There is no more contentious issue than the possibility that mothers wilfully harm their children, and there is no more contentious figure among the doctors who specialise in this area than Professor David Southall. Last week, he was struck off by the General Medical Council (GMC). The chairman of the panel, Dr Jacqueline Mitton, told him: "You have deep-seated attitudinal problems and your conduct is so serious that it is fundamentally incompatible with your continuing to be a medical practitioner."
The case she had in mind was of Mandy Morris, a mother whose son Lee died hanging from a curtain rail. According to Mandy Morris, Southall had wrongly accused her of drugging and killing Lee. Almost as shocking was the case that caused the GMC to ban Southall from engaging in child protection work. That was after he became involved in the case of Sally Clark, wrongly imprisoned for killing two of her children. Southall had watched a Dispatches programme in which her husband Steve described one child bleeding from both nostrils, and called the police to express his opinion that the children's father might have been responsible. To many, this appeared to put this distinguished paediatrician on much the same level as the pundits who watch programmes about Madeleine McCann and then turn to each other and exclaim, "It was the father!"
Two days later, Janet Alexander, mother of a boy who had been made a ward of court as a result of Southall's intervention, and who, she said, had been damaged by research the professor conducted on him, declared on the Today programme: "David Southall was using our son for research purposes." He is, she said, "a very dangerous doctor".
Another allegation, which the GMC did take seriously, was that Southall had taken children's records from their medical files 4,500 of them for his own purposes. Nonetheless, 38 senior paediatricians last week complained in The Guardian about Southall's punishment. There was, they said, a conspiracy "to deny the existence and reality of child abuse in all its forms". Some of them had worked with Southall. So, indeed, did my husband, several years ago, for his international children's charity. All of them say the same thing: that he really does care passionately about children.
But paediatricians are also worried that the GMC's treatment of Southall could affect them all. And not just because the panel that condemned him included three lay people and an orthopaedic surgeon no one with any experience in child abuse.
In the case of Mandy Morris, Southall denies that he accused her of murdering her son. He was putting different scenarios to her to try to establish the truth. One of them was the possibility that she had brought about her son's death. The GMC accepted the mother's version. But the professor had brought along to this fraught interview a senior social worker who took notes, and who testified that he had behaved in an "exemplary way". So, the GMC discounted the evidence of two professionals in favour of that of a mother, testifying from memory.
As one paediatrician said: "What's the point of taking notes if they're disregarded in favour of an angry mother relying on her memory?" Margaret Crawford, another paediatrian asked: "Where does this leave us? What kind of witness do we need?" Crawford was herself a prospective witness in the case, on the question of whether Southall had wrongly appropriated children's notes from their files for his own private use. She read the evidence and thinks the charge is a result of the GMC's failure to understand that what seemed like aberrant behaviour is actually quite common practice.
"We all kept child protection records in a separate file," she said. "It's done all over the country. He didn't hide records." Paediatricians are still reluctant to keep sensitive child protection papers solicitors' letters for instance among ordinary medical records that do the rounds of hospital wards. Another colleague, Dr Martin Samuel, who worked with Southall for more than 20 years, explains that of the 4,500-odd files, almost all related to his work on breathing problems, which were entirely uncontentious. "The documents were not kept outside the hospital," he said. On the subject of Southall's research work on breathing in which Janet Alexander said he harmed her son Samuel is emphatic that he would never have harmed a child. "Any research was done with consent," he said.
There have been about 20 complaints about this research, suggesting that Southall deprived children of oxygen or administered carbon dioxide to them. But those involved explain that what he did with the approval of his hospital's ethics committee was give children the same levels of oxygen they would breathe on a plane, and that he never administered carbon dioxide. Remarkably, the police investigation into the allegations has still not been concluded after 10 years. So far as Janet Alexander's accusations against Southall are concerned, they were dismissed by the GMC.
So what about the serious allegation that he impulsively accused Sally Clark's husband of murder? The GMC says that he did not make clear, throughout his involvement in the case, that all he had to go on was the Dispatches programme. This is not true. In the first place, the bleeding from both nostrils described by Steve Clark, is a symptom that alarms most experts. Chris Hobbs, a paediatrics professor at Leeds, says that many doctors do not realise that nosebleed in babies very often has sinister implications. Now a research paper from Edinburgh by Neil McIntosh, professor of child health, which looked at a large database, has confirmed that.
And by the time Southall came to write a report on his concerns, he had spoken to expert witnesses and to the police, and sat in on a strategy meeting on the case. Certainly, he didn't have access to medical records. But this was because another doctor involved, who had already said that the Clarks' remaining child was safe with their father, had denied Southall access to them.
Southall rouses strong passions, both ways. But it would be a grim irony if the way his career has been concluded means that people who should be protecting children from abuse now feel too intimidated to do so.
Further browsing: http://www.gmc-uk.org/concerns/hearings_and_decisions/index.asp