Professionals Against Child Abuse

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

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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.

——

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.