The Circus On Euston Road

http://www.cryshame.co.uk//index.php...6&Item id=169



The Circus On Euston Road
Allison Edwards (italics)
& Martin J Walker (regular type)
http://www.cryshame.co.uk

Getting an innocent London bus from Victoria to Warren Street, on Monday
12th January, I found myself regaled by a robotic female voice that told me
whenever the bus reached any notable point on the journey. Although this
broke into my solitude and private thoughts I found it more or less
acceptable, until we reached a point just past Westminster, when the voice
suddenly intoned in a slightly more discursive manner, 'The next bus stop is
closed'. As it was raining, my first thought was that this was a good thing,
until that is, I realised that 'closed' in this case meant non-functioning.
Britain is going through a language crunch just as important as the credit
crunch. Very little means anything anymore, especially a high-sounding
Fitness to Practice Hearing that actually has more similarities to a
corrupted eighteenth century trial for debt.
On Monday the 12th, I showed up at the GMC just before the end
of the morning session being at the mercy of Virgin Trains Saver ticket
rules, for off-peak travel times; my earliest possible arrival at Euston was
midday. The whole excursion, including an overnight stay came in at £112,
better than a standard day return fare of £153.00. It's steep for any
parent/carer of an autistic child but a price worth paying, I feel, to show
my unstinting support for these three eminent doctors. So, during my son's
four night stay at respite, I travelled to London.
I had bad dreams in the early mornings of the days that
followed New Year's Day. They were all to do with Finlay Scott, the Chief
Executive of the GMC, receiving the Commander of the British Empire (CBE) in
the New Year's Honours list. In the dreams, the GMC building remained as it
had been, except when I got to the third floor and approached what used to
be reception; I found that I was on the Star Ship Enterprise. Captain Kirk's
position in the chair was now taken by Finlay Scott. As I came in he was
saying quietly and assuredly, to a statuesque black woman 'Warp Three Uhura,
let's break the Wakefield hearing'. Scotty, who seemed tired and emotional,
questioned the Commander, 'But Sir I might have to tighten some nuts and
bolts on the engine before we can outrun Wakefield's ship'. Finlay Scott
gave a questioning frown, 'I'm Commander of this Star Ship Scotty, and don't
forget it', 'Yes Commander, of course Commander, it's just that at warp
speed 3, our whole strategy will be exposed'. 'Scotty, this isn't the time
to argue the toss on this one, the Lord High Commander of the Star Fleet,
His Great Master Salisbury, has instructed that we bring this adventure to
an end'. With this last statement, the Star Trek theme began, but it seemed
different; mainly it had Chinese instruments and Miss Smith's voice-over
said something about 'I'm going where no man has boldly gone before.' I
always woke up scared and in a terrible sweat.
You can imagine my relief when I did get to the hearing, only
to find that none of the staff were wearing the tight, powder-blue uniforms
of my dreams, and apart from new ribbon bedecked pictures of Finlay Scott
giving a wave, entitled 'Our New Commander' everything was as drab and
dreary as usual. The dreams about Finlay's CBE did make me think, however,
and not for the first time, about the linguistic dissonance, the grammatical
dysfunction, that exists in Britain, and I wasn't really surprised when I
found that the Chief Medical Officer, Liam Donaldson was on the committee
that gave him this honour. Unfortunately I haven't had the time to research
how much influence GSK have in this matter, although I have heard the rumour
that in the next New Year's Honours list, the honour will be called CBDGSK.
That's Commander of the British Dominions of GlaxoSmith Kline. This is far
more applicable anyway because there no longer exists any Empire to speak
of. These acronyms, and the failing of language, brought to mind an acronym
in the civil service that I think well fits Finlay's situation, POWG (Paid
Off With Garbage).
My parental anger simmers because it was whilst these
top-flight pioneers were delving into discovering the 'whys' of regressive
autism in some children, that they were confronted with these ridiculous
charges. Undoubtedly those who brought the charges were more deserving,
themselves, of some sharp questioning about their own motives for this 110
day fandango. How have these people got away with stifling medical and
scientific investigations and more crucially the treatment of very poorly,
vulnerable children?
And in the newspapers and on the telly, the same old lazy
media, denials, disguising any opportunity to shed light on this important
topic, constantly churning out the original charge sheet, time and time
again, screaming guilty whilst bowing to the political factions hell-bent on
putting this WMD type issue to bed. The 'can't-be-bothereds' who won't do
what we parents do and sit in on and find out the facts of this stitch up
job by listening to the defence. Where have all the decent reporters gone,
did boredom eventually kill them off? How can the media be so uncaring
towards our babies? Hush, hush from the top seems enough for them!
The next three weeks of the hearing is devoted to the defence
of Professor Simon Murch. Murch is defended by Mr Adrian Hopkins. I was
wondering how I could write about Hopkins without seeming somehow
condescending - after all, who am I to critique a barrister of 20 years
standing - so I turned to the web site of 3 Serjeant's Inn, to see what the
site said about him:
"...'incisive and knowledgeable, with an amazing grasp of detail'..." Legal
500 2008
'The "flawless" Adrian Hopkins QC offers "great attention to detail,
combined with the ability to step back and look at the broader issues of a
case." His "low-key, quietly courteous and moderate approach" stands him in
good stead with disciplinary tribunals.' Chambers & Partners 2009
'Adrian Hopkins QC heads the set's medical team and is a perennial
favourite with solicitors. "Low-key and deadly," he boasts "a
clear-thinking, analytical approach," which he deploys in negligence issues
of considerable importance.' Chambers & Partners 2009
"Hopkins is very diligent and measured. He is excellent in complicated,
high-value cases where he has delivered some impressive results. He really
knows how to make the most complex case appear straightforward while showing
such good attention to detail." Legal Week article, 8 December 2005
Well, I agree with all of that and these brief reviews come amazingly close
to the words I would have used myself. From the very beginning, as Hopkins
began leading Professor Murch through his evidence in chief, he showed an
intuitive grasp of the case and it's context. He led us into the Royal Free
Hospital and gave us a tour of the Department; he described through
Professor Murch's eyes, what the team of highly skilled doctors did in the
Department. During this tour, he opened all the doors on the muddled
prosecution charges, and Simon Murch explained and refuted them from his
singular point of view.
Dr Simon Murch and his Counsel, Adrian Hopkins,
conducted the defence adeptly. Both are as confident and concise as an
Oxford Dictionary. Two or three times or more I felt like bursting into a
spontaneous round of applause for the crystal clear explanations of this
particular group of children with a novel form of bowel disease and
regressive autism. Like partners in a waltz the questions led well to
answers in step and in sequence. Dr Murch puts everyone at ease with his
manner, particularly empathic he began some answers with, 'If it was my own
child this had happened to..'
Questioning highlighted the care and diligent enquiries needed
to understand whether the children really were in need of investigation due
to their histories. Had they carried out appropriately required
colonoscopies? They had. Were the biopsies necessary, where from and how
were they done, and for what purpose? For good, proper and accurate
diagnosis to help the child and parents and not specifically for research.
Meetings were discussed, who was there, what was recommended by whom and
why? Much of what was said had been covered by previous defence counsels for
Wakefield and Walker-Smith, but we heard again how this was teamwork,
carried out by the best of the best, carefully drawing from the wealth of
experience they all had in their field. All carried weight in their opinions
and the opinions of others connected with the Department.
As far as I could hear, not one of them would have been able to
make rash, ill-considered decisions without being noticed. The families were
crying out for help. Quality of life was impaired by severe gut pain and
brain function deterioration following MMR; they suffered amongst other
things from various allergies. The doctors' aim was ultimately to diagnose
and treat. Cause and science are rarely challenged or brought into question
here, so why is this not the case when it's reported. These doctors and
their right and proper work, are being junked in the most unforgivable way.
Failure to continue with such important research is indeed Britain's loss.
Hopkins chose the days of a week to describe the work that went
on at the Royal Free, and by the end of Monday he and Professor Murch had
between them presented an intimate picture of work in the department, of its
challenges, its routine and a solid refutation of the bizarre intervention
of this much later prosecution.
Most important, it seemed to me in this break down of work at
the Royal Free, were the following.
The role of Professor Walker-Smith as one of the founding fathers of
paediatric gastroenterology.
The different diagnostic needs of world wide referrals to the unit.
A look at mitochondrial disorders that were being researched at the Royal
Free as early as 1996.
The especially important matter in this case of clinical protocol books.
The lack of involvement of Dr Wakefield in any of the clinical work of the
hospital.
Professor Murch's role on the hospital ethics committee and ways in which
conflict of interests were avoided.
A detailed look at the tests given to children, in order to work up a
complex but realistic diagnosis.
How biopsy samples were dealt with.
A detailed picture of why and how a colonoscopy is carried out and what
exactly this process is used for.
Mother and child 2, used to explain in detail the considerable complexities
of children presenting with serious bowel problems and regressive autism.
Perhaps the most interesting aspect of Hopkins' analysis of Professor
Murch's work, was the way in which he approached it from a position that was
empathetic with
both the children and the parents. Hopkins' trek through Murch's evidence in
chief was marvelously post-modern and multi-layered. It spoke eloquently
about the role of the doctor in modern society, the needs of parents and
children with undiagnosed illnesses, and most of all it created an umbrella
of explanation about human concern, and therefore ethics, that surrounded
surgeons and researchers.
Professor Murch never ceased to be quietly reasonable, the kind
of doctor one might only dream about in the hubbub of modern urban society.
His tone was measured and fair, except where he refuted the mainly absurd
prosecution allegations, such as those that he examined children and then
performed colonoscopies on them for research purposes. These often ludicrous
assertions were put with a chilling clarity, delivered by Hopkins in a tone
equal to that of the chillingly logical Dr Spock, to be answered by Murch in
an alert, definite and even forceful manner.
Perhaps being only day one, all in the room are alert, a perky panel on the
right and down at the prosecution end of the room is the same twitching,
flappy, hair flicky, and scratchy, as a bad case of nits. Lots of coughing
and nose blowing going on too - in the circulating air conditioning all
sorts could be blowing about. Let's hope a clear run at some good evidence
is possible throughout the month of January without cases of plague.
Throughout Professor Murch's evidence I was constantly
reminded, as I had been during Professor Walker-Smith's case, that both
these doctors placed considerable reliance on nutrition. This opens up a
whole new area of speculation, because since 1988, the quack-busting groups,
now consolidated with Sense About Science and the Science Media Centre, have
been attacking nutritionists, especially those that suggest that nutritional
treatments can help alleviate cases of serious illness. Most strenuous in
the attacks on nutritional medicine are the followers of the
pharmaceutically dominated and genetics lobbies, who not only suggest that
every condition is genetic in origin but that nutritional approaches to
treatment should be banned.
It was odd and rather surprising to hear Professor Murch
describe Candida as most noted in the 'grey literature' and then to talk
about Professor Jonathan Brostoff as a widely respected allergist. The
original quack busting group in Britain - the Campaign Against Health Fraud,
now called HealthWatch - spend years campaigning against allergy, saying
that anyone who claimed to have it was probably mentally ill. While
Professor Murch might be right today in saying that the whole field of
allergy has changed and much more credence is now given to claims of it, the
exposure of this subject reminds us that as well as the pharmaceutical
companies, the processed food industry is also involved in the refutation
that nutrition has any bearing on health. While from the perspective of a
hospital consultant, appraisals of nutrition might have changed, on the
ground, nutritionists are still mercilessly attacked by quackbusting
reporters like Ben Goldacre.
At around mid-day on Tuesday, Mr Hopkins leaned on his rostrum
and apologised to the panel for what he said he was about to begin; going
through the Lancet cases one by one. He was aware, he said, that the panel -
and everyone else in the room - had heard this detailed evidence over and
over again. However, it was not until Mr Hopkins began down this path that I
really understood his need to apologise. Master of detail that Hopkins is,
this review of the twelve cases is evidently going to be a tour de force, a
kind of War and Peace version of the Lancet paper. One has, at least, to bow
to Mr Hopkins' judgment even if his approach could well be heralded as the
new post-industrial equivalent of Chinese Water Torture. He is obviously
right to be so descriptive in building up a material picture of all twelve
cases, after all it has been the very looseness of the defence case
generally that has left the clear ground on which Miss Smith has erected her
shibboleths.
* * *
The beginning of the hearing on Monday 12th of January was considered with
excitement by those who had closely followed the hearing. The last episode
had ended with the vague possibility that Richard Horton might return to the
hearing to explain how he had failed to recall that he had known for at
least a year before the publication of the Lancet paper; that Dr Wakefield
had been promised funding by the Legal Aid Board.
This matter of a conflict of interest is at the very centre of
the case against Wakefield and was the core of Horton's evidence to the
Panel. His case was that he was suddenly and virginally surprised, almost
shocked to find in 2004, following his briefing from Brian Deer, that
Wakefield had a conflict of interest. When the defence produced papers,
after his evidence, that showed clearly that he should have known about the
legal aid money, it was asked if Horton could be recalled. At the end of the
last session Miss Smith adroitly presented 'the dog chewed my homework'
defence for Horton and most observers saw a full blooded cross examination
of Horton drift away.
At 4pm the afternoon session drew to a close,
Professor Murch was invited to leave if he so wished and that was when the
Horton shenanigans reared its head. A statement was to be read by the panel,
who would deliberate after adjournment and give a response as to whether Dr
Richard Horton, Editor of The Lancet would be called for further questioning
on the 21st of January. If I have rightly understood what I was hearing,
Horton, during his evidence, had not been precise with the facts regarding
dates and what he knew when. The reality of his knowledge was exposed in a
letter discovered in a lost filing cabinet at the Wakefield's home which now
left room for further investigation.
We were all to find out in the morning what the panel's
decision would be in relation to that statement, although it seems
discussions between Counsel Smith for the prosecution and Counsel Coonan
for the defence had already taken place on whether or not it was necessary,
and seemed to be a 'done deal' for the let's-not-bother-brigade AGAIN with
the panel beginning to look weary at the thought of anything that might
prolong and interfere with the smooth running timetable of Dr Murch's
defence - it was a hefty consideration! But how come, from the beginning the
whole prosecution has been swept along in the prosecutors wake ? And she
makes up the most cloying disguises for her true intentions. She gave the
impression of WANTING Horton to be summoned back there to be cross-examined
harshly - as he so rightly should have been - she said in a fake serious
voice, but " not wanting to run the risk of being the most unpopular
person in the room" she would concede. We could all see what she was playing
at, creating yet another dread of stretching it into forever, implying it
was the others, the defence who didn't want that to happen, and the panel
too, Que Sera Sera! She tried..sigh! Shocking tactics I felt.
On the afternoon of Monday, the hearing was told that Mr Coonan
and Miss Smith were, not for the first time, in complete agreement, that
there was no need to recall Horton, especially as his diary was so full.
Both barristers were sure that a statement from him would be completely
sufficient. The Panel were sent into camera to discuss this important
agreement and to consider whether they would like to see Horton back at the
witness table. Inevitably they endorsed the unanimity of the counsel and it
was agreed that Horton's statement should be read on Tuesday morning.
And so, tomorrow... Tuesday 13th January. Will it be drama or a
damp squib? A long lens got me as I came in. Why? Maybe they liked my jacket
and scarf combination! Up on the 3rd floor, a little later than the intended
9.15am start, it began. And just like The Magic Roundabout's Zebedee, Brian
Deer arrived, dropped out of nowhere, ready to hear the Horton statement
even though he hadn't been there the day before to hear which act was on
next. Curiously, this man seems to get wind. When something goes on, he's
there, then vanishes like Harry Houdini. How come? Is he the Ring Master or
merely an entertaining plate spinner? Tiresomely, the rest of us have to sit
through the gusty slow flow of this age-old case barely knowing when the
circus is next coming to town.
Horton's statement was worse than even I expected. In it's introduction it
pointed to papers he had been supplied that hinted at the fact that he had
known for years before 2004 about the LAB money. These papers referred to a
Dawbarns fact sheet, the agreement between Dr Wakefield and the Legal Aid
Board and the letter from Mr Rouse printed in the Lancet. Horton didn't
waste words, he simply said that he had considered each of these references
and claimed that none of them had forewarned him of any conflict of
interest.
Given that Horton's maligned contention - that Wakefield's
case review paper in the Lancet was hopelessly compromised because he failed
to note funding for other forthcoming work from the Legal Aid Board - is at
the very centre of the case against Wakefield, I personally will never be
convinced that it wasn't in the interest of the defence to force Horton's
second appearance at the GMC. Never was there a better case, in my opinion,
for an aggressive cross examination of a major prosecution witness who had
failed to give the facts in his evidence in chief.
The problem appears to be that while the prosecution and its
agents, from the government down to Brian Deer, have poured venom into the
prosecution, the defence, apart from a couple of incidents of intransigence
and some exceptions in attitude, have been strolling through the park,
smelling the flowers and pretending that the case isn't actually about
thousands of vaccine damaged children.