From Community Care.org.uk:
Baby P and abuse scandals make mockery of child protection, says Lancet
Posted: 29 May 2009 | Subscribe Online
writes Gordon Carson
The baby Peter case and other child abuse scandals have sparked calls from The Lancet for a national commission to deal with the “disastrous mess” in child protection in the UK and Ireland.
In an editorial comment in its latest edition, the medical journal said three major cases last week had “made a mockery of child protection by further adding to the confusion around how best to protect vulnerable children”.
The Lancet referred to the second serious case review into the death of Baby P, and the decision by the High Court to uphold the General Medical Council’s ruling to strike off paediatrician Dr David Southall for allegedly accusing a mother of killing her son. It also pointed to the final report of Ireland’s commission into child abuse.
Lack of consensus
According to The Lancet, “no amount of reflex retribution, retraining and tinkering around the edges” would be enough to fix the child protection system, and there was “clearly no overall consensus among professionals on how best to serve children”.
One group of paediatricians and child protection workers believed earlier involvement of police may be required in cases involving deceptive perpetrators, it said.
But authors of a series of reports in The Lancet had argued for a “comprehensive child and family welfare approach”, and said earlier police involvement might cause more harm to children from “chaotic and incapable families with social instability”.
The editorial added: “The government should put the children’s commissioner in charge to urgently set up a national child protection commission that reviews all the evidence emerging from national and international data and devise evidence-based recommendations on how best to protect vulnerable children.”
Shaun Kelly, head of safeguarding at charity Action for Children, hoped the creation by the government of the National Safeguarding Delivery Unit would help all child protection staff to “work together more effectively, build on good practice and promote excellence across the board”.
“Investing in our social workers and other professionals will ultimately help keep vulnerable children safe from harm,” he added.
A spokesperson for the Department for Children, Schools and Families said it was “disappointing” that The Lancet had “failed to acknowledge” the National Safeguarding Delivery Unit and Social Work Taskforce, plus £58m to support and develop social workers.
The unit would “drive continuous improvement in frontline practice across all services, and provide support to every local authority and every children’s trust as they fulfil their safeguarding responsibilities”.
NHS safeguarding review
Meanwhile, the NHS was starting to review arrangements for safeguarding children. It follows a request in December 2008 by NHS chief executive David Nicholson to local chief executives and boards.
The DSCF is also “completing preparatory work” in the Southall case before reviewing case files that the attorney general said it should examine.
The review should focus on 82 special case files kept by Southall that are linked to court proceedings of some kind, to identify which of those had links to family proceedings.
Now, regarding the 82 special case files that Southall had kept, I think there is a bit of a muddle up here - at least, I HOPE it is a muddle up, as I would not like to think that this website has deliberatly tried to mislead anyone. The Guardian is usually pretty reliable on legal issues, and I should think Clair Dyer would have done some very careful research on this issue, for fear of being sued if she got it wrong:
Inquiry into criminal cases after expert witness's secret patient files revealed
· Controversial professor kept 4,450 'special' files
· Goldsmith acts over fears of withheld evidence
Claire Dyer, legal editor, The Guardian, Wednesday 21 February 2007 00.07 GMT
The attorney general launched a review yesterday of criminal cases over the last decade in which the controversial paediatrician David Southall acted as a prosecution witness, amid concerns about nearly 4,500 secret files he kept on patients and former patients.
Lord Goldsmith said he was concerned about whether Professor Southall had disclosed all the material he held when acting as an expert witness in criminal trials, after it emerged that he had kept 4,450 "special" files separate from patients' normal hospital records, some dating back two decades.
The Crown Prosecution Service will be asked to cross-check the documents, which came to light during a General Medical Council investigation, and identify those relating to prosecutions.
In the GMC case, which has been adjourned until November, Prof Southall is accused of keeping "what amounted to secret medical records" on four children, tampering with records and not making files available to others involved in the children's care. He denies serious professional misconduct.
Like his fellow paediatrician Sir Roy Meadow, who gave misleading statistical evidence at the murder trial of Sally Clark, Prof Southall has been vilified by parents' rights campaigners, who claim he is too ready to accuse parents of abusing their children. Parents also accuse him of involving their children in research without their consent.
He is equally vociferously defended by doctors who say he was a pioneer in cot death research and the identification of Munchausen syndrome by proxy, the form of child abuse in which parents induce or fabricate illness in their children.
Prof Southall has provided expert evidence in many prosecutions. The only high-profile case in which he has appeared was the trial of Sion Jenkins for murdering his foster daughter, Billie-Jo. He told the jury that Jenkins's explanation of how Billie-Jo's blood got on his clothes was "impossible".
Many of the files, kept while working at London's Royal Brompton hospital and in his current post at consultant paediatrician at North Staffordshire Royal Infirmary in Stoke-on-Trent, are thought to relate to controversial research he has been involved in over the past 20 years.
In an eight-year study from 1986 he secretly filmed dozens of parents harming their children, many of them by attempted suffocation. The filming led to prosecutions of 33 parents and step-parents, but many, if not most, would probably be outside the 10-year file-review period.
The attorney general said in a statement to the House of Lords: "It is said that Prof Southall kept so-called 'special case' files containing original medical records relating to his patients that were not also kept on the child's proper hospital file.
"Concerns have been raised that in some of those cases criminal proceedings may have been taken but the existence of the files not revealed, resulting in their not being disclosed as part of the prosecution process. I share those concerns.
"What is not clear at this stage is the nature and extent of the failure of disclosure, if such it be. I have therefore decided that I will conduct an assessment of the cases where Prof Southall was instructed as a prosecution witness to determine if any 'special case' files existed in any cases involving criminal proceedings."
Doctors engaged as prosecution witnesses are obliged to reveal all their material to defence lawyers, including an index of any unused material. John Hemming, Liberal Democrat MP for Birmingham Yardley, who helped to persuade Lord Goldsmith to launch the review, called for it to be expanded to cover earlier prosecutions and child protection cases in the family courts where children were taken into care.
"This review continues to turn a blind eye to the full nature of the abuse of process," he said. A review by the attorney general in 2003 of 297 cases in which parents or carers were convicted of killing their children, after the murder convictions of Sally Clark and Angela Cannings were overturned, threw up a number of cases in which Prof Southall appeared as a witness. But the CPS could not recall the details of any of the cases yesterday.
Prof Southall was found guilty of serious professional misconduct and barred from child protection work for three years in 2004 after accusing Mrs Clark's husband, Stephen, of murdering one of their sons on the basis of watching a TV interview with Mr Clark.
He also faces a new GMC case relating to his research into an experimental system of helping premature babies breathe, to which parents say their babies were subjected without informed consent. Several inquiries into the research have cleared Prof Southall.
Lord Goldsmith said later: "My concern is that there could be cases in which there has been non-disclosure of some evidence from one of the special case files. That might affect a prosecution that has taken place in which Prof Southall was a prosecution witness."
He said he was unable to estimate how many of the cases detailed in 4,450 special files had involved a criminal prosecution.
"Until we have been able to look at the special case files, and until we have been able to compare them with prosecution files, I won't know. But I think it is sufficiently concerning that we ought to start that now.
"We know how many special case files he has, but many of those will not be tied with criminal cases."
· The Medical Defence Union, which represents Prof Southall, said he did not want to comment on the review.
Profile: Prof David Southall
David Southall has been praised by colleagues as a pioneer, but vilified by patients as arrogant and dangerous.
At London's Royal Brompton and North Staffordshire Royal Infirmary, he made his name by covert surveillance to identify children at risk of abuse.
Children aged two to 44 months were found by videos to have been deliberately injured in cruel attacks by parents or step-parents; in 23 cases, the parents were diagnosed with the attention-seeking Munchausen syndrome by proxy.
Despite praise by a judge in a successful action against one abusive mother, his work raised difficult ethical issues and anger from parents.
In 2004, he was found guilty by the General Medical Council of serious professional misconduct after he appeared as a prosecution witness after he accused Sally Clark's husband.
A high court judge reviewed an appeal contesting as too lenient the resultant ban on child work for three years, but solicitors for the GMC and Prof Southall had said striking-off would be "disproportionate and draconian" and could demoralise professionals in the child protection field.
The GMC heard testimonials from 85 individuals - surgeons, nurses, social workers, and a judge, who held him in high esteem.
David Hall, professor of community paediatrics at Sheffield university, said: "He is a pioneer, a man who pushed the limits and went where others would fear to tread."