Part Four: After Goudge: Will there be lasting change? Not Necessarily; The Cleveland Child Abuse Case; (Continued); No Consequences For Dr. Higgs;

One of the most unsettling aspects of the Cleveland Child Abuse case - the subject of several recent postings - is that Dr Marietta Higgs is still permitted to practice medicine - in spite of all of the harm her questionable diagnostic technique caused to so many innocent parents.

It is also troubling to learn that several of her colleagues took it upon themselves to attack the evidence that had been presented against her - and to rally for her reinstatement.

The Cleveland case has me wondering what Dr. Charles Smith will be doing several years from now.

He is, after all, only about 57-years old and could end up actively practicing medicine somewhere in Ontario, Saskatchewan, or elsewhere in the world where the news of the destruction he has caused has not sunk in.

(We learned from the Goudge inquiry that several of his colleagues at the Hospital for Sick Children in Toronto agreed to provide references for Dr. Smith on his application for a position in Saskatchewan - after his work had been severely criticized by hospital staff);

The efforts of the British professionals to cover up for their colleague was disclosed to the British House of Commons by Sir Stuart Bell, a British Labour Party politician and Member of Parliament for Middlesbrough.

Sir Stuart was so horrified by the horrors of Cleveland that he wrote a book called; "When Salem Came to the Boro, The True Story of the Cleveland Child Abuse Crisis," which was published in 1988. (I would love to get my hands on a copy!)

"This is the first occasion that the Cleveland child abuse crisis has been brought to the Floor of the House other than through parliamentary statements and questions," Sir Stuart told the House of Commons at the outset of his March 2, 1989 address.

"I have taken the opportunity of raising the matter on an Adjournment debate because of the deep concern that my constituents feel at the turn of events following the publication of the consultants' statement in The Guardian," he continued.

"It is a matter of regret to me and to my constituents that once again the consultants should feel that they ought to prove their innocence on matters which have been through the courts.

The motion arises out of the action of 11 paediatricians, who submitted a statement to The Guardian newspaper, among others, in which they stated :

"In our opinion, the majority (quite possibly 90 per cent.) of the children were abused, and the paediatricians' diagnoses were accurate to a far higher degree than the public realise."

The sequence of events that led to the submission of that statement will not be time-consuming in relation to the role of the consultants within the NHS.

Towards the end of last year, at a specialists' sub-committee of the Northern regional health authority, the future of Dr. Marietta Higgs was discussed.

It was decided that a recommendation should be made to the regional health authority that Dr. Higgs be reinstated in Cleveland.

Some of the consultant paediatricians at that meeting had come from as far away as Carlisle, let alone Cleveland.

Some of the Tyneside consultants also formed part of a support group organised in the new year under the guidance of Dr. David Scott and his wife Anne.

It transpired later that Dr. David Scott had worked with Dr. Higgs on a study of cot deaths, and that his wife Anne had been a former secretary to Dr. Higgs in that study.

That support group met early in February and a draft letter of support for Dr. Higgs was prepared and submitted by Dr. Nigel Speight, a consultant paediatrician at Dryburn hospital in Durham.

Dr. Speight has long been an avowed supporter of Dr. Higgs.

He telephoned me in her support when the crisis began, and invited himself to a television broadcast on the extent of the crisis.

However, he did not give evidence to the Butler-Sloss inquiry.

In Cleveland in January, the Communist party got into the support act when it called a meeting in Middlesbrough to discuss the Cleveland child abuse crisis, although the crisis was now fading from public memory.

After that meeting, addressed by another ardent supporter of Dr. Higgs, Ms. Bea Campbell, who subscribes to the view that one in four of the population are abused as children, it was decided to set up a support group similar to the one in Newcastle, again with the avowed purpose of reinstating Dr. Higgs in her old neonatological job at Middlesbrough general hospital.

The draft letter of Dr. Speight found its way to Middlesbrough and was discussed at a meeting of consultant paediatricians on 15 February.

Dr. Geoffrey Wyatt, who was banned from child sexual abuse cases by the regional health authority following his involvement in the Cleveland child abuse crisis, and who accepted that ban as well as a reprimand and warning as to his future conduct, presented on an overhead projector facts and figures which seemed to justify the diagnoses that he and Dr. Higgs had made at Middlesbrough general hospital.

Apparently, Dr. Wyatt proposes to publish those facts and figures in an article in The Lancet.

The meeting discussed the statement of Dr. Speight, made some deletions, principally in reference to police surgeons, and agreed its onward submission to the press.

The purpose of the letter was contained in its last paragraph:

"Following the crisis in Cleveland, Doctor Higgs has been seconded to look after babies at the Princess Mary hospital, a university teaching hospital in Newcastle. We strongly support and would welcome the return of Doctor Higgs to her former post in Cleveland where she was employed with special skills for the care of sick newborn babies."

Pressure on the Northern region health authority, as the employer of Dr. Higgs, has become urgent, in view of the allegation that her secondment to the Princess Mary hospital in Newcastle was about to end, and the fact that a paediatric post was about to be advertised for Cleveland by way of an advance appointment to cover the future retirement of Dr. Hilary Grant, the senior consultant paediatrician.

In any event, Dr. Higgs is still on the books as a consultant paediatrician at Middlesbrough, and her work has been carried on by locums.

There were also court proceedings which I do not intend to cover tonight.

The statement was supposed to be a letter signed by all 11 consultants from Tyneside and Cleveland, but such was the haste to get it out that signatures could not be gathered.

The author of the statement had already left for Khartoum.

The statement was sent out by Val Hall, who turned out to be Mrs. Dr. Geoffrey Wyatt, although Dr. Hall has since said that she was merely the secretary.

In fact, her role has been greater than that. Dr. Hall is also a member of the Cleveland support group, and she has been in touch with several members of Parliament, seeking their support for Dr. Higgs.

There is nothing reprehensible in any of those activities, except the deceit and dissimulation that has accompanied them in the failure to declare an interest.

There was, of course, an anguished reaction by parents and children who were innocently caught up in the crisis.

It might be convenient to state the number of children who were involved. About 121 children were diagnosed as allegedly having been sexually abused.

Of those 121 children, 98 were returned home by the courts.

There were eight arrests but only four successful prosecutions.

Two men hanged themselves in Durham gaol, and in two other cases in which the only evidence was the diagnostic technique of reflex anal dilatation, the charges were dropped.

It is against that tide of the court decision that the paediatricians, in their statement to The Guardian and elsewhere, seek to swim.

Hardly surprisingly, parents and children alike, settling down about 18 months after the crisis, were traumatised by the sudden appearance of the consultants' statement which was promptly picked up and relayed throughout the media.

Some children immediately asked their parents whether it meant that they had to go back to Cleveland hospitals. Mothers and children, too, had nightmares.

Children were afraid to return to school on the Monday morning after the mid-term holiday, because they feared that someone would take them away.

There was dread and horror that the cycle of repeated physical examinations and disclosure work was back again.

There is no new evidence available to the consultant paediatricians that was not in the hands of the Butler Sloss inquiry, to the medical assessor appointed to that inquiry, or to the courts that dealt with the cases.

When I called him on this specific point, the author of the letter, Dr. Nigel Speight, accepted that he had seen no medical records.

The evidence that was available to the courts in relation to the 98 children was weighed carefully by High Court judges, magistrates and registrars alike, who preferred the alternative available medical evidence which concluded that the children had not been abused.

The consultant paediatricians were not entitled to bring new grief and anguish to the innocent families of Cleveland.

The question for the Minister to weigh is this: how can they justify their conduct, ethically and professionally?

Several of the Cleveland consultants who agreed the statements under their name are still in charge of children who were caught up in the crisis.

After publication of the statement in The Guardian, many parents were encouraged to go to those consultants, and everyone who did so was assured that they were not included in the 90 per cent.

The most appropriate statement of the so-called evidence was given by Dr. Douglas Hague, the regional general manager of the health authority. On local television, he said:

"The precise figure will never be known partly because of the weakness of the medically recorded evidence."

That weakness was revealed even by the signatories to the statement that appeared in The Guardian.

Thus, Dr. Peter Morrell and Dr. Marietta Higgs examined a seven-year-old girl at Middlesbrough general hospital on 5 May 1987.

They diagnosed vaginal and anal abuse, but the minutes of a case review meeting held on Friday 5 June 1987 show that Dr. Peter Morrell pointed out that there was no conclusive medical evidence of sexual abuse.

It is to the credit of Dr. Peter Morrell that he changed his mind.

Dr. Nyint Oo, another signatory to the statement, along with his co- signatory, Dr. Diaz, examined three children aged five, seven and 10 who had been diagnosed by Dr. Higgs as having been sexually abused.

This examination took place at 10 o'clock on the evening of Wednesday 24 June.

According to the parents of the children, they were roused from their hospital beds for examination.

Both Dr. Oo and Dr. Diaz disagreed with the diagnosis of Dr. Higgs, and all three children were allowed home.

Another signatory, Dr. Caroline McCowen, could not agree with Dr. Higgs' diagnoses after an examination which she made on 10 July 1987 on three children, all girls, aged 10, eight and two, and those three children were subsequently reunited by the courts with their parents.

Are these now the children whom the consultants say were being abused all along?

To their credit, those consultants, along with three others in Cleveland, have since offered their apologies to the families for the distress that they had caused.

It is a pity that they did not go further and retract their 90 per cent. statement, leaving that task to the regional general manager of the northern regional health authority and the Minister of State, Department of Health.

The families, however, cannot leave matters as they stand.

They cannot leave their future in the hands of irresponsible statements.

They have waited to hear what the Paediatric Association might have said about the letter.

There has been a deafening silence.

Sadly, the paediatricians--the consultants in this matter of the letter--exercised power without responsibility.

Fortunately, I have 21 letters in support of the parents and the children from other doctors and consultants throughout the country which rectify the balance, but the parents have seen the destruction of childhood innocence in their children by repeated medical examinations and disclosure sessions.

Now they are seeing the steady destruction of what is left of their children's childhood...

Harold Levy...hlevy15@gmail.com;