Professionals Against Child Abuse

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.

PACA has released the following Press Release in response to information on the Channel 4 Cutting Edge programme website that stated they were going to perpetuate a story that is now finished with.

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.”

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

Article cited with kind permission of onmedica.com

A recent OnMedica poll of 589 doctors has found that 74% disagree with the General Medical Council’s decision to remove paediatrician David Southall from the medical register.

Dr Southall was struck off the register in December 2007 after being found guilty by the GMC of serious professional misconduct. The GMC decided Prof Southall’s conduct in a case where he accused a mother of drugging and murdering her son was an abuse of position and fundamentally incompatible with his continuing as a registered medical practitioner.

At the time of the ruling, the Royal College of Paediatrics and Child Health spoke out against the GMC’s decision, and paid tribute to the major contribution to child health made by Dr Southall during a distinguished career.

Kamran Abbasi, CEO of OnMedica, said: “The GMC was criticised for its decision at the time of the ruling. This poll proves that a large majority of doctors agree that Dr Southall should not have been struck off. It is important that doctors are not deterred from undertaking child protection work.”

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

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

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

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

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

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Motion for RCPCH AGM – York University, April 2008

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

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

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

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

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

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

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

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

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

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

It is becoming clear that children remain at risk if they do not have the protection and advocacy of professionals. There has been an increase in violent crime against children according to figures from the NHS as published in the Observer, April 20 2008 by Jo Revill, Whitehall editor.

Observer article: http://www.guardian.co.uk/society/2008/apr/13/childprotection.health

There are many reasons for this, but it is the view of PACA that one major contributory factor is the increasing reluctance of doctors and other professionals to risk bringing concerns about child abuse to light for fear of condemnation and censure. The Guardian has published an article about this “climate of fear” (April 13 2008 by Gaby Hinsliff, political editor) which has arisen consequent to the GMC actions against Southall, Meadow and San Lazaro. The consequence of this “climate of fear” may be that in another 5 years we will see a further tragic rise in assaults on children.

Guardian article: http://www.guardian.co.uk/society/2008/apr/20/children.nhs

The GMC feel that this is not their responsibility and continue to repeat the same reassurances about numbers of paediatricians brought to fitness to practice hearings. PACA feels that the GMC figures do not reflect the true impact of the high profile cases; nor do their statements reflect the RCPCH work on this subject, as evidenced by the numerous unfilled child protection consultant posts.

The Guardian article, whilst being very helpful in highlighting many of the concerns that PACA seeks to publicise, has been challenged by David Southall. Southall’s concerns relate to details of Finlay Scott’s statement and some assumptions made in the text of the article. He has written a letter to the Guardian explaining this which was not published but reads as follows: