THE STATE IS THE REAL VILLAIN
IN CHILD PROTECTION CASES
21 December 2003
That there is a crisis in British paediatrics is
beyond doubt. Following a series of high-profile court cases during which
expert paediatric testimony has been discredited, public confidence in the
profession has slipped to an all-time low.
Peter Bossley What is not so clear is the identity of the heroes and
villains in this deeply troubling and upsetting business. Who are the bad
guys? 'Easy', say the critics, many of whom are parents who have suffered
the loss of a child, 'it's the all-powerful consultant paediatricians like
the controversial Professor Sir Roy Meadow and North Staffordshire's own
Professor David Southall.'
'Rubbish', claim the professors, 'the real villains of the piece are
parents who kill and those well-meaning but misguided media supporters who
end up protecting child killers.'
And what of the heroes? Are the good guys those brave parents who fight to
clear their name or is it the eminent, brilliant medical men and women who
devote their own lives to saving the lives of children - people, in other
words, like Professors Meadow and Southall?
Only one thing is clear, however, and that is the identity of this story's
victims: children - innocent, trusting children. Among them are new-born
babies spirited away by social services departments. Then there are the
other child victims, those for whom intervention came too late and whose
short, tragic lives ended beneath a blanket or pillow held against their
tiny, trusting faces by a parent.
For at the heart of this terrible, heart-wrenching tragedy is one
indisputable fact: some parents do kill their children.
It is difficult to come to terms with this dreadful truth but health
professionals have long accepted that some people are capable of betraying
the most important relationship of all: that of a mother and her child.
The shocking fact that this most basic of bonds can, and does, break down
is the cause of much of today's controversy. That anyone - least of all a
mother - could harm so defenceless a being as a new-born baby is an
effrontery to humanity, a reversal of everything we believe to be
civilised. Such behaviour provokes extreme - and in many cases emotional -
In prison, the child killer is regarded with almost mythical hatred. The
presence of such an inmate engenders moral outrage (and often extreme
violence) among the rest of the prison population.
In hospitals, child victims tend to rouse a deep-rooted protective
instinct among health professionals.
For all the adverse publicity heaped upon Professor Sir Roy Meadow's
controversial views on Munchausen Syndrome By Proxy (MSBP), the fact
remains, he is not a villain.
(MSBP is the theory, first proposed by Prof Meadow in 1977, that depressed
mothers harm their babies in an attempt to gain attention. It was, and
remains, a deeply controversial view).
Prof Meadow is a passionate, driven defender of children whose expert
opinion and research has saved many, many children from a miserable life
And yet it is this very real desire to save babies which may be causing
irreparable damage to innocent children and their parents.
For, in his desire to protect society's most vulnerable victims, Prof
Meadow (and supporters like Prof Southall) can all-too easily adopt an
evangelical zeal. Whenever a paediatrician as eminent as Prof Meadow
offers expert opinion in the closed, secretive world of the Family
Division, the court tends to take notice. In such proceedings, the stakes
are high indeed. Get the decision right and a baby's life will have been
saved. Get it wrong and the parents (and child) will become victims of a
cruel and unending agony.
Take the case of Karen and Mark Haynes of Birmingham. Their first baby,
Robert, died aged four months. Thirteen months later a daughter, Sarah,
was born. The Haynes held her 20 minutes and then social workers removed
The cause of the Haynes's heartbreak was an emergency protection order
granted to Birmingham Social Services after the department had
commissioned two paediatricians to review young Robert's case notes.
One of them, Prof Sir Roy Meadow, said he believed that Robert's death was
the result of smothering.
Four months later the case was heard in a Family Division court where Prof
Meadow repeated his opinion that Robert was smothered due to MSBP. Other
experts disagreed, but the court believed Prof Meadow.
Sarah was put up for adoption and the Haynes went home to grieve - again.
No police investigation, no criminal case and no jury trial. Just one
eminent and expert opinion from a man who has dedicated his life to the
protection of children.
The Haynes case was heard in open court. This is unusual because Family
Division proceedings are normally held in camera. It has allowed the
Haynes to protest their innocence - long and loud. Other parents in a
similar situation have been the subject of gagging orders meaning that, as
well as losing a child, they are unable even to plead innocence.
Franz Kafka would have understood. And Kafka would also identify the real
villain in all of this - the state. Not the doctors on whose words hang
lives. Not the parents - both innocent and guilty, for even the latter are
victims of psychological illness.
No, the real villain is a state which has failed to protect parents from
those protecting their children. MSBP syndrome remains a controversial
illness - many experts doubt it even exists. Yet all agree that some
parents do kill babies.
The problem is that Family Division verdicts destroy. Such decisions - in
secret, behind locked doors, without a jury and requiring only proof
"on the balance of probabilities" rather than "beyond
reasonable doubt" - destroy families, break hearts and, agonisingly
slowly, over years of sadness and impotent rage, sometimes destroy
Of course, vulnerable children need protecting. But there's something
wrong with a system that removes babies from mothers within minutes of
birth yet which allows the gross wrongs visited upon the Sally Clark and
Angela Canning to fester for year after year.
The CPS has ordered a review of every past case that relied on Prof
Meadows' expert testimony. That is a start, but it is not the end. We need
to review the whole paediatric system. No longer should the word of one
paediatrician - no matter how well-meaning - be sufficient to cast a
family into the darkness of forced separation from a child.
Too many questions remain unanswered when it comes 'cot death'. We must
not allow unproven, controversial theories to rush into this void. In the
event of a suspicious death, there must be closer co-operation between the
various parties - police, social services coroner, paediatrician and
paediatric pathologist. Inviting a variety of opinion and expert advice
will help protect parents and children from the dangers of zealotry
Finally, decisions to remove children from their parent should - and must
- be subject to the standards of criminal law. Until the state gets its
act together and starts to protect parents and children by policing the
experts, it will remain the real villain of this piece.