Doctors
accuse regulatory body of increasing risk of child abuse
http://society.guardian.co.uk/children/story/0,1074,1678353,00.html
Guardian
- 5th January 2006
·
Experts afraid to speak out after two were struck off
· GMC 'pays more attention to parents than children'
Children
are being left at risk of abuse because doctors are afraid to speak
out following the pillorying of paediatricians in the media and
by the General Medical Council, senior doctors warn today.
In a strongly
worded article for a leading medical journal, a former president
of the Royal College of Paediatrics and Child Health criticises
the GMC, the doctors' regulatory body, for the disciplinary action
it took against the child protection experts Roy Meadow and David
Southall.
Many in
the profession no longer have confidence in the GMC, says Sir David
Hall, implicitly accusing it of paying more attention to parents
who complain than to the welfare of the child. "Changes in
the way complaints are managed are urgently needed," he writes
in the Journal of the Royal Society of Medicine.
Professor
Meadow was struck off the medical register by the GMC for wrongly
asserting that the chances of a second cot death happening in a
family were one in 73 million. His expert evidence was given during
the trial of Sally Clark, who was convicted of killing her second
child but later freed on appeal.
Professor
Southall was suspended from child protection work for contacting
police to accuse Mrs Clark's husband of killing two of their babies
after watching him on a television programme. Both paediatricians
have been the target of vociferous campaigns by groups defending
parents accused of abusing their children. But Sir David writes
that a paediatrician fundamentally owes a duty of care to the child,
not the parent. Guidance from the judiciary and the Children's Act
make it clear that the child's interests must be paramount.
"With
regret, it must be recorded on behalf of many UK doctors that they
currently have no confidence in the competence of the regulatory
authorities to apply this guidance when making judgements about
the expertise or professional behaviour of those working in child
protection," he says. "Nor do they believe that the authorities
are able to withstand public, political and media pressures in high-profile
cases."
The evidence
base in child protection cases is still weak, he says. Insufficient
research has been done on forensic questions, such as the ageing
or pattern of bruises or the significance of human bite marks. "It
is a bitter irony that among the doctors who have been called before
the General Medical Council are several who have contributed so
much to our knowledge of child abuse."
An editorial
in the journal says the profession is becoming frightened of speaking
up for abused children. After the GMC verdicts against "the
leading lights of child protection", writes editor Kamran Abbasi,
"paediatricians began to wonder who would protect them if they
raised concerns about child safety or gave evidence in court.
"These
were also worrying omens for children who are at risk of injury
or abuse but on whose behalf the medical profession finds it increasingly
difficult to speak up. How did we come to this? What forces have
cowed a profession that prides itself on improving the health and
consequently the lives of the most vulnerable members of our society?"
The way
forward, says Sir David, is through changes in the regulatory system,
a stronger evidence base in child abuse cases, and better training
and continuing education for paediatricians.
"Our
hope is that protecting children will once again be seen as a core
part of paediatric practice and that health professionals can continue
clinical work and research with skill, compassion and humility,
recognising the difficulties, but aware of their duty to protect
children from cruelty, abuse and neglect.
"Our
aim is that they will no longer need to be preoccupied with the
risk of having their career abruptly interrupted or terminated by
inappropriate management of complaints about their work."
Backstory
Roy Meadow,
who retired in 1998, was an eminent paediatrician who frequently
gave expert evidence on child abuse in court. In 1999, he testified
at the trial of Sally Clark for the killing of her first two babies.
She was freed on appeal because of undisclosed evidence from the
baby's postmortem examination, but the judges said his statistical
error - saying the chances of a second cot death in such a family
were 73m to one - would also have made the conviction unsafe. Other
convictions that relied on expert medical evidence have been reviewed,
and Angela Cannings and Donna Anthony, both convicted partly on
Meadow's evidence, have been freed. Professor Southall was brought
before the GMC and banned from child protection work for three years
for intervening in care proceedings over the Clarks' surviving child.
