages in the event of a wrongful allegation undertaken in good faith. The decision of the House of Lords was that for the sake of safety of children, parents should not be permitted to pursue a doctor for damages. No hearing has ever tested whether or not Professor Southall, or any of the other 20 professionals at a child protection case conference who placed the particular child concerned on the Child Protection register, made an error in pursuing child protection proceedings.

Case 2
The second case dates to nearly 25 years ago and was reported in a social care journal (reference: 2). The professionals involved with the case were concerned enough to hold two case conferences and a Family Court Judge made a Care Order, which helped to protect the child. Again, Professor Southall was only one of a team of professionals involved in this case.

Case 3
The third case also has been extensively reported in the media. The allegations the parents made about Professor Southall resulted in a protracted police investigation from 2003 to 2011. The programme reported that “the police have told Dee and Dave that the CPS believes there is insufficient evidence to secure a conviction”. In fact, Professor Southall was advised by the Police on 24th March that the Crown Prosecution Service had: “completed their detailed review of all the documentation submitted to the police” and “have concluded that there should be no criminal prosecution against you”.

Case 4
The final case involved the use of covert video surveillance (CVS) in the diagnosis of fabricated or induced illness. The mother alleged that Professor Southall falsely accused her of fabricating or inducing her two year old daughter’s illness and of “punching” her in the face when under surveillance in the hospital. The illustration in the programme enables a viewer to identify the case in the CVS paper (reference 3). In the 39 cases reported, only one of the children was reported as being hit on the mouth. The covert surveillance, as reported in the journal Pediatrics, revealed additional serious abuse of this child by her mother.

The use of CVS, which is only undertaken in collaboration with the police and social care, has established that parents do, indeed, abuse their children (reference: 3). Fabricated and induced illness is a complex pattern of harm to children. Doctors are reluctant to consider early the possibility that this type of abuse may be occurring, and proving it is difficult. However, the work of Professor Meadow and Professor Southall has provided substantial evidence for the harm this abuse causes to children; Professor Southall also pioneered the importance of a thorough forensic approach, obtaining confirmation with the use of CVS. It is extremely worrying that the media does not have such a thorough approach.

The media continues to give publicity to articulate parents who claim that they have been falsely accused of abusing their child/children. However, no responsibility is taken to raise awareness of the challenges faced by paediatricians with a duty to safeguard children or the multiagency processes that ensure decisions are taken by a wide range of professionals. The parents’ allegations should be verified without reliance solely on the parents’ stories. In the field of child protection, it is well recognised how parents, who may come across as loving and caring, can manipulate health and social care professionals. For example, the mother of Baby Peter convincingly lied to a social worker and was, tragically, believed. A video clip of this revealing interview is available, but was not included in the programme. As professionals have now learnt to think the unthinkable, so the media too must learn that some parents can be very dangerous. Cutting Edge did not present the whole truth and this does injustice to children who were and are abused.

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References

1.JD v East Berkshire Community Health NHS Trust [2005] UKHL 23

2.Rees SV, Munchausen syndrome by proxy: another form of child abuse. Practice 1987;3:267-82

3.Southall DP, Plunkett MCB, Banks MW, Falkov AF, Samuels MP. Covert video recordings of life-threatening child abuse: lessons for child protection. 1997;100: 735-60.

Here are links to two very important reports of the UN Committee on the Rights of the Child (CRC) for the protection of physically and sexually abused children and for the protection of those who report their suspicions.

The reports recommendations support safeguarding professionals who mostly feel greater protection is needed for those who in good faith report suspicions of abuse regardless of outcome.

The relevant reports of the 2 Special Rapporteurs have been discussed at the 16th sessions of the Human Rights Council at Geneva, this link leads to a list of the reports for the 16th session.

http://www2.ohchr.org/english/bodies/hrcouncil/16session/reports.htm

1. The Committee of the Children Rights has adopted General comments n.13 on 17th February 2011 concerning the Article 19 of CRC: The right of the child to freedom from all forms of violence. This link is to a list again, but the top one is the one to click on, also see first attached file.

http://www2.ohchr.org/english/bodies/crc/comments.htm

Page 20 paragraph 45. states

“In every country reporting of instances, suspicion or risk of violence should, at a minimum, be required by professionals working directly with children. When reports are made in good faith, processes must be in place to ensure the protection of the professional making the report.”

2. The joint report of the special Rapporteurs, The Special Rapporteur on the sale of children, child prostitution and child pornography and the Special Representative of the Secretary-General on violence against children on 7th March 2011.

http://www2.ohchr.org/english/bodies/hrcouncil/docs/16session/A-HRC-16-56.pdf

P22

Recommendations paragraph 112

(a) Mandatory reporting by professionals who work with children of sexual abuse and other acts of violence causing physical injury and psychological violence should be given due consideration by all countries. Rules that protect the identity of professionals and private individuals who bring cases of violence against children to the attention of the competent authorities should also be enacted into law;

(f) Safety and confidentiality should be safeguarded to protect children and their representatives from any risk of reprisal when complaints are lodged or incidents of violence reported, and to ensure that all actions are carried out in the best interest of the child and with children’s involvement and informed consent. Children must be confident that no information will be shared without their consent and their confidentiality will not be breached, unless there is a well-founded belief that doing so would be necessary to protect them or others from serious harm;”

then

Paragraph 54 – Reporting by professionals who work with young children is especially important; these children are more susceptible to injury and unable to make complaints, and early detection and intervention can help reduce the risk of repeated abuse and long-term health and social consequences.

Paragraph 55 – The authors of the present report consider that some form of mandatory reporting, including the reporting by professionals who work with children, of sexual abuse and acts of violence causing physical injury and psychological violence is appropriate for all societies.

Paragraph 60 – The authors of the present report consider that standards establishing an obligation to report violence should be incorporated into the regulations or rules of conduct of all institutions or agencies that deal on a regular basis with children at risk of violence, such as residential facilities, schools, medical services for children and law enforcement bodies.

PACA continues to be concerned about the GMC performance in general, and in particular with Doctors involved with complaints regarding Child Protection.

The following post gives a few examples of GMC behaviour which we feel could be seen as inconsistent.

GMC double standards:

Number 1:

GMC insisting that Dr Al-Zayyat attends a FtP Hearing over the allegation that she missed Baby Peter’s broken back (even though it might have been broken after she saw him) because: “there was a public interest in having the complaints against Dr Al-Zayyat scrutinised in public and in having the panel reach a formal decision and announce its findings of fact in public”. This is to satisfy “the maintenance and promotion of public confidence in the medical profession and the maintenance and promotion of public confidence in the GMC’s performance of its statutory functions”. Even though this doctor is back in the Middle East and suicidal and wants voluntary erasure.

versus:

GMC accepting breast surgeon, Mr Gilmore’s application for “voluntary erasure” from its medical register just before a FtP Hearing, stating “Our primary role is to ensure that those doctors on the medical register are fit to practise: however, in dealing with concerns our process must be fair to the doctor concerned”. See: http://www.telegraph.co.uk/health/8105203/GMC-has-let-down-public-over-breast-surgeon.html

Number 2:

GMC erase names from medical register of Professor Sir Roy Meadow (Founding President of RCPCH) and Professor David Southall OBE for giving honestly and reasonably held opinions in child death cases – both now overturned in High/Appeal Courts, with GMC actions said to be irrational, inappropriate. Both were experts in child protection esp relating to infant deaths.

versus:

GMC actions, eg short term suspensions, in cases of doctors dealing in child pornography (ie child abuse media). For example, Hereford Times Jan 2010: “GMC have suspended a family doctor who downloaded an “abhorrent” collection of child sex stories. Dr XX was described as a “sexual deviant with an interest in children” at the General Medical Council hearing. The GP, who practised at XX Surgery, admitted to using his home computer to download written pornographic material. But the GMC cleared Dr X of misconduct, as it believed his fitness to practise was not impaired by the fetish. The Manchester panel heard that Dr X, a GP of 25 years, downloaded the material between 2003 and 2007″.
…
In 2008: “Out of five doctors convicted for possessing child pornographic material, four were allowed to continue in practice and one case is still to be considered”.

Following a negative response from the GMC to our open letter published in the BMJ, a judicial review was put in motion by a senior paediatrician, with PACA’s assistance, to have Mrs Penny Mellor removed from the GMC expert group on child protection. Some days after the papers were delivered to the GMC Mrs Mellor resigned.

PACA issued this press release today.

3rd November 2010

Re Mrs Mellor’s resignation from the GMC Expert Group on Child Protection

PACA welcomes the resignation of Mrs Penny Mellor from the expert group set up by the GMC to review doctors’ conduct in child protection matters. Mrs Mellor has led a long-standing campaign against professionals who take a lead in complex and life-threatening child abuse, including paediatricians, pathologists, radiologists and social workers. She has spun a series of false allegations that have impacted on the lives of professionals, as well as the resources of the NHS and GMC, and not least continues to post confidential material concerning families involved in child protection proceedings on public web sites.

PACA’s original complaint regarding Mrs Mellor’s inclusion in the group was published on 15th July. Niall Dickson, Chief Executive of the GMC, chose not to respond publicly, but in a belated response to PACA of 24th August, he chose to ignore not only the above issues, but also that she had been severely criticised by a judge when convicted of conspiring to abduct a child from the protection of the court.

We expect the GMC to comply with their statement that they seek the “views from all groups who are affected by GMC guidance”: that is, the children, who have been affected by abuse and by other child protection agencies such as the police and teachers. In this way, future progress of this group will hopefully lead to a productive outcome and be accompanied by an increased willingness of professionals to engage in child protection work. The GMC have done much to discourage doctors’ involvement in the last 10 years – it is within their remit to change this for the benefit of vulnerable children.

The GMC have included Mrs Penny Mellor on their panel looking at producing guidance for Paediatricians. This caused widespread indignation in safeguarding circles.

PACA wrote a response which was published in the British Medical Journal (BMJ) and we are awaiting a reply from the GMC. The letter is produced in full below.

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Published 21 July 2010
Reference/Cite as: BMJ 2010;341:c3884

Open letter to Professor Peter Rubin, chair of the General Medical Council

You must know that the inclusion of Mrs Penny Mellor on the General Medical Council Expert Group on Child Protection¹ which has been set up in the wake of David Southall’s successful appeal, is an affront to paediatricians and other professionals involved in child protection work.

On 9 May 2010 we wrote to you and Mr Dickson congratulating you on setting up an expert panel to review what is expected of doctors involved in child protection. We had stated: “We have long argued that child protection is an area of medicine made uniquely difficult because the parents of children [or their appointed advocates, that is, those who complain about doctors to the GMC] cannot be assumed always to be acting in the best interests of their child. It is difficult for lay [fitness to practise] panel members, or medical panel members who do not have personal experience of child protection work, to understand this professional environment.”

We are astonished that you consider Mrs Mellor an appropriate person to contribute to this group, given that she has:

• Made false allegations against numerous paediatricians, other doctors, and nurses about their involvement in child protection cases, even to the extent of accusing doctors of sexual abuse of children and paedophilia and comparing one paediatrician to Josef Mengele
• Reported such professionals to their employers, regulatory bodies, politicians, and in the media, in some cases wrecking their professional lives
• With others, led a misguided and hostile media campaign against internationally acclaimed paediatricians who were central to the recognitionand diagnosis of fabricated and induced illness (FII, previously known as Munchausen’s syndrome by proxy), which contributed to your fitness to practise panels’ decisions to order the names of Professor Sir Roy Meadow and Professor David Southall OBE to be erased from the medical register in 2004 and 2007 respectively. After much damage to child protection work, these decisions were found to be erroneous: Professor Meadow was reinstated to the medical register by the High Court and Professor Southall by the Court of Appeal
• Created an environment in which doctors are now turning their back on child protection work for fear of being targeted in the above way
• Been convicted herself of “conspiring to abduct a child,” Judge Whitburn concluding:
  

  … you have been a self-appointed advocate for those, amongst others, whose children are taken into care on the basis of what was known as Munchausen’s Syndrome By Proxy, now known as Fictitious Illness Syndrome. Your view was that this was a misdiagnosis, designed to cover up medical negligence. Impervious to debate, convinced you are right, you have traduced, complained about and harried dedicated professional people working in this difficult area. I do not punish you for that, let me make it clear, however tiresome and eccentric your views are, the toleration afforded to you who expressed them, by those who hear them, is part of the price we gladly pay for living in a liberal democracy.

  What is unforgivable is the way in which you manipulated for your own … purposes, the genuine distress of the [XXXX] family … I have no doubt … that you were the architect, the Svengali of the whole plan. As the Court of Appeal Criminal Division pointed out … those who act as you and they did commit a serious offence, especially where what is done is to thwart the orders of the Court in respect of a child or proceedings taken in respect of a child, by removing the child from the jurisdiction of theCourt and assisting the continuing absence of that child from the jurisdiction.

  What you are being punished for is orchestrating an abduction of a child, in part at least for your own propaganda purposes; an abduction which lasted over a month… The very least sentence I can pass upon you, Penelope Mellor, is two years’ imprisonment.” [Her sentence was later reduced on appeal to 18 months' imprisonment.]

But not least, we cannot understand how you can appoint Mrs Mellor to the expert group when she herself has been engaged by parents whose complaints you are currently hearing in a fitness to practise panel in relation to David Southall. We believe that the GMC and its fitness to practise panels have already been unduly influenced by the campaign Mrs Mellor has been a major contributor to. Now she may again exert undue influence and make false representations within your expert group.

We have no objection to the inclusion of critics in the expert group, but by including Mrs Mellor and giving her credence, we consider that the GMC denigrates the work of doctors involved in child protection.

Cite as: BMJ 2010;341:c3884

John M Bridson, retired paediatrician, and chair², Martin Samuels, paediatrician, and member², Nigel Speight, paediatrician, and member², Catherine Williams, retired academic lawyer, and member²

Competing interests: The authors are members of PACA (Professionals Against Child Abuse), www.paca.org.uk. PACA was set up to support professionals, to share information, and to try to provide a more positive view of safeguarding in the media and as a result enable children and families to receive better care.

References

1. Dyer C. Child abuse experts “astonished” that convicted doctors’ critic is in guidance group. BMJ 2010;341:c3788. (14 July)

2. PACA (Professionals Against Child Abuse), www.paca.org.uk

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

David Southall is now back on the register and licensed. Many people have been striving for this outcome for a long time, but it is not the time for any of us to rest on our laurels.

PACA will continue to support safeguarding professionals when this is needed, and endeavour to support the accurate portrayal of safeguarding issues in the press, and assist the GMC where we can.

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