[UPDATE 25 May 2017: Further blog post on this case here : Judge flags complaint on behalf of child against journalist who sneaked into hospital]
We posted a short blog yesterday noting that The (Sunday) Telegraph’s Christopher Booker had reported on a case involving an intelligent but physically unwell boy approaching his 16th birthday, who had been recently taken to a psychiatric unit, against his wishes, under the auspices of The Children Act. We said that the case was both puzzling and concerning. You can read our initial blog post here and Mr Booker’s original column “A gifted child in a psychiatric unit is madness” (scroll down, premium content).
We have now located a judgment (thanks to those who flagged it for us) which appears to relate to the same child, and it sheds a wholly different light on this case. As a result, we are very concerned that the Telegraph‘s piece is seriously misleading. We can’t be 100% sure that the case is one and the same as the one reported by Mr Booker, but we have cross referenced facts and details in the judgment and the article and are confident that either this is the same family or there is a very surprising coincidence of facts between two different families (we’ve set out the common facts below at the foot of this post).
As reported by Booker, the case is inexplicable and worrying. Ignoring the wishes of a “highly gifted” child, and removing him “forcibly” into a psychiatric unit, on the basis of some technicality about his impending 16th birthday. Removing his social connections by restricting access to the internet and devices, and cutting off his contact with his family. All pretty grim and highly unusual.
Sadly, the reality is perhaps more upsetting, but not in the way that Booker describes. That story is told in the judgment of Mr Justice Hayden delivered in mid March this year, in the case of H (A Child), Re (Interim Care Order : fact finding) [2017] EWHC 518 (Fam). Booker’s summary appears to represent steps taken subsequent to the delivery of that judgment, which are not at all inexplicable once you have read the judgment.
The judgment tells us in very clear and distressing terms that H is a young man who for many years has been exposed to the harmful behaviour of his parents, and that behaviour has jeopardised his physical and educational development and wellbeing and has put his life at risk. The judge summarises his findings :
- …I intend that this judgment should be made available to a wide range of medical practitioners presently and historically involved in H’s care. I propose that key staff at the unit should read it. I am determined that it should be placed on H’s medical records. I intend that H’s parents be distanced from any involvement in his medical care, physiotherapy or therapeutic support in order that H may be afforded the opportunity to assert his most basic of rights, his own personal autonomy.
- In order that my intentions can be effective and conscious that this is a lengthy judgment, covering a wide range of issues, my findings require to be set out clearly and accessibly. Thus:
i) The parents have misreported and exaggerated H’s medical symptoms, which has led to his physical and emotional harm;
ii) The consequence of (i) above, particularly the exaggerated gastro-intestinal pain, led to the unnecessary insertion or prolonged use of a Hickman Line which exposed H not merely to risk of short term infection but to the risk of liver failure in the longer term;
iii) M, through her bullying and bombastic behaviour has intimidated medical professionals and others, to the extent that she has confused and undermined their confidence in their own professional judgement. This generated a febrile atmosphere in which there was an elevated risk of clinical error, thus compromising H’s safety;
iv) In April 2016, both parents and on separate occasions, covertly tampered with H’s TPN pump. The effect of this was to cause confusion and alarm on the ward and jeopardise professional objectivity;
v) F has both directly supported and passively acquiesced in M’s distorted perspective of H’s medical needs;
vi) M presented H to the world as dying and inculcated in him a view that he was;
vii) The parents’ actions above led to H’s prolonged stays in hospital and denied him his opportunity for education and socialisation.
-
Again, in order that the point is not lost in the detail of the judgment the harm caused to H by his parents, protracted over many years, exposed him to significant harm at the most serious end of the spectrum, ultimately risking his life. [our emphasis]
What is perhaps the most striking line in the judgment is the quotation from the treating consultant (an expert in the connective tissue disorder that H suffers from who had “championed the cause” for H and his family :
- Dr Ninis told me, in powerful language, what in her view, the future medical/emotional/educational objectives should be for H:
‘[H] has been taught how to die, he now has to learn how to live’
Although the judge doesn’t use the term FII or factitious disorder (what used to be called Munchausen’s by Proxy), he describes this as case involving allegations of “misreporting, exaggeration or fabrication of the symptoms of illness“.
When one understands that this was a case of factitious or induced illness, and the judge’s remarks about the pressing need for H to be placed in a situation where he can develop the personal autonomy he has so far been denied, the reported move of H to a children’s psychiatric unit makes sense, although it is likely to have been distressing for him and his family. It can be understood as the logical implementation of the judge’s remarks at paragraph 98. It is quite possible that it was realised that the options for H were narrowing and that if H were not admitted before his 16th birthday he would be left with a more limited range of therapeutic options or less appropriate placements designed for adults, which would not meet his needs.
As Mr Booker correctly identifies, the decision to make the move for H will have been taken with his best interests in mind, albeit quite possibly against his clearly and articulately expressed wishes. The judgment tells us that H was separately represented in the proceedings, so those wishes will have been conveyed to and taken into account by the judge (assuming the move was sanctioned by the judge and not made after the conclusion of proceedings). However, the judge found that H’s relationship with his mother was “enmeshed” and he lacked personal autonomy, so those wishes may – unusually but lawfully – not have been granted. (For a discussion of circumstances in which the wishes and feelings of an articulate and intelligent teenager may have to be overridden, see the recent judgment of Mr Justice Macdonald in L v L (Child : Arrangements Following Treatment) [2017] EWHC 1212 (Fam) (19 May 2017), which involved a 14 year old girl suffering with anorexia who wished to return to live with her mother. The judge decided she could not.).
There is, as you might imagine, a lot more detail to the judgment than we have summarised above – the court heard from or read documents prepared by a number of medical and other professionals, and was critical of one expert and some of the care provided to H since his removal into the residential unit (you can read a bit about that here) – but the thrust of the judgment is that this young man has been seriously harmed by his parents and is at risk of that continuing, if something does not change.
It is important to note that the only source of information about what has happened to H since mid March (i.e. the move to a “psychiatric unit” is Mr Booker. In view of the way in which the case has been reported, we do not think it is wise to rely too heavily upon the way in which Mr Booker describes these events or the nature of the placement and its “house rules” (although some restrictions on visitors and access to the outside world are not uncommon for a period in cases of residential psychiatric treatment). So for example, when it is said that the mother has been told she may never see her son again, that may not represent an accepted or accurate picture – it may be merely be the perspective or report of someone Mr Booker has been talking to, or his own interpretation. The Telegraph cannot have it both ways – they assert Booker’s writing is opinion when we complain that it is not accurate, as if that offers some sort of immunity; we think it is therefore legitimate to question the accuracy of material that The Telegraph concede is only “opinion” rather than fact. If it is opinion however, it is opinion couched in the language of fact – and that is the source of the problem.
Mr Booker’s account then appears to be written from the sole perspective of the family, without any acknowledgment that there is any other perspective, let alone any acknowledgment that the court has heard and read vast amounts of evidence (including that of the parents who were represented by highly experienced and specialist leading counsel), before concluding that the parental perspective was completely irrational, wrong and directly harmful to H. For Mr Booker to peddle this “opinion” in the absence of any counterbalance is shockingly irresponsible and misleading. People who read the column may have been very worried by what was going on here, and it may have made the parents of disabled children in particular very anxious. We think it highly unlikely that Mr Booker was unaware of the existence or gist of the judgment, but his failure to give readers any information about the findings made against the parents (even if just to disagree with those findings as wrong) is misleading and completely distorts the reality.
We will complain about this to The Telegraph, and pursue the matter through IPSO if necessary. We consider the article to be a significant breach of the Editors’ Code requirements in respect of accuracy through omission. We do not accept that the inclusion of this material in a piece characterised as “opinion” should excuse the Telegraph or its journalists from the basic requirements of accuracy and avoiding misleading reports. This is a misleading report because it posits H’s situation as inexplicable, unjustified and heavy handed, when it is entirely explicable and justified in the context of the harmful conduct of H’s parents – even if one does not accept the findings or agree with the steps apparently taken as a result, there is no conscionable way of describing this as the “oddest“, “most troubling” case or that what has happened is “madness” without engaging with the very obvious rationale for what has happened since March, even if one still draws the conclusion that it is a wrong thing to have happened.
It is important to note that Mr Justice Hayden has published his judgment on the basis that H may not be identified. We have been sent various information which appears to identify H, but we are unable to publish any information which in our view may risk the identification of this very vulnerable young man. We do not think that cross referencing with Mr Booker’s article runs that risk, because it contains very little factual information at all, and none of significance that is not in the judgment (although it does of course appear to describe a further step in the care planning for H since the judgment was delivered). The important feature of Mr Booker’s article is what it leaves out.
Cross referencing between Booker and Hayden judgment
| Booker (21 May 17) | Hayden J (16 Mar 17), Re H |
| A boy who is almost 16 | H is male.
DoB provided, confirms H will be 16 shortly |
| Children Act best interests / paramountcy principle relied upon | H is on an interim care order (in March) and had previously been a ward of court. Interim Care Orders are made under The Children Act and the best interests / paramountcy principle applies. |
| Exceptionally bright child, won a place at a school for gifted children (before a period of home education), refers to linguistic ability (Japanese / Hindi). | Judge refers to child’s “vibrancy and curiosity of intellect”, “sophisticated powers of expression” (90)
H won a place at a highly regarded public school. Real academic potential (91). |
| Complex physical disabilities | Complex needs including a connective tissue disorder and orthostatic tachycardia – but “virtually every aspect of H’s childhood, education and medical treatment is the subject of different interpretations or impressions between the parties”. |
| Last year education ceased, removed from family and moved to a “respite home” (until last week i.e. mid May) – article suggests somehow required prior to 16th birthday. | In August 2016, H was moved from hospital to a residential unit (under the ICO).
Judgment confirms that a move in mid May 17 would have been a few weeks prior to H’s 16th birthday. |
| Does not have any mental difficulties (refers to intellectual capacity) | “He shares parents’ profound and…entirely irrational opposition to psychological support…. H will most certainly require it in the future”. (92). |
| Parents told may never see him again | I intend that H’s parents be distanced from any involvement in his medical care, physiotherapy or therapeutic support in order that H may be afforded the opportunity to assert his most basic of rights, his own personal autonomy. (98) |
Feature Pic : Ink Stained Wretches by Jeff Eaton on Flickr (creative commons – thanks!)
It’s a surprising the Transparency Project has not used its usual scrutiny in view that much of the judgement has used copious accounts of heresay?
Is not the whole point of this blog to level out the arguments from both sides yet there is an omission of a recommendation from the judgment of Sir James Munby (P) in Re A (A Child) (Fact-finding hearing: speculation) [2011] EWCA Civ 12 (see also: Re B [2008]
Is it such ususal practice to dismiss any evidence in the Family Courts and go almost entirely on heresay, as is seemingly evident in this judgement?
Art
We assume you mean hearsay not heresy. There is an entirely separate blog post we could write about the issue of hearsay evidence generally and as applied in this case – but that would be a different exercise than the one we have just performed. The issue is not whether or not the judge is right but the complete failure of the news article to even acknowledge the existence that there is any ruling of this sort at all (be it flawed, watertight or whatever). As it happens the judge in this case does quite a thorough traipse through the law on hearsay evidence and its admissibility in order to justify the approach he takes. Hearsay IS admissible in family proceedings and is often admitted. Although some hearsay evidence was admitted here, it’s not clear to us that the judge DID go almost entirely on hearsay as you suggest – his judgment contains references to direct oral evidence given by various treating staff, and the judge also relied upon contemporaneous medical and nursing records (although it is not clear that he heard directly from each of the persons making those notes).
If Christopher Booker had written his article saying that we should discount the judgment because of its over-reliance on hearsay we’d have far less to complain about. Whilst we might not agree with his assessment, it would at least be an acknowledgment that an alternative world view exists to his own and to that of the parents and would give readers a chance to make up their own minds.
Forgive my grammatical errors, quite correctly as you say, I meant “hearsay”.
So pleased you spared judgment on my “judg(e)ment!
Ah, the spelling of judgment / judgement is complicated and not uncontroversial! 🙂
A more recent judgment given about this case, on 19 May, has now been published on BAILII here –
http://www.bailii.org/ew/cases/EWHC/Fam/2017/1221.html
This appears to relate to intrusive and unethical behaviour by a journalist (not Mr Booker.)
We will update our post shortly.
Would these descriptions in the judgment not be considered a contradiction I wonder?? “What can be said for certain is that H has been diagnosed with a connective tissue disorder which is associated with joint laxity, bowel problems, pain and hypermobility. H also has orthostatic tachycardia. This, as I understand it, is a relatively unknown but, nonetheless, common condition affecting the autonomic nervous system (the blood pressure control system), causing an increase in heart rate on standing. It can produce a range of heart symptoms which include dizziness and blackouts, palpitations, breathlessness and chest pain. The condition can also be associated with hypermobility (high range of joint movement) which can cause joint discomfort or pain. Fatigue is often a prominent feature.” Yet in this Julie D has published; says “Yet again the mother describes H as suffering from serious illness. As those reading my earlier judgment will appreciate and as time has now borne out, H is not suffering from any serious illness. Those conditions which he does have are not seriously debilitating.” Looking up those symptoms and what they are in relation to sounds pretty debilitating indeed!
Hi Art,
The judgments are complex but i think Hayden J was distingusihing between what H had earlier been diagnosed with because of symptoms, some of which now seem to have been induced, and what he now actually suffers from, partly as a result of unecessary treatment. I agree with you, it is difficult to make sense of what has happened.
I would be interested in exactly how much of this case revolves around provable facts, because you slam Christopher Booker, but there are very real families out there going through similar appalling situations with their special needs children, where social services fabricate a case against parents and they lose their children.
Sometimes, a journalist like Christopher Booker is all these families have, to highlight the corruption of the system. I know of someone who has just lost their child wrongfully to adoption. A false case of FII was made against this parent. I have also just read an anonymous professional blog advising parents on what to do should they be accused of FII. That this incredibly rare behaviour called FII is being blogged about by a professional who clearly recognises the scale of the problem, says it all. This professional says at several points that pretty much anything the parent does will be seen as confirmation of FII. The criteria is designed to find parents guilty!
How on earth anybody in their right mind could say, that someone who is Gillick competent and has capacity should for any reason be locked up in a mental health unit for their own protection, because despite being Gillick and having capacity, they don’t know what’s best for them, it beggars belief.
“misreporting, exaggeration or fabrication of the symptoms of illness“.
Opinions made on the basis of what? The public are learning to question things they read because so many now have experienced the corruption for themselves. And it really is corruption. Parents with children who have medical difficulties, neurodevelopmental conditions or rare disorders, are extremely vulnerable to these false accusations.
Invisible disabilities especially, leave parents wide open to being misunderstood and misrepresented. So many times, children hide their difficulties in front of others, especially in the case of ASD. This appalling situation has been going on for years.
1991 article which revealed misrepresentation of abuse – with the issue having got even worse since that time. Six families, falsely accused of emotional harm when it was actually Asperger’s in their children: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1793147/pdf/archdisch00649-0033.pdf
It has been reported to Parliament and still it is allowed to continue. Why? Because when children have medical/clinical needs, it costs money. Professionals have an automatic parent-blame culture and want to deny access to those resources. Also to cover up medical/clinical negligence. So it’s very convenient for them to falsely accuse parents. There are hundreds of parents out there who have and are experiencing it. So much so, decent professionals are aware of it and organisations are producing advice on it!
http://www.ehlers-danlos.org/patient-support/your-child-and-eds/child-protection-and-ehlers-danlos-syndrome/eds-child-safeguarding-non-accidental-injury-nai-f11-munchausen-by-proxy/
http://www.tymestrust.org/pdfs/falseallegations.pdf
https://www.youtube.com/watch?v=XcRZo1vO53c A paediatrician speaking out.
I am disappointed in your article. I don’t think you should be calling yourself the transparency project because transparency should be used to expose wrongdoing and corruption, not make excuses for it.
We can only suggest that you read the judgment EJ. It doesn’t sound like a case of corruption. When we see something dodgy we say so. If something has gone wrong in this case we haven’t seen evidence of that.
I have tried in the past to post a Booker article where he was spot on but the Transparency Project failed to publish it!
Hi Ray, If you would like to alert us to this again please do, but if you believed it to be ‘spot on’ by adding identifying details about a case, you will understand why we can’t publish that.
I could read it. But I also know that judgments can contain completely wrong findings and statements. I know of two terrible cases this has happened in resulting in parents losing children, one a CoP case, so I cannot trust what is in judgments. Judges are human and prone to err. Judges can be biased. Judges can misunderstand medical situations. Judges rely on ‘expert evidence’ which can be wrong, because the people behind it can be corrupt, covering backs, paid to say what is required, etc. I simply do not believe this judgement because I know what is going on in the courts, both the cases I refer to were false allegations of FII.
All of those things can happen because judges are human like the rest of us EJ. That does not necessarily mean that all judgments should be disregarded as biased or unreliable. If you don’t read it it’s difficult to form a valid view isn’t it?
MSBP or FII has been repeatedly disproved. only to have relaunches by its diehard advocates.
I have seen a case halted as the judge has said “I will here no more evidence, until I hear expert opinion from both sides of the medical argument.
The court report details that, after being told that the boy was making progress in physiotherapy and was being discharged to home physio, the mother posted on Facebook suggesting that he was dying, and mentioning palliative care. That the boy had been convinced he was terminally ill, even though there was no medical reason for this. I wonder, did Christopher Booker not even read the court reports before he wrote his column?
“[M] ‘Feeling heartbroken at St Mary’s Hospital, Paddington. Our news today is not good but we have known it was coming for a very long time. [H] is comfortable but as parents we cannot describe our pain. Thank you everyone for your continued support. We are devastated.’ ”
The ‘devastating news’ was in fact that the parents had been informed that a discharge planning meeting was to take place for H the following week. Dr Ninis told me this was arranged because H had progressed in physiotherapy to the extent that he was assessed to be able to manage at home with the community physiotherapy service. M says that her ‘devastation’, the word she accepts using in her Facebook post, resulted from her despair that nothing had been accomplished for H in hospital. Further explaining this in her oral evidence M said ‘I didn’t believe he was dying… it was worse’. Mr Verdan describes this response as ‘unconvincing and bizarre’. I agree. With respect to Ms Bazley, who advances M’s case in a measured and careful way, this aspect of M’s evidence tortured belief. I reject it entirely. The simple fact is and it requires to be stated unambiguously, M was presenting H to the outside world as a child who was dying. He was not.
Dr Ninis also reports that the person who passed that Facebook post on to her confirmed that M had requested that H be sent home with ‘palliative care’. M did not dispute this but asserts that she did not mean to imply that this was somehow ‘end of life care’ but regarded it as a reference to pain care specialism. Again, I reject that. M is an educated and articulate woman, she knows well that palliative means terminal. This was the impression she intended to convey and is consistent with the broader canvass of evidence. ”
From http://www.bailii.org/ew/cases/EWHC/Fam/2017/518.html
Marie,
We don’t know if he read the judgment or not. If he did to write what he did without explaining that the judge said something very different that he thinks was wrong is extraordinary. If he didn’t read it or did not appreciate that there might be another side to the story that is of concern too.
Another journalist who seems to suggest that she naively failed to realise the possibility that the parents account might not have been the whole picture is Sue Reid – see our post about that here : http://www.transparencyproject.org.uk/judge-flags-complaint-on-behalf-of-child-against-journalist-who-sneaked-into-hospital/.
Lucy