Medical treatment was used as cover for sexual abuse of children, inquiry concludes
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4745 (Published 04 December 2020) Cite this as: BMJ 2020;371:m4745
The sexual abuse of children in healthcare settings has typically been carried out under the guise of medical procedures, the independent inquiry into child sexual abuse in England and Wales has concluded.
Perpetrators were commonly male GPs or other healthcare practitioners with clinical access to children, who were in positions of trust and whose actions were not questioned by parents, children, or other staff, a research report for the inquiry found.1
The report, based on victims’ experiences from the 1960s to the early 2000s as told to the inquiry’s Truth Project, is the fifth report from the inquiry. Set up in 2015 to look at how institutions have failed to protect children from sexual abuse and exploitation, it has already reported on religious institutions, residential care, custodial institutions, and sports.
Cloaking the abuse under the guise of clinical procedures or examinations made it difficult for the children to identify it as abnormal or wrong, the report found. Only a quarter had reported the abuse to an adult at the time, and few were believed.
One victim said, “Under the guise of performing a medical test, called a high vaginal swab, he used that as an opportunity to rape me. I thought I was dying, but I also thought I had to be very quiet, because it was the right thing to do.”
Apart from the victims’ lack of knowledge about medical procedures, the position of trust and authority held by healthcare professionals and physical isolation in private consultation rooms were factors facilitating the abuse identified by the report.
Level of trust
One victim who at the time was under the age at which smear tests are first recommended said, “He told me it [a smear test] was for cervical cancer, that I need to be careful; I could get blood clots because I smoked and, you know, I took the pill—which I know is true, but not after one year or less than a year, and not like 10 [cigarettes] a weekend.”
Some victims explained that the GP was trusted by their family, who had a long relationship with him. One said that, when the GP was being investigated, her parents wrote a letter in his support, highlighting the level of trust they had in him.
Only 3% of victims (109) who related their experiences to the Trust Project had been abused in a healthcare setting. Of those, 83 had been abused by a healthcare professional, 59 of them by doctors. Accounts describe abuse in hospitals, psychiatric institutions, and GP surgeries.
Some doctors who used medical examinations as a cover for abuse have since been prosecuted and convicted and are serving long sentences. Manish Shah, a GP who mainly assaulted women but whose victims included a 15 year old girl, was handed three life sentences last February.2
Myles Bradbury, a consultant paediatric haematologist at Addenbrooke’s Hospital in Cambridge, is serving 16 years in prison for the sexual abuse of 18 boys aged 10 to 15 under his care from 2009 to 2013.3 Alan Tutin, a former senior partner in a general practice who sexually molested women and girls from the early 1980s to 2003 under the guise of medical examinations, was jailed for 10 and a half years in 2019.4
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