Secret
witch-hunt syndrome
Camilla Cavendish
http://www.timesonline.co.uk/article/0,,6-2195803,00.html
The
Times - Thursday 25th May 2006
NEVER HAVE
THE powers-that-be collected more information. But never has it been
so difficult to find out what they know. It took months of questioning
by an MP on the Public Accounts Committee to expose the foreign prisoner
debacle; Whitehall twisted and ducked. Now another committee of MPs
is being fobbed off in answer to a question that could prove to be of
similar importance. The question may not sound like much. It is how
many people are being accused by social workers of having the psychiatric
disorder Munchausen syndrome by proxy (MSbP).
The MPs in
the all-party group have an unusual link: each has constituents who
were wrongly accused of having Munchausen’s. It is legitimate
for them to wonder whether these individual cases might form part of
a systemic pattern of overzealousness on the part of the authorities,
a concern that was being expressed in Parliament as long ago as 2001.
But Beverley Hughes, the Minister for Children, is not prepared to answer
their question. “We don’t collect the data,” she told
them at their recent meeting. She may come to think better of that statement.
MSbP, also called factitious illness, is a perverse disorder in which
an adult invents or deliberately creates a child’s illness to
draw attention to themselves. Even the experts agree that it is extremely
rare, affecting about 50 people a year in Britain. But campaigners fear
that far more people are being accused of it because of steady definitional
creep. Psychologists in the mid-1990s established a set of traits of
the Munchausen mother that are broad enough to cast suspicion on many
whose children are genuinely ill. The signs include attentive mothering,
a reluctance to leave the sick child’s side, familiarity with
medical terms and, most devastating, the denial of accusations of abuse.
There, but for the grace of God.
You may think
that is just so Nineties, That if there really was overzealous diagnosing
of MSbP, it must have ended with the high-profile release from jail
of women such as Angela Cannings. Not necessarily. Two months ago Mr
Justice McFarlane castigated social workers who had removed a nine-year-old
girl from her parents after her mother had sought help for the girl’s
modest behavioural difficulties. Social workers decided that the mother
had Munchausen’s after a nurse rang them to say that she had taken
the child to hospital with stomach pains and was asking to see a doctor
when the nurse found nothing wrong. Within hours, and without consulting
the doctor, social workers were seeking an emergency order to take her
into care. Despite no doctor ever suggesting fabricated illness, they
kept the girl from her parents for 14 months. This judgment is only
public because Mr Justice McFarlane chose to make it so: we cannot know
how many other cases there are.
Which is
precisely why MPs are asking questions. Among other things, they are
concerned that the 2002 Department of Health guidelines for social services
may encourage professionals to spot the disorder where it doesn’t
exist. Charity workers, nursery nurses, teachers and pharmacists are
all told to look out for and help to identify it. The dreadful risks
of a false positive are barely mentioned. What used to be treated as
a rare condition, diagnosed by a paediatrician and a psychiatrist, looks
dangerously like becoming a way of relabelling sick children as abused.
“A
significant number of (abusive) parents,” say the guidelines,
“are likely to report having experienced genuine medical problems.
They may or may not have been substantiated by medical investigations.”
Come again? Their children may “present a rosy picture to the
outside world”, “have been seriously ill” or have
a medical history that started early in life. This is a charter for
Little Hitlers and busybodies.
Innocent
parents are in a double-bind. If they deny the accusations, they may
be seen as a danger to the child who will be taken away from them. If
they “admit” that the child is not ill, she or he stands
less chance of being treated. The worst of both worlds came to Donna
Reid, of Los Angeles, in 1997, when social workers said she was exaggerating
her son’s asthma. He was taken from her and died six weeks later
in care, of an asthma attack. The foster mother complained that she
hadn’t been told how bad his asthma was.
Have we learnt
nothing? Three weeks ago the High Court ruled that the General Medical
Council should re-examine the complaint by a mother from Braintree about
two paediatricians. The doctors believed that her daughter was not genuinely
ill, but was feeling low because of her mother’s excessive anxiety.During
a long battle to keep her out of care, another doctor finally diagnosed
chronic fatigue syndrome in the girl. We know about this case only because
the parents fought all the way to the High Court.
A simple
answer to a simple question would be of enormous help here. If Whitehall
does not know how many cases there are, it should ask each social services
department. The excuse is that it is expensive to go through individual
case files. But accurate data could at one stroke show either that there
is no problem — if there are fewer than 50 cases a year —
or indicate where the problem really lies. It is quite possible, for
example, that an analysis by region would show clusters of cases —
clusters that could indicate overzealous clinicians and social workers.
They are the only people who have an interest in keeping this secret.
While the
information vacuum persists, there is a huge undercurrent of claims
and counter-claims. Attempts are already being made to rubbish the MPs
as naive. I have spoken to four of them. They are not. And they have
a duty to their constituents. Those are real people, people who were
hunted down as monsters for seeking help for children. We should not
permit the authorities the protection of obfuscation. This is a democracy,
and all we need is the answer to one simple question.
