Letter: Beverly Allitt: the necessity of a public inquiry and a syndrome that can be used as an excuse

Sir: Has any doctor actually said that the serial killings by Beverly Allitt are the product of a form of Munchhausen syndrome by proxy? Or is it merely the defence offering mitigation for these dreadful deeds?

Munchhausen syndrome was first described by Asher in 1951 and it was applied to people who travelled from hospital to hospital seeking attention for fictitious illnesses.

The first description of a proxy form appeared in 1976 in an American law journal, in relation to the deliberate withholding by parents of medical attention from children. Professor Roy Meadow, of Leeds, in 1977, described a quite contrary proxy form, in which almost always the mother, rarely the father or other blood relative, and hardly ever, it seems, a non-related carer, repeatedly fabricated or caused illness in just one child, apparently in order to fulfil some personal need.

Is this latest manifestation a third proxy form? Will the doctors say the spectrum of proxy forms of Munchhausen syndrome ranges from harmful inaction to serial murder?

In the past 18 months or so I have interviewed a dozen mothers labelled MSBP. They were diagnosed thus by doctors who could find nothing medically wrong with children displaying worrying chronic symptoms whom the mothers had repeatedly taken to hospital. In all 12 cases, the mothers denied abuse. As time goes by they are being vindicated, either by the decision of a court or as a result of more expert diagnosis.

Their medical records will always carry the stigma of a MSBP diagnosis. Two of the mothers rang me early this morning despairing of ever putting the trauma behind them, now they have been categorised alongside a multiple child killer.

Two years ago the Department of Health put MSBP into Working Together, the 1989 Children Act child protection guidelines, as a recognised form of abuse. Is it any wonder that MSBP cases are being increasingly reported? Sue Amphlett of Parents Against Injustice told me last year that it could become a 'dustbin diagnosis' for lazy clinicians. Has it also become a dustbin excuse for criminality?

All that King Herod needed was an inventive lawyer with a medical textbook.

Yours etc,

BRIAN MORGAN

Cardiff

18 May

The writer is a journalist who has been investigating Munchhausen syndrome by proxy.