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The GMC decision to strike this doctor off the medical register exposes its ignorance and leaves professionals in despair, says senior paediatrician Nigel Speight Last week's decision of the General Medical Council to strike distinguished paediatrician Dr David Southall off the register is causing shock waves throughout the profession. Paediatricians are in despair at the controversy their work is attracting, and are worried about participating in child abuse cases. Junior doctors contemplating career choices will surely shy away from paediatrics in future. Already there is a practical consequence to the verdict in that many of the members of our group, Professionals against Child Abuse (Paca), may be reluctant to participate in the child death review panels being set up to scrutinise all cases of child deaths. Paca discussed the likely consequences of past and future actions in this area with the GMC last summer. We obviously failed in our attempts at quiet diplomacy. We feel the GMC as it currently functions is not 'fit for purpose' in assessing and judging cases involving child protection and we have lost all confidence in it in this area. David Southall was suspended from child protection work three years ago after raising concerns about an incident involving nasal bleeding and difficulty in breathing in the first baby in the Clark family 10 days before he died. This present case that has led to his erasure from the medical register concerned a woman whose 10-year-old son had been found dead in the family home from hanging. Her other eight-year-old son was subsequently taken into care because he was allegedly expressing threats to kill himself. Because of concerns about the possibility of an abusive cause for the first child's death, Dr Southall was instructed by the family court and social services to interview the mother and explore these issues. This he did in the presence of a senior social worker who took a written account of the whole interview. The mother claimed - and the GMC chose to believe her - that Dr Southall had accused of murdering her son: Dr Southall denied that he had said this or that he had interviewed the mother in an aggressive and intimidating manner and his statements on this were completely supported by the social worker who had been present throughout the interview. There has been an orchestrated and vindictive campaign against Southall ever since his work proving (with video evidence) that in some cases where babies presented with recurrent apnoeic attacks the cause was repeated episodes of smothering by the mothers. This important insight saved the lives of significant numbers of children but also inspired something akin to hatred among his opponents. These include an organisation fronted by the MAMA website (Mothers against Munchausen). Ringleaders in the campaign include Mrs Penny Mellor (who has reported Dr Southall to the GMC over 20 times, has accused him of murder and says she wants to see him behind bars), certain journalists and an MP, who has used parliamentary privilege to liken Dr Southall to Joseph Mengele in his 'experiments' (ie research) on children. All of this would be laughable if the GMC could be trusted to take a critical view of where these complainants are coming from. Unfortunately, it is under pressure from the government to be seen to be tough on doctors, so it could be said to have a conflict of interest. Even more serious, they are untrained and largely ignorant of the complex realities of child abuse and also of professional guidelines in the field. The panel in Southall's hearing consisted of three lay assessors and an orthopaedic surgeon. In finding him guilty of keeping 'secret', ie separate, records they showed their profound ignorance of normal practice. They chose to disbelieve the senior social worker who was present during the interview and kept a written record of what was said, and accepted instead the mother's story in its entirety. As it happens, Dr Southall had already been investigated and cleared by his employers on precisely the same charges regarding this mother's allegation eight years earlier, the panel then consisting of three paediatricians experienced in child protection work.
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