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Danger Zone: David Southall “smear" attack Professor David Southall, the beleaguered paediatrician at the centre of the CNEP controversy, claims to have been the victim of a smear campaign. According to an article by James Murray, published in the Sunday Express on 8th April 2007, outrage followed the Professor’s decision to set up covert video surveillance of children suspected of being abused at the Royal Brompton Hospital in London. As a result of his actions, many parents were prosecuted after being caught on film as they harmed their children. The article goes on to say that, during his work in the field of child abuse, Professor Southall diagnosed some mothers as suffering from Munchausen’s Syndrome By Proxy (MSBP), a condition in which some mothers injure their children in order to seek attention. His diagnoses enraged some mothers, who bitterly proclaimed their innocence and formed a small group to actively campaign against the doctor. It is this tiny group of activists that Professor Southall now accuses of trying to destroy him. Independently of, and indeed unaware of, Professor Southall’s intended revelations in the Sunday Express, NHS Exposed has been observing this group of activists for some time – with, it must be said, a mounting degree of concern. In the interests of scientific inquiry, we conducted a brief experiment into whether this group can accurately interpret and analyse information when challenged. As is often the case with outspoken minority groups, the activists in question frequent an internet message board, facilitating easy observation of their stated responses, views and intended actions. We compared this group to a support group raising concerns about the MRSA superbug, which was able to study complex evidence and present it succinct, reasoned responses. Unfortunately, in the case of the anti-Southall campaigners, we found that there appeared to be gross misinterpretations of evidence, a persistent failure to adequately research material before reaching illogical conclusions and leaps of “logic” used to extrapolate a given piece of evidence into a conclusion that was irrelevant to the original evidence. Disturbingly, the group frequently made emphatic assertions on matters requiring a high degree of scientific knowledge and expertise in a number of fields, but were seemingly unable to back up their conclusions with an explanation of the scientific theory required to support their “conclusions”. Indeed, when asked to explain such underlying points, and how they had reached their conclusions, the group flatly refused, despite being asked to do so over a number of weeks. Further, when we pressed for more information on these points, the group’s response was a swift and determined attack upon those who dared to question them. During the course of our research, we accrued a number of threats to complain to our web hosting companies, which may, or may not, have been carried out – if they were, we’re still online, and we’ve heard nothing of them from our hosts. There was also a fascinating discussion thread on how to find, contact and complain to the companies and individuals who advertise on NHS Exposed, presumably intended to impose financial hardship on those pesky folks who asked awkward questions. Finally, we managed to clock up at least three threats of complaints to the General Medical Council. We have little doubt that this article will result in renewed apoplectic outbursts from the group, and, if any of them are sufficiently interesting, we will update this article to document them. We found the group to be highly motivated, well coordinated and energetic in launching such attacks against those who appear to question their position. Threats of (or actual) complaints to the GMC would be a potent deterrent to most medical professionals, and this appears to be the group’s weapon of choice against the individuals most likely to know (and say!) exactly how malformed some of the group’s assertions really are. For this group, the prospect of inconveniencing a doctor who challenges them appears to be a form of “punishment” for this unthinkable transgression. Even a baseless complaint would, in many cases, cause the doctor concerned significant distress and this fact does not seem to have escaped the group. Rather, they appear to relish the prospect. It is regrettable that the much-vaunted Shipman Inquiry recommendations, which in themselves were well-intentioned, have spawned a situation in which a doctor can be harassed, haunted and hunted by a tiny but vocal minority, purely because he disagrees with them. Indeed, our overall impression of all this frenzied activity against someone who questioned the group was one of a fox hunt – vicious, visceral and irrationally instinctive. The group pack appeared determined to pursue their quarry, using any means available, in the hope of bringing them down. It may be that the influences of emotional distress, trauma and the consequences of hardship are potentially responsible for the disturbing behaviour exhibited by this group. Similar causes may be attributed to the group’s dislike and distrust of many doctors, although at no point were we able to ascertain logical evidence to show why the group considers these doctors to be inherently “evil”. In some instances, we saw evidence of "red rage" and "revenge", with no apparent evidence of logical thought or debate. Naturally, the issues frequently discussed by this group are highly emotive, and this appears to fuel further emotional responses from others. The language used is often crude and created to distress the victim substantially. The aggressive, unreasoned behaviour demonstrated towards us and others by this group over a period of several weeks’ observation is, of course, nothing new. Any reader who has used any form of internet discussion forum for any period of time is likely to be familiar with the notion of a “flame war”. We are not psychologists, but this quote from a review of Holmer’s The Internet Regression seems particularly apt: “There is no doubt that people regress on the internet. Anyone who has been consumed by a flame war or visited some of the more outlandish "alt" newsgroups will attest to that. Cyberspace weds the highest intellectual functions and most primitive instincts of the human personality” We strongly suggest that a psychologist should review the observed behaviour of the activist group in question, to assess whether the demonstrated patterns of behaviour may fall with the terms of the Protection from Harassment Act 1997. Unless and until such an assessment can be carried out, we would very strongly suggest that under no circumstances should individuals – be they medical professionals, persons involved in child protection or the general public – become involved with this group of minority activists. For those readers who have been wrongly accused of child abuse etc. there are alternative sources of support, advice and assistance, and we strongly suggest that you seek them out. We should stress that NHS Exposed is neither pro nor anti-doctor for the sake of it. We approached this issue as we do with all issues that come to our attention – with an open mind and an interest in seeing the evidence. On each point, the activist members of this group were asked to state their case and show evidence to support it. That they did not do so, but chose instead to attack us, does not, in itself, demonstrate that they have no evidence to support their position. It does, however, suggest that they have no insight into the potential effect of their actions on others, or consideration for the possibility that they might be wrong in any particular case. In general, we believe that internet support groups are an excellent thing, in that they allow geographically distant individuals to come together to exchange information, ideas and advice. This group, however, is a very clear exception. In our opinion, their behaviour poses a significant risk to healthcare professionals who disagree with them, and an at least equally grave risk to individuals who may have legitimate concerns about certain health workers. How are such individuals ever to express and prove their concerns in an environment where assertions are, apparently, made as fact without recourse to the underlying science? We believe that failure to recognise this group for what it is, together with continued propagation of its propaganda through media channels, may eventually come to represent a significant danger to the public. How long will it be before this group’s activities cost the life of an innocent doctor, harassed beyond endurance by complaint after allegation after threat? That several members of this group have been involved in a contempt of court action, at least one of them has served time in prison and another extracted confidential documents whilst in the trusted employ of one of the doctors they accuse suggests that the rule of law has very little meaning for these individuals. The impression we received was that they will do whatever they feel is necessary in order to achieve their aims, and will be applauded for doing so by other members of the group. Unfortunately, the stories put forward by this group appear to have an irresistible attraction for the media. Scores of column-inches are devoted to the antics of Professor Southall and others, while practically nothing is written about the dubious backgrounds of the vocal but otherwise vanishingly small group of activists who promote the story. Even more unfortunately, the General Medical Council is infamous for paying close attention to so-called high profile cases. According to a little-known article in the Observer, published on February 6th 2005, “Senior General Medical Council officials knew of serious concerns about the paediatrician, Professor Sir Roy Meadow, before he gave evidence which led to at least two mothers being wrongfully jailed for murder.” The article goes on to say that Isabel Nisbet, then the Head of the GMC’s Fitness to Practise Directorate, sent an internal memo to a colleague within the department, saying, “I realise that the RCPCH [Royal College of Paediatrics and Child Health] have been trying to contact me for some weeks ... I fear that I shall need to be brought up to speed on the issues regarding Prof Meadow. Could you please add it to the list for the next "high profile cases" meeting?” The key words here are “high profile cases” - perhaps the GMC could let us know whether they hold equivalent meetings for “low profile” cases? It has long been suspected that the GMC is more interested in being seen to do its job than in actually doing it, and that cases with a great deal of media attention are given special treatment. Indeed, in recent years, the GMC has even taken to entrapping doctors via journalists. The relationship between them is so close that it could well be argued that, in a high-profile case, the accused doctor is, effectively, guilty until proven innocent as far as the GMC is concerned. They are, to use a colourful term, burned at the stake in order to reassure the public that the GMC is actually doing something, while, in less “high profile” cases, doctors are let off despite strong evidence of misdeeds on their part. Sadly, the price of protecting rather than earning their reputation is to deny accused doctors access to Article 6 of the European Convention on Human Rights, the right to a fair trial. The GMC claims to apply the criminal standard of proof to its hearings, yet, in a criminal trial, it would be necessary to appoint a jury whose members had not, and could not have, been influenced by media coverage of the events in question. It seems most unlikely that the panel members who consider cases such as Meadow and Southall have not read, or been influenced by media coverage – a situation that would be considered catastrophic in a criminal trial. Unfortunately, the media’s point of view is necessarily almost always that of the layman, and it is heavily influenced by unscientific views of what is right or wrong. Further, it is open to influence from activists and pressure groups, who, through regular contact with journalists, promote their view of the rights and wrongs of the case. The implication is obvious – by making a loud enough noise, minority pressure groups with their own agendas can easily influence the media, and, through the media, the self-serving attitudes of officials at bodies such as the General Medical Council. As if these concerns weren’t serious enough, a recent article by Catherine Williams LLB, of the University of Sheffield’s Department of Law, suggests that General Medical Council is failing in its duty to protect children. She states "We consider that the United Kingdom has no system for dealing with complaints submitted by parents who claim false allegations of child abuse". The article argues that the actions of the GMC conflict with current child protection laws and guidance for professionals. Williams goes on to say, “By deterring doctors from raising concerns about a child's safety and giving opinions on child deaths, the General Medical Council may be increasing the risk of serious child abuse. It is unacceptable that to date the General Medical Council has refused training in child protection offered by the Royal College of Paediatrics and Child Health”. Again, this dire situation is self-evident. If a doctor raises concerns about a child’s welfare, the accused parent(s) may well seek support from the group discussed above, and, before long, the doctor will find themselves facing the GMC in the full glare of artificially induced media speculation and accusation. The GMC, a media puppet to the last, will feel obliged to show that it is taking a tough line in such matters, and the doctor’s career will be lost without trace. Under these circumstances, it would take a very brave doctor indeed to raise concerns about a child’s welfare. Yet, many children continue to be neglected, and go unprotected. It is their heartbreaking stories that should occupy the column-inches currently festooned with dubious, frequently artificially generated hype about doctors who have dared to try and help children. Victoria Climbie was one such case. This little girl was failed by just about every part of the social health services, and her death resulted in an important inquiry. But, amongst the self-importance and occasional selfishness of this particular group of activists, her name and its significance is more or less forgotten. Perhaps, in these circumstances, it is unsurprising that the NSCPP estimates that at least 32,000 children are at risk of abuse right now. After all, doctors are afraid to report suspected abuse, campaigners and activists are quick to complain about those who do, and the GMC, being more interested in maintaining its image, refuses even to contemplate training its staff on child protection issues. It is clear to us that, for as long as too many people, groups and organisations have their own agendas, the people who will suffer the most are the thousands of at-risk children, closely followed by those who are brave enough to help them. Finally, it seems that we are not alone in reaching the conclusions outlined above. We received the following email from a former member of the activists’ message board. In view of the methodology employed by this small group of activists, we have withheld the senders’ identity, and edited her message slightly to avoid identifying individuals, but the following is otherwise a verbatim extract from the email we received: “There was a time when I once visited the [the group’s message board], for a few weeks only and I came to my own conclusions about the nature of it, the mode of expression, the lack of restraint etc. Circumstances in my life have contrived to ensure that I have a toe in both camps of the debate with regard to child abuse / wrongly accused etc. and apart from any other considerations, this affords a unique perspective. On the one hand, the medical profession is assured of its position and on the other are those who have been wrongly accused. Each are equally vehement in their views. So it is all but impossible to ennervate robust debate that does not soon degrade itself by the very personal nature it often adopts. Although I have nothing do with [the group] per se, I often look at the board as there are some useful links posted from time to time and some of the exchanges are so awful to witness that they are compelling by nature. Then there was the [username] debate, and so on and so forth. I did not really get to know [a senior board member] and whilst I recognise considerable intellect, I would concur with your list of assessments about the board and their take on the world. For me, the issues are considerably more important than any of the personalities involved, although because of the nature of the subject-matter - always evocative, and the personalities involved, it rarely develops beyond the he said this to who and what, why and whom, although any debate is often conducted with a higher IQ than the average. But there is a bigger picture, and whilst [the group] may have a point, it is a very small point in a very large world. One question I ask sometimes is why their pain is seemingly more important than anyone else's. It is as if many cannot and do not want to move beyond victim status, which when there are many in the world who do not have the luxury of choice, saddens and angers me.” Related links Trial
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