INDEX TO PAPERS 23 July 2007 Dr David Patrick SOUTHALL tem | Deseripion oe No i] The GMCS determination eter of 8 Rugust 2004 t0Or D Souinall [1-7 2 The GHC Teter of 7 September 2004 to OF D Souihalh 3 |The GMCS later of 22 Apri 2008 to Dr O Southall, encosing — |) High Court Judgement dated 14 Apri 2008 | i) High Court Order dated 14 Apri 2005 | Later dated 2 une 2005 ror Eo Or 0 Southal ~~} Te GMCs foier of 23 June 2005 to Or O South | Letter dated 17 July 2008 from Dr D Southall tothe GNC GNC ‘othe GNC 43-44 oul ae [11 Celt datea 10 Apa 2008 Wom Or D Souial the GC 48-47 | [12 [Later dated 19 Apri 2008 rom! jorhe Gwe 1 3_| The GHC lelter of 29 September 2006 to Or O Southall) 4 elter dated #1 October 2006 from Dr O Southall to the GMC I [soe ‘dated 8 Noversber 2008 fo forecwe (st | Fineas io Practise Panel Hearing Agenda dated 19 November /52=60-| | 2008 | | 17 | News Release dated 20 February 2007 Cea 18 |The GMC'sfeter of 30 March 2007 to Or D Southall 3 19" Latter dated 13 Apri 2007 Yom Or O Southa tothe GNC ea 0 Tali dated 13 Apri 2007 tom Col 6 i Calter dated 8 May 2007 fam Dr 0 Soutnal 22 Leiter dated 15 May 2007 From Or D Southall tothe GNC 87 23 Leiter of elerence dated 21 tay 2007 ron I 8 24 Let ofeference dated 25 May 2007 ron I 692% 26 a Leiter of reference dated 25 May 2007 From ‘atier of eterence dated 29 May 2007 from Letier dated 3 July 2007 fem Dr Souihalto the CMC 0 7‘dane Ace a nen fasn amen ene inter Pf ‘Stein Case No: €o/4738/2004 Royal Courts of Justice Strand, Londen, WC2A 2UL Date: 14 April 2005 Before : Mr Justice Collins Betwee Council for the Regulation of Healthcare Aoetare Professionals end Genera! Medical Council First Respondent ‘And. Professor David Patrick Soutnall Second Resgondent ushpinder Saini (instruced by Baker & Mekenzie) for the Appellant Mark Shaw Q.¢. & Jemima Stratford (Instructed by Field Fisher Waterhouse) for the First Respondents Kieran Coonan Q.¢. & Andrew Kennedy (instructed by Hempsons) for the ‘Second Respondent Monica Carss-Frisk Q.¢. Hearing dates: 3 - 4 March 2008 Judgment Approved by the court for handing down (subject to editorial corrections) 10feng seca anna Sttinertiney ries: Mr Justice Collins: 1 professor David Soutral a paediatrician of interntionsl renown. He has done pioneering work on cid abuse and has Deen reccgniatd oe 9m expert in that [eld tn November 1999 Saly Clark was convicted of murdering two af her Baby Chidran, ‘One ofthe expert witnestes at her tal at wmch the detence mwas that fhe enildren Nad not sled unnatural deaths, was Professor Si Roy Meadow, whose fvidence has subsequent been called Into question, In particular In relation to fhe virtual impessibity of mare than ‘one infant’ death in 2 family. tobe ‘tenbutablefo"eok death’ of natural causes Sally Clar’s husband was convinced chat his wife was indeed not guity ofthe sitences of which she hag been convicted. He wes loking after a third chi, who fos bean retaved to as-&, while sne mae in poson pending ner appeal. On 27 Mart 2000, Channel television, in Rs "Dispatches" erie cevoted 8 programme {the case of Saly Clark. fe contained a lengthy interview with her husband Professor Southal Nad an obvious interest Init and watched In the course of Nr Gark described how one of Fis sone whe had die nine days later had suffered {howe Bleed whe he was looking after him ata Rota in Landon. The description rth event led Professor Southal, who at that tise knew nothing of te cose Seyond what he saw In the course of the programm, to reach 9 firm conclusion {hat thers Rad bean an attempt to suffocate the chi and that Mr Clark had not ‘nly been responsible for that attempt but had Kiled he cl Professor Southall immecately decided to convey hs concerns to the police and {he next day contacted an offes at the Child Prtetion Unt in Staffordshire. “The oficer was known fe him since he worked for the North Staffordshire Hospital (nits) Trust at tne North Staffordshire Hospital and the course Of his work hod feterred a number of caues of suspected chld abuse to the police. The CPS 30 {the Cheshire Socol Services, who were concerned tecause there ware ongoing fate proceedings in the igh ‘Court In relston to Chid A, were noted and ‘rofefsor Soutnal was sean on 2 June 2000. Me later attended a meeting with resentative of Cheshire Socal Services and Chig A's guardian ad item on 22 July 2000. Ne had by then spoken to Professor Green, nino was one of the pathologists wine had appeared on behalf ofthe Crown at Sally Cark’s til, and Professor Meadow and had 95.8 result got some mare information. He did not however, disclose the fact tat he Rad hed those conversations to focal services Bnd tothe guardian ad item elleving, as he later sa, tat he might get the fo Into trouble Ihe ai He maintained his concioions that Mr Clack haa atenpted to suffocate ns son at {he ote! and that he and not nie wife hed killed hs two children. It olowed that Mr Clark was not ft ta look after Child A who would be in grave danger ithe die. Fe has, dente the existence of evidence which shows that Mr Clark could not have been responsible for his sons’ dest and mis continuing leck of fll Knowledge ofa the relevant moteral which would hive tobe taken Into account Invranching such 3 positve conclusion, not resid fram that concusion, 18 wil in due course be necessary to consider what Ihave set out in Introducing this case in more deta, professor Southalls conduct was the subject of & omplait tothe General Medical Counell (GMC) that he hae Been gulty of seriouE professional misconduct. In due course, he appeared before the Professional Eenauer Commitee (Pcc) whieh, flowing & hearing lasting some 9 days, on 6 ogust 2008, having found him gulty of serous profersiorel miconauct, rected {hat fora pevod of years 9 condition should be impesed on hs registration that fe 4gen za ea ass ae he eof a Pn ‘iets must not engage in any aspect of child protection werk either within the NHS (Category 1) or outside 1 (Category I) 5. The appellant Council (whieh has now changed its tle to the Council for Health Gare Regulatory Excelence) was created by Secton 25 of the National Healt Service Reform and Health Care Professions Act 2002 (the Act). "The rested ‘tom cancers thatthe system of sell regulation af health care professional dd ‘ot always lead to proper concern for or protection ofthe public but as weighted In tavour ofthe professionels. Similar concerns have recently been expressed 5Y Dame Jenet Smith in her report following her inquiry Into the actives of OF Shipman. One of the powers conferred on the Councilis-to-refer to this court penalties Imposed by a professional body which carsigers to have Been unduly foment: see's 29(4) of the Act, Suen references are treated oe appeal. Te {Counc tk the view thatthe decison to impose the conation was unduly lenient and that, having regard to all the crcumstances, noting short of erasure would have been appropriate 7. Te approach to be adopted by this court in considering an appeal such as this has recenty Dean the subject of » decision by tre Cour ef Appeal in two Conjoined appeals, one invalving a decsion of the GMC, the other a secision of {the Nursing and Midwifery Counel. The case 'cted 2s [2004] EWCA Ci 1356, the practitioners being ealed Ruse and Truscott ressectvely, 8. The present cate Is concerned only withthe alleged undue leniency ofthe enalty Inmponed. tis not suggested that ail material facts were not put before the PCC or that there was any ‘under prosecuting. The power to reer conferred by 5529(4) extends to ndings and fack of ndings os wel as to penalties and i tht Rorclo cove those elements were of Importance and it wes necessary for the ‘our to decise whether the power to refer extanded to what can be dese os Sequitats. AE paragraph 67, the Court remove s.29{4 (a) n te folowing way! = “A relevant decision fang within subsection () has been unduly lenient, whether Because the findings of professionel mscanduct are Inadequate, or because the penalty does not adequately Feflet the findings of professional misconduet that have: Dee ‘made ofboth” ‘The actual wording of s.29(8)(2 st ~ “A relevant decision faling within subsection (3) has been unduly lenient, whether 8 t0 any finding of professioal misconduct, ot ‘eness'to practise on the par ofthe pracutioner concerned (or lack of sucha finding} or as to any penalty impesed or bath As the Court saa, its rewriting (wth, I would suggest the addition of the words “or ness ta practise’ after professional misconduct) accords withthe Scheme of ‘ection 29 ang is natn confit withthe language vee 1m paragraph 73, the Coure was considering the correct approach to a reterence Wena! “what are the cnterla to be applied by the Court when deciding whether a relevant ‘econ mas "wrong? ‘The task of the iseipinary tnbural ig to consider whether ‘78 relevant facts Gamonstrate that the pracclioner has been guity of the defines Professional misconduct that gves rise to the "ght oF duty to Impose @ penalty ana, where hey co, to impose the penalty that 12's appropnate, having regard to the safety ef the public and the ‘reputation af the profession. The role ofthe court when a case = feferred. is 22 consider whether the discipinary tribunal hat bropery performed tat task 30 98 to Teach correct decision a= {othe impouton of s enalty. Ie that any défeent from tho Tle ‘ofthe Council m considering whether relevant decison has been ‘unduly lenient’? We do not consige tht It The test of undue leniency In. this context must, we think, involve considering tnmether, having regard tothe material acs, tne decision reached fas due regard forthe safety of the puble and the reputation of the profession” ‘Tne Court then went on to consider how the fue of undue leniency shouls be addressed in the ight ofan argument put forward bythe Councl that i alone BOG to consiger whether a: decision was unduly lenient ana, if id, the Court mas thon concerned to consider the Geisian as fan an oidinry appeal. In relation fo penalty, the Court said thie (at paragraph 76): = we consider that the test of whether» penalty is unduly lenient In'the context of section 29s whether It is one which 8 Sisciplinary tlbunal having regard tothe reltvant facts and the Sbjec of the clscilinery proceedings, coud reasonably have ‘and in paragraph 77, the Court sad: “In any particular case under section 28 the Issue is lkely to be winether the ‘iscpinary tebunol has reached a decision as &o Benalty that is manifestly inappropriate having regard to the practtoner's conduct and the ingeress ofthe Dust ‘The use ofthe adverbs ‘reasonably’ and "manifesty’-eflect ‘unduly’ and makes it ‘lear that i's only I iis vous tothe cour thatthe penalty imposed was f00 lament should ie intervene, It'must bear in mind thatthe overriding concerns {he safety ofthe publ coupled withthe reputation x the profession, but must ‘ot interfere with the penalty Imposed unless satsfed that that penalty carnct Feasonabiy be regarded as presucng the necessary protection forthe puDic or 98 Upbelding in an appropriate ‘ashlon the reputation of Ihe profession, 30, The Court also considered » motter whichis almost alvays raised in appeals from professional bodies such as the GMC, namely the extent to which the Court Shoule defer to the expertise of the discpinary tebsnol. In paragraph 78 the Cour of Appeal sald Enis: “Tat expertise Is one of the most cogent erguments for self- regulation. At the same time Part 2 of the Act has been Inerosuced because of concer 98 to the relabilty of sei ‘equation. Where all materal evcence has been placed before {he alsciginary tribunal and Ie has given due consideration to the Felevant factor, the Counel ena the Court should place weight on the expertise brought to bear in evsloting now best the needs of the publie and. the profession should be protected. "Where, however, there has been 8 failure of process, or evigence i taken Ingo aeedunt on appeal that was nat placed before the diecplinary ‘buna, the decision reached by thet tribunal mil Inevitably need to be reaisessea" 13‘atu spent nena aan Capea teen Pf eee Ce es os 11, The amount of weight tobe attached to the expense, assuming regard has been had to relevant factors, wil cepend on the creumbionces of 8 particular case. ‘This where there is miscanduet constituted by 2 falure to reach proper standards Intreating patients, the expertise ofthe tribunal in ceeding what is needed In the Dartculary in cases involving lines to practice. But were, for example, Sishonesty or sexual misconduct is Ivelved, the cour i kely to feet Ut ca sse55 what Is needed to protect the puble of to maintain the reputation of the profession more easy for self ond thus attach less weight to tre expertise of the toural. The question af deference hos been covsdered by the Privy Counel ina number of cases. The more recent approach, which reflects the influence of [ticle 6 ofthe European Convention on Human Rights, so be found in Ghosh Y General Mecica! Counei {2001} 1 W.LR. 1915. At >aragraph 34.0n page 1323, Goro tet said thie: = “For these reasons the Bosrd wil accord an apstoprate measure of respect tothe judgment of the committe whetrer the praciboners faiings amount to serous. professional miscenduct and. on the measures necessary to maintain professional standards and provide ‘Bdequate protection to the publi. Sut the Board wil not deter tothe Committee's Judgment mere than is warrantea by the circumstances, ‘The councll conceded, and their Lardhipe accep, that its open To thems to consider all the matters raises by Or Ghesh in her appeal, to decide whether the sanction of erasure wes" approprate, and hecessary in” the pualle interest or “was excessive an Gsorepartionate; and ih the later event either to substitute seme ‘ther penalty or to. remit the case tate committee for reconsideration”. ‘That approach was followed in Preiss v Genera! Dent Council {200%} 1 WLR. 1926 and is reflected n what the Court of Appeal said in Ruscio at paragraph 78, 12. As wll become apparent, the PCC were very much influenced by testimonials Which ware put before than on behalf of Professor Southal "The weigh to. be ccorded to Festimoniais has been considered in a cfarent context im Bolton ¥ {aw Society (1994) 1 W.L-R. 312. However, the purpase of sisipinary sanctions |S meterah AS the GMC's own guidance corecty makes pion, the purpose of ‘sciplinary sanctions isto protect the puble snd the reputation ofthe profession In-question, not to punish. Tt Is obvious that whatever sanction imposed wil Involve to a greater or lesser extent areal penalty, but the word penalty inet, ‘the Court of Appeal pointed aut in Auscilo' a paragraph (60, relly 2 Appropriate one ta describe ascpinary sanctions. In ts tndieative Senedions cence, the GMC points out that the purpose ofthe sanctions le net to be Dunit, ‘but to protect the publle interest, which Ieludes the maintenance of Buble confidence’ in the profession ard uphelaing proper standards of conduct ‘The spproacn set out in Botton v Low Sectety Nas been approved and apPited to the GMC by the Pry Councllin Gusta v GMC [2002)1 WLR 1691, AE 318 of Botton, Sie Thomas Bingham, MR sald tit = “The second purpose isthe most fundamental of al: to maintain the reputation of the Solitary profession as ene in which every member, of whatever standing, may be trusted to the ens of the arth. Te maintain this reputation and sustain puble confidence Inthe integrty ofthe profession Ie is often necessary that those Sully oF serious lapses are not only expelled but denied ve Semission.I'a member af the pubic sels his house, very chen his" largest sset, and entruste the proceeds to Nis soleter, 14tun axe sure ont Rp Ye Seay ntact Rae 2. Dencing reinvestment in another house, he ordinarily ented fo expect thatthe salctor wil be a person whose trustworthiness Is not, and never hes been, serousiy in question, Otherwise, the whole profession, and the pubic ot" a whole, is inured, {he confidence which that inspires ‘Because orders made by the tribunal are not primary punitive, follows. that considerations ‘which would ordinary. weigh In rritigotion of purahment have less effect on the exercise of this [inedetion than on the ordinary run of aestences. imposed In Ernminal eases. it oen happens that soiilor appearing before {the tribunal can agcuce a meslth of glowing toutes om hs Drofessionol brethren. He-con often show that for him ang Ns family the consequences of strking offer stopension would Be Ite Short oF tagie Often he wil say, convincingly, that be has learned his leon and ll not offend again. Gn applying for rettoraton after steking ‘of, al these points may be mace’ and the former solietor may aso be able to pont to real efors ede tarve-estabish himget’ and redeem hs reputation. Al ese ‘atters are relevant and should be considered. But none of them ‘uches the epsenta sue, which is te need te maintain mony ‘members ofthe pub a well founded confidence that any aottot tihom they Instuet wil be person of unquestionable integrity, roby and trustworthiness. Thus lt can never be an objection (6 8n order of suspension in an appropriate case tht the soctor ‘ay be unable to re-estabish hs practice whan the period of Suspension is pest. I that proves, of appears likly, tobe a0 the Consequence for the individual and he farnly Tay be decoy Unvoreunate and unintended. But t does not rake suspension the larong. order Wf tis hecwse right. The reputation of the Drofesion ts more umportant than the fortunes ot any indvidual rember. Membership of 2 profession brings many benefit, But thats @ par of the pre” iss Carssfrisk, when I draw her attention to this passage In Bolton, suggested that testimonals should not be accordad susstential weight and cerehly shoud Tot produce lower sanclon than thet whizn would otherwise have been oprecriate Testimonios inte case of 9 doctor can go much forthe: thon it The {ase ofa soletor since they can show that he has teen and ly art from the Imseonduct in issue, 9 thoroughly good doctor. Its dearly inthe pooh terest That doctors" who ‘are competent and. for whose skis many ‘aaients. re coleagues ave nothing Dut praise should ‘nat be preclded trom practice latogether if that can be achieved with no. danger to’ the public ard mith no Gamage to the reputation of the profession. ‘So much wes made clear bythe Privy Counc in Bj General Mecca! Counc! [2002] Lloyd's Med Rep 60.” The serious professional misconduct In that case arose Irom 9 falire by tne appelant {o stay witha patent when ne consiered thet he, 9 De surgean, hag corpleted Fis part af the aperation but the Patent was"sil in's serous condition, The Datlent died snd the appeliones conduct was righty" castigated ot "sriouny ‘rezponsible and » grave neglect of proper professional standaras'. There wa, 0 ‘uation, a real concern that Me Mad'b continuing lack of insight m that iehoogh he accepeed that he had mace an error.n leaving the Postale ed ast seem fo Bpprecate tnat ne hac a continuing duty to do his vimost to ensure that the Batient ved and could rat place that burden onthe shoviders of the Snaesthetst. th paragraphs 13 and 34 on page 62, Lord Holtmann said this = 15fun aa ae se adi ea case fete tee Pa ‘Sikeston cosa ane ed Re So “The Committee was rightly concerned with public confidence in te profession and its procedures for dealing with doctors whe lapse fom professional standards. But this should nat be carried {0 the extent of feling it necessary to sacrifice the career of an otherwise competent and useful doctor who oresents no dander to the’ pubic inorder to satisfy a demand for blrre and punishmert [AS was sald in A Commitment to Qualty, A Quest for Excellence, ‘recent statement on behalf of the Government, the mediest profession andthe National Health Serve he Government-the-medial-profession and-the NHS-pledge without lessening commitment to safety and pubic acountabity SF services, to recognise that’ honest. faire should ‘ot be Fespended to primary by blame and retiouten But by learning ‘nd by a dive to reauce risks for future patents. ‘The Board, a6 their Lordships said atthe outset, is relvetant to Substitute HS own views for those of the Committee on the appropriate penalty. In the present case since Mr Bi = aged $6 frasure means the end of his medical career. The. Commitee have not ‘expressly’ sald. why” this, the maximum aentenes valabl, was necessary in tis ease. So far or they clearly {thought this was 2 serious lapse which they descnbe asthe ‘Appelant abandoning his patient when her condition was stil Serious, thelr Lordships entirely agree. However the Appellant Becepted that his decison to leave the hospital was ceeanty 5 Imistake, but as already mentioned, he cleo determined never {0 make that mistake again. Their Lordships note that there was {period of over four” years between the operation and. the Committee's “decision. When these "serlaut” charges were Dutstanding, Ouring that time Mr Bill did succeed in obtaling employment as a locum consutant urologist nother hospitals, Without 30 ar as appears any complaint about the standard of hs work, While giving great. weight to. the ‘udgmert of the _Commetee their Lordships fel aieuty in the ight of theses Circumstances in being satisfies that erasure involving a complete Cessation "of Mr Bits medical. work was necessary when Suspension withthe possibilty of imposing detaled conditions on his corying on practee Is avelabe™ “Those observations are of general application 1t follows that in my view testimonials ean In the case of doctors be accorded greater weight than In the case of solicitors. The requirement of absolute honesty fo that there can be absolute trust in a sollctor Is obviously oF parorrount importa. That he may be 2 good solicitor is ebvieuly something to be Taken Ineo aezount, but the public interest in tir being abe to conte In practice Ve rot so important. Thus testimoniats which estaish that coctor i, inthe view Gt eminent caleagues ard of nursing sta who have worked with im, one who 1 hot any competent but whese loss fo the profession and ta his potential patients would Be serous Indeed can, In my opinion, be accorded substantial weight { must now consider the misconduct which was establishes in more detail, It has fed the Counc to submit that Professor Southal abused hs professors) postion by, m effec, misusing his eminence n the feld of chi¢ abuse, that he violated odors Imposed by the Trust under which he was having Yo Cord Miself at {the time, thathe nad shown no remorse and #0 lacked insight that whet he hod 16len Amr ses ea ole eminent v. done was wrong and that a message aught to have been sent tothe profession that such conduct could not be tolerated. The only result in al the cvcumstances Muivch could nave followed the findings was ove of erasure. If that meant (@rotessor Southall being 57 years old) that he would never practise agai, "ae Sn inevitable and justfabie result of the serious profesional misconduct of which fe mad been found guity. The los of ns servees as 9 hrt class poedatrican ‘nas unfortunate ut was a price which hoo to 36 paid in the ight of his ‘misconduct and in particular bacause Ns arogant atitude that he was "gh 9nd, Aespite the findings made against him and his tnowledge, becauze of matters put to him Invcrose examination, that his theory that hr Clark klled his sons wos Senously owed, ris falure-to aezept even that he-might be wrong showed that there was 2 Peal danger that he would do something smlar fin he work a 8 Baediatrican, he came across a case which ne beleved Indicated child abuse, ‘Thus to impose the condition dd not adequately prtec the puble since Me hod areaay breached a similar condition in acting as he had and certainly ais nat Send out the rght message to satisfy the publle that they coula be sure that there was ne nsk of irresponsible reporting of sileged chi abuse 1 have referred to conditions imposed by the Thst. Those resulted from ‘ompisints made of rafessor Southails conduct in inter ai dealing with Cnla Shute, in particular In elation to his use of covert video recording which hes emonstrated. abusive “conduct by some parents, The. allagations, wore Investigated in depth and were all found to be without substance, Ther Felevance les in the fact that atthe material me the slegatons were stil Deng Investigated and the Trust had requrea him not to undertake any cl protection ‘work unless. he ‘ecved wertten_ confirmation from the then Acting. Medical Director, Dr P.M. Chipping. On 3 June 1999 he Nad been tld thet he should not Undertake any further category tl work without Dr Chipping’: express wien authorty. Category it work is Wark outside the ANS. On 18 October 1999, OF Chipping wrote in these terme "wate to provide further clanty in relation ta your agreement to comply with the Trusts request In ceasing work on ny of your irrent child protection cases [As you are aware, the Trust has made their request on the advice (ofthe inter-agency review panel. Unt the pacel are sta stage in {hs inquiry to vise atherwise, your cmpllance with this request |S required. 1 will wre ta you to confirm f the postion changes, Unit you receive written confirmation from myself, you should ot Undertake any protection work He was also suspended from his duties with effect from 3 December 1999 Decguse of the serous nature of the allegations, unfounded though they were subsequently recognised to have been linen she gave evidence atthe hearing, Dr Chipping sald that Professor Southall ‘ought to have asked her permission Before contacting the police about his {Concerns falowing the television programme, She hai wrtten to im on 12 Dune 12000 making this point, saying, mtr alia, that he had “potently put yoursc fang tne Trst ma Very imate postion’. However, she accepted that, ihe had informed her, she would have contacted the police to enable him to "aise his Concerns and, no doubt, to ensure that the pole Knew of his suspension sithough they Pad been aware of tnat in any event. Professor Southal's excuse ‘or nat informing DF Chipping or aking Mer permision was thet he was not acting 438 an employee of the Trust but as an informed indwvdual. Tt was, a8 he put Ie Inetner category Tf work nor acute hid protean work ofthe kind f was dong 17cane agen econ nnn Cope tenn na ota ‘gum sma toaec coarseness lence 1. in october when asked to stop. This was something :ompetely diferent to those tho iebues”(Franscript Ony § p.248G), That excuse fs unimpressive and no more than soahistry. His actions in this IRepect ware regaraed by the PEC a precintate ord 40 they clear were. In ‘Seaton, to have reled on the contents of the televison programme and to have resented tothe police theory as fact was properly regarded es irresponsible, but the fact that he had reported his concerns and the manner in whch he ed presented them were not regarded as an sbuse of his profesional positon ‘he abuse'of te professional postion arse-from 9 report that he produced on 30, ‘August 2000 af the request of the solictors acting forthe guarcan ad item of Cia Anis conclusion was expressed a5 follows: = “1 was stunnes when watehing ths television programme since t peared extremely ikely F net certain to me thet Mr Clark must have sufocated [cf i te hotel rocm, I fel that the police had Deen mised into believing thet Mrs Clark cova have suffocated {] betore she left the hotel and that the subsequent bleeding ‘was 2 celayea consequence of this. My expesience with cases of Intentional suffocation, where there was nasal or oral bleedin, Goes not concord mith ts view of the expert advice given tothe police, From my experience the ieedhg always occurs Simultaneously with the procsse ef intentional suffacation, T was ‘ware of ted child inthe family wn could be Teceving care from Mr Clark Conseguenti, Une next mering, I contacted the Chia Protection Divison of the Staffordshire lice to "por my 5 feel that every event subsequent to that inthe hotel should be Fesexamined with this new evicence 9 Mind. 1 remain convinced that te third child in this fori is unsafe in the care of Mr Clark | suggest that all of the remaining film work undertaken for the ‘ispatenes” programme but not shown be examined “rasically» considerable time has now elapsed making the task of the palce in rechecking Mr Clark's allo for te Mest_death very samen, 1 declare that the contents ofthis report are tre and that they may be used In a cour flaw" Following this, he received an e-mall fom Profesor David, who hao & “Considerable interest dnd expertise in shaken beby synarome (anion hag. been ‘ginaly said to have been the cause of at least one af the chiens” death) and ‘ino was involved es oh independeat expert to give evidence tothe court ithe Care proceedings. Ths e-mail so far a5 material sted: ~ My question is simple. Oo you accept that Is possible that there's either medial data, of reurstantial ata, or both, tht {ould im Tact largely or even completely exclde the possiity that Mr Clark kid ether of his children? 18‘ature ct ae a baton net ae he 1 eal I have to ask this question because newhere in your report ‘id you say something ike These opinions are based an the very Imed date avaiable to me in the televisor programme. have at had the opportunity £0 study the papers in ths case, and f Inconsistent withthe apinans expressed here My guess Is that you 4d not insert a caveat like this simply because you were In a hurry to send It of, but of course tis possible that you take a much sfonger view. I want to make = = fore-that I fairy and sccurstey represent your opinions, and hence this e-mail 20. Professor Southall nad nether the sense nor the humility to accept this Wfeline Ins reply, he sal this. = “ty onty smallest reservation relates to an extremely unlke'y prospect that bath parents are implicated im the deaths. f hove fever seen this and therefore rejected Thus there can, I my pinion and beyond Feasonable coubt, be ne explanation for the Spparent life threatening evert suffered by the frst Baby which ‘would account for the bleeding other than that the person with ‘the baby atthe time caused the bleeding tough the process of Intentional sutfocatan. The subsequent urexplained deaths of the batles with other injuries makes kely beyond ressonsble ube tat Me Clark was responsibe. Im not used to ghing fpinans without all ofthe evidence being made available and Yee! ‘oinerable aver my repor. However, based en wht I sow in that ‘ideo alone and my discussions with the 2olice offer, socal ‘worker and guordian, [remain af the view tht other explanations Cannot hold, The evidence of the family end fs parteury [And, atthe hearing, at the outst of his ctss-examination, Professor Scuthall ‘matoained his view that Mr Clark had lls both the dren 21. As is the practice in the GMC, the charge against Professor Southall was broken ‘down into @ rumber of allegations of fact and of cancusions to be derived from tose facts. Te convenient to set out what can be dosenbed asthe charge sheet Inva ay which shows whet was admitted and what, having been dened wos found proved: “That, being registered under the Medical Ac, 1. In November 1999 Sally Clark was convictad of the murder of two of er cigren, {C) and (Hi Clarks ‘Admitted and found proved 2, On sbout 27 April 2000 you watchee the “Dispatenes” Brogramme about the Say Clark case thot was brosdass on Channel # television hat eights [Admitted and found proves 3. Asa result of information gleaned during your watching ot the programme, on the next day You contacted the Child Protection 19Unt of the Staffordshire police to voice your concerns about how the abuse to [C] and (H] Clark had in Yack ocurred ‘Admitted and found proved 4, As 9 resut of sueh contact, an 2 June 2000 you met getectve Inspector Gardner of the Cheshire Constabulary, the senior Investigating officer inte the deaths of (C] and (H] Clark, and in ttc tla him that, 282 result of watching the programme, You ‘onsicered that 1. Stephen Clark, Sa Suflcated hs on {C] at 8 hotel peor to hs eventual death, », Stephan Clark wes thus implicated in te deaths of both (C] ‘and (H) Clark, there was thus concern ever Stephen Cark’s access to, and the safety of, the Clarks thre hl, Cd 8; ‘Admitted and found proved 5. At the time of meeting Detective Inspectar Gardner, you ‘2 were not connected withthe case, ‘Admitted and found proved made it cear that you were acting in your capacity a8 a Consultant paediatrician witn considerable experience of ie Ehreatening chils abuse, Aamitted and found proved were suspended from yaur duties by your employers, the North Statfordshire Hospital tust ("he Trust), ‘Admitted and found proved 4, knew that was an agreed term of toe Trust’ enauires that led to such suspension that you woulé not undertake new touted chid protection work without prar permission of the Dating Meaial Director of the Test, [Admitted and found prove 4. had not sought permission of the Acting Medical drector porto contacting. the Chil. Protecion’ unit of the Starordenie Police and mesting with, Oetecive, Inspector Gardner, [As amended, admitted and found proved raed on the contents of the “Dispatches” television programme asthe principal factual source fr your ances, ‘Admitted and found proved Clark's husbard, had deliberately 20oy eSransateicterreta, 4g. had 2 theory about the case, a5 set cut In head 4 above, hat you presentes as fact as underpnned by "your own ‘Your actions 9s described in heads 3 and/or 4 andar S were ‘2. Preciptate and/or, bi irespansbie and/or, Denied and found proved in relation fo Head 5, but not proved in relation to Heads 3 and 4 an abuse of your professional poston; Denied and found not proved In relation to Heads 3, 4 7. On 30 August 2000 you produced a resort on the Clark family Si the Fequest of Fornaws, Sobeitors ‘Admitted and found proved 2, At the time that you produced your repart you {bie not have any access to the case papers, Incuding any ‘eciesl records, "laboratory investigatens, postmortem ‘eons, medial reports or 0/2; Admitted and found proved Us, Had not interviewed either Stephen or Sally Clark, 14 found proved Your report conetuded that |. Te wos extremely ely if not certain that Mr Clark hed Sutfcated [C]in the hot! room, ‘Admitted and found proved 1k You remained convinged the third child of the Clark famiy, Chia Ay wos unsafe inthe hands ct Mr Clark, [Admitted and found proved Your report implied that Mr Clack was espansibie for the eau of his two eldest ehldren (C] and (4 [Admitted and found proved 24dena Ags ince année ‘SiS acaoy 22, 4, Your report was thus base on a theory that you nad about the case that you presentes as fact as underpinned By your wn research, Denied and found proved ‘2. Your report declared that ts contants ware tre and may be Sued in >. cour of law [Admitted] whereas i contained ‘matters the truth af which you could nat have known or did Denied and found proved Your report contained no caveat to the effet that its Conclusions ware based upon very limited information about the case held by you, 45, When glven the opportunity to place such 9 caveat In your Feport you declined, by faxes email dated 11 September 2000, fn the Basis thot even without oll the evidence being made be to you Ie was bkely beyond reasonable coubt that Mr Clark was fespensibe for the deaths of his 2 other chlcren; ‘Admitted and found proved 8. Your actions as described in Hesd 7 above were individually ‘and/or callectvely Inappropriate and/or, b leresponsibie andor misleading and/or, <4. an abuse of your profesional positon. Denied and found proved ‘And that in relation tothe fects alleged you have been guity of ‘Serious professional misconduct Denied and found proves ‘The submissions made by counsel who, as he pointed out, represented not only fhe GMC But ai Me Clark, In felaton to penaly were clear and unequioc rothing shor of erasure would be epproprate, Senaus heads of charge were 7" and g. Professor Soutral’s value to admit the Eensequences of his acceptance of the faces set out In 7h and 9 showed, Teas ‘aid, 2 complete lack of insight into the 9 continued (Transcript Day 8 p.4620)~ “ie follows, we woulé submit, that a doctor who has ne Insight, and who arrogantly continues to believe thet hel igh, 19 very ongerous deetor. This especialy so where, as tere, we have fector who practices in the extremaly aenstive and ‘mportant He submitted that the most frrors that ne had made. He 22ate sacha ea bain epilogue ‘Sette tesa 23. 24, field of child protection. Ths is a feld where, largely on a consultant paeelatician’s sayso, families can be spit asunder of patents can be convicted of very sereus crimes agains their Eden. ‘That in my brief anchyts of the Greumstancas of the background leading tothe fats fours” Further, there can be no doubt that Professor Southalls report had breached the ‘guceines for mesical experts in cour proceedings and hed failed to have proper ‘egard tothe need far caution in advising that a particular event had taken pace. Further, he Rad for no good reason faied to disclose that he had spoken to Professor Green-ang Professor Mendov over the-telephone-and had obtained what he regarded as important information from them which fortified him ia’ hit [Apart from the specif risk to children and, more partially, to thelr parents oF {pre's shawn by Professor Southalls misconduct, there was 2 wider sve ot Dubie confidence in hig. protection srangements, While fe is Important thet hirer who are being abused should be protected and indications of abuse Should be carefully and thoroughly investigated, tis important tha famives Should nat be torn opert 9s 9 result of mistaken diagneses. That is hardly vn 8 Ehid’s best interests, Counsel put the general issue in these words (Transcript ay 8 posest-sse8): “Public confidence in doctors, especialy in preciatricians, correct identiving rue cases of abuse, ls, we would aus, fn Some sort of 2 cris. We would submit that he only oy of Festricing public confidence (and, incidental, getting. more Paedstrilane: tobe Involved in ‘tha. senate, aiMeui ond Important work) is Tor ths Commitee to take rong, effective 4nd. publ action against psedlatreans, such as" Professor ‘Soutnall, who have been found, the wording of head of charge 8, to have behaved inappropriately, iresponstiy, misleedinly and fo have abused thee professiona! portbon” hie f am not convinced af the valdty of the point made in parenthesis, the {eneral Sentiment it one which hos very coniderabe ore, Counsel further drew attention to the Indicate Sanctions Guidance. Miss Cass Frisk also relied on matters set out Inthe Guidance, submiting that, they were Folowed as they should have been, erasure mas the only appropeate penaky Paragraphs 10, 11 and 12 describe the purpone of the PEC's sanction in these words “10. The purpose of the sanctions Is not to be punitive, out to protect patients ang the pubic Interest, although fey may have s LL. There 15 clear judidal authonty that the public interest ‘rcivdes 2. The protection of patents 2. The maintenance of pubic confcence in the profession «Declaring and uphalding proper standards of conduct 23dessa tem 2s, 26. arene nce ea tne ase fe ei haa Pan ree 12, The public interest may aiso include the doctors return to safe wor ‘Te only gloss 1 would place on those overarching pincpls In that protection can ntend, in appronriate cates Devond patients Yo those who are diecty adverse, Secieg by the doctors actions. Reference is than mage to the need t0 have Tegard to propertonaty in balancing the interests ofthe public against those oF the practioner, bearing in mind any mitigation which might be put before the ‘The guidance sets out factors specifealy said not to be exhaustive whose Presence may make a paniclar sanction appropriate. The sanctions are Set Out, ecoure that ic the way the statutory provisions reyure the PCC ta approach ‘sk, in reverse arder of seriousness, They are reprmand,conaitions imposed On ‘registration, suspension ang erasure. Under erasure thst spi = “this sanction is tkely to be appropriate when the behaviour Is fundamentaly incompatbie with being a dader and involves my afte feilowing (this ist snot exhaustive) ‘+ Sericus departure from the relevant pstessional standards {8 st out Good Medical Practice. + Going serious harm to others (patents or otherwise), ther “deliberately or through incompetence,” and particularly where there's @contining risk to patents, + Abuse of postion/st (particulary Involving vulnerable ‘atiets) or violation of the nghts of patients, + Offences of @ sexual and/or violex nature including Invelverent in child pornegrapiy. + Dishonesty (especialy where persistent or covered up) 1+ Persistent lack of Insight Into seriousness of actions oF Mss Carss-Feisk submitted that four out of the six bullet points were involved [that isto say all except offences of @ gexual or vident nature and dishonesty). ‘he abuse of postion arose because of Professor Sathal's expertise in the fed oF chid. protection and nis reputation. The pole were (to the. Detective Inspectors ereelt) unimpressed by Professor South's allegations, stating thot they ilustrated "Row a welrmeaning but seantly iormed person can theerise [bout what etually happened”. aut the Socal Services fe, understandobly, that they could net be ignore, particularly 9s they involved very serious allegation, ‘aiseg by a Consultant Practitioner with extensive experience in the fet ot Me: ‘reatening chi abuse in infancy” Fortunately, was not felt necessary to remove Chi A from nis father’s care Ik was accapted ~ or rather, the contrary was not arcued ~ by counsel before me that suspension war notin the circumstances a senile ternative to erasure. there was to be acholee, it Iay Betwoun erasure and conditions registration, Tht twas essentially because suspension could be for 8 nokimum of 12 months and there was mited scape for subsequent conaitions to be Imposed ar for an ‘xtengion of suspension. What mas needed {if anhieg shor of erature wae Spproprote) was a condition which precluded Professor Soutmal, atleast for 2 24Eescrri-rir arD eon eb ea a Pt eo For Sa 28, substantial period, from involving himself In chi protection as opposed to treating indivgual sik ehgren, “he Guidonce says this about conditional registration: - “This sanction may be sppropriace when mest oF all of the following factors are apparent (this lst snot exhaustive): + No. evidence of harmful deep-seated personality or + sentifiabe areas of doctor's practice In need of besessmentor retraining. + No evidence of genera incompetence + Potential and wilingness 10 respond. pestvely to retaining. + Patients wil not be put in dange” either directly or indirectly asa Feout af Conatonal regstration tse ‘+The conditions wil protect patents during the period they are in force + 1 is possible to formulate appropriate and practeal conditions to impose on registration” Conaions are ssid to be inappropriate since Professor Southall nad already broken the conditions which the Trust had imponed and there tz no reason t0 Delve that In 2 case vinere he beleved abuse Red eccurred he would not do the ‘ame again. Further, sie he remains adamant that he was Maht and has shown foremerse and no anion is sad tat he has ra ionght nd for that reason {oo there i reo nak of futher simir offering, Dr Chipping te addtion eo her evidence to assist the PCC in its fact finding fxerose, gave evidence on beholl of Professor Southal in migaton. She Explained the system whieh Med been put in place since Professor Southal’s ‘etuon to work with the Trt in Oceber 2001, once the allegations against nim ‘arien ha Tea to his Suspension had been rejected. He was limited to paediatric Shork ona, fhe care oeross what he Seleved to be case of abuse, he was tO Contact the child protection officer on duty ond should nat invelve himself further ‘nis system had worked well.” These questions and answers are important (Transerst day 8 p.a3tF-c): = Q, So far as Professor Southall I concerned, has that structure ‘ffectively prevented him from doing. what may be called, ‘generically, hid protection work? [A Yes. hat has happened Is that If Prlessor Southall has ‘Concerns that ths might be a child who hes Seen abused, he Seary instructed to contact the Trust child grotection coctar on fall at that time. I have In "act Spoken Just yesterday with the Trust's ehils protection doctor, whe happens, also, to be the head of avision for women and children, whieh is Jost slightly obove {he lineal director This indwduel confirmed that there Is 3 very robust system at work) and that approprana aterais have eon 25gunn ge ec eases Srton te ects ne ‘eat coed ald Rb 29, 2. received. She is confident, as I am, that this system has worked ‘busty Are there any breaches by Professor Sotho? Aer “while OF Chipping accepted that it would not be posible forthe Trust to control what private work Professor Southall chose to do autsige nis working hours fr he Trust she was anxious, If possible, not to lose is "very considerable onerbutoh to. geneva! BBBBiatric work” "She-recignised that, es-one ot the fminent doctors who hed writen testonisis had tig, Professor Southall wos ‘unprepared to view things as 9 spectator he considers tat certain aspects have faled to receive the attention that they deserve’. Nonetheless, she wos confident, naving regard to her experience of working wth Professor Soutall ‘when subject to the condition preventing Rim from engsging a child protection Shore, that he had accepted and would, Nonever pala! lt wos, continue to secept {he restrictions. He recognised thet she would be the fist to report hin tote [Gli there were any breach ana that erasure would then be viusly autora In adation, she meade the point that what might be sean as a weokness In cd protection work appeared to be a strength in genera paedistric, since Professor Eoutnirs cetermination to. arrive at an’ eparopite in ‘rough, wal thought through and detailed dagnosbe work 1 Chipping was azo asked about Insight. She gave this answer (Transcript Oey Bpaaeh. “1 would not subscribe to the fect hat he does not have any Insight. T think Me has good Insight, but I tht he fe@ man wh does not cnange Ns mind easiy, and 1 thine that ls 2 sightiy fiferene ening. One of the things thank | am sure wil have come ‘ut inthe testimonials is that Professor Southall fe actualy a man fF great principle. He wil not change his ing i he does not {hrc his ming should be changed. Goes he tave an insight Into the impact he has on others = I think he probably has # etter Insign than he dd eater nhs career, yes" [ean understand the distinction being drawn, but a refusal to change his mind espe creumstances which shoul tell reasonatie person that hit wien Ie \erang isa serous weakness which can lead to 9 risk t» pationty and others nthe Same way asa lac of insight. Nonetheless, the PCC esrd sd saw sod wos able to evaluate the evidence gWven by Dr Chipping and to attach, I I 80 chose, Considerable welght to ‘She had worked closaly with Professor Southat fot eary 3 y8ers during which Ne had been prevented ‘rom eoing ehid protection Work. She telleved that any risk to patents or others was ieignficart, That tras a view which the PCC was ented to accept, parlelary If suicentiy ght Eoralvons were imposed since Professor Southall would know that any seach ‘woul, unless there ware wholly exceptional cumstances lead to erasure, Apsence of remorse and contrition iskely tobe indicative of lack of insight oF sfrmaintenance of unreasonable views. In eter event may show thats ok oF repetition exists. This i dearly relevant in deciding onthe aporoptiste seneton, But lace of remorse. should nat result in 9 higher sanctan ss punishment Punishment may be an inevitable effect of whatever sanction Is imposed But ‘must not ean element in deciding what's the sppropriste sanction, The Sco Imust deege whether the Fisk of repetition does realy exat, Proviced that they. have property considered al the relevant creumstarecs and have hed fegarsaun Asc bean td ape re et ater Pai ‘ee ens ne Ri Set at the correct princples and have reached a conclusion which is ze reasonable, {this court wil ot Interfere, Furthermore, the Guidence ls Just that ond i does ot automatically Yolw that erasure must follow i ry ofthe Bullet pots set out ‘pr. The overarening principles must be taken ite account and they neue 3 ‘econnition thatthe public terest ay. despite a ring that he haw Rea git oF serous professional misconduct, Inecate that a doctor tnould be tbe taeturn to ‘safe work. And the conduct must, i erasure 8 to. be justified, be ‘nasmentaly incompatible with being a doctor In that respect, 1 agree with 11, [do not propose to set out the PCC's conclusions at great tength but merely to Inghight heir more important observations. They emphasised the faire 2 make. an ‘adequate assessment of Cid. A and Mr Clare actors or to take Feasanable steps to very what he put his repert of 30 August 2004, Ths wos ‘contravention of the GM's guidance contained ins publication Good Megat Practice. They continued: = “The Committe do not believe tna you dé tate reasonable steps betore you signed the report on the Cark care. Your fallure to rere to these princples resulted in substnwal stress to Hr ark snd his famiy at a tine when they were most vulnerable ‘nd could have resulted in Onis A'beig taken back Into care Unnecessary 9nd Mr Clark's prosecution asa reslt of you false ‘tegation. The Committee are concerned thal etna tine during {hese proceedings have you Seen fk to withdraw those alegatlons orto offer any apology" ‘The PCC had also pointed out that Professor Sovtnal’s view, based on what he had sean inthe television programme, coupled with hi undisclosed conversatlons With Professors Green and Meadow, was @ theory whieh had been presented ot Bea theory but ass near certainty, 32, The PCC retired to consider what to do in the aftemgan of the eighth and tured in the afternoon of the rth ay.” This wes e lengthy consiceration They must have appreciated that erasure Could not have been regarded es too Severe or the serious professional misconduct which fad been found proved. ‘As Wil be apparent trom what they sais (and {fer It wilbe necessary to set ou), {hey were very much influenced by the testimonials which had Been provided ‘They re Indeed mest Impressive 33. Professor Southall snow 57, He has been a consultant paediatrician since 1988. He has been responsibie for much research and Mos published many stiles, Including important studies in ration to ld abute. Between 1993 and 1995 he twas consultant hesith advisor to UNICEF Inthe former Yugeslovie, Ty 1995 he was involved Inthe setting up ofa charity, Chi Aavoeacy Intemational, whieh is Invelved in international child health issues. In 1998 he was awarded an OBE in Particular recognition af his humanitanan work. One ef the testimonials came from Professor sir David Hall the immediate pest president ofthe Reval College (ef Paeclaties and Child Health. AS such, he was aware of ahd advised the Trost {on and saw al the reperts relating to the investigation inte the allegations which had been made against Professor Southall and whieh had led to his Suspension bY the Trust.” Sir David was satisfied, ater considering the rgorovs investigation Inhich had been carried out into Ue allegations, that “notwithstanding the move he presents of single-minded enthusiest for hs research and forthe protection if chdren, no major criicam could be leveled a him any ares of his practce He concluded thus 27agua gett eases Sort ctxt tear tt Davi Southall is an unusual man, single minded and totaly committed t9 what he wants {© achieve. In 9m era when many aediatreians ‘are extremely reluctant to get Involved in child bose cases, oF stand ut agolnst the tide of opinion, for fear of compiaines against mem, ne ll do wnat ne Seieves Co De Pgh vithout counting the cast to himself. "We need people like Nim ‘io challenge perceived wisdom, tes new ideas ane suggest new Spproaches. They are rare, RGPCH recently published a survey showng the escalating number af complaints against paediatncans ataut chia protection work and the unacceptable vacancy rate for paediatric chia Protection posts,” paediatricians Rave been attacked verbally, {hveatencd physically, emonised In te press, and referred to the [GMC for dlagrosing ‘child. abuse ~ and for missing David Southall is widely respected, as one ofthe few men who has had the courage to stand up to these attacks and keep on working in the Meld Hs grforced retvement fom the scene would ave atastrophi effect on paediatric mora ‘There were in sdlton tributes trom colesgues and ou'sing staf to his excellence 4 poeciatrican and reference to leters trom parsits of hicren waom he had treated expressing thelr gratitude for what he haa dove for them, 34. _Imexpaining why they were deciding 60 the sanction sf imposing a condition, the “in considering whether to take action In relation to. your registration, the “Committee ‘nave considered the” issue of Preportonaity and ave belanced:the interests of the public Sains your own. The Committee “have given care {ansderation to the submissions made on your Behalf and [Sena of the GMC and Mr'Clark Te nas also Considered carefully the GHC's Tecieative Sanctions Document._‘The Committee Nave been-extrely imprassea by the vast number of and the gualty (of testimonials that have been put Before ther. Tes cleae from ‘the testimonials that you are held in the highert esteem by Your professional colleagues. both in the. United “Kingaom ‘and Ineermatonaly. They al testify &o your outstanding cima skis nd unparalleled commitment to the welfare of chicren all over the word. In partcular wa have noted the comments of Professor Sir Alan cra, President of the Royal College 3f Paediatrics and Cia Heath (RC2CH) who states that there Pas been mo douDt that you have been on acedemie leader and that you have Undertaken extremely Important 97ound breaking researeh which “has greatly Influenced the way tat bables and chien have been managed allover the wort. The testlmoriols deat with not hip your research work, but aso your work pacdiates 3d hid protection. There are many references 19 your snetintng Invelvernent in the care of seresly il chilgrer both within your wn Trust and wider ofl. Your colleagues have testified your ‘ingress to help them when faced with ict coses no matter the personal cast to yours. The Committe have also hear land ave been impressed by the fact that you set up Chie ‘Agvoceey international a chartable organization which helps ord promotes the welfare of ick enidran in less pivleged parts of 2823. the world. The Committee notes that prior to this hearing you hove more than 20 years of unblemished medical practice, ‘The Committee have taken into account the evidence of OF give an oral testimony on your behalf. Or Chipping stated thet Since your return to work In October 2001, y>u have only worked Inthe area of general paediatrics and that you ne longer involve ‘yours n paediate intensive care or Indeed in chi protection ‘The Committee nevertheless concluded that the findings against you reflec 2 serieus breach of the panels of Good Medial Practice and the standards” of conduct, woich the publ. ntled to expect from registered medial practitioners and toe Committee therefore fea! obliged fo take ‘ction in the public Interest. In aching tis conclusion the Committee have borne Is ‘ming the Privy Counel Judgment in the case of Or Gupte (Priy Counai Appeal No sof 2001) which states tha “The reputation of the profession is more important than the fortunes. of any. individual member. Membership of 8 Drofession beings many bendhts, but that Ts part of the In considering what action to take against your registration, the Committee recognise that taking ne action and’ concluding ths {ase with 9 reprimand would be whaly napprepiae. In the circumstances, the Committee have concluded that In your ‘own and the pubic interest ie must take ection regarding Your Feajstraton. Based on the fingings on facts tis ease and Your Spparent lack of insight the Commitee have decited that it would Be inappropriate for you to contnue witn cid protection work for the foregeeobe future. Theretore, the Commitee have deeded to Impose the following condition on your registration for a period of Sears: 4. You must not engage in any aspect of ehié protectin work etter within the NHS. (category 1) or outage. it (Category 1)” For Professor Southall preclusion from child protection work was a severe penalty. His reputation had toa great extent been buon hs pioneering work In this Nel 4nd ft must have been 3 hurilation to Reh to have been found guity of serious Brofessional misconduct in connection with ehié protection. "The PCC cid, os Ecems to me, have regard to al materal matters andt cannot ve said thet trey Imisdirected themseves. They ware, as I Rave alredy soi ented to consider that there was no rea risk thatthe conctionexciusieg him from child protection work would be broken.” The Naws disclosed by Professor Soutrails misconduct, Serious though they are, do not prevent the wew reesonsely being taken that they should not prevent him continuing to practise ae 9 paediatrician, provided Inst there i 90 Feat risk to patients or thers f he le petted to do so. Thus farasure was rot In my view an inevitable result of the misconduct which the PCS found provec. A reasonable observer would appreciate thatthe aanction ws fer im severe indeed ana tat it would produce a stficent deterrent eect ord ses Out the right message. a the testimonials shamed, Rwss inthe pubic Inesest 29juan gta ea ena ot Sittin inl sede sae Sa 2. tat Professor Southa’s great sklls as a paediatricin should not be fost If that ould be achieved nithout Sanger tothe public. The PCCs decision that could be achieved seems to me tobe entirely reasonable in al the circumstances, {sto prevent any involvement in chia protectin work. ‘The ACC sated that & Stould be inappropriate Tor Professar Southell to centnue with chid protection wore for the foreseeable future’ It imposed the maximum peried over which the Condivon covls apply, nemely 3 years, which is Rarely the foreseeable future. 1 fecognise that, a 2 result ofthe conatons imposed by the Trust, he had sieady teen prevented from Involving himaeit in child protection work in estegory 1 and Fed'not involved himself in any category i work sine September 2000. There's ‘Dower to extend the period Ging which a condition can apply: see Mega! Act 1989 s.2e(a). The GMC ete Rules Order of Counci 1988 (5! 1988/2255) paces some procedural constraints upon the exercise ofthis power. Rule 41(5) provides that, were the PCC has Gecided tht 8 practitoner's registration shal be subject ta conatons, they may. when anneuneing the clvection to give eect to such fetermination, inmate that they mil, a9 meeting “0 be hela before the end of [the serad during whlch the conditions are Co app] resume consideration a te Sie itn view to determining whether or not ty should then direct that the period of candional registration should be extendet or the conditions vared oF {hat the name of the practioner should be erased fram the Register if no 300% ‘intimation is given, Rule 37(2) provides: = “UW appears to the Chaieman of the Preliminary Proceesings| Commitee (the. Chairman’, a8 @ consequence of the receipt dorng that specined pares of information as to the conduct or onvieton of the practioner since the date of the direction five effect to the determination that the Professional Conduct Gommittes shoulscansiser whether oF not ~ (2) the period of suspension oF conditional repstration should be (©) the conditions should be vated or evoked: ot (e) te name of the practioner should be erased from the Register he shall direct the Solicitor to netfy the practitioner that the Professional Conduct Committe wil resume consideration ef the ase at such meeting as the Chairman shall Spec" ‘Tous some postive action \s requrad to ensble the matter to be kept under ‘eview and that s unlikely to happen unless the pracitioner has done something ‘rong, In the light ofthe fndings and the seriousness ofthe misconduct, t seems to me that the PCE ought to have given an intimation In aeardonce with Rule 315) tO ‘rable Professor Southal’s canduct to be kept unde review and for a easton °9 Seimede at the end of the thvee Wear period whether any conltion should be Imoineained, Isis thine the conditions could be draws mare tghtiy 20 tat tf ‘rage clear that al that Profesor Southall can co if he believes © patient may ‘ve suffered abuse and is in need of protection is ta resort his concerns fo the felevant child protection doctor. He must not Invaive himself beyond that Mor ea to inivence that doctor to take any parucularacion. Sven canatons must 30gna aaa tse ans Cape Regn tee ni ‘cients nea ES Fete be imposed in respect of any Trust for which he works and must equaly be applied if Pe does any Category IT work 38. Iefllows that 1 do not think tht to impose conditions upon Professor South's Fegatation was unduly lenent Erauure mas not reaoieds, Out tre PCS ad ny \iew show undue leniency in the form of the canditen and in fing to give oh Intimation in accordance with Rule 31(5). Ms Carae-frik has submited tha, sere to decide inthis way, 1 should nck devise condivans myself but should remit the ease to the PCC ta impose appropriate conditions following futher argument (oe, pernaps, agreement) by the interested parties I see the force of trisy but veil Rear counsel upon it 38. This appeat wil therefore be allowed tothe extent 1 have indicated 34INTHE GH COURT oF westICE coussscamns ADMINISTRATIVE COURT BEFORE MRJUSTICE COLLINS THURSDAY 1 APRIL 20, BETWEEN: THE COUNCIL FOR THE REGULATION (OF HEALTHCARE PROFESSIONALS. and = () THE GENERAL MEDICAL COUNCIL (@) PROFESSOR DAVID PATRICK SOUTHALL Responulents ORDER AND ON HEARING Moet Cansfeik QE an Pope Sik (nimel foe the ent, Monks ond fr sao! Cums forthe Vs Renn sl rae (i and ec Kany cans! ot Sco Resp, IT IS ORDERED: 1. the. ppl’ appeal allo dhe extent st ow a fa) the Fite Respondent do pay ne hid ofthe Appa costs, 0 be subset dete assent if age nd 1) there he dk or ct in cation the Seed Reape 1) af the Natoma Heals Serice Refi ade Respondkt of gis 20 323. The Sceond Respondent mst aot eget ane ape of ld postion wk ster shin the NS (Caton 1) oe abide i (Can Hor pera thee yan ran 7 September 204 dein he enti of his mil practice bute stn or ots the NS beens the Scound Respondent sod chethor lial rescnc-se) Fis any concer om dpe nse in elation ta pace chill ve luke (whether or ot hepatica hther king om any Fama intemal appeach eo him cocring il pret ns he mu ct repurt thate cocems a+ snom as posite tthe most seni protection doctor wring fr his empigce (rt the parson response fei prtceton tthe evan Ine primary ate st) ho eo cal ae the elvant ine (he “eid protection deta and ot tke any Gunter stp have any inns whatever in elation r vo any eomidration, eps oF aetons in any way connected such ceeent or iniate any commictons with osc inf any ‘ens whatsoever, tha chil! protection dacta or any oer person nly in clin to sch concer 5. Foe the reining hrition of eve contin, interes months staring from dhe de of this On, he Sood Respondent most poi tothe Fist Respondent fll dale of any exes (whether inslsing an indiden oe indy) in respect of which he has reported conceit aceon with 4 sue of altematively, comin that dete fave Be sich cases ring hat 6 ‘The Scvond Responncar mst infor his cure emplayr and any subsequent pe (oe reovant el pray care nf she exerce and ems 3.4 and 5 aon 7 Port to re S15) and cs S91) a (28) othe General Mee Conn Peciminaee Procsings Gommatce an Professional Conder Commiee Posie) Rls 194K, comsierton of the Second Responses case be resumed aa mecsing fa Finest Pectie al of the Fis Resp 9 be : 33ated by dhe Second Respondent, bf the cmd of the dese yout peso spin 3 above fr the purpose of consiing wheter to take Fer ston in relation tothe Seen Respordents retain, 2) The Secon Responden should be given reasonable novice ofthe date of the sumed hear 1) A seasomable tne Beton the resumed bering the Second Respondent hon provide the Fist Respondent with evidence of compliance wih 3-46 abo; and i pames and kris of profensioral elles a persone ‘of standing to hom the Hie Responds Retr may apply toe infomation as ta tke Scand. Respondent's ‘condt since dhe evan decison, PUSHPINDER SAINI (Coase forthe Appelant MARK SHAW QC. (Cosel forthe Fist Respondent) ANDREW KENNEDY (Cons forthe Seon ReportGeneral Medical Council FITNESS TO PRACTISE PANEL HEARING (On 13 November 2006 a Fitness to Practise Pane! will consider the case of Dr David SOUTHALL Registration number: 1491730 Registered Address: Academic Department of Paediatrics, City Goneral Hospital, Stoke on Trent, Staffordshire, ST4 6G. ‘This case will be considered by a Fitness to Practise Panel applying the General Medical Council's Proliminary Proceedings Committee and Professional Conduct Committee (Procedure) Rules 1988 ‘The hearing will commence at 09:30 at: General Medical Council 444 Hallam Street London wiwess ‘The case is expected to last 15 cays, DrJ Miton, Chairman (Lay) Mrs LLoyd (Lay) Mr MePariane (Medica!) Dr § Sarkar (Medical) Me A Simanowitz (Lay) Panel Memb Legal Assessor: Mr Robin Hay If you raquie any futher information or assistance, please cal Adjudication Management Section on 020 7189 5186, o vist ihe GMC website wivw.gme-uk.or, Ian emergency arises out of hour that may prevent your atendance atthe required lime please call 020 7189 586 and leave a message. We wil not be able to all you ‘back at the time, butt will enable us fo act on your messages soon as the office ‘opens the next working day. 52