Southall plans new career as expert witness in child protection cases

I wish to respond to an inaccuracy in Clare Dyer’s article, and raise
other
issues that have been neglected in the coverage of this saga.

The text box entitled ‘David Southall: timeline’ uses the words: -
‘1998 – 2000 The Griffiths Enquiry into research on non-invasive
ventilation
…’
If you read the terms of reference for that review, it was to examine the
framework for supervision of research in North Staffordshire. The purpose

was not to investigate research misconduct, indeed that is made very clear

in two places in the report. As the chair of that review panel I have to
say
that we were told to look at research governance and that is what we did.

All our recommendations stem from that. It is true that the stimulus for
the
review was related to some of David Southall’s work but the minister who
appointed us was quite clear that it was the research governance issues
that
we should look at. The trust itself looked at issues of individual
performance, as did the GMC in different ways.

It is true that Chalmers and Hey criticised our report and to some
extent
started this fiction that we were investigating research misconduct. In
effect
they constructed a straw horse that said we were looking at research
misconduct and then destroyed the straw horse. I have corresponded at
length with Iain Chalmers and Ed Hey (before he died) and I am not
unsympathetic to their motives. Their action can be justified as a
debating
ploy, in that it provided a convenient hook on which to hang their
contention that an effective and respected method of dealing with
allegations of research misconduct is required. I agree with them in
stressing the need for such a mechanism. It does not exist, and it is
time
that it did.

It is also true that our report did in some places repeat some of the

allegations that had been made against the research; that was inevitable
because these allegations were presented to us as evidence. However
almost all the evidence we were given about CNEP had errors in some
aspect, but it was not our task to draw conclusions about that. We simply

asked the question as to whether the governance systems current at the
time could deal with such allegations, whether they were true or not. We
concluded that the system was not up to the task and recommended that it
be improved.

Throughout this saga some sections of the media and many of David
Southall’s critics have paid very little attention to facts. Indeed the
media
carried interviews with some individuals who announced what they said our
findings would be some while before we had concluded our work, and well
before we had written a word of the report. What they said bore no
relation
to our actual conclusions and recommendations yet the fictitious versions
were repeated in the media many times. If these people were as fanciful
in
other things they said then little reliance can be placed upon them. It
is not
for me to speculate as to why some sections of the media indulge in such
practices, perhaps it is a fact of life, but I would rather that the BMJ
did not
repeat these errors.

Repeating falsehoods is not the only error the media make. For
example it
seems that suspension as a neutral act in disciplinary cases, is a concept

beyond the understanding of the British media. Suspension is undertaken to

make a situation safe and create a level playing field while an
investigation
takes place. If some allegation has been made that implies a public risk
then it is best for all if the activity ceases until investigations are
complete.

Unfortunately some managers and HR departments still behave as though

suspension is a punitive act and the media frequently treat suspension of
an
individual as proof of wrongdoing. Suspension is often reported alongside

the allegations and however carefully worded the reporting might be the
reader is left with the impression that the allegations must have some
validity. The reader is invited to conclude that there is no smoke with
out
fire.

We need to find a better way of dealing with such matters. The most
obvious one would be some sort of ban on reporting while an investigation
was in progress. This is often achieved in a partial sense, the person
suspended may be advised to say nothing and anyway may be so distressed
by the allegations, particularly if they are untrue, that they are not
capable
of effectively defending themselves in the media. Similarly those
carrying
out the investigation are unable to say anything of substance until they
have
completed their work. On the other hand, those making or repeating the
original allegations are able to say what they like and there is
frequently no
comeback if their allegations are subsequently proved to be unfounded.
The overall effect is to reinforce bias.

It would surely be better if all investigations could be brought
under some
sort of quasi-judicial umbrella where there were restrictions on reporting

imposed on all sides, and those breaching such rules were treated as being

in contempt of court.

Once an investigation is under way, and implicated activities are
under
control, there is little to be achieved by publicity and often a real
possibility
that harm will be done by further repetition of unproven allegations. I
am
sure that all the participants in the North Staffordshire saga and
paediatrics,
and child protection in general, would have benefitted if such
restrictions
had been available. Those making the various allegations would have lost
little by not being able to frequently repeat them.

I think there are three lessons to be learned from North
Staffordshire.

Research and clinical governance systems must be able to provide an
environment, backed up by relevant documentation, in which clinicians and
researchers can be sure that they are protected from malicious
allegations,
and patients can be sure that they are as safe as possible.

A system must be created to properly investigate allegations of
research
misconduct. When questions are raised they must be dealt with promptly.
It cannot be sensible that the North Staffordshire saga has stretched over
a
decade.

Protocols should be developed which restrict reporting once an
investigation
is under way so that unproven allegations do not gain credibility by
repetition.

rod.griff@gmail.com

Competing interests:
No financial interest but I am
cited in the article