Meadow v General Medical Council

JurisdictionEngland & Wales
JudgeMr Justice COLLINS,MR JUSTICE COLLINS
Judgment Date17 February 2006
Neutral Citation[2006] EWHC 146 (Admin)
Docket NumberCase No: CO/5763/2005
CourtQueen's Bench Division (Administrative Court)
Date17 February 2006
Between
Meadow
Appellant
and
General Medical Council
Respondent

[2006] EWHC 146 (Admin)

Before:

MR JUSTICE COLLINS

Case No: CO/5763/2005

IN THE HIGH COURT OF JUSTICE

QUEEN'S BENCH DIVISION

ADMINISTRATIVE COURT

Royal Courts of Justice

Strand, London, WC2A 2LL

Nicola Davies Q.C. & Ian Winter (instructed by Hempsons) for the Appellant

Roger Henderson Q.C. & Adam Heppinstall (instructed by The GMC) for the Respondent

Mr Justice COLLINS
1

Professor Sir Roy Meadow is an eminent paediatrician. He is now some 73 years old and has retired from the clinical practice of medicine. He qualified in 1960 and in 1970 was appointed to the post of senior lecturer and consultant in paediatrics and child health at Leeds University. Following his observations in two cases in which the only explanation for the child's illness was that it had been fabricated by a parent, in 1977 he wrote and had published in the Lancet an article entitled "Munchausen's Syndrome by Proxy. The Hinterland of Child Abuse".

2

The article led to awareness in the medical profession of the possibility that false illnesses in children were being created and so child abuse was being practised. He continued to research into this area and in the 1980s began to be used to make reports and give evidence in family proceedings. In 1991 he was asked for the first time to produce a report for criminal proceedings and was involved in the notorious prosecution of Beverley Allitt. He continued to be used in court, mainly in family proceedings. He gave reports in all in some 10 criminal cases. He maintained a general paediatric practice and, as the many testimonials which were provided to the GMC and to this court show, he was regarded as a superb practitioner and teacher. Many families have cause to be grateful to him for what he did for their children. In 1980 he became Foundation Professor and Head of the Department of Paediatrics and Child Health at St James' Hospital in Leeds. On his retirement from clinical practice in 1998, he was appointed Emeritus Professor in Child Health at Leeds University.

3

Professor Meadow prepared at about the time of his retirement a paper for publication describing his clinical experience relating to children who had died because of what was regarded as child abuse. He sought in that paper to identify clinical features common to those cases. This paper was in due course published in the Archives of Disease in Childhood under the title 'Unnatural Sudden Infant Death'. As is usual in such publications, the paper was sent out in draft to be reviewed by his peers. Its relevance will become apparent when I refer to the evidence which was before the Fitness to Practise Committee of the GMC against whose decision Professor Meadow appeals in these proceedings.

4

In 1998 Professor Meadow, whom I shall henceforth refer to as the appellant, was approached by the Cheshire Constabulary and asked to provide a medical opinion on the deaths of Christopher and Harry Clark, sons of Sally Clark, both of whom had died when a few weeks old. The appellant reviewed all the material provided to him, in particular the medical records and the findings of the pathologist, and in June 1999 provided a statement of 10 pages in which he concluded that the deaths were not natural. He was called to give evidence both at the committal proceedings and at the trial in the Chester Crown Court. Sally Clark was convicted of murder of both children. She appealed to the Court of Appeal which upheld the convictions on 2 October 2000. In 2002 it was discovered that the results of important and relevant microbiological tests had not been disclosed by the pathologist. This led to a referral to the Court of Appeal which allowed Sally Clark's appeal on 29 January 2003. No retrial was ordered.

5

Complaint was made to the GMC by Sally Clark's father against the appellant. This alleged, broadly speaking, that the evidence he had given to the criminal courts had been badly flawed, particularly in the misuse of statistics, and so he deserved to be found guilty of serious professional misconduct and dealt with accordingly. The complainant did not suggest that he desired to have him erased from the register but that he should be prevented from acting as an expert in child protection cases. In due course, following a hearing lasting some 16 days between 21 June and 15 July 2005, the Fitness to Practise Panel (FPP) found serious professional misconduct proved and ordered that his name be erased from the register. He appeals both against the finding of serious professional misconduct and the sanction of erasure.

6

The decision of the FPP in this case has concerned medical practitioners who are asked to prepare reports for or to give evidence in court. Those concerns are the more acute since the FPP specifically found that the appellant had not intended to mislead the court and that there was no evidence of any calculated or wilful failure to use his best endeavours to provide evidence. He had acted in good faith. There can be no doubt that the decision has had a damaging effect in that it has increased the reluctance of medical practitioners to involve themselves in court proceedings, particularly in cases before the Family Court. In evidence before the FPP, Professor Sir Alan Craft, the President of the Royal College of Paediatrics and Child Heath, identified the concerns. They have been reiterated and reinforced in correspondence sent to the appellant's solicitors and to the GMC and I am aware of the real difficulties experienced in the Family Division because of the reluctance of doctors to produce reports and give evidence. Professor Craft said this:-

"[The campaign against paediatricians in the field of child abuse] has had an absolutely enormous effect on paediatricians. Paediatricians are frightened of getting involved in child protection work … I do not think you can actually underestimate what being reported to the GMC actually does to you – and paediatricians, I think, are pretty sensitive people, that is probably why they are paediatricians – and they do take it incredibly personally when the letter drops through the door saying that they have been reported to the GMC. It has a huge effect on them and on their families and on their children, particularly if there is a press campaign associated with it which there often is. Children have been excluded from school, people have had their car tyres slashed – all sorts of things that are really quite horrible have happened to paediatricians, so it is not surprising that they are fearful of being involved in child protection."

7

This appeal of course concerns medical practitioners. But the possibility that they may be disciplined even to the extent of losing their livelihood will apply to other professionals who give expert evidence to courts. It is particularly worrying that disciplinary action may result even if reports have been prepared and evidence given in good faith and with no intent to mislead. Accordingly, I received a request from the Expert Witness Institute to allow it to intervene in order to "indicate some issues of principle relating to the duties of expert witnesses in both the criminal and civil courts". I indicated that I was prepared to accept written submissions, provided that both parties to the appeal had no objection. Unfortunately, there was a failure by the EWI to notify the parties and the court assumed from the terms of the letter of request that the parties had been notified. In the result, I received and read the submissions, which I have taken into account only insofar as they make submissions on the general duties of expert witnesses and the jurisdiction of regulatory bodies in disciplining them in respect of evidence given by them. Mr Henderson Q.C., on behalf of the GMC was unhappy at what had happened. He suggested that, although such interventions are more common in the higher courts, they should not normally be allowed at the first instance level. However, he recognised that I had read them and he was able, so far as necessary, to deal with them and so he did not maintain his objections. I do not need, therefore, to consider whether they ought to have been admitted. I merely observe that the court should be careful not to allow costs to be increased by unnecessary interventions and that they should be limited to such interventions as genuinely assist the court, for example by identifying matters which go beyond the circumstances of the case in question and raise arguments which might otherwise not be properly considered.

8

Before going to the circumstances in more detail, I should deal at the outset with a point that I raised but which was not taken either before the FPP or in the grounds of appeal. However, since it goes to the jurisdiction of the FPP to deal with a complaint such as that made against the appellant, it seemed to me that it was a point which ought to be considered, particularly as it might be determinative of this appeal.

9

The point is based on the immunity from suit of a witness in respect of evidence he gives in a court of law. That immunity applies as much to an expert as to any other witness: see X (Minors) v Bedfordshire CC [1995] 2 A.C.633 approving Evans v London Hospital Medical College [1981] 1 W.L.R. 184. The immunity extends to any civil proceedings brought against a defendant which are based on the evidence which he gives to a court. It extends to any statement which the witness makes for the purpose of giving evidence.

10

The immunity has not been extended to prevent the bringing of disciplinary proceedings. That seems to be because the argument has not hitherto been deployed that the rationale...

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