In March, the number of applications by social workers to take children into care set a new record: 882 in a single month. Over the past year, my reports on how our highly secretive “child protection” system seems, too often, to collude in seizing children without proper justification have provoked considerable irritation in a number of judges – and last week the judiciary hit back. Mr Justice Bellamy, presiding over a case to which I have referred several times, took the unusual course of publishing a judgment in which he was highly critical of me for my “unbalanced” and “inaccurate” reporting. Then the head of the family courts, Lord Justice Wall, in his ruling on another case, swiftly endorsed Bellamy’s attack on me (despite his own earlier criticisms of the “shocking” determination of some social workers to place children in “an unsatisfactory care system”).
I am not displeased that Bellamy has published his judgment, because the main part of it provides a rare opportunity to see how a judge may rely on a particular medical argument which has become increasingly controversial. But first I must deal with his criticism of my reporting. In the many hundreds of words I have written about this case, on five separate occasions, he singled out only two points as inaccurate. On one of these he was right: I was misinformed that a particular medical witness had appeared in another of Bellamy’s cases.
The next day, however, the judge had to add a supplementary judgment, correcting some of what he had said. It emerged that he had made several factual errors in his references to me. These included misquoting what I had written, through reliance on a website (which he misspelt), and claiming that my articles had appeared in The Daily Telegraph.
Bellamy went on, however, to use my two errors as his text for a general homily on how inexcusable it is to give a tendentious account of family cases based on a one-sided picture given by aggrieved parents. This might sound damning to anyone unfamiliar with the whole secretive system, but it takes no account of the extraordinary obstacles placed in the way of any journalist wishing to report fairly on them.
On more than one occasion when I approached a local authority to check on the facts of what seemed a very disturbing case, the only response was to seek a gagging order prohibiting me from mentioning the case at all. When I accurately reported on one case so embarrassing to the council concerned that it eventually dropped its bid to seize a child, the judge ruled that any future reference to the case outside the court could lead to summary imprisonment.
Something else came to light in Bellamy’s judgment, however, that is far more important than his criticism of me. The case before him concerned a couple who last year became so concerned that their six-week old baby had developed a “floppy arm” that in the middle of the night they took it to hospital to be examined. X-rays showed the child had suffered a “non-displaced” fracture of the humerus. The police were summoned to arrest the parents, who were led off in handcuffs and held for hours in police cells. Coventry social workers took the child into care and the police charged the father with physically abusing his son.
Now the judge has delivered his fact-finding judgment, on the basis of which he will decide the child’s future in September, we can see, for the first time, that its injuries included not only the fractured arm but also six “metaphyseal fractures” and several marks or bruises. (“Metaphyseal” refers to the metaphysis, the part of a long bone near where it meets a joint, the part that grows in childhood.) All of this sounded like a very grave set of injuries, which might point to serious physical abuse.
The court heard that in every other respect the couple seemed to be devoted, conscientious parents, anxious only to do the right thing by their child. But what clearly weighed most heavily with the judge were those “metaphyseal fractures”. He heard evidence from no fewer than four medical experts that metaphyseal fractures are a virtually certain sign of “non-accidental injury” (a phrase used 20 times in his judgment), implying intentional physical harm.
Finding on this basis that the child had definitely been abused, Bellamy then saw it as his duty to identify the “perpetrator”. Based on the timing of the events that led to the parents rushing their child to hospital, he concluded that the main injury must have been inflicted in a brief interval when the father was out of the room, and the person responsible must have been the mother. The police, he argued, had been wrong to charge the father (a charge still awaiting trial). The judge was thus, in effect, accusing the mother of a crime.
The problem with regarding metaphyseal injuries as an indicator of abuse is that in recent years ever more medical experts have strongly questioned the idea. Their studies show that metaphyseal fractures may occur in babies with soft, still-forming bones, with minimal trauma. They even question whether such injuries can be properly described as fractures at all. The real explanation, they believe, lies in a metabolic bone disease, a contributory factor to which may be a deficiency in Vitamin D (of the type which evidence showed the mother in our present case to have). Only this month a leading American expert, Dr Marvin Miller, published a major new study suggesting that “the cause of multiple unexplained fractures in some infants” might be “metabolic bone disease, not child abuse”.
Also something of an expert on this subject is Dr James Le Fanu of this newspaper, who in 2005 published a paper in the Journal of the Royal Society of Medicine entitled “The wrongful diagnosis of child abuse: a master theory”. In another paper, “The misdiagnosis of metaphyseal fractures: a potent cause of wrongful accusations of child abuse”, he described how the theory of metaphyseal fractures as characteristic of child abuse, first advanced by Dr Paul Kleinman in the US in 1986, was taken up by a small group of radiologists in Britain who became much in demand in our courts as expert witnesses. In 2005, under the headline “Happy, loving parents? They must be child abusers”, Dr Le Fanu explained in these pages how reliance on this diagnosis in the criminal courts was already strongly contested, to the point where it became discredited. But in the family courts, he wrote – citing a case remarkably similar to the one before Mr Justice Bellamy today – the theory was unchallenged.
It is certainly noticeable from Bellamy’s account of the evidence that it was all strictly according to Kleinman’s theory. The four expert witnesses he heard all came across as committed advocates of the Kleinman thesis, in arguing that metaphyseal fractures are an indicator of child abuse. For whatever reason, not one expert was called who was prepared to challenge that view. Bellamy himself said that these injuries are often regarded as “pathognomonic of abuse”, meaning they can have no other cause – seemingly unaware that there is a growing body of scientific opinion to suggest that this may not be their cause at all.
The lawyers for the mother, who has effectively been accused by the learned judge of a criminal act, are said to be considering an appeal against Bellamy’s ruling. If so, one hopes they will take the opportunity to call expert witnesses ready to challenge this still prevailing orthodoxy, on the basis of which scores of children have been removed from loving and conscientious parents – so that the bench on that occasion can at least be given a rather less “one-sided” view.
http://www.telegraph.co.uk/comment/columnists/christopherbooker/8513956/A-judge-attacks-my-one-sided-child-protection-stories-but-it-cuts-both-ways.html
Now the judge has delivered his fact-finding judgment, on the basis of which he will decide the child’s future in September, we can see, for the first time, that its injuries included not only the fractured arm but also six “metaphyseal fractures” and several marks or bruises. (“Metaphyseal” refers to the metaphysis, the part of a long bone near where it meets a joint, the part that grows in childhood.) All of this sounded like a very grave set of injuries, which might point to serious physical abuse.
The court heard that in every other respect the couple seemed to be devoted, conscientious parents, anxious only to do the right thing by their child. But what clearly weighed most heavily with the judge were those “metaphyseal fractures”. He heard evidence from no fewer than four medical experts that metaphyseal fractures are a virtually certain sign of “non-accidental injury” (a phrase used 20 times in his judgment), implying intentional physical harm.
Finding on this basis that the child had definitely been abused, Bellamy then saw it as his duty to identify the “perpetrator”. Based on the timing of the events that led to the parents rushing their child to hospital, he concluded that the main injury must have been inflicted in a brief interval when the father was out of the room, and the person responsible must have been the mother. The police, he argued, had been wrong to charge the father (a charge still awaiting trial). The judge was thus, in effect, accusing the mother of a crime.
The problem with regarding metaphyseal injuries as an indicator of abuse is that in recent years ever more medical experts have strongly questioned the idea. Their studies show that metaphyseal fractures may occur in babies with soft, still-forming bones, with minimal trauma. They even question whether such injuries can be properly described as fractures at all. The real explanation, they believe, lies in a metabolic bone disease, a contributory factor to which may be a deficiency in Vitamin D (of the type which evidence showed the mother in our present case to have). Only this month a leading American expert, Dr Marvin Miller, published a major new study suggesting that “the cause of multiple unexplained fractures in some infants” might be “metabolic bone disease, not child abuse”.
Also something of an expert on this subject is Dr James Le Fanu of this newspaper, who in 2005 published a paper in the Journal of the Royal Society of Medicine entitled “The wrongful diagnosis of child abuse: a master theory”. In another paper, “The misdiagnosis of metaphyseal fractures: a potent cause of wrongful accusations of child abuse”, he described how the theory of metaphyseal fractures as characteristic of child abuse, first advanced by Dr Paul Kleinman in the US in 1986, was taken up by a small group of radiologists in Britain who became much in demand in our courts as expert witnesses. In 2005, under the headline “Happy, loving parents? They must be child abusers”, Dr Le Fanu explained in these pages how reliance on this diagnosis in the criminal courts was already strongly contested, to the point where it became discredited. But in the family courts, he wrote – citing a case remarkably similar to the one before Mr Justice Bellamy today – the theory was unchallenged.
It is certainly noticeable from Bellamy’s account of the evidence that it was all strictly according to Kleinman’s theory. The four expert witnesses he heard all came across as committed advocates of the Kleinman thesis, in arguing that metaphyseal fractures are an indicator of child abuse. For whatever reason, not one expert was called who was prepared to challenge that view. Bellamy himself said that these injuries are often regarded as “pathognomonic of abuse”, meaning they can have no other cause – seemingly unaware that there is a growing body of scientific opinion to suggest that this may not be their cause at all.
The lawyers for the mother, who has effectively been accused by the learned judge of a criminal act, are said to be considering an appeal against Bellamy’s ruling. If so, one hopes they will take the opportunity to call expert witnesses ready to challenge this still prevailing orthodoxy, on the basis of which scores of children have been removed from loving and conscientious parents – so that the bench on that occasion can at least be given a rather less “one-sided” view.
http://www.telegraph.co.uk/comment/columnists/christopherbooker/8513956/A-judge-attacks-my-one-sided-child-protection-stories-but-it-cuts-both-ways.html
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