More than 50 UK paediatricians today launch an unprecedented attack on the General Medical Council, accusing their regulatory body of deterring doctors from speaking out, and arguing that the stance could increase the risk of child abuse.
The doctors take issue with the GMC over its handling of the cases of David Southall and Sir Roy Meadow, two senior paediatricians disciplined in relation to the case of Sally Clark, the solicitor accused of killing two of her three children, who was jailed and later cleared and freed on appeal. Mrs Clark died two weeks ago. Her family said she had not recovered from the miscarriage of justice.
In an article in the American journal Pediatrics, written before Mrs Clark's death, the paediatricians claim the GMC does not understand child protection work. The GMC's actions "conflict with current child protection laws and guidance for professionals and already might have contributed to the reduction in the willingness with which doctors raise child protection concerns", they say.
Doctors are already fearful of raising concerns, they argue. The number of children being placed on child protection registers by the authorities dropped by 28% between 1995 and 2005, they write, yet the number of criminal convictions for cruelty to, or neglect of, a child increased by 247% between 1998 and 2005.
Professor Southall was disciplined for contacting police with his theories about the Clark case, in which he had no professional involvement, after watching a television interview with Mrs Clark's husband.
The paediatricians say he was justified. The European convention on human rights says citizens are entitled to voice concerns, subject to the law of defamation. In 2005, the doctors add, the Lords ruled that "when considering that something does not feel 'quite right', a doctor must be able to act single-mindedly" for the child.
The paediatricians also say: "The views of the GMC were contrary to current child protection guidance, which treats the child's safety as paramount - that is, 'the doctor is charged with the protection of the child, not with the protection of the parent'. We do not consider that the reporting of genuine concerns about the safety of a child to responsible authorities, within the confidentiality of established processes, brings the medical profession into disrepute, but the GMC did because it failed to understand the medical responsibilities in child protection."
Professor Meadow was struck off the medical register in 2005 by the GMC for giving misleading evidence in court when he said that the chances of two sudden infant deaths in an affluent family (the Clarks) was "one in 73 million". But, the doctors say, he had not set himself up as a statistical expert. Prof Meadow was reinstated to the register on appeal.
The Royal College of Paediatrics and Child Health found in a 2004 survey that 14% of 3,853 member paediatricians had been the subject of a formal complaint. The paediatricians say a third of child protection posts are unfilled and many trainees do not want to enter the field.
"The actions of the GMC have been accompanied by an effective campaign led by a group of parents accused of abuse and supported by some influential journalists. One aim ... is to deny the existence of certain types of child abuse. This has resulted in politicians stating [in parliament] how fabricated and induced illness is a 'pernicious and ill-founded theory'."
The GMC said it had acted properly. "We agree that it cannot be in the public interest if doctors are inhibited from acting to protect children, or deterred from giving evidence honestly and truthfully ... But equally it cannot be in the public interest, or the profession's interest, if the GMC is not free to act when doctors practise incompetently or inappropriately. We have sought only to act to protect the public interest from doctors who fall significantly short of accepted standards."
The GMC says the paediatricians are making matters worse. "By overstating their case, they fuel a perception that the GMC is somehow bent on persecuting doctors involved in child protection work."