(Queen's Bench Division (Admin), Blake J, 22 May 2009)
The paediatrician was a well-known and eminent expert witness in the field of child protection. Following a disciplinary hearing by the Fitness to Practice Panel of the General Medical Council he was found guilty of serious professional misconduct, and his name was erased from the register. The paediatrician appealed. The paediatrician had previously been disciplined for sending an unsolicited letter following a television programme in the Clarke case, but the conditions imposed, preventing him from engaging in child protection work, had subsequently been lifted. The fresh allegations against him were (i) that he had written about his child protection concerns in a case to an un-named medical colleague; (ii) that he had maintained special files on children about whom he had child protection concerns, containing original medical records not found elsewhere; and (iii) that he had conducted an aggressive interview with a parent about her possible murder of one of her children. The mother's elder child had been found dead in his room when he was 10 years old, having apparently committed suicide by hanging himself. When the mother reported that her younger child was also suicidal, the local authority began to have concerns that the mother was exhibiting signs of Munchausen's Syndrome by Proxy; the child was removed from the mother's care under an emergency protection order and the police agreed to investigate the elder child's death further. The paediatrician gave evidence at the interim care hearing, but the judge refused to make an interim care order. Nothing new had been found in relation to the death, and, taking account of the child's views, the child was returned to the mother's care. The paediatrician was asked to prepare a report with a view to the local authority applying for a full care order, and he asked the mother to attend his hospital for an interview. The mother was not informed what the interview was about, and no suggestion was made that she should bring a solicitor with her. In fact the paediatrician had invited the social worker involved in the care proceedings to sit in on the interview. During the interview the paediatrician expressed strong suspicions as to the death of the elder child, based on his belief that the curtain pole would not have been able to bear the child's weight, and discussed with the mother the possibility that she had drugged and then murdered the child.
Serious professional misconduct had been made out. In respect of the letter setting out real child protection concerns, sent to an unnamed consultant at a particular hospital, it was not best practice to send a letter containing confidential information other than to a named individual, but this did not amount to serious professional misconduct. In respect of the creation of special files containing original medical records not held elsewhere, this was capable of constituting serious professional misconduct, as in this case any signposting on the main records of the existence of additional material held by the paediatrician had been insufficient, but was not conduct justifying erasure of registration. However, the interview with the mother had been truly shocking, and an abuse of the role of consultant and expert instructed in ongoing litigation. During the interview the paediatrician had speculated on non-medical matters in an offensive manner entirely inconsistent with the status of independent expert. While matters properly recorded in medical notes or substantiated by other evidence could properly form the basis of conclusions by an expert paediatrician, investigative concerns of alternative scenarios must be founded on evidence and the proper experience of the expert evaluating such evidence within his or her area of competence. The paediatrician in this case was not an expert in curtain poles, or pathology, or the means by which young people might choose toharm themselves. Not only was there no evidence to support the hypothesis that the child had not self-harmed, but all the inquest evidence had pointed the other way. Nothing less than erasure from the register would suffice to maintain confidence in the medical profession in general and the specialist discipline concerned with the difficult task of giving expert evidence in child protection cases in particular. Public confidence in the science of expert assessment in those cases in which serious issues of child protection were raised would be undermined if egregious behaviour of this kind, combined with the paediatrician's lack of insight into or acknowledgement of its nature and extent, was considered to be compatible with continued registration as a medical practitioner.