David Southall is a formidable paediatrician who, as a result of his advocacy for children and his child protection work, made many effective opponents.

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

PACA believe that Dr Sabah Al Zayyat has been appallingly treated. It has taken a long time to get something in print, but at last one of our members has managed it, albeit on a personal basis.

PACA wonders about the nature of scapegoating, and whether it is normally done deliberately, or associated with wilful blindness.

For the article you may follow the link below, or just click on the title above to read it here:
http://www.bmj.com/content/343/bmj.d4691.extract/reply#bmj_el_269426

Accountability for the failure to protect Baby P.

Ivor T Rowlands, Retired engineer

The article is concerned as to whether there has been a cover up with regard to the Sibert and Hodes report and the implication of dishonesty and bad faith by Great Ormond Street Hospital [GOSH]. As reported similar concerns have been voiced by Lynne Featherstone and the GOSH response has been principally concerned with the defence of the managements actions and integrity. I am happy to accept their good faith but totally reject that the numerous repeated apologies for the catalogue of management errors made constitutes an adequate response if faith in the management of GOSH in particular and child protection in general is to be restored.

The concern is with GOSH management’s accountability for a whole series of actions with regard to the death of Peter Connelly. I include Baroness Blackstone in the management command of GOSH because she has become involved in this issue from the earlier stages and has aligned herself with the management to the degree that I think she is now equally accountable for their conduct.

At present the general public’s understanding of the failure to protect Peter is that it lies with Dr. Al-Zayyat, “the doctor who failed to notice Peter’s broken back”; few, if any appreciate the many failures of GOSH that played the major part. This is a gross injustice that needs to be righted so far as that is now possible.

The issue for GOSH is one of management competence and accountability throughout a whole series of bad decisions and judgments. That managements be held accountable for their performance is a necessary requirement for the good governance of all organisations and, in this case, for responsibility to be justly ascribed and future child protection improved The relevant decisions are described in the order they occurred.

1. Establishment of the Child Development Centre [CDC] at St. Ann’s in 2003.

Clare Dyer reports that two senior GOSH staff members have stated that the decision to operate a partnership in such a clinic was a mistake and naive. In my opinion an institution such as GOSH, with all the expertise available to it both from staff members with relevant past experience and external advice, has no business being naive; it is management incompetence. The eventual abandonment of the arrangement to my mind demonstrates that this is now recognised.

2. The deterioration of the service and the consultants letter in 2006.

The article also reports that the situation within the CDC deteriorated resulting in a letter by the then four consultants which, inter alia, classified child protection as high risk. In my opinion this letter described a safety critical situation and deserved appropriate response. The Children Act states that the welfare of children is paramount, a status accorded nowhere else in law. Again in my opinion, the only options available to GOSH in that situation were to immediately ensure the resources were adequate [for example by secondments from GOSH] or to close it, with temporary arrangements to cover existing commitments. GOSH did neither, merely exhorting staff to do their best. Budgetary constraints have been reported as a reason for this but, bearing the clear declaration of the Children Act in mind and also the declared reasons for starting the CDC, it is simply not credible that GOSH resources could not meet the need in either financial or resource terms.

I believe the management failure at this point led directly to the failure to protect Peter and is its prime cause.

3. The treatment of Dr. Kim Holt.

This issue has been well ventilated and at least to some degree resolved by the Bevan Brittan investigation. The resolution is due to the persistence and steadfastness of Dr. Holt and in no part due to GOSH seeing the error of their ways so far as the evidence I have seen suggests. It is yet another in the catalogue of errors by GOSH and failures to comply with NHS requirements, importantly an instinct to suppress issues and a total failure to acknowledge and accept the good faith actions of a whistleblower.

GOSH has apologised [again] but if I have read the full text of the apology it reads more like an expression of sympathy for distress resulting from an act of God than an acknowledgement of specific GOSH failings.

4. The appointment of Dr. Al-Zayyat. and her consultation with Peter.

The article describes the circumstances of Dr. Al-Zayyat’s appointment as a locum consultant in 2007 when there were only two consultants in post and her experience and training did not meet the requirements for the position in critical areas. In my opinion this was an act of desperation to staff the CDC and was consequent to the failure described in 2. above.

I am privileged to have access to an expert analysis of the available information on the conduct of Dr. Al-Zayyat’s consultation with Peter. Some of the main features are as follows it was a long standing clinical appointment with no child protection connotations; Dr. Al-Zayyat took on the consultation from a sick colleague; no social services were in attendance; Dr. Al-Zayyat had no nursing assistance; she was about to be confronted with an accomplished con merchant, Tracy Connelly [as demonstrated by the video clip]; a person she believed to be the foster mother was present and supported Tracy; Peter was fractious with a history of head banging.

Dr. Al-Zayyat was not negligent, the consultation took an hour and she sought advice but no designated doctor for child protection was in post. Dr. Al-Zayyat referred the child on for consultation at GOSH and had Peter not been killed the consultation would probably have not attracted further attention.

It is argued that while a better performance from Dr. Al-Zayyat may be wished in identifying abuse despite the circumstances of the consultation, several important factors in that consultation were the direct responsibility of GOSH for which no one has been held to account.

5. Information to the Serious Case Review.

Clare Dyer covers this issue comprehensively but there is still no explanation of how on earth GOSH came to such a view. Again the Children Act is relevant: the priority clearly lies with supporting the SCR to prevent future failures as far as possible. Peter is dead and nothing further can be done to benefit him so to that extent the trial is secondary. As regards legal advice which seems contrary to this, further advice should have been obtained – there are as many opinions as there are lawyers. As for the police, contact them again to inform them that you are passing the full report to the SRC together with a request that is kept secure.

If it is accepted that GOSH acted in good faith, then GOSH must equally accept that their judgment on this issue was appalling, contrary to the public interest and, in my view, incompetent.

6. The subsequent experience and treatment of Dr. Al-Zayyat.

The article does not discuss the consequences of the saga for Dr Al- Zayyat in detail. Following Peter’s death and the consequent public furore, particularly when the prosecutor in the trial of Tracy Connelly et al stated unwisely and unnecessarily that Dr. Al-Zayyat had probably missed Peter’s broken back, Dr. Al-Zayyat became a public hate figure. She was hounded by the press and the subject of a 1.5 million signature petition to Downing Street that she be struck off.

Shortly after the prosecutor’s statement, it must have been apparent to GOSH, as it was to many other doctors, that the probability of Peter’s back being broken at the time of the CDC consultation was small but I am not aware of any public statement by GOSH to that effect. Equally GOSH made no public statement regarding its own failure to resource the CDC adequately and its potential contribution to the failure to protect Peter. Such statements would have relieved the pressure on Dr. Al-Zayyat, their employee to whom they owed a duty of care, not to mention the moral imperatives and common humanity that the situation demanded. Later, when more details of the back injury were known, medical opinion was clear that the injury would have caused death within hours and therefore could not have been present at the CDC consultation; Peter would have been incapable of sitting up and being weighed on scales during the consultation.

GOSH continued to employ Dr. Al-Zayyat for nine months after the consultation and was considering her for a permanent position. When the public furore blew up, GOSH’s attitude seemed to change and gave the perception of wishing to use Dr. Al-Zayyat as a scapegoat for their own failings. Whatever the truth of the matter, GOSH terminated her employment and referred her, as complainant, to the GMC. It is not at all clear as to why this was necessary and why the matter could not have been dealt with by an NHS inquiry.

Those close to Dr. Al-Zayyat at the time relate that she was petrified at the prospect of a public hearing, fearing that the press harassment would begin over again. Psychiatrists stated she was suicidal and she returned home to Saudi Arabia where she remains in poor health.

Later the GMC held a second hearing in Dr. Al-Zayyat’s absence at which her counsel requested voluntary removal from the register which was refused by the GMC and her counsel stated that they would apply for Judicial Review. The hearing nonetheless proceeded to a telephone interview with an obviously sick and distraught Dr. Al-Zayyat which lasted about three quarters an hour. As complainant, GOSH could have halted this inhumane process at any stage by withdrawing the complaint; GOSH did nothing. This interview must rank as one of the most disgraceful occurrences by a body with “Medical” in its title and GOSH was party to it. The GMC have not published the transcripts of this hearing – I wonder why that could be? Perhaps GOSH could publish them to make the public aware of the degrading, humiliating treatment to which Dr. Al-Zayyat was subject. Mr Justice Mitting eventually overruled the GMC and strongly criticised them for their perverse conduct.

Conclusion

Of the medical staff involved only two have faced public sanction, Dr. Al-Zayyat and the GP, Dr Ikwueke. Dr Ikwueke’s case is not discussed here only because GOSH was not involved. Dr. Al-Zayyat is a Saudi national, an immigrant to this country welcomed because of her skills and was working in one of the most deprived areas of the country. She is recognised as a good person dedicated to doing her best for her patients. She did Peter no harm and committed no crime. If the description naive is to be applied to anyone in this saga it is perhaps Dr. Al-Zayyat But she is still seen by the public as the doctor who missed Peter’s broken back, a belief now known to be wholly untrue. She was caught up in a situation she could not possibly have foreseen in a non viable clinic to which she had been recruited despite not having the required experience or training. The price she has paid is to be a public hate figure, her health and career destroyed and her family life damaged, including that of her two daughters who have seen their mother destroyed. Where was the child protection for them?

Like GOSH, both doctors apologised for any part they played in failing to protect Peter but to no avail. By contrast, I believe that much the greater part of the responsibility for the failure to protect Peter lies with GOSH and for which no-one has been held to account or accepted accountability. Despite the fact that all formal proceedings against Dr. Al-Zayyat are now finished I am not aware of any public statement by GOSH in her support or stating that Peter’s back was not broken when she examined him. The perception persists that Gosh is content to let matters lie and all the public anger for the failure to protect Peter be carried by the two doctors, principally Dr. Al-Zayyat.

This situation is a national disgrace and needs to be acknowledged. It is past time that management at GOSH faced their responsibilities and followed the recent impressive displays of public accountability by the Metropolitan Police Commissioner and his assistant.

If I have misunderstood matters I stand to be corrected and it is important that I should be because I know that many share similar views.

Ivor Rowlands. [Mr.] Cheshire

Competing interests: I have supported paediatricians engaged in child protection for many years. I am a non-medical member of Professionals Against Child Abuse [PACA]

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

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.

PACA Press Release, 12 May 2011 – The Crown Prosecution Service (CPS) has ruled that there is no case against Professor David Southall for allegedly causing harm to a 5-year old boy, over twenty years ago—allegations which PACA has learned from the Channel 4 website will be included in their TV programme, Cutting Edge, aired this evening.

Since 2003, the South Wales police have been investigating allegations made by Mr and Mrs Hollisey-McLean over child protection proceedings in which their son was taken into care following Professor Southall and many other professional’s concerns that his parents were abusing him. The parents alleged that their son was brain damaged during his time in care as a result of “unethical” experiments carried out in the University Hospital of Wales in 1991 as part of the child protection investigation. Professor Southall was actually an external expert involved in organising non-invasive overnight recordings of their son’s breathing for four weeks and was one of a team of more than 20 professionals involved in his care.

The police interviewed Professor Southall over the parents’ allegations in 2009 and in 2010, referred the matter to the CPS.

On 24th March 2011, Professor Southall was advised by the South Wales Police 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”.

In addition, and in 2005, the GMC rejected complaints against Professor Southall over these same allegations following an analysis by the Hollisey-McLean’s own medical expert working under GMC proceedings who did not back up their allegations.

The Filmmaker and Channel 4 knew about the CPS rulings and GMC findings.

John Bridson, Director of PACA says: “The recent ruling by the CPS, and analysis by the family’s own medical expert under GMC proceedings six years ago, shows that there is absolutely no evidence to uphold the allegations made by the Hollisey-McLeans against Professor Southall, which according to the programme’s information on Channel 4 website are repeated in the Cutting Edge Programme today”.

The allegations made by Mr and Mrs Hollisey McLean with support from a renowned group campaigning against Professor Southall’s child protection work have incited mass biased media coverage over the past ten years—three television programmes; two radio programmes and multiple articles in tabloid and broadsheet newspapers denigrating Professor Southall and his work and supporting these parent’s specific allegations.

The earlier negative media coverage and today’s programme were timed to cause maximum damage to Professor Southall by coinciding with Professor Southall’s appearances at General Medical Council (GMC) fitness to practice hearings.

This is also the second time that Professor Southall’s work has been investigated by the police following complaints made by the same organised campaigners against his work. The previous investigation involved allegations that Professor Southall had forged parental consent in a research trial involving a safe, non-invasive ventilator. This investigation closed in October 2002 when the police stated: “there is no evidence which could conceivably satisfy the CPS’s tests of 1) sufficiency of evidence and 2) Being in the public interest to prosecute”.

John Bridson of PACA concludes: “The only proof is that by giving air time to repeated lies, the film maker and Channel 4 have contributed to damaging crucial child protection work, which ultimately harms children.”

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.

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”.

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.

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