A disturbing tale and a host of ugly conclusions

Another story of gross liberties taken with the distressed parents of vulnerable children has concluded with condemnation of medical professionals. The Griffiths report, released yesterday, was launched in response to allegations by parents that they had not been informed when their premature babies were placed in experimental ventilators at the North Staffordshire Hospital trust in Stoke-on-Trent.

The ventilators, which were designed in the US in an attempt to assist babies' breathing without inserting tubes down their throats, are no longer used to treat premature babies in British hospitals. In the experiment, led by Professor David Southall and Dr Martin Samuels, 43 of 122 babies suffered brain damage or died. Of 122 babies treated conventionally in a control group, 32 died or suffered brain damage.

Among the families whose children became involved in this experiment, none was more cavalierly treated than the Henshall family.

Carl and Debbie Henshall lost one daughter in the continuous negative extra-thoracic pressure (CNEP) chamber, while another suffered brain damage. The parents did not know their daughters were undergoing experimental treatment, and they believe that under the usual treatment their daughters might have made full recoveries.

The harsh fact is that there is nothing in the report which upholds their belief.

Premature babies sometimes die, whether new treatment is being tried out on them or not. What is wrong here is that the parents were not given the opportunity to make an informed choice. Several, in fact, say signatures on their consent forms were forged. And it is that aspect of this sorry case that the Griffiths report seeks to remedy, with new measures governing the procedures under which consent of this kind is given.

The man who ultimately carries the can for what went on during this four-year experiment is Professor David Southall, who was actually based in London when the trials were begun. But his troubles are by no means over with the conclusion of this inquiry. In the last year, five inquiries have been launched which involve him. Late last year, the first of them, conducted by the North Staffordshire Hospital trust, exonerated him of accusations of personal and professional misconduct.

This inquiry dealt with a quite separate matter - accusations that he had been using hospital resources to fund his charity, Child Advocacy International, which fights child abuse in the Third World. One result of the controversy surrounding Professor Southall is that a lottery grant of £150,000 assigned to the charity has been put on hold.

Professor Southall was suspended by the trust two months after the inquiry vindicated him, this time over allegations made by parents campaigning against his work in child protection. It was Professor Southall who pioneered techniques whereby parents suspected of harming their own children in order to gain attention from the medical profession were secretly filmed. Professor Southall says he has worked with 109 families, in which there have been 43 deaths and 184 children taken into care. Guidelines on the use of covert video surveillance have also been recommended by the report.

But Professor Southall's techniques have angered some parents who say they have been falsely accused. A pressure group, called Mothers Against Munchausen's syndrome by proxy Allegations (MaMa), accuses not just Professor Southall, but 13 other doctors of "perjury, attempted blackmail, and child abuse", and is campaigning to have Munchausen's by proxy discredited as a diagnosis.

The most disturbing story of a mother falling foul of Professor Southall's diagnoses comes from Mandy Morris.

Her son, Lee, hanged himself after being bullied at school, and when her younger son Carl had difficulty in coming to terms with the loss, she confided her worries to a colleague at work. This colleague got in touch with Professor Southall, who said that it was possible that she was suffering from Munchausen's. The colleague, in turn, passed this suggestion on to the police.

Unbelievably, this unsubstantiated diagnosis led to the police and social services arriving in Mrs Morris's doorstep, complete with an emergency protection order. Mrs Morris's son was taken into care, while investigations were made. In an interview with Professor Southall and three other doctors, Mrs Morris was found not to be a sufferer and her son was returned to her.

The case is interesting because it suggests that hospital staff, social services and even police are willing to act on the very mention of Professor Southall's name, however little involvement he himself may have had in diagnoses or decisions. This I'm sure is largely a function of Professor Southall's undoubted dedication and commitment, which those around him clearly find inspirational. But what seems to have been happening is that they have been too willing to accept everything at Professor Southall's own estimation, and wandered into some quite dubious territory in the process.

Professor Southall certainly appears to believe that, to some extent, the end justifies the means.

It is not only the case of the respirators and the covert filming that suggest this. Years ago Professor Southall generated controversy when conducting experiments into the possible links between cot death and air travel. His trials exposed babies to 15 per cent oxygen in order to simulate the effects on their health of air travel. This is certainly a high-risk experimental strategy.

But the great danger now is that because of a doctor's over-zealous techniques he has become vulnerable to extremely unfair treatment himself. Many people working in the area of child abuse develop a messianic attitude towards their work, simply because their intimate knowledge of the possibilities of cruelty to the innocent urges them to act too hastily.

Some of those who feel themselves to have fallen foul of Professor Southall's uncompromising techniques have every right to be angry. But some of those allied against him seem almost unbalanced in their hatred. Those who demand that the diagnosis of Munchausen's syndrome by proxy should be banned - it in fact is under investigation as terms are drawn up for a more useful and specific definition - seem as recklessly committed and uncompromising as the groups in the Eighties who began campaigning for it to be recognised that there is no such thing as recovered memory syndrome. Their protestations are so extreme that their cause is hugely damaged.

Those allied against Professor Southall have been campaigning against theories about Munchausen's by proxy since 1992. Finally, their net around Professor Southall is tightening. There are still three enquiries into various aspects of Professor Southall's professional life to be concluded. It is estimated that they could take years. Meanwhile, Professor Southall remains suspended from his consultancy, with his charity under suspicion and his clinical work effectively over for the time being at least.

Meanwhile, Professor Southall is pinioned by several forces. First there is his own eager unorthodoxy, an unorthodoxy which seems able to transmit itself to less fastidious colleagues and other professionals. Second there is the very real and intensive campaign against him by those who are not happy with his diagnoses of Munchausen's or indeed with the idea of the existence of such a condition at all. Third there is the beleaguered state of the medical profession, eager now to be seen to be capable of dealing firmly with its members from within.

Professor Southall many have behaved less than perfectly on many occasions. But we must continue to ask ourselves why that may be, rather than be tempted to scapegoat him or even to give any credence to the ugly conclusions that the anti-Munchausen's brigade are so keen to spread far and wide.

d.orr@independent.co.uk

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