Sally Clark

Sally Clark 1964-2007

Sally Clark

GMC Professional Conduct Committee

Session beginning 7 June 2004

St James's Building, 79 Oxford Street, Manchester, M1 6FQ

New Case of Conduct - Professor David Patrick Southall

"Professor Southall:

In November 1999 Sally Clark was convicted of the murder of her two children, Christopher and Harry Clark. On or about 27 April 2000 you watched the "Dispatches" programme about the Sally Clark case that was broadcast on Channel 4 television that night. As a result of information gleaned during your watching of the programme, on the next day you contacted the Child Protection Unit of the Staffordshire Police to voice concerns about how the abuse to Christopher and Harry Clark had in fact occurred. Following this contact, on 2 June 2000 you met Detective Inspector Gardner of the Cheshire Constabulary, the senior investigating officer into the deaths of Christopher and Harry Clark, and in effect told him that, as a result of watching the programme, you considered that Stephen Clark, Sally Clark's husband, had deliberately suffocated his son Christopher Clark at a hotel prior to his eventual death. Stephen Clark was thus implicated in the deaths of both Christopher and Harry Clark. Based on this opinion, you raised concern about Stephen Clark's access to, and the safety of, the Clarks' third child, Child A.

At time of meeting Detective Inspector Gardner, you were not connected with the case. You made it clear that you were acting in your capacity as a consultant paediatrician with considerable experience of life threatening child abuse and that you were suspended from your duties by your employers, the North Staffordshire Hospital NHS Trust ("the Trust"). You knew that it was an agreed term of the Trust's enquiries that led to your suspension that you would not undertake any new outside child protection work without the prior permission of the Acting Medical Director of the Trust. Despite this, you had not sought permission of the Acting Medical Director prior to contacting the Child Protection Unit of the Staffordshire Police and meeting with Detective Inspector Gardner. You relied on the contents of the "Dispatches" television programme as the principal factual source for your concerns. You had a theory about the case that you presented as fact as underpinned by your own research. The Committee found your actions in contacting the child protection unit of the Staffordshire Police to be precipitate and by not seeking the permission of the Acting Medical Director of the Trust before meeting D I Gardner to be precipitate and irresponsible.

On 30 August 2000 you produced a report on the Clark family at the request of Forshaws, Solicitors. At the time that you produced your report you did not have any access to the case papers, including any medical records, laboratory investigations, post-mortem records, medical reports or x-rays. You had not interviewed either Stephen or Sally Clark. Your report concluded that it was extremely likely if not certain that Mr Clark had suffocated Christopher in the hotel room. You remained convinced that the third child of the Clark family, Child A, was unsafe in the hands of Mr Clark. Your report implied that Mr Clark was responsible for the deaths of his two eldest children Christopher and Harry. This was based on a theory that you had about the case that you presented as fact, as underpinned by your own research. Your report declared that its contents were true and may be used in a court of law whereas it contained matters the truth of which you could not have known or did not know. Your report contained no caveat to the effect that its conclusions were based upon the very limited information about the case known to you.

When given the opportunity to place such a caveat in your report you declined, by faxed email dated 11 September 2000, stating that even without all the evidence being made available to you it was likely beyond reasonable doubt that Mr Clark was responsible for the deaths of his two other children. The Committee have found your actions as described above to be individually and collectively inappropriate, irresponsible, misleading and an abuse of your professional position.

The Committee are extremely concerned by the facts of this case. The Committee have heard that a formal complaint was made against you in January 1999. The Trust placed a limitation on your work preventing you from undertaking any category 2 work (work that is commissioned by an external agency) pending the outcome of their investigations. You agreed to the Trust's request. Due to the seriousness of their concerns in November 1999 the Trust suspended you for the duration of their inquiry and you were therefore prevented from undertaking any child protection work.

The Committee have heard that you had been following the Clark case with interest as a proportion of your clinical and research work involved the sudden and unexpected deaths of infants and on 27 April 2000 you watched the Channel 4 Dispatches programme which featured an interview with Steven Clark. As a result of viewing the programme, you formed the definite view that Mr Clark had murdered both Christopher and Harry and that accordingly not only had the wrong person been convicted but that the life of the remaining child (child A) was in danger by virtue of the fact that he was being cared for by Mr Clark. You were so convinced of your opinion that you contacted the local child protection team, and subsequently met with Detective Inspector Gardiner, the police officer in charge of the case. The matter was reported to Social Services and subsequently there was a meeting between yourself, Social Services and the Guardian of child A. This in turn led to Social Services convening a Child Protection Planning meeting. The result of this meeting was that you were asked to produce a report and the matter was investigated further. You did produce such a report, dated 30 August 2000, in which you concluded that Steven Clark was responsible for the deaths of both Christopher and Harry and that the Clark's third child was unsafe in his care.

The Committee are extremely concerned that you came to this view without ever meeting or interviewing Mr or Mrs Clark, without seeing any of the medical reports, post mortem reports and without knowledge of the discussions between the experts or witnesses involved with the Sally Clark case. You did not put yourself in a position to give a meaningful explanation. Your view was a theory, which was however not presented as a theory but as a near certainty. Your hypothesis, based on your research, was that the nosebleed that Christopher suffered in the hotel room whilst alone with Mr Clark was a result of an assault. Your view is that a bilateral nose bleed in an infant in the absence an identifiable disease or accident, was virtually always the consequence of life threatening child abuse, usually an attempted smothering. We heard from Professor David, the GMC expert witness that in order to come to such a firm view, one must explore all the potential causal explanations for the nose bleed and detail this process in the findings. In your evidence you stated you did not do this, as it was known to all the recipients of the report that you did not have access to any other documentation. However you have accepted that it would have been good practice to have detailed the diagnostic process in your report.

The Committee have been directed to the guidance entitled 'Expert Witnesses in Children Act Cases' produced by Mr Justice Wall, which you have acknowledged as good guidance. However, it appears that you did not follow this guidance in the circumstances of this case. Paragraph 5.4 states that 'You should be very cautious when advising a judge that in your opinion a particular event occurred. You should do this only if you feel you have all the relevant information.' You accepted the fact that you should have made it clear in your report that you did not have access to any documents and that the views expressed were based solely on watching the Dispatches programme. The guidance further states at paragraph 10.5 'What the court is anxious to prevent is any unrecorded informal discussions between particular experts which are either influential in, or determinative of, their views and to which the parties to the proceedings do not have access.' You further conceded the fact that you should have disclosed the involvement of Professor Roy Meadow and Professor Green who you stated helped confirm your theory on the case. Your reason for this omission was out of concern for them as they had given evidence at the trial of Sally Clark.

As a potential Expert Witness, you had a duty to list in your report the limitations of either the method you used to come to your conclusion or the results. The Committee were concerned by the fact that when given the opportunity to add a caveat to your report to state that your views were based solely on your viewing of the TV programme and not on any other evidence, you refused to do so. In fact your opinion was put in more concrete terms by using the words 'beyond all reasonable doubt'.

The Committee accept that as a Consultant Paediatrician you had a duty to report any concerns that you may have regarding child safety with other professionals, but as you were prevented from undertaking any new child protection work due to the suspension imposed on you, you should have contacted Dr Chipping, Medical Director as the terms of your suspension required, prior to taking any action.

The Committee also accept that the nature of child protection is such that sometimes concerns are raised which prove to be unfounded. However, despite this, there is a duty of care to raise such concerns in order to ensure the protection of children.

Taking into account the facts found proved against you including inappropriate and irresponsible behaviour and an abuse of your professional position, the Committee consider your conduct amounts to a serious departure from the standards expected from a registered medical practitioner. The GMC's guidance Good Medical Practice (July 1998) states that 'Good clinical care must include an adequate assessment of the patient's condition, based on the history, and clinical signs and if necessary an appropriate examination'. In providing care you must 'recognise and work within the limits of your professional competence', 'be competent when making diagnoses and when giving or arranging treatment.' You did not adhere to this guidance when you involved yourself in this case. You must also 'respond constructively to assessments and appraisals of your professional competence and performance'. GMP further states under the heading 'If things go wrong' that 'If a patient under your care has suffered serious harm, you should act immediately to put things right. When appropriate you should offer an apology'. GMP further states that 'Registered medical practitioners have the authority to sign a variety of documents, on the assumption that they will only sign statements they believe to be true. This means that you must take reasonable steps to verify any statement before you sign a document'. The Committee do not believe that you did take reasonable steps before you signed the report on the Clark case. Your failure to adhere to these principles resulted in substantial stress to Mr Clark and his family at a time when they were most vulnerable and could have resulted in Child A being taken back into care unnecessarily and Mr Clark's prosecution as a result of your false allegation. The committee are concerned that at no time during these proceedings have you seen fit to withdraw these allegations or to offer any apology.

Taking all these matters into account, the Committee find you guilty of serious professional misconduct.

In considering whether to take action in relation to your registration, the Committee have considered the issue of proportionality and have balanced the interests of the public against your own. The Committee have given careful consideration to the submissions made on your behalf and on behalf of the GMC and Mr Clark. It has also considered carefully the GMC's Indicative Sanctions Document. The Committee have been extremely impressed by the vast number of and the quality of testimonials that have been put before them. It is clear from the testimonials that you are held in the highest esteem by your professional colleagues both in the United Kingdom and internationally. They all testify to your outstanding clinical skills and unparalleled commitment to the welfare of children all over the world. In particular we have noted the comments of Professor Sir Alan Craft, President of the Royal College of Paediatrics and Child Health (RCPCH) who states that there has been no doubt that you have been an academic leader and that you have undertaken extremely important ground breaking research which 'has greatly influenced the way that babies and children have been managed all over the world.' The testimonials dealt with not only your research work, but also your work in paediatrics and child protection. There are many references to your unstinting involvement in the care of seriously ill children both within your own Trust and wider afield. Your colleagues have testified of your willingness to help them when faced with difficult cases no matter the personal cost to yourself. The Committee have also heard and have been impressed by the fact that you set up Child Advocacy International, a charitable organization which helps and promotes the welfare of sick children in less privileged parts of the world. The Committee notes that prior to this hearing you have more than 30 years of unblemished medical practice.

The Committee have taken into account the evidence of Dr Chipping, Medical Director who appeared before the Committee to give an oral testimony on your behalf. Dr Chipping stated that since your return to work in October 2001, you have only worked in the area of general paediatrics and that you no longer involve yourself in paediatric intensive care or indeed in child protection work. The Committee nevertheless concluded that the findings against you reflect a serious breach of the principles of Good Medical Practice and the standards of conduct, which the public are entitled to expect from registered medical practitioners and the Committee therefore feel obliged to take action in the public interest. In reaching this conclusion the Committee have borne in mind the Privy Council judgement in the case of Dr Gupta (Privy Council Appeal No. 44 of 2001) which states that:

"The reputation of the profession is more important than the fortunes of any individual member. Membership of a profession brings many benefits, but that is part of the price."

In considering what action to take against your registration, the Committee recognise that taking no action and concluding this case with a reprimand would be wholly inappropriate.

In the circumstances, the Committee have concluded that in your own and the public interest it must take action regarding your registration. Based on the findings on facts in this case and your apparent lack of insight the Committee have decided that it would be inappropriate for you to continue with child protection work for the foreseeable future. Therefore, the Committee have decided to impose the following condition on your registration for a period of 3 years:-

You must not engage in any aspect of Child Protection work either within the NHS (Category I) or outside it (Category II).

The effect of the foregoing direction is that unless you exercise your right of appeal, your registration will become subject to the specified condition 28 days after the date when written notice of the direction is deemed to have been served upon you."

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