Protecting children, supporting professionals
Archive for the ‘PACA News’ Category.
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.
Beatrix Campbell is a writer of great wisdom and talent. She has written perceptively about child protection “scandals” for many years, certainly since the problems that arose some years ago in the north east of England. Her comments in this article triggered by the tragedy of Baby P are very relevant and could be used to guide those in positions of influence.
Peter Gooderham is a PACA member and a former GP. He is currently an academic lawyer with an interest in clinical negligence, professional regulation, and the role of expert witnesses. He recently gave this presentation on the role of the GMC to the Birmingham medico legal society.
Download PDF here (3.6MB)
The determination of the GMC panel, following the recent hearing looking at the condition imposed on Dr Southalls’ license to practice, was not fully explained in a sympathetic article in the BMJ written by Clare Dyer. This rapid response now published as a letter sought to make things clearer.
Here is the letter, published 13 October 2008, doi:10.1136/bmj.a2069, and reprinted here with permission.
Letter Title: Southall verdict
Subject: Clarification
PACA members wish to make it clear that the apology Professor Southall made at his recent hearing was not about the child protection importance of the episode of nose bleeding and difficulty in breathing described by Mr Clark in his own words on a television programme—an incident that had occurred in his 10 week old infant just 10 days before his sudden death.1 Southall apologised about the language in his report, which was an agenda item for a meeting of professionals involved in the family court case, including Southall, Professor David, who was acting as the instructed expert, and the child’s solicitor.
The phrasing he used was regarded as injudicious by one of five child protection experts at the recent General Medical Council fitness to practise hearing, and as a result he apologised (only to Mrs Clark) because it damaged the message he was giving and because it was originally used by the GMC in 2004 to find him guilty of serious professional misconduct, thereby causing damage to child protection in this country.
Panel members indicated that they understood only too well the importance of the nose bleeding incident (see transcripts on www.paca.org.uk). The latest GMC panel was thus very clear and supportive regarding Southall’s evidence on the incident of nose bleeding and difficulty breathing; they accepted his opinion as a result of what they heard from the five experts. The panel also dismissed the issue of Southall’s failure to interview the parents, given that he was acting as an informant to the proceedings and not as an instructed expert.
John Bridson, coordinator,
Professionals Against Child Abuse (PACA)
References
Dyer C. Southall is allowed to return to child protection work. BMJ 2008;337:a1811. (24 September.)
Many of the misunderstandings of the 2004 panel were cleared up by the five new expert witnesses called by Dr Southalls team. Undue weight has been given in the media to Dr Southall’s humility in this hearing, the fact that his opinion about the need to inform the police has not been altered, more it has been reinforced by the passage of time and the arrival of supporting evidence, hasn’t been given the same prominence.
Dr Southall is now able to practice without restriction pending the appeal against the panel’s findings at the Mrs M hearing.
Download the transcripts of days 1 to 6 here (PDF) and days 8 and 9 here (PDF).
Some years ago David Southall watched a TV programme which led to him speaking confidentially to the police about his concerns over the imprisonment of Sally Clark and the safety of the third child.
In 2004 he was found guilty of serious professional misconduct, and was banned from carrying out clinical child protection work. At this hearing the renewal was opposed by Dr Southall and the sanction duly lifted after further witnesses were heard and supported of Dr Southall’s actions.
PACA and others will provide balance to some of the biased media reporting that has been the norm throughout this sorry saga. PACA will have information to provide.
Read the Outcome of the Fitness to Practise Panel here (PDF.)
Press Release 21st September 2008
PACA welcomes the GMC removing the sanction against Dr David Southall, which prevented him from undertaking child protection work. Dr Southall, like Professor Meadow, has undertaken pioneering work in the field of child protection, which is internationally acclaimed.
PACA has had major concerns about the GMC’s Fitness to Practice procedures, especially in their dealing with complaints in cases where child abuse was considered. PACA has seen leading experts inappropriately censured by the GMC and vilified by the media. This has reduced the willingness with which paediatricians will report suspicions of child abuse and engage in child protection work, including acting as expert witnesses. This is of no benefit to the welfare of children, especially given that child protection is everyone’s business and forms an important part of the practice of most paediatricians. Recent GMC guidance states: “Your first concern must be the safety of children and young people” (Rule 61, GMC Guidance for Doctors Treating 0 – 18 Year Olds, 2007).
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”. Yet members of the Royal College of Paediatrics and Child Health voted virtually unanimously for a motion at their AGM in March this year on a number of areas of grave concern and called for the GMC to review their Fitness to Practice procedures as a matter of urgency.
We consider the GMC have been wrong in imposing sanctions against Dr Southall and their Fitness to Practice Panel was wrong in 2004 to have found him guilty of serious professional misconduct. His legal advice not to appeal the GMC finding was in retrospect in our opinion the wrong decision.
Many of the findings of fact in the 2004 Hearing were merely the opinions of panel members, and substantially influenced by the one paediatric expert who was called and acted for the GMC and Clark family. This expert, Professor Tim David, had numerous conflicts of interest: he had acted in the Family Court with an opinion opposed to Dr Southall’s, failed to follow due process in the child protection process and finally denigrated Dr Southall’s view in the Family Court.
At no time was Dr Southall acting as an expert in the Family Court himself, but had contacted child protection services with concerns as an informed member of the public. The hearing just completed, reviewing the sanction, heard the Dr Southall’s behaviour was completely in?line with his role under the 1989 Children Act. Indeed in documenting his “points of concern” to Professor David, Dr Southall expressed himself strongly as is common in an exchange of views between colleagues.
The GMC seem unable to regulate judiciously cases involving leading child protection professionals. They were unable to recognise their error in erasing Professor Sir Roy Meadow from the medical register, and we believe they have inappropriately censured Dr Southall. His appeal against erasure from the medical register is currently awaited. The GMC must acknowledge their past mistakes – we call again for Professor Catto and Mr Finlay Scott to consider their positions. We expect to see the GMC move forward with an urgent review of its approach to child protection cases.
Interested parties may like to read the transcripts of the recent hearing reviewing Professor Southall’s sanctions, which we hope will become available on our website www.paca.org.uk.
Press Release: Friday 4th July 2008
Following the Determination by the GMC Fitness to Practise Panel in the cases of Dr Spencer, Dr Southall and Dr Samuels that there is No Case to Answer
This decision must put to an end the longstanding allegations[i] that have been repeatedly quoted in the press regarding the CNEP trial[ii]. This whole process has led to cruel and unnecessary anxiety for those families who may have thought that their children had been given harmful treatment.
After hearing detailed evidence from the complainants, from 22 GMC witnesses and from three experts, the GMC panel concluded that there was no case to answer and abandoned its case. No evidence was presented to the Panel to show that any baby had been damaged by CNEP or by poor quality care. One independent GMC expert described the conduct of the CNEP trial as outstanding and another expressed regret that the longstanding media campaign has deprived children of a very promising treatment.
PACA considers that this case is a disturbing demonstration of how the GMC ignores the findings of previous investigations. The issues in this case had already been investigated by the doctors’ employing Trust[iii], the NHS Regional Office and Staffordshire Police. Professor Rod Griffiths concluded in 2006 that “CNEP did no more damage than any other treatment that might have been used to try and help these [sick, preterm] infants.”[iv] Others had previously stated that “the conduct of the CNEP trial was exemplary”[v]. Yet this is the third time the GMC have considered this complaint over 11 years and in doing so the GMC Panel acknowledged that delays in the GMC process had breached the human rights of the doctors under investigation as set out in Article 6 of the European Convention on Human Rights.
PACA is concerned that GMC reform has led to the pendulum swinging so far in the direction of protecting patients that the doctors’ rights are being abused and that this may deter those doctors who must act on behalf of the vulnerable child. The RCPCH passed a motion at its AGM in March 2008 expressing “grave concerns over current GMC procedures for dealing with cases related to child protection”. Whilst this Hearing was about a research study in newborn infants and not ostensibly about child protection, it is part of a pattern targeting doctors who have been involved in child protection. Two of these doctors had pioneered the use of covert surveillance to detect life-threatening child abuse. One of these, David Southall, is currently appealing his erasure from the medical register arising out of his child protection work. The GMC does not recognise vexatious complaints. These complainants are putting vulnerable children at risk by trying to discredit certain types of child abuse, particularly FII, and by recruiting the GMC to discredit those who make that diagnosis.
The GMC must reform its procedures to ensure justice for both patients and doctors and, in particular, to support those doctors whose duty is to protect vulnerable children.
Click here to download the transcript of the hearing – PDF file, 5.8MB
Footnotes
[i] Allegations of forgery, fraud and killing babies have been repeatedly made against medical staff over the last 11 years, led by the complainants in the Fitness to Practise Hearing concluded today.
[ii] The CNEP trial was a research study undertaken to examine whether the use of Continuous Negative Extrathoracic Pressure (CNEP) could help reduce the incidence of chronic lung disease of prematurity. It was carried out in two newborn intensive care units at Queen Charlotte’s Hospital, London and the North Staffordshire Hospital, Stoke-on-Trent between 1989 and 1993.
[iii] The North Staffordshire Hospital suspended two out of the three doctors from 1999 to 2001 for 20 and 27 months, whilst undertaking inquiries into their work in research and child protection.
[iv] Quote from Griffiths R. CNEP and research governance. Lancet 2006;367:1037-38.
[v] Quote from Hey E, Chalmers I. Investigating allegations of research misconduct: the vital need for due process. BMJ 2000:321:1-8
PACA has Early Day Motion in the House of Commons put forward by Daniel Kawczynski
“General Medical Council Complaints System – 10-06-2008
That this House believes that the General Medical Council’s (GMC) complaints mechanism fails to comply with standards of fairness and due process required by Article 6 of the European Convention on Human Rights; observes that the GMC’s role in investigating, prosecuting and sentencing falls below the standard required of an independent and impartial tribunal; notes that in practice the GMC represents the interest of parents in cases where doctors suspect abuse; further notes that children themselves have no independent representation to present a doctor’s concerns; further believes that no published guidelines appear to guide prosecution decisions and that, as prosecutor, the GMC amends and adds charges in an ad hoc fashion; considers that doctors are uncertain of the allegations they face, compromising their ability to mount a cogent defence; further considers that the GMC calls expert witnesses with clear conflicts of interest in the proceedings who are unrepresentative of mainstream practice or opinion, and that the GMC adopts a populist, punitive, deterrent and disproportionate approach to sentencing; further considers that the GMC’s apparently arbitrary admission and exclusion of evidence extends to ignoring the findings of previous investigations into a case conducted by an accused doctor’s employer; further believes that the GMC values the public perception and integrity of the profession above individual rights; and further observes that, contrary to basic principles of justice, the GMC appears to assume the guilt of doctors before it, and refuses to acquit when a conviction is impossible, instead finding ‘no realistic prospect of prosecution’.”
For the full article, please visit: http://edmi.parliament.uk/EDMi/EDMList.aspx
Please help PACA’s campaign by getting your MP to sign the EDM. It’s as easy as 1-2-3 and you can do it online right now!
Step 1
Copy the text in the box below by highlighting it.
Step 2
Go to this link: Upmystreet.com and enter your postcode to find your MP
Once you have found them, Click on the link provided to send them an email.
Step 3
Add your personal details to the email form and paste in the text
copied in step 1. (Feel free to add your own paragraph to our text)
Click send.
