UP-DATE: DR. DAVID SOUTHALL; LOSES BID TO BE RESTORED TO MEDICAL REGISTER; BBC REPORTS;

"IN 2004, DR SOUTHALL WAS FOUND GUILTY OF SERIOUS PROFESSIONAL MISCONDUCT AND SUSPENDED FROM CHILD PROTECTION WORK OVER HIS ROLE IN THE CASE OF SALLY CLARK, WRONGLY JAILED OVER THE DEATH OF HER TWO SONS. DR SOUTHALL ACCUSED MRS CLARK'S HUSBAND STEVE OF MURDERING THE TWO BOYS ON THE BASIS OF A TELEVISION INTERVIEW. AT THE TIME HE WAS BANNED FROM CHILD PROTECTION WORK FOR THREE YEARS, A BAN WHICH RAN OUT LAST YEAR. DR SOUTHALL IS VIEWED AS AN EXPERT IN MUNCHAUSEN'S SYNDROME BY PROXY, A CONDITION WHICH MEANS PARENTS DELIBERATELY INDUCE OR FABRICATE ILLNESSES IN THEIR CHILDREN TO GET ATTENTION FOR THEMSELVES. HE PIONEERED THE USE OF COVERT VIDEO SURVEILLANCE IN THE LATE 1980S AND EARLY 1990S, WHICH LED TO A NUMBER OF PARENTS AND STEP PARENTS BEING PROSECUTED FOR ABUSE."

BBC NEWS:

-------------------------------------------------------------------------------

BBC News reports Dr. David Southall has lost his bid to end a ban imposed by the General Medical Council.

The story appears under the heading "Southall loses bid to end GMC ban" and the sub-heading "David Southall has had a controversial career."

"Paediatrician David Southall has lost his bid to have the decision to strike him off the medical register overturned by the High Court in London," the story, published May 22, begins;

"The General Medical Council (GMC) struck off Dr Southall in 2007 after he accused a Shropshire mother of drugging and murdering her 10-year-old son," the story continues.

"It had ruled he was guilty of serious professional misconduct.

It has previously rebuked him over the case of Sally Clark, who was wrongly jailed for the deaths of her two sons.

He was speculating on non-medical matters in an offensive manner entirely inconsistent with the status of an independent expert

Mr Justice Blake:

In 2007, the GMC panel said Dr Southall had a "deep-seated attitudinal problem".

It found that his actions had added to the distress of the mother - Mrs M - following the death of her son, who hanged himself in 1996.

Dr Southall made the claim in an interview with Mrs M about the safety of her surviving son.

He had been instructed by a county council to provide an independent expert report to the court.

'Lack of insight':

During his High Court case, lawyers for Dr Southall had argued that the GMC panel had failed to give "any or adequate weight" to inconsistencies in Mrs M's evidence, and that they did not understand what child protection work involved.

But in his judgement, Mr Justice Blake, ruled the decision to strike the paediatrician off was justified.

The judge added: "He was speculating on non-medical matters in an offensive manner entirely inconsistent with the status of an independent expert."

I am very disappointed by today's judgment:

And he said public confidence in child protection expertise would be undermined if "behaviour of the kind under consideration here, when combined with the lack of insight into, or acknowledgement of, its nature and extent, was considered to be compatible with continued registration as a medical practitioner".

In a statement Dr Southall said: "I am very disappointed by today's judgment.

"I have had tremendous support throughout this difficult period from my family, dear friends and legal team and I would like to thank them all.

I have no further comment to make at this stage."

A spokesman for the Royal College of Paediatrics and Child Health said Dr Southall was a "highly respected paediatrician and academic with an excellent record of published peer reviewed work".

And the organisation Professionals Against Child Abuse (PACA) said it was "saddened" by the judgement and warned it could have "further serious and negative effects " on the willingness of doctors to engage in child protection work.

Paul Philip, deputy chief executive of the GMC welcomed the ruling.

He said: "The vast majority of doctors in this country do an excellent job often in difficult circumstances. This includes paediatricians engaged in essential child protection work.

"Like other doctors, they need the confidence and support of the public.

"But where our standards have not been met, we must - and will - act to protect patients and the public interest."

Previous controversy

In 2004, Dr Southall was found guilty of serious professional misconduct and suspended from child protection work over his role in the case of Sally Clark, wrongly jailed over the death of her two sons.

Dr Southall accused Mrs Clark's husband Steve of murdering the two boys on the basis of a television interview.

At the time he was banned from child protection work for three years, a ban which ran out last year.

Dr Southall is viewed as an expert in Munchausen's syndrome by proxy, a condition which means parents deliberately induce or fabricate illnesses in their children to get attention for themselves.

He pioneered the use of covert video surveillance in the late 1980s and early 1990s, which led to a number of parents and step parents being prosecuted for abuse.

Dr Southall faced another GMC hearing into work that he carried out in the early 1990s, testing a new type of ventilator for premature babies. Accusations that he failed to gain proper consent for the work were dismissed.

Dr Southall worked as a consultant paediatrician at London's Royal Brompton Hospital from 1982 before moving to the same post at the North Staffordshire Hospital in Stoke-on-Trent in 1992."

Harold Levy...hlevy15@gmail.com;

Part Thirteen: Think Dirty; Donna Anthony; A Moving Post-Script: "Look St All The Suffering Since Then."

”SHE WAS CONDEMNED BY THEORY BASED ON SUSPICION MASQUERADING AS MEDICAL OPINION, WHICH WAS COMPLETELY WRONG”, HE ADDED.

FELICITY MCCALL; FROM POST-SCRIPT PUBLISHED ON WEB-SITE DEDICATED TO FREEING DONNA ANTHONY;

-------------------------------------------------------------------------------

This moving "post-script" - described as a "Conviction Quashed Addendum - appeared on a Web-Site dedicated to freeing Donna Anthony under the heading: "Look at all the suffering since then."

It describes the horrific consequences caused to innocent parents, caregivers and their families when societies abandon reason, go on crusades, and rely on so-called experts like Drs. Charles Smith, Roy Meadow, and David Southall to achieve their misguided ends.

"On Monday, April 11, 2004, Donna Anthony finally walked free after the Appeal Court quashed her “guilty” verdict as unsafe and unsound," the post-script begins.

"The legal ruling was something of a formality; the crucial breakthrough had come 18 months earlier when the same court had cleared Angela Cannings of murdering her two babies," it continues.

"It had taken six years and sends the 31 year old out into a world where she is effectively homeless and has no family.

Her mother died when she was in prison.

Her husband, from whom she is divorced, had originally said he believed she had smothered her 11 month old daughter Jordan and a year later four month old Michael.

Throughout her questioning, trial and imprisonment Ms Anthony had maintained they were victims of cot death.

Her former husband now says he “accepts the appeal court’s judgement.”

Outside the Appeal Court, it was left to Donna Anthony’s solicitor, George Hawkes, to speak for her.

She was, he said “overwhelmed by her freedom”.

”She was condemned by theory based on suspicion masquerading as medical opinion, which was completely wrong”, he added.

Mr Hawkes said the whole episode” had completely shattered her life”.

“There are immense problems facing her out there which she has got to cope with, and she is going to need a lot of help and assistance” he added, as Ms Anthony, a silent, shadowy figure, was ushered into a waiting car.

The smiling young mother in the baby photographs reproduced at her trial seems a lifetime away. No amount of compensation can buy her back.

As the ruling was announced, newspapers were already reporting that the discredited paediatrician Sir Roy Meadow whose evidence had effectively sealed her conviction, has been paid £50,000 to testify in court.

The head of the Royal College of Paediatricians, Sir Alan Craft, says “lessons are being learned” from what he called “these difficult cases.”

Harold Levy...hlevy15@gmail.com;

Part Twelve; Think Dirty; Dr. Charles Smith's Notoriety Spreads to England; Alongside Meadow and Southall; Powerful Telegraph Story;

"SIR ROY AND SOUTHALL ARE UNREPENTANT BUT, IN CANADA, THERE HAS BEEN AN INQUIRY INTO THE ACTIONS OF DR CHARLES SMITH WHO WAS FOR TWO DECADES ONE OF CANADA'S TOP FORENSIC PATHOLOGISTS. HE TESTIFIED IN 45 CASES DATING BACK TO 1991, TO CHILDREN BEING SUFFOCATED, SODOMISED AND SHAKEN. MANY OF THOSE PARENTS HAVE SINCE BEEN EXONERATED. 'I BELIEVE I HEARD WHAT I WANTED TO HEAR,' HE ADMITTED AT THE INQUIRY IN JANUARY."

CASSANDRA JARDINE: THE TELEGRAPH;

-------------------------------------------------------------------------------

In 2003 Sally Clark was released from jail after being falsely accused of murdering her two sons.

She never recovered from the trauma and died a year ago, effectively of a broken heart.

Cassandra Jardine looks at how such a gross miscarriage of justice could occur, asks whether lessons have been learnt, and places Dr. Charles Smith in the ranks of notorious British "expert witnesses" such as Drs. Roy Meadow and David Southall;

Jardine has written many times exposing the madness which has led to innocent British parents and caregivers being wrongly convicted of killing children.

This moving story ran in the Telegraph on March 16 of this year, under the heading, "Has Sally Clark's case changed attitudes to infant death?"

"Exactly a year ago Sally Clark died, aged 42, while her solicitor husband, Steve, was on a business trip," Jardine's article begins.

"At an inquest her death was ascribed to acute alcohol poisoning resulting from her grief and 'enduring personality change after a catastrophic experience," it continues;

"In other words she never recovered from the nightmare that began on December 13, 1996, when her first son, 11-week-old Christopher, stopped breathing.



Sally and Stephen Clark outside the Court of Appeal in January 2003. Sally was released from prison after serving more than three years for killing her two baby sons;

Mothers never get over the death of a baby, though they may move on.

For Sally - once a bright and capable solicitor - even that was not possible.

Two years later her second child, Harry, who was eight weeks old, also died suddenly.

From that moment Sally received not sympathy but condemnation.

Paediatricians decided - in line with what was then current thinking on child abuse - that two deaths in a family was suspicious and a Crown Court jury found her guilty of murdering both of her sons.

'Die, woman, die,' other prisoners shouted out as she climbed into the prison van.

What happened next made legal history.

In January 2003, after serving three and a half years of a life sentence, Sally was freed.

The defence at her second appeal revealed that Harry's body had been riddled with the bacterium staphylococcus aureus, which would have caused a form of meningitis - information that the prosecution pathologist Dr Alan Williams had not shared with Sally's defence at her trial.

As she left the High Court, Sally declared, 'There are no winners here.'

Others charged with similar crimes, however, hoped that lessons would be learnt from what was called in the Court of Appeal 'one of the worst miscarriages of justice in recent years'.

The way the medical evidence was presented to court was 'shoddy', said Dr Sam Gullino, a forensic pathologist from Florida, who prepared a report for Sally's second appeal.

'Sound medical principles were abandoned in favour of over-simplifications, over-interpretations, exclusion of relevant data and the imagining of non-existent findings.'

For a short while it looked as if the tide had turned.

Inherited disorders were found to explain other babies' deaths: three other mothers, Trupti Patel, Angela Cannings and Donna Anthony, accused of shaking or smothering their own children, were found not guilty or had their convictions quashed.

Meadow's Law - named after Prof Sir Roy Meadow - was discredited: no longer were two cot deaths in a family to be deemed suspicious and three murder unless proved otherwise.

Summing up at Cannings' appeal in December 2004, Lord Justice Judge said that courts should not convict on disputed medical evidence alone: 'It is better for some of the guilty to go unpunished than for innocent women to be jailed.'

But, the cheers were short-lived.

Fast-forward three years to last November.

Once again the scene is a courtroom.

This time the woman on trial is mother-of-two Keran Henderson, a childminder who was looking after 11-month-old Maeve Sheppard at her home in Iver Heath, Buckinghamshire, in March 2005 when - according to Keran - the child suddenly went floppy.

Maeve died in hospital two days later, and Keran was accused of having caused Maeve's death by shaking her violently, having lost her temper over a dirty nappy.

As the verdict of guilty was delivered, Keran let out a piteous wail.

'If you could hear, as we did, the sound of that woman's grief you too might think her honest,' Mike Seckerson, the foreman of the jury, said.

But it wasn't this alone that caused him to reveal his 'disgust' at the way the trial was conducted.

He and the other medically unqualified jurors were bombarded by information from a dozen medical experts.

The majority of the jury 'listened to expert opinion and thought it evidence', leaving Seckerson with the unhappy task of delivering a majority verdict with which he disagreed.

Seckerson is not alone in fearing that yet another terrible miscarriage of justice has occurred.

Jack Straw, the minister for justice, has been inquiring solicitously about Keran's comfort in prison, says her husband Iain, who is campaigning to bring his wife home to their nine- and 14-year-old sons.

Neighbours have rallied around in support of a woman who had been a respected childminder for seven years, ran the local Beaver Scout group, helped elderly neighbours and was always up for any charity event.

Neither of her own children has ever suffered at her hand.

Significantly, Maeve had been in and out of hospital during her short life, yet none of this counted.

Someone had shaken the child, medical experts concluded, on the basis of certain signs.

'As an ex-policeman, I can't get my head around the fact that people are found guilty without any real evidence,' Iain says.

'There's no CCTV footage, no witness statement or weapon with fingerprints or blood. I think doctors are scared of saying, I don't know what happened.'

He is shocked that no one from the police or the CPS that he encountered was medically trained.

'I know the pressure is on the police to get results, to find someone guilty, but I wasn't even asked for my statement. Nor did they question the other children who were in the house that afternoon, who went home calm and happy. Would they have behaved like that if Keran had flown into a rage?'

Keran is not the only person in prison for a crime that might never have occurred.

Suzanne Holdsworth, another childminder, is three years into a life sentence for causing the death of two-year-old Kyle Fisher who also, she says, went floppy.

Doctors have compared the bleeding in his brain with injuries that would occur as the result of being thrown from a car at 60mph, yet he was not bruised and the banisters against which she supposedly battered him bear no traces of DNA.

Chaha'Oh-Niyol Kai-Whitewind is in prison for suffocating her son, though her appeal may reveal natural causes as an alternative explanation for his nosebleed and blood found in the lungs.

Criminal convictions for harming children are just the visible tip of the iceberg.

A far greater number of cases, where the evidence is insufficient for a criminal trial, are heard in the family courts, where on the 'balance of probabilities' parents are deemed to have harmed or (yet more vaguely because of 'personality disorders') be capable of harming children who are then removed from them, often at birth.

Information about family court cases is hard to obtain.

Proceedings are secret so no one knows which experts are saying what, though observers note clusters of similar cases involving certain consultants.

Parents claim that they are being accused of emotional and physical abuse on the basis of theories or syndromes that are not as foolproof as is claimed.



Angela Cannings, with her husband Terry. She was jailed for life for murdering her two baby sons, but had her conviction overturned in 2003

In the year since Sally Clark died, those facing family court proceedings have at last acquired a champion in the form of the Liberal Democrat MP John Hemming who set up Justice for Families after his girlfriend's baby was nearly taken from her because she had once failed to report a stillbirth.

His office at the House of Commons contains files on more than 200 individual cases, which he uses to identify patterns and lobby for changes in the law.

'I hear of a new case almost every day,' he says.

'Smothering' has gone out of fashion as an accusation.

So has 'salt poisoning', which Ian and Angela Gay were accused of.

The couple were released from prison in 2006 when it was shown, at appeal, that their foster son Christian Blewitt suffered from a faulty osmostat, which allowed his body to accumulate fatally high levels of sodium.

They had not, as was claimed, force-fed him teaspoons of salt.

There remain, however, two controversial medical diagnoses: shaken baby syndrome (SBS), a cluster of symptoms deemed to indicate shaking; and metaphyseal fractures, which are fractures at the ends of the long arm and leg bones, believed to denote that a child's limbs have been wrenched.

Events usually start with a paediatrician or radiologist who flags up the possibility of non-accidental injury (NAI).

Social workers and police officers then look for evidence, sometimes ignoring information about good character or happy family life.

And often solicitors acting for the defence are 'supine', says Bill Bache, who having successfully represented Angela Cannings and the Gays is now working on Keran Henderson's appeal.

Bache, like Hemming, has many suggestions for improving the system: a thorough multi-disciplinary discussion of possible causes of injuries or illness before cases proceed being one of them.

At the heart of the problem, he says, lies 'angled dogmatism' on the signs and symptoms of abuse and a willingness by some doctors to give opinions outside of their areas of expertise.

'I am handling 35 cases of parents accused of child abuse at the moment,' he says. 'All medical conundrums.'

The drive to hold parents accountable for abusing children began in 1962 when a Colorado paediatrician, Dr Henry Kempe, published his research into 'battered child syndrome'.

Drawing on 302 cases of abuse of children under three, he concluded that 'beating of children is not confined to people with a psychopathic personality or of borderline socioeconomic status'; parents often denied causing the injuries but 'to the informed physician, the bones tell a story the child is too young or frightened to tell'.

This information was shocking.

It had always been accepted that psychopaths, addicts, sociopaths or even women suffering from post-natal depression could harm children.

Kempe was saying that apparently normal, loving people could be abusers.

His research changed the role of paediatricians; it became their task to spot hidden abuse.

Identifying the signs provided a useful career opportunity for ambitious doctors in the 1970s and 80s.

Dr John Caffey in the US wrote the first influential paper establishing SBS in 1973.

In Britain, Prof Sir Roy Meadow, author of the ABC of Child Abuse, rose to fame on the strength of his 1977 academic paper on Munchausen's Syndrome by Proxy (MSbP) - children made ill by attention-seeking adults - based on the behaviour of two mothers, one of whom had (Sir Roy claimed) poisoned her toddler with salt, while the other had contaminated her child's urine sample with her own blood.

Knighted in 1996, Sir Roy was soon lecturing on the hidden epidemic of abuse and appearing as an expert witness.

By the time he gave evidence at Sally Clark's trial, Sir Roy claimed to have found 81 cot deaths which were in fact murder though, unfortunately, he destroyed the data.

He told the court that he could think of no natural explanation for either of the Clarks' children's deaths and quoted the case-clinching statistic that the chances of two cot deaths in one family was one in 73 million - a figure arrived at by multiplying the incidence of one death (1:8543) by itself.

It later emerged that the chance of a second death was more like one in 120 because there could be an underlying defect.

Though struck off by the General Medical Council in 2005 for 'gross professional misconduct', he was reinstated the following year.

The other leading light in the drive to unearth hidden abuse in Britain was Prof David Southall.

Working on aspects of MSbP in the late 1980s and early 90s, he videoed parents whom he suspected of suffocating children.

Thirty-three parents or step-parents were prosecuted, though the evidence may have been unreliable: clasping a child to the chest could, for example, indicate feeding rather than smothering.

The Clark case was also his undoing when, having merely seen Steve on tele?vision, he stated to police that it was 'beyond reasonable doubt' that Steve had murdered his sons.

A three-year ban from child protection work followed in 2004; in December 2007 he was struck off for, among other charges, concealing the medical records of some 4,500 children.

Sir Roy and Southall are unrepentant but, in Canada, there has been an inquiry into the actions of Dr Charles Smith who was for two decades one of Canada's top forensic pathologists. He testified in 45 cases dating back to 1991, to children being suffocated, sodomised and shaken. Many of those parents have since been exonerated. 'I believe I heard what I wanted to hear,' he admitted at the inquiry in January.

But the fall from grace of some of the theorists of abuse has not made as much difference as expected.

The term 'noble cause corruption' has entered the language.

The tainted term MSbP has fallen into disuse, only to be replaced by another set of initials, FII - Factitious or Induced Illness.

Real abuse is still being missed, as in the case of Victoria Climbié, partly because social services are busy investigating false allegations.

Change is slow, says Penny Mellor, who campaigns against non-scientific medical syndromes such as MSbP, because a small coterie of expert medical witnesses are sticking to theories that have been undermined by subsequent research.

'We have pathologists who don't have adequate training and experts who are so busy being experts that they have little time to keep up to date.'

Sir Roy's portrait still hangs in the London offices of the Royal College of Paediatrics and Child Health.

'Why not? He is a past president,' says Prof Terence Stephenson, the dean of the medical school at Nottingham University and the college's vice-president for science and research.

He is one of the doctors who has adopted attack as the best form of defence in response to the fall of Sir Roy and Southall.

Speaking as Professionals Against Child Abuse, they argue that doctors are being victimised by parents and the media who deny the reality of child abuse.

'Protect doctors to protect children,' he wrote to the Prime Minister in February, following a report on the case of Jessica Randall, whose abuse at the hands of her father was missed by 30 professionals.

False allegations campaigners consider Prof Stephenson a 'hawk' who has appeared in 50 cases: he prefers, he says, civil cases where a single expert witness is jointly appointed.

'In criminal cases you have to be willing to be countermanded and cross-examined' - although later he says that 'an expert is only tested by being challenged by another expert'.

Stephenson comes across as a pleasant man, driven by a passionate belief in his cause.

'I have two children. If someone were to accuse me of harming them I would be heartbroken. But our role at the Royal College is to do what's best for children. Child abuse is still under-diagnosed.'

I want to question him about evidence that casts doubt on current orthodox thinking.

Diagnosis of SBS is based on a triad of symptoms: subdural haemorrhages, retinal haemorrhages and cerebral edema (swelling of the brain).

The triad is important because regardless of other evidence, such as the absence or presence of bruises, these symptoms - particularly retinal haemorrhages - are used to diagnose abuse.

Sally Clark would never have been put on trial had Harry not been found (erroneously it transpired) to have bleeding behind the eyes.

Equally, Jessica Randall was never put on the 'at risk' register because MRI and eye scans showed no retinal haemorrhages.



Jay and Trupti Patel after Trupti was found not guilty of murdering her three children;

Dr Jennian Geddes, a neuropathologist, has suggested in the Court of Appeal that the triad need not arise from shaking.

Choking could be an alternative.

'She admitted in court that it was only a hypothesis,' Prof Stephenson says dismissively.

(The same could be said of the theory that the triad always denotes shaking.)

There is research, too, which shows that the triad can result from a fall from only 3ft, as from a bed.

'Fewer than three per cent would get retinal and subdural haemorrhages,' he replies.

But are children who fall from beds always tested?

We move on to the other contentious area - meta?physeal fractures. Stephenson appears equally dismissive about possible alternatives to a diagnosis of abuse.

'I've seen hundreds. They are extra?ordinarily rare in real, witnessed accidents.'

Yes, but they are also hard to see and radiologists won't look for them unless the possibility of abuse has been flagged.

When I suggest that paediatricians, especially those appearing regularly as expert witnesses, appear to have fixed minds, he counters by making a derisive comment about Dr Colin Paterson, a pathologist struck off by the GMC (General Medical Council) for suggesting for the defence in 30 cases that children could suffer from temporary brittle bones, resulting in multiple fractures.

Some pathologists believe he had a viable theory, but the wrong causation. Stephenson says, 'There's no evidence to back up temporary brittle bones.'

Isn't there?

Infants are being diagnosed with rickets resulting from vitamin D deficiency due to insufficient exposure to sunlight. 'Only in ethnic minorities.' Not according to research from Birmingham University, which states that one in eight Caucasian children has rickets.

'No doubt there are grey areas,' he concludes. 'If we only reported cases where we were absolutely right we would miss lots of cases. Society wants us to err on the side of caution. If society wants us to, we could go back to the situation pre-1962 and turn a blind eye.'

The problem with grey areas is their tendency to become black and white.

The doctors who see a child in hospital believe absolutely in what their colleagues have published - that what they are seeing is child abuse - and alert social workers and police.

They in turn hire expert witnesses who believe in the abuse diagnosis.

The result is costly.

'Money is certainly wasted pursuing these cases, but I'm more concerned about the human cost,' says Bill Bache, who speaks of distraught parents not allowed to be left alone with their dying child in hospital because they have fallen under suspicion; couples often forced to live separately and encouraged to blame one another; and children denied the comfort of family life.

Yet some children do die of natural but unidentified causes.

Cot deaths, for example, dropped from 30 to seven per week after 1990, when parents were advised not to put babies to sleep on their fronts.

Though they may not acknowledge it, doctors can also cause harm by giving inappropriate treatment.

The routine practice of resuscitating children by putting them on a drip is one that worries Penny Mellor, who campaigns on behalf of parents who claim to be wrongly accused of child abuse.

'If they aren't dehydrated, putting more fluids into them can cause swelling of the brain and bleeding,' she claims.

More information is needed to protect the innocent - children, parents and, indeed, doctors.

Slowly it is emerging.

When the history of false allegations is written there will be a roll-call of honour for those who have taken a fresh look at the medical conundrums and questioned orthodox thinking.

Some Americans will feature:

0: The forensic pathologist Dr John Plunkett, an expert in childhood head injuries;

0: Dr Patrick Lantz, who has been looking at retinal haemorrhages;

0: the biomechanics expert Dr Kirk Thibault, who has looked at the resulting impact when a child has a fall or is shaken;

0: and Dr Chuck Hyman, who has investigated a link between short umbilical cords and weak bones.

British experts will be on that list, too:

0: The chemical pathologist Dr Glyn Walters, who gave evidence about alternative causes of death in the Clark and Gay cases;

0: the neuropathologists Dr Waney Squier, Dr Jennian Geddes and Dr Helen Whitwell, who have found that oxygen deprivation, possibly from choking, can cause brain swelling and bleeding;

0: the geneticist Prof Michael Patton, who has looked at defects that can cause cot death;

0: the ophthalmologist Gillian Adams, who was has raised doubts about retinal haemorrhages being solely indicative of shaking;

0: Prof Nick Bishop, who is investigating why some children fracture easily;

0: and Dr Paul Johnson, who has asked courts to take obstetric history into account.

It is not easy standing against the tide, says Dr Squier, a prosecution witness at the trial of Keran Henderson.

She identified brain damage but said there was no evidence that the child had been shaken, which led to tense discussions among the medical experts.

'As a pathologist I describe what I see,' she said. 'It's not my business to say what caused an injury if I don't know.'

Despite her caution, a dozen experts who were prepared to theorise about shaking won the day and Keran Henderson is now serving a three-year prison sentence.

I asked her husband Iain whether he thinks that, even if exonerated, she will emerge, like Sally Clark, a broken woman.

'I don't know if she'll survive,' he replied.

'She went to prison eight years after Sally Clark. Prisoners aren't stupid, so she hasn't been given such a hard time. I'm hoping that hers is the case that brings about real change.'

Harold Levy...hlevy15@gmail.com;

Ban Imposed On Controversial British Pediatrician Dr. David Southall Lifted Pending Appeal Court Decision To Permit Humanitarian Work;

BBC News reports that the ban imposed on Dr. David Southall by the British Medical Council has been lifted to allow him to perform humanitarian work;

Southall was the subject of an earlier post entitled, "Part One: After Goudge; Will there be lasting change? Not necessarily; The British experience." (March 13, 2008);

That post read:

"The other leading light in the drive to unearth hidden abuse in Britain (apart from Sir Roy Meadow H.L.) was Prof David Southall. Working on aspects of MSbP in the late 1980s and early 90s, he videoed parents whom he suspected of suffocating children.

Thirty-three parents or step-parents were prosecuted, though the evidence may have been unreliable: clasping a child to the chest could, for example, indicate feeding rather than smothering.

The (Sally) Clark case was also his undoing when, having merely seen Steve on television, he stated to police that it was 'beyond reasonable doubt' that Steve had murdered his sons. (This statement is explained in the CBC report below);

A three-year ban from child protection work followed in 2004;

In December 2007 he was struck off for, among other charges, concealing the medical records of some 4,500 children."

(For more on Dr. Southall, see: "Part Five; After Goudge; Will there be change? Not necessarily; Dr. David Southall; The British Experience;" (March 20, 2008);

"Paediatrician David Southall has overturned a ban which stopped him working as a doctor," the BBC report, published Wednesday, April 23, begins;

"The General Medical Council struck off Dr Southall for serious professional misconduct. His appeal is continuing," the report continues;

"But it admitted at the High Court it was wrong to apply 2004 guidelines retrospectively in enforcing the ban.

Dr Southall, still employed at the North Staffordshire University Hospital, remains banned from undertaking child protection work.

He was barred from working as a doctor after the GMC decided he had abused his position by accusing a mother of drugging and murdering her son.

Mother distressed

The GMC found that Dr Southall's actions added to the distress of the mother - Mandy Morris, from Shropshire - whose 10-year-old son Lee hanged himself in 1996.

The hearing in December heard how Dr Southall made the claim in an interview with Mrs Morris about the safety of her surviving son.

The GMC also ruled Dr Southall had acted inappropriately in some cases by keeping original medical documents on children in his care separate from their medical records.

The GMC told the High Court that rules used to apply for Dr Southall's suspension were introduced in 2004.

As the allegations centred on events prior to 2004, the previous set of rules should have been applied, which would have meant the ban was not imposed.

Work abroad

The GMC said in a statement on Tuesday: "We can confirm that the immediate suspension imposed on Dr David Southall's registration has been lifted by mutual consent.

"The GMC supports the application to lift the immediate suspension, pending the outcome of the appeal against the panel's direction to erase Dr Southall's name from the medical register.

"Dr Southall's registration will be subject to previously imposed conditions which prevent him undertaking any child protection work."

Dr Southall said it was important for him to have the suspension overturned so he could work as a doctor for "humanitarian aid work abroad".

Wrongly jailed

He added that he would be leaving his job at the hospital in Staffordshire from June.

In a separate case in 2004, he was suspended from child protection work over his role in the case of Sally Clark, wrongly jailed over the death of her two sons. Dr Southall had accused Mrs Clark's husband Steve of murdering the two boys on the basis of a television interview Mr Clark gave.

The doctor also faces another GMC disciplinary hearing into the so-called CNEP breathing tank experiments at the hospital in the 1990s.

The case is expected to start in Manchester next week and will look into the research carried out which involved placing premature babies into low-pressure incubators so they could breathe on their own."

Harold Levy...hlevy15@gmail.com;

Part Five: After Goudge: Will There Be Lasting Change? Not Necessarily; Dr. David Southall; The British Experience:

"PAEDIATRICIANS FULFIL AN ABSOLUTELY VITAL ROLE IN CHILD PROTECTION, BUT A MINORITY OF THEM HAVE BEEN MAKING FALSE ALLEGATIONS AGAINST INNOCENT MOTHERS FOR MANY YEARS.

"IT IS ABOUT TIME THE MEDICAL ESTABLISHMENT STOPPED DEFENDING THESE PEOPLE."

LAWYER JOHN BATT:

I am very grateful to several readers who drew my attention to Dr. David Southall, an internationally renowned British pediatrician, who, like Dr. Charles Smith, managed to remain in practice for years in spite of efforts to have him booted out of the medical profession.

These readers broached the subject of Dr. Southall in the context of several recent postings in which I explored whether there would be real consequences for Dr. Smith after Commissioner Stephen Goudge files his report;

I am very grateful to Jason Day of the General Medical Council Press Office for providing me with the disciplinary body's recent decision finding Dr. Southall guilty of serious professional misconduct and erasing his name from the medical register;

In addition to providing our readers with this decision - a fascinating document which prompted several comparisons with Dr. Smith in my mind - I am providing a Wikipedia biographical excerpt on Dr. Southall, and the BBC's Internet account of his erasure.

(It should be noted that Dr. Smith received a mere "caution" form the Ontario College of Physicians and Surgeons for his sub-standard work on three cases in which his sub-standard work led to disastrous consequences for those involved. "Cautions" are not even recorded on the College's official Register);

The Wikipedia account answers the question "who is Dr. David Southall?" as follows:

"Professor David Southall is a UK paediatrician who is regarded by some as a leading expert in Fabricated or Induced Illness (FII, also known as "Munchausen Syndrome by Proxy"), and who has performed significant research into sudden infant death syndrome<" the Wikipedia account begins.

"Southall was struck off the medical register on 4 December 2007, after being found guilty of serious professional misconduct by the General Medical Council," it continues.

"In his early career, Southall spent four years in general adult medicine, one year in obstetrics and two years as a general practitioner.

Between 1986 and 1994, Southall led a pilot research project into FII involving video surveillance of young hospital patients in an effort to observe their carers (such as parents or guardians) harming them.

The project, which was conducted at the Royal Brompton Hospital in London, and the North Staffordshire Royal Infirmary in Stoke-on-Trent, observed carers using methods such as suffocation and poisoning to harm the children.

As a result of the project, thirty-three parents or step-parents who had harmed their children were prosecuted, and twenty-three were diagnosed with FII.

The project attracted controversy for its methods and for the ethical implications of the research.

Critics argued that the desire of the researchers to observe the carers harming the children exposed the children to further abuse, that the betrayal of doctor-patient trust necessarily involved in the surveillance could cause harm to the subjects, and that "a diagnosis should lead to treatment, not punishment".

However, the researchers argued that the surveillance saved the lives of many of the children involved, and Southall himself said that "[b]y doing covert video surveillance we are betraying the trust of parents... [b]ut if a parent has been abusing his or her child in this way then the trust between child and parent has already gone."

In the early 1990s, Southall led a study which pioneered continuous negative extrathoracic pressure therapy, a treatment for breathing difficulties in young children involving the application of pressure to the patients' chests.]

The study was controversial, with some parents of the children involved suggesting that the treatment was linked to subsequent death or brain injury.

The research was the subject of investigations by the hospital involved and inquiries from police.

An independent follow-up study concluded in 2006 that there was "no evidence of disadvantage, in terms of long-term disability or psychological outcomes" from the use of the technique.

In 1993, during the Bosnian War, Southall traveled to Sarajevo as a participant in a medical evacuation programme for sick children from the area.

Prompted by his experiences there of what he described as "trauma inflicted on children and their families, not only by warring factions, but also by the indolence of the international community", Southall established Child Advocacy International on his return, to advocate for international child health issues.

In 2004, Southall was found guilty of serious professional misconduct by the General Medical Council (GMC), after alleging to police that the husband of Sally Clark was responsible for murdering the couple's children.

Southall made the claim to child protection officers of the Staffordshire police after watching a television documentary about the case.

The GMC banned Southall from child protection work for three years; the Council for Healthcare Regulatory Excellence challenged the decision as insufficient and argued that he should be deregistered, but a High Court of Justice decision in 2005 held that the sanction was not unduly lenient.

In February 2007, Attorney-General Lord Goldsmith announced that a review would be held into a number of criminal cases in which Southall gave evidence for the prosecution, following allegations that Southall kept up to 4,450 personal case files on children patients which were kept separate from the official hospital records."

The BBC Internet news report, published on Dec. 4, 2007, under the heading "David Southall struck off by GMC," demonstrates the powerful support that Dr. Southall drew from some of his colleagues in the medical profession, in spite of the disturbing nature of the proven allegations;

"Controversial paediatrician Dr David Southall has been found guilty of serious professional misconduct and struck off the medical register," the report began;

"The General Medical Council decided last week that he had abused his position by accusing a mother of drugging and murdering her son," it continued:

The GMC said Dr Southall had a "deep-seated attitudinal problem".

The GMC found that Dr Southall's actions added to the distress of the mother - Mandy Morris, from Shropshire - whose 10-year-old son Lee hanged himself in 1996.

Dr Southall made the claim in an interview with Mrs Morris about the safety of her surviving son.

He had been instructed by Shropshire County Council to provide an independent expert report to the court.

Special files

The GMC also ruled that, in some cases, Dr Southall acted inappropriately in keeping original medical documents on children in his care in his own special case files separately from their official medical records.

Lawyers acting for the Attorney General are now examing thousands of these files amid concerns that they were not revealed during criminal proceedings.

In 2004 Dr Southall was suspended from child protection work over his role in the case of Sally Clark, wrongly jailed over the death of her two sons.

Dr Southall accused Mrs Clark's husband Steve of murdering the two boys on the basis of a television interview.

Dr Jacqueline Mitton, chair of the GMC disciplinary panel, told Dr Southall: "Your multiple failings over an extended period caused the panel great concern.

"Furthermore, the panel is influenced by the fact that although the events in the current case predate those in the Clark case there are now two instances were without justification you have accused a parent of murdering their child.

"In all the circumstances the panel has concluded that you have deep seated attitudinal problems and that your misconduct is so serious that it is fundamentally incompatible with your continuing to be a registered medical practitioner."

In a statement issued after the hearing, Dr Southall admitted he had taken "difficult and sometimes unpopular decisions" in his career.

But he added: "The welfare of the children has always been paramount in my mind."

Supporters

Dr Paul Davis, a consultant paediatrician in Cardiff, said Dr Southall had been a great pioneer in helping identify mothers who hurt their babies, and, as a result, had become the target of a hate campaign.

He said: "It is a great shame for David Southall personally, and a huge deterrent for paediatricians in Britian to get involved in this kind of work."

The Royal College of Paediatrics and Child Health expressed sadness and disappointment at the ruling.

President Dr Patricia Hamilton said "David Southall has made a major contribution to child health both nationally and internationally and has been a strong advocate for children during a distinguished career."

And Dr Evan Harris, MP called the ruling "disproportionate" and a "serious miscarriage of justice".

But John Batt, lawyer to the Clarks, said: "This has got to be the right decision.

"Paediatricians fulfil an absolutely vital role in child protection, but a minority of them have been making false allegations against innocent mothers for many years.

"It is about time the medical establishment stopped defending these people."

Dr Southall worked as a consultant paediatrician at London's Royal Brompton Hospital from 1982 before moving to the same post at the North Staffordshire Hospital in Stoke-on-Trent in 1992.

The Staffordshire trust said it would now review Dr Southall's position. Trusts are not allowed to employ doctors without the appropriate professional registration.

In a statement it said Dr Southall's competence as a general paediatrician had not given cause for concern.

He has (Filed an appeal aginst the GMC decision."

Here, at last, is the General Medical Council's Fitness to Practise Panel's decision;

"Dr. Southall; The Panel has considered this case in accordance with the General Medical Council Preliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules 1988.

The Panel has heard that from 1982 you were a senior lecturer and subsequently a consultant paediatrician based at the Royal Brompton Hospital, London.

From 1992 you were professor of paediatrics at the University of Keele and also a consultant paediatrician at the North Staffordshire Hospital, Stoke on Trent.

In January 1998 you were contacted by local authority social workers who had concerns about the welfare of Child M2.

You were told that there were similarities between current events in Child M2’s life (including apparent suicide threats) and events in the life of his elder brother, Child M1, who in June 1996, when aged 10, had died by hanging.

You gave the social workers certain advice.

On 29 January 1998 the court made an emergency protection order.

As a consequence Child M2 was removed from his parents’ care.

On 2 February 1998 you wrote what you described as a preliminary report, following which on 3 February 1998 the local authority applied for an Interim Care Order.

On 17 March 1998 you were instructed by the local authority to prepare a report for the care proceedings.

Your report was to cover both Child M2 and his family.

For the purpose of preparing your report you interviewed Mrs M on 27 April 1998.

The Panel has found proved that during the course of this interview you accused Mrs M of drugging Child M1 and then murdering him by hanging.

This was done in an accusatorial and intimidating manner.

The possibility of M1 being the victim of murder had not been raised until you became involved.

At the inquest the coroner had recorded in his verdict that he had considered suicide and accident but in the event he returned an open verdict.

It is apparent that no evidence was presented at the inquest to suggest that murder was a possibility.

Despite the verdict, you formed the belief that the circumstances of M1’s death needed to be investigated by you.

The Panel is extremely concerned by these facts.

You are a registered medical practitioner and in that capacity you were instructed by Shropshire County Council to write an expert report for the court in care proceedings based on the papers that had been provided to you.

The letter of instruction made it clear that it was important that the parties had confidence in your independent status.

Your action in accusing Mrs M of murdering Child M1 was inappropriate, added to her distress as a bereaved person and was, in the circumstances, an abuse of your professional position.

By acting in an accusatorial and intimidating manner you failed to treat Mrs M politely and considerately and did not respect her dignity.

This behaviour was also inappropriate and caused distress to Mrs M.

In some situations doctors have responsibilities not only to patients but also to third parties.

Although Mrs M was not your patient you interviewed her in your capacity as a registered medical practitioner and you had a clear obligation to
treat her as you should treat a patient, that is politely and considerately and respecting her dignity.

The manner in which you conducted the interview, questioned and directly accused Mrs M was incompatible with your position as a doctor.

The Panel regards your behaviour towards Mrs M as a very serious instance of misconduct.

In March 1989 Dr Dinwiddie, a consultant paediatrician at Great Ormond Street Hospital, referred Child H to you for investigation and advice.

In September 1989 and again in March 1990 Child H was admitted to the Royal Brompton Hospital where his breathing was monitored.

In March 1990 you proposed to the parents a home monitoring and care regime.

However, on about 22 March 1990 Child H’s parents informed you that they no longer wanted you to be involved in the management of Child H’s care.

On 22 March 1990 you wrote to Dr Dinwiddie to the effect that the parents were not acting in Child H’s best long term interests, that they liked the idea of him having a rare illness, that you were suspicious of their motives and that you viewed the long term prognosis with great concern.

You copied and sent this letter to an unnamed Consultant Paediatrician at the Royal Gwent Hospital even though no one there was currently involved in Child H’s care or had been involved in the past.

The letter contained sensitive and confidential information.

Your action was inappropriate and in breach of the confidentiality owed by you to Child H and his parent’s.

In the General Medical Council’s Guidance, Professional Conduct and Discipline: Fitness to Practise (March 1989), which was in force at that time, paragraphs 79-82 cover the subject of professional confidence.

It is a doctor’s duty, subject to the exceptions listed in Paragraph 81, to strictly observe the rule of professional secrecy by refraining from disclosing voluntarily to any third party information about a patient which he has learnt directly or indirectly in his professional capacity.

None of the exceptions applied in this case because the letter was sent to an unidentified recipient.

In relation to Child D and Child H, you created, or caused to be created, an “S/C” File for each child wherein certain original medical hospital records relating to the children were then placed by you or on your behalf.

These medical records are not elsewhere in the children’s hospital medical records. The placing of the original medical records in “S/C” Files damaged the integrity of the children’s hospital medical records and caused the items concerned to be inaccessible to others involved in the medical care of the children at that time or in the future.

You have a responsibility and duty as a doctor to ensure that medical records are readily available to colleagues as and when required.

Failure to do so can result in serious consequences.

Your action in this respect was not in the best interests of either Child D or Child H.

It was inappropriate and an abuse of your professional position.

You treated Child H at the Royal Brompton Hospital, and there created an “S/C” file for the child.

The “S/C” file contained original Royal Brompton Hospital medical records relating to Child H.

When you moved to the North Staffordshire Hospital in 1992 you took, or caused to be taken from the Royal Brompton Hospital, the “S/C” File relating to Child H.

Your action was not in the best interests of Child H.

It was inappropriate and an abuse of your professional position.

The damage to the integrity to the child’s hospital medical records was compounded by transferring them to a hospital at which the child was not being and had not been treated.

The Panel takes a serious view of your conduct in relation to the “S/C” files over a considerable period of time.

In 2004 the Professional Conduct Committee (PCC) found you guilty of serious professional misconduct in relation to the ‘Clark case’ and placed a condition on your registration for a period of three years.

The events in that case took place in 2000 and also concerned child protection issues.

The Council for the Regulation of Health Care Professionals appealed the decision of the PCC.

In his judgment given on 14 April 2005 Mr Justice Collins held that that the PCC’s decision to impose conditions was not unduly lenient but that the condition imposed was not sufficient to prevent any involvement by you in child protection work.

Moreover, the PCC should have directed that a resumed hearing take place towards the end of the three year term.

He substituted more tightly drawn conditions for that originally ordered.

A Fitness to Practise Panel reviewed the case on 23 July 2007 and determined that you had complied with the conditions.

It directed that the period of conditional registration should be extended for a further period of twelve months.

The events that gave rise to the Clark case occurred after the matters before this Panel.

These events and the consequent finding of serious professional misconduct have been disregarded by this Panel when considering the question of serious professional misconduct before it.

In February 2007 the Attorney General set in hand a review of cases in which you had acted as a prosecution witness.

This was with particular reference to the S/C Files.

The report is yet to be published.

The Panel has also heard that the South Wales police are investigating the treatment of Mrs H’s son.

The Panel has concluded that any police investigation and the Attorney General’s review are not relevant to its consideration of the question of serious professional misconduct, nor indeed to any sanction.

It has been accepted on your behalf that, in the light of the findings of fact there is evidence before the Panel from which it could conclude that you are guilty of serious professional misconduct.

The Panel has found that your conduct has fallen well below the standard expected of a registered medical practitioner in a number of respects.

It therefore finds you guilty of serious professional misconduct.

The Panel next considered what action, if any, to take in relation to your registration.

The Panel has borne in mind throughout its deliberations that any sanction imposed must be proportionate and appropriate, and that the purpose of sanctions is not to be punitive, but to protect patients and the public interest.

The public interest includes not only the protection of patients, but also the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour.

The public interest can also include a doctor’s return to safe practice.

The Panel has balanced the public interest against your own interests.

It has taken into account the Indicative Sanctions Guidance published by the General Medical Council.

The Panel is aware that the question of what, if any, sanction to impose is a matter for the Panel, exercising its own independent judgment.

The Panel has given consideration to the submissions made by both Counsel.

Mr Tyson, on behalf of the Complainants has submitted that the only appropriate sanction in this case is that of erasure.

Mr Coonan, on your behalf, has submitted that an order placing tight restrictions on your registration would be sufficient.

The Panel is in no doubt that it is necessary to take action against your registration and that the sanction imposed must mark strong disapproval of your behaviour.

Given the serious nature of your misconduct the Panel has determined that to conclude this case without making any direction in respect of your registration or to issue a reprimand would not be sufficient.

The Panel next considered whether it would be sufficient to impose conditions on your registration.

The Panel is aware that you are a paediatrician of international renown and that you have contributed significantly to the field of paediatrics and child protection.

The Panel recognises that your misconduct has arisen as a result of the child protection work that you were undertaking at that time and that your actions, although clearly misguided, may have been motivated by a concern to protect children.

There is no evidence before the Panel to demonstrate that your actions have caused direct harm to patients or their families other than in cases involving child protection.

Since your reinstatement in 2001, following suspension by your Trust, you have not worked in child protection.

You have complied with the conditions to which your registration has been subject.

The Panel has been provided with testimonials indicating that you are held in high regard by your professional colleagues.

The testimonials highlight your clinical skills and commitment to the welfare of children.

They also indicate that you have undertaken important ground-breaking research, which has influenced how the medical care of babies and children has been managed both in the United Kingdom and internationally.

The Panel has heard oral evidence from Dr Parke, a consultant paediatrician at the University Hospital of North Staffordshire and from Dr Bridson, a recently retired consultant paediatrician and Chairman of the Trustees of Child Health Advocacy International, a charity founded by you.

Dr Parke has given evidence about your outstanding clinical ability and your compliance with the conditions currently on your registration.

He also informed the Panel that numerous letters of support and thanks from your patients have been received.

Both witnesses confirmed that they were aware of the findings of fact made by this Panel.

Nevertheless they remain confident in your clinical abilities.

The Panel has also considered carefully the evidence given by Dr Chipping, Medical Director at the time, to the Professional Conduct Committee in August 2004 and her testimonial dated 16 November 2006.

She holds in high regard your clinical skills and the contribution you have been making to the paediatric team at North Staffordshire Hospital.

The Panel has noted the determination of the Professional Conduct Committee in August 2004, the judgment of Mr Justice Collins in April 2005 and the determination of the Fitness to Practise Panel at the review in July 2007.

The panel has been mindful of Lord Bingham’s well known observation in the case of Bolton v The Law Society, adopted in the case of Dr Gupta, as noted in the Indicative Sanctions Guidance:-

“A profession’s most valuable asset is its collective reputation and the confidence which that inspires………The reputation of the profession is more important than the fortunes of an individual member……… Membership of a profession brings many benefits, but that is part of the price.”

The Panel also had in mind Lord Hoffman’s judgment in Bijl v General Medical Council [2002] Lloyds Med Rep 60, in which he said:-

“The Committee was rightly concerned with public confidence in the profession and its procedures for dealing with doctors who lapse from professional standards. But this should not be carried to the extent if feeling it necessary to sacrifice the career of an otherwise competent and useful doctor who presents no danger to the public in order to satisfy a demand for blame and punishment……..”

Having considered all the evidence that is before it, the Panel accepts that were your registration to be restricted by tightly drawn conditions, patients would be unlikely to be at risk.

However, in considering the maintenance of public confidence in the profession and the declaring and upholding of proper standards of conduct and behaviour the Panel has concluded that the imposition of conditions would not reflect the gravity of your misconduct.

Your multiple failings over an extended period caused the Panel great concern.

Furthermore, the Panel is influenced by the fact that, although the events in
the current case predate those in the Clark case, there are now two instances where without justification you have accused a parent of murdering their child.

The Panel has therefore determined that to impose conditions on your registration, no matter how tightly drawn, would not be sufficient to protect the public interest.

The Panel next considered whether a period of suspension would be appropriate.

It has carefully balanced the public interest against your own interests.

It has taken into account the aggravating features of this case and the mitigation that has been advanced by you.

The Panel is particularly concerned by your lack of insight into the multiplicity of your failings over a long period.

The Panel is aware that an apparent lack of remorse should not result in a higher sanction but it has noted that notwithstanding the findings of fact you have not either directly or through your counsel offered an apology to any of the Complainants for your actions nor has there has been any acknowledgement by you as to your failings.

In all the circumstances the Panel has concluded that you have deep seated attitudinal problems and that your misconduct is so serious that it is fundamentally incompatible with your continuing to be a registered medical practitioner.

The Panel therefore directs that your name be erased from the Medical Register.

The Panel is satisfied that this is necessary in the public interest for the maintenance of confidence in the profession and in the interests of declaring and upholding proper standards of professional conduct and behaviour.

The effect of the foregoing direction is that, unless you exercise your right of appeal, your name will be erased from the register 28 days from the date on which notice of this direction is deemed to have been served upon you.

Having reached a decision that your registration should be erased, the Panel is minded to consider, in accordance with Section 38 of the Medical Act 1983 as amended, whether to direct that your registration be suspended forthwith.
The Panel will invite submissions from both Counsel on this matter.

Quite predictably, Dr. Southall has filed an appeal;

Harold Levy...hlevy15@gmail.com;

Part One: After Goudge: Will There Be Lasting Change? Not Necessarily: The British Experience;

"IN 2003 SALLY CLARK WAS RELEASED FROM JAIL AFTER BEING FALSELY ACCUSED OF MURDERING HER TWO SONS. SHE NEVER RECOVERED FROM THE TRAUMA AND DIED A YEAR AGO, EFFECTIVELY OF A BROKEN HEART. CASSANDRA JARDINE LOOKS AT HOW SUCH A GROSS MISCARRIAGE OF JUSTICE COULD OCCUR AND ASKS WHETHER LESSONS HAVE BEEN LEARNT."

CASSANDRA JARDINE: TELEGRAPH;

One of the most extraordinary perspectives wrongful convictions caused by flawed forensic expert testimony recently appeared on the Telegraph Web-site.

It is written by Cassandra Jardine, a Telegraph feature writer who has been writing about parenting for more than ten years and is the author of a book called, "How to be a better parent."

Jardine's insightful story appears under the heading, "Has Sally Clark's case changed attitudes to infant death?.

It has an eerie applicability to Canada where we are still reeling from the devastation caused to individuals and the criminal justice system by Dr. Charles Smith and the officials and institutions who failed to rein him in.

(Jardine refers to the On-going Goudge Inquiry in Canada as she cites just one line from Dr. Smith's testimony: "I believe I heard what I wanted to hear.")

The Canadian version could have been entitled: "Has William Mullins-Johnson's case. Brenda Waudby's case, Sharon's mother's case, Sherry Sherret's, and far too many other cases, changed attitudes to Infant deaths?"

Jardine also asks whether the initial cautions injected into Britains system in light of the Sally Clark case have evaporated in the wake of some forensic experts who have found different ways of casting their evidence so that even more innocent parents and care-givers can be charged with murdering children?

That's also a fair question in Canada: The Goudge Inquiry has done a phenomenal job of discovering what went wrong. But will its recommendations - expected later this spring - be enough to create lasting change?

Will Justice Goudge's recommendations be enough to overcome a culture in which police, prosecutor's, judges, and Children's Aid Societies all too easily set aside the fundamental protections which are supposed to exist for all persons investigated or charged with crimes, because an infant has died?

---------------------------------------------------------------------------------------

"Exactly a year ago Sally Clark died, aged 42, while her solicitor husband, Steve, was on a business trip," Jardine's story begins.

"At an inquest her death was ascribed to acute alcohol poisoning resulting from her grief and 'enduring personality change after a catastrophic experience'. In other words she never recovered from the nightmare that began on December 13, 1996, when her first son, 11-week-old Christopher, stopped breathing," it continues.

"Sally and Stephen Clark outside the Court of Appeal in January 2003. Sally was released from prison after serving more than three years for killing her two baby sons.

Mothers never get over the death of a baby, though they may move on. For Sally - once a bright and capable solicitor - even that was not possible. Two years later her second child, Harry, who was eight weeks old, also died suddenly. From that moment Sally received not sympathy but condemnation. Paediatricians decided - in line with what was then current thinking on child abuse - that two deaths in a family was suspicious and a Crown Court jury found her guilty of murdering both of her sons. 'Die, woman, die,' other prisoners shouted out as she climbed into the prison van.

What happened next made legal history. In January 2003, after serving three and a half years of a life sentence, Sally was freed. The defence at her second appeal revealed that Harry's body had been riddled with the bacterium staphylococcus aureus, which would have caused a form of meningitis - information that the prosecution pathologist Dr Alan Williams had not shared with Sally's defence at her trial. As she left the High Court, Sally declared, 'There are no winners here.'

Others charged with similar crimes, however, hoped that lessons would be learnt from what was called in the Court of Appeal 'one of the worst miscarriages of justice in recent years'. The way the medical evidence was presented to court was 'shoddy', said Dr Sam Gullino, a forensic pathologist from Florida, who prepared a report for Sally's second appeal. 'Sound medical principles were abandoned in favour of over-simplifications, over-interpretations, exclusion of relevant data and the imagining of non-existent findings.'

For a short while it looked as if the tide had turned. Inherited disorders were found to explain other babies' deaths: three other mothers, Trupti Patel, Angela Cannings and Donna Anthony, accused of shaking or smothering their own children, were found not guilty or had their convictions quashed. Meadow's Law - named after Prof Sir Roy Meadow - was discredited: no longer were two cot deaths in a family to be deemed suspicious and three murder unless proved otherwise. Summing up at Cannings' appeal in December 2004, Lord Justice Judge said that courts should not convict on disputed medical evidence alone: 'It is better for some of the guilty to go unpunished than for innocent women to be jailed.'

But, the cheers were short-lived. Fast-forward three years to last November. Once again the scene is a courtroom. This time the woman on trial is mother-of-two Keran Henderson, a childminder who was looking after 11-month-old Maeve Sheppard at her home in Iver Heath, Buckinghamshire, in March 2005 when - according to Keran - the child suddenly went floppy. Maeve died in hospital two days later, and Keran was accused of having caused Maeve's death by shaking her violently, having lost her temper over a dirty nappy.

As the verdict of guilty was delivered, Keran let out a piteous wail. 'If you could hear, as we did, the sound of that woman's grief you too might think her honest,' Mike Seckerson, the foreman of the jury, said. But it wasn't this alone that caused him to reveal his 'disgust' at the way the trial was conducted. He and the other medically unqualified jurors were bombarded by information from a dozen medical experts. The majority of the jury 'listened to expert opinion and thought it evidence', leaving Seckerson with the unhappy task of delivering a majority verdict with which he disagreed.

Seckerson is not alone in fearing that yet another terrible miscarriage of justice has occurred. Jack Straw, the minister for justice, has been inquiring solicitously about Keran's comfort in prison, says her husband Iain, who is campaigning to bring his wife home to their nine- and 14-year-old sons. Neighbours have rallied around in support of a woman who had been a respected childminder for seven years, ran the local Beaver Scout group, helped elderly neighbours and was always up for any charity event. Neither of her own children has ever suffered at her hand. Significantly, Maeve had been in and out of hospital during her short life, yet none of this counted. Someone had shaken the child, medical experts concluded, on the basis of certain signs.

'As an ex-policeman, I can't get my head around the fact that people are found guilty without any real evidence,' Iain says. 'There's no CCTV footage, no witness statement or weapon with fingerprints or blood. I think doctors are scared of saying, I don't know what happened.'

He is shocked that no one from the police or the CPS that he encountered was medically trained. 'I know the pressure is on the police to get results, to find someone guilty, but I wasn't even asked for my statement. Nor did they question the other children who were in the house that afternoon, who went home calm and happy. Would they have behaved like that if Keran had flown into a rage?'

Keran is not the only person in prison for a crime that might never have occurred. Suzanne Holdsworth, another childminder, is three years into a life sentence for causing the death of two-year-old Kyle Fisher who also, she says, went floppy. Doctors have compared the bleeding in his brain with injuries that would occur as the result of being thrown from a car at 60mph, yet he was not bruised and the banisters against which she supposedly battered him bear no traces of DNA. Chaha'Oh-Niyol Kai-Whitewind is in prison for suffocating her son, though her appeal may reveal natural causes as an alternative explanation for his nosebleed and blood found in the lungs.

Criminal convictions for harming children are just the visible tip of the iceberg. A far greater number of cases, where the evidence is insufficient for a criminal trial, are heard in the family courts, where on the 'balance of probabilities' parents are deemed to have harmed or (yet more vaguely because of 'personality disorders') be capable of harming children who are then removed from them, often at birth.

Information about family court cases is hard to obtain. Proceedings are secret so no one knows which experts are saying what, though observers note clusters of similar cases involving certain consultants. Parents claim that they are being accused of emotional and physical abuse on the basis of theories or syndromes that are not as foolproof as is claimed.

Angela Cannings, with her husband Terry. She was jailed for life for murdering her two baby sons, but had her conviction overturned in 2003

In the year since Sally Clark died, those facing family court proceedings have at last acquired a champion in the form of the Liberal Democrat MP John Hemming who set up Justice for Families after his girlfriend's baby was nearly taken from her because she had once failed to report a stillbirth. His office at the House of Commons contains files on more than 200 individual cases, which he uses to identify patterns and lobby for changes in the law. 'I hear of a new case almost every day,' he says.

'Smothering' has gone out of fashion as an accusation. So has 'salt poisoning', which Ian and Angela Gay were accused of. The couple were released from prison in 2006 when it was shown, at appeal, that their foster son Christian Blewitt suffered from a faulty osmostat, which allowed his body to accumulate fatally high levels of sodium. They had not, as was claimed, force-fed him teaspoons of salt.

There remain, however, two controversial medical diagnoses: shaken baby syndrome (SBS), a cluster of symptoms deemed to indicate shaking; and metaphyseal fractures, which are fractures at the ends of the long arm and leg bones, believed to denote that a child's limbs have been wrenched.

Events usually start with a paediatrician or radiologist who flags up the possibility of non-accidental injury (NAI). Social workers and police officers then look for evidence, sometimes ignoring information about good character or happy family life. And often solicitors acting for the defence are 'supine', says Bill Bache, who having successfully represented Angela Cannings and the Gays is now working on Keran Henderson's appeal.

Bache, like Hemming, has many suggestions for improving the system: a thorough multi-disciplinary discussion of possible causes of injuries or illness before cases proceed being one of them. At the heart of the problem, he says, lies 'angled dogmatism' on the signs and symptoms of abuse and a willingness by some doctors to give opinions outside of their areas of expertise. 'I am handling 35 cases of parents accused of child abuse at the moment,' he says. 'All medical conundrums.'

The drive to hold parents accountable for abusing children began in 1962 when a Colorado paediatrician, Dr Henry Kempe, published his research into 'battered child syndrome'. Drawing on 302 cases of abuse of children under three, he concluded that 'beating of children is not confined to people with a psychopathic personality or of borderline socioeconomic status'; parents often denied causing the injuries but 'to the informed physician, the bones tell a story the child is too young or frightened to tell'.

This information was shocking. It had always been accepted that psychopaths, addicts, sociopaths or even women suffering from post-natal depression could harm children. Kempe was saying that apparently normal, loving people could be abusers. His research changed the role of paediatricians; it became their task to spot hidden abuse.

Identifying the signs provided a useful career opportunity for ambitious doctors in the 1970s and 80s. Dr John Caffey in the US wrote the first influential paper establishing SBS in 1973. In Britain, Prof Sir Roy Meadow, author of the ABC of Child Abuse, rose to fame on the strength of his 1977 academic paper on Munchausen's Syndrome by Proxy (MSbP) - children made ill by attention-seeking adults - based on the behaviour of two mothers, one of whom had (Sir Roy claimed) poisoned her toddler with salt, while the other had contaminated her child's urine sample with her own blood. Knighted in 1996, Sir Roy was soon lecturing on the hidden epidemic of abuse and appearing as an expert witness. By the time he gave evidence at Sally Clark's trial, Sir Roy claimed to have found 81 cot deaths which were in fact murder though, unfortunately, he destroyed the data.

He told the court that he could think of no natural explanation for either of the Clarks' children's deaths and quoted the case-clinching statistic that the chances of two cot deaths in one family was one in 73 million - a figure arrived at by multiplying the incidence of one death (1:8543) by itself. It later emerged that the chance of a second death was more like one in 120 because there could be an underlying defect. Though struck off by the General Medical Council in 2005 for 'gross professional misconduct', he was reinstated the following year.

The other leading light in the drive to unearth hidden abuse in Britain was Prof David Southall. Working on aspects of MSbP in the late 1980s and early 90s, he videoed parents whom he suspected of suffocating children. Thirty-three parents or step-parents were prosecuted, though the evidence may have been unreliable: clasping a child to the chest could, for example, indicate feeding rather than smothering. The Clark case was also his undoing when, having merely seen Steve on tele?vision, he stated to police that it was 'beyond reasonable doubt' that Steve had murdered his sons. A three-year ban from child protection work followed in 2004; in December 2007 he was struck off for, among other charges, concealing the medical records of some 4,500 children.

Sir Roy and Southall are unrepentant but, in Canada, there has been an inquiry into the actions of Dr Charles Smith who was for two decades one of Canada's top forensic pathologists. He testified in 45 cases dating back to 1991, to children being suffocated, sodomised and shaken. Many of those parents have since been exonerated. 'I believe I heard what I wanted to hear,' he admitted at the inquiry in January.

But the fall from grace of some of the theorists of abuse has not made as much difference as expected. The term 'noble cause corruption' has entered the language. The tainted term MSbP has fallen into disuse, only to be replaced by another set of initials, FII - Factitious or Induced Illness. Real abuse is still being missed, as in the case of Victoria Climbié, partly because social services are busy investigating false allegations. Change is slow, says Penny Mellor, who campaigns against non-scientific medical syndromes such as MSbP, because a small coterie of expert medical witnesses are sticking to theories that have been undermined by subsequent research. 'We have pathologists who don't have adequate training and experts who are so busy being experts that they have little time to keep up to date.'

Sir Roy's portrait still hangs in the London offices of the Royal College of Paediatrics and Child Health. 'Why not? He is a past president,' says Prof Terence Stephenson, the dean of the medical school at Nottingham University and the college's vice-president for science and research. He is one of the doctors who has adopted attack as the best form of defence in response to the fall of Sir Roy and Southall. Speaking as Professionals Against Child Abuse, they argue that doctors are being victimised by parents and the media who deny the reality of child abuse. 'Protect doctors to protect children,' he wrote to the Prime Minister in February, following a report on the case of Jessica Randall, whose abuse at the hands of her father was missed by 30 professionals.

False allegations campaigners consider Prof Stephenson a 'hawk' who has appeared in 50 cases: he prefers, he says, civil cases where a single expert witness is jointly appointed. 'In criminal cases you have to be willing to be countermanded and cross-examined' - although later he says that 'an expert is only tested by being challenged by another expert'. Stephenson comes across as a pleasant man, driven by a passionate belief in his cause. 'I have two children. If someone were to accuse me of harming them I would be heartbroken. But our role at the Royal College is to do what's best for children. Child abuse is still under-diagnosed.'

I want to question him about evidence that casts doubt on current orthodox thinking. Diagnosis of SBS is based on a triad of symptoms: subdural haemorrhages, retinal haemorrhages and cerebral edema (swelling of the brain). The triad is important because regardless of other evidence, such as the absence or presence of bruises, these symptoms - particularly retinal haemorrhages - are used to diagnose abuse. Sally Clark would never have been put on trial had Harry not been found (erroneously it transpired) to have bleeding behind the eyes. Equally, Jessica Randall was never put on the 'at risk' register because MRI and eye scans showed no retinal haemorrhages.

Jay and Trupti Patel after Trupti was found not guilty of murdering her three children

Dr Jennian Geddes, a neuropathologist, has suggested in the Court of Appeal that the triad need not arise from shaking. Choking could be an alternative. 'She admitted in court that it was only a hypothesis,' Prof Stephenson says dismissively. (The same could be said of the theory that the triad always denotes shaking.) There is research, too, which shows that the triad can result from a fall from only 3ft, as from a bed. 'Fewer than three per cent would get retinal and subdural haemorrhages,' he replies. But are children who fall from beds always tested?

We move on to the other contentious area - meta?physeal fractures. Stephenson appears equally dismissive about possible alternatives to a diagnosis of abuse. 'I've seen hundreds. They are extra?ordinarily rare in real, witnessed accidents.' Yes, but they are also hard to see and radiologists won't look for them unless the possibility of abuse has been flagged.

When I suggest that paediatricians, especially those appearing regularly as expert witnesses, appear to have fixed minds, he counters by making a derisive comment about Dr Colin Paterson, a pathologist struck off by the GMC for suggesting for the defence in 30 cases that children could suffer from temporary brittle bones, resulting in multiple fractures. Some pathologists believe he had a viable theory, but the wrong causation. Stephenson says, 'There's no evidence to back up temporary brittle bones.'

Isn't there? Infants are being diagnosed with rickets resulting from vitamin D deficiency due to insufficient exposure to sunlight. 'Only in ethnic minorities.' Not according to research from Birmingham University, which states that one in eight Caucasian children has rickets.

'No doubt there are grey areas,' he concludes. 'If we only reported cases where we were absolutely right we would miss lots of cases. Society wants us to err on the side of caution. If society wants us to, we could go back to the situation pre-1962 and turn a blind eye.'

The problem with grey areas is their tendency to become black and white. The doctors who see a child in hospital believe absolutely in what their colleagues have published - that what they are seeing is child abuse - and alert social workers and police. They in turn hire expert witnesses who believe in the abuse diagnosis. The result is costly.

'Money is certainly wasted pursuing these cases, but I'm more concerned about the human cost,' says Bill Bache, who speaks of distraught parents not allowed to be left alone with their dying child in hospital because they have fallen under suspicion; couples often forced to live separately and encouraged to blame one another; and children denied the comfort of family life.

Yet some children do die of natural but unidentified causes. Cot deaths, for example, dropped from 30 to seven per year after 1990, when parents were advised not to put babies to sleep on their fronts. Though they may not acknowledge it, doctors can also cause harm by giving inappropriate treatment. The routine practice of resuscitating children by putting them on a drip is one that worries Penny Mellor, who campaigns on behalf of parents who claim to be wrongly accused of child abuse. 'If they aren't dehydrated, putting more fluids into them can cause swelling of the brain and bleeding,' she claims.

More information is needed to protect the innocent - children, parents and, indeed, doctors. Slowly it is emerging. When the history of false allegations is written there will be a roll-call of honour for those who have taken a fresh look at the medical conundrums and questioned orthodox thinking. Some Americans will feature: the forensic pathologist Dr John Plunkett, an expert in childhood head injuries; Dr Patrick Lantz, who has been looking at retinal haemorrhages; the biomechanics expert Dr Kirk Thibault, who has looked at the resulting impact when a child has a fall or is shaken; and Dr Chuck Hyman, who has investigated a link between short umbilical cords and weak bones.

British experts will be on that list, too: the chemical pathologist Dr Glyn Walters, who gave evidence about alternative causes of death in the Clark and Gay cases; the neuropathologists Dr Waney Squier, Dr Jennian Geddes and Dr Helen Whitwell, who have found that oxygen deprivation, possibly from choking, can cause brain swelling and bleeding; the geneticist Prof Michael Patton, who has looked at defects that can cause cot death; the ophthalmologist Gillian Adams, who was has raised doubts about retinal haemorrhages being solely indicative of shaking; Prof Nick Bishop, who is investigating why some children fracture easily; and Dr Paul Johnson, who has asked courts to take obstetric history into account.

It is not easy standing against the tide, says Dr Squier, a prosecution witness at the trial of Keran Henderson. She identified brain damage but said there was no evidence that the child had been shaken, which led to tense discussions among the medical experts. 'As a pathologist I describe what I see,' she said. 'It's not my business to say what caused an injury if I don't know.'

Despite her caution, a dozen experts who were prepared to theorise about shaking won the day and Keran Henderson is now serving a three-year prison sentence. I asked her husband Iain whether he thinks that, even if exonerated, she will emerge, like Sally Clark, a broken woman. 'I don't know if she'll survive,' he replied. 'She went to prison eight years after Sally Clark. Prisoners aren't stupid, so she hasn't been given such a hard time. I'm hoping that hers is the case that brings about real change.'

Harold Levy...hlevy15@gmail.com