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Michael Sharpe: "Chronic fatigue syndrome: Neurological, mental or both" incl. PACE

Discussion in 'Latest ME/CFS Research' started by Dolphin, Apr 25, 2011.

  1. In Vitro Infidelium

    In Vitro Infidelium Guest

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    Of course individual cases should be learned from, but in terms of psychiatry the horror cases are frequently presented as critiques of the whole discipline, not as criticisms of local failings in a broad system or as abuses by individual practitioners; which was why I phrased my response as does Harold Shipman tell us something fundamental about General Practice in the UK ? That a systematic change in the way that General Practice is organised can reduce the opportunity for a psychopath like Shipman to exploit his position is undoubtedly true but the Shipman case doesnt tell us that all single GP practationers are abusive, nor does it tell us that all multi GP practices are free of abuse. Similarly the Bristol paediatric cardiology case revealed much that was wrong in a particular hospital whose practices had much wider relevance to paediatric cardiology throughout the UK, what it didnt show was that the practice of paediatric cardiology was fundamentally bad.

    Across the planet tens of thousands of people die at the hands of surgeons every day, most of those deaths are unavoidable but inevitably many deaths will be the result of errors of both surgical practice and the judgement of individual surgeons. Millions of people are prescribed medications that harm them and for some people the basis of the prescription is flawed because the medication does more harm than the condition it is prescribed to treat. In surgery, medicine, General Practice and every other area of health intervention there needs to be constant re-assessment of what is good/best/most effective practice but medicine will for the foreseable future be an inexact application of sicence and it will have regular failures in outcome. Psychiatry is no more immune to this circumstance and unless we are going to say that there will no longer be psychiatric treatment for anyone, then there has to be a pragmatic interaction between patients and advocates with/of illnesses which may reasonably be expected by the general public to involve psychiatry at some level, with psychiatric practioners.

    The several known cases of abusive psychiatric treatment of young people with apparent M.E/CFS (who knows what illness they had at the time) certainly need to be carefully examined with a view to informing future best practice but that can only happen within a process of engagement. Shouting at psychiatrists youre evil and stupid and harm children will not change how children are dealt with by psychiatrists, nor will it remove Societys expectation that psychiatrists have a role in intervening where parents may be acting abusively in preventing a child from receiving appropriate treatment.

    In the UK at least there is (albeit very slow) progress to more strongly empower children and young people to have a voice in their treatment and care plans, although not in anyway specific to M.E/CFS there should be future benefits for those children and young people with M.E/CFS who do, for whatever reason end up encountering psychiatric services.

    IVI
  2. Wildcat

    Wildcat Senior Member

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    The influence of British psychiatrists on the portryal of ME and Guidelines for the treatment of ME, extends far beyond the involvement of individual psychiatrists in individual cases.


    Child Protection Issues:
    A Presentation to the All Party Parliamentary Group on ME (2008)
    http://www.tymestrust.org/pdfs/childprotectionissues.pdf

    Jane Colby
    Former Headteacher
    Executive Director, Tymes Trust (The Young ME Sufferers Trust)


    Joanna Smith
    Welfare Rights Advisor, Brunel University
    The Young ME Sufferers Trust
    Registered Charity 1080985
    Founder Patron : Lord Clement-Jones CBE

    Abstract
    On 2nd July 2008, Jane Colby and Joanna Smith gave presentations by
    invitation of the All Party Parliamentary Group on ME on Child Protection
    Issues, covering Child Protection procedures and recommendations,
    misunderstandings over parental or carer influence, and the personal
    experiences of a parent of a Tymes Trust member.





    The Forgotten Children A Dossier of Shame.
    Tymes Trust ME Childrens Charity Report 2003:
    http://www.tymestrust.org/pdfs/theforgottenchildren.pdf
  3. Wildcat

    Wildcat Senior Member

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    The 1999 Panorama Investigation Sick and Tired

    http://news.bbc.co.uk/1/hi/health/509670.stm

    ME children treated as mentally ill

    Children suffering from chronic fatigue syndrome (CFS) are being pressurised into having psychological treatment which may not be appropriate, according to a BBC survey.
    Some 25,000 children in the UK are estimated to be suffered from the syndrome, also known as M.E. (myalgic encephalomyelitis), and it is recognised by the Department of Health.

    However, doctors are divided on how it should be treated and many do not accept that it exists.

    An exclusive survey for the BBC's Panorama programme found that 60% of families of children with CFS were told their symptoms were a result of psychological problems.

    In a disproportionate number of cases, doctors had suggested that the children's parents had Munchausen's Syndrome by Proxy - a condition which causes parents to harm or fake symptoms of illness in their children in order to gain attention.

    Some who had opposed psychological treatment for their children had been threatened with having them taken into care.

    <Snip>
  4. Wildcat

    Wildcat Senior Member

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    The producer of this Panorama program stated that they were overwhelmed with the number of families who contacted the programme maker before the programme was made, but obviously could only use two or three cases in the programme, but that doesnt mean there were only two or three cases of very inappropriate psychiatric treatment of children with ME.



    TRANSCRIPT - PANORAMA "SICK AND TIRED"

    http://news.bbc.co.uk/hi/english/st.../panorama/transcripts/transcript_08_11_99.txt



    MATTHEW HILL
    A child is taken to a locked psychiatric ward against his parents' wishes.


    DOCTOR FRANKLIN
    Why go to those extreme and draconian measures? It's horrendous.


    M.HILL
    Doctors divided over the best way to treat children with chronic fatigue syndrome.


    GEORGIE SHELDON
    M.E. SUFFERER
    I came out a hundred times worse.

    M.HILL
    Tonight on Panorama: "Sick and Tired" - the families caught up in a medical dispute.


    Georgie Sheldon developed a brain tumour when she was ten years old. It was removed at one of the county's leading children's hospitals - Great Ormond Street. Although her cancer was cured, her recovery didn't go the way her doctors expected. After a series of viruses,
    Georgie developed an illness called M.E., or chronic fatigue syndrome.

    Continues..
  5. Wildcat

    Wildcat Senior Member

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    'An exclusive survey for the BBC's Panorama programme found that 60% of families of children with CFS were told their symptoms were a result of psychological problems.'
    http://news.bbc.co.uk/1/hi/health/509670.stm


    60% is not a minority.
  6. Wildcat

    Wildcat Senior Member

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    As late as 2008 it was discovered (by a patient whilst net surfing) that ME/CFS had been classified as a mental health disorder by the East Sussex County Council and NHS Joint Services document for Commissioning and Planning services. Chronic Fatgue Syndrome was listed between Eating Disorders and Psychosis.

    It took nearly a year of writing to the supposedly appropriate authorites and the intervention of an MP before the document was removed. The Director of Childrens Services stated that the document which inaccurately included CFS in the list of mental health disorders had been provided by 'an outside agency'.
  7. Wildcat

    Wildcat Senior Member

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    Further to the post just above, CFS was specifically listed as 'Somatisation Disorder' in the East Sussex County Council and NHS Joint Services document for Commissioning and Planning services.
  8. In Vitro Infidelium

    In Vitro Infidelium Guest

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    A 13 year old opinion survey of an unknown number of carers selected on an unspecified basis what does that tell us about anything in general, what does it tell us about anything today ? A bureaucracy screws up and is resistant to enquiries how is that remarkable and what does it say about psychiatry or any other medical specialism ? The Thymes Trust report does indeed quote an instance of practitioner abuse by a GP !

    None of this even begins to address the practical challenges that children with illnesses of undiagnosed cause present for Teachers, GPs, Paediatricians, Psychologists, Psychiatrists and Social Workers. Is it really the case that merely on the basis of parental diagnosis that all those charged by society with having a legal responsibility to ensure a childs well being are to accept there is no case for intervention ? With all the history of child protection failings in the UK that is not going to happen. Certainly when professional zealots are allowed free reign, monstrous harm can be done in the name of child protection but such instances can not be allowed to inhibit the usual processes of child protection from taking place. Of course we want children and young people with M.E/CFS to treated with very particular care but we are not going to engender an effective dialogue with child protection professionals by representing them as uncaring, malign or stupid.

    The pyschologising of M.E/CFS isnt simply a process of psychiatry, it is function of attitudes prevalent throughout medicine. As wrote early on in this thread:

    We can endlessly rehearse the arguments about how and why Sharpe, White and Wessely are dreadful people promulgating specious doctrines, but that is not going to change the professional landscape in which the arguments that affect us, actually take place. Some way forward can maybe be seen via Suzy Chapmans excellent work on the ICD -11 proposals http://dxrevisionwatch.wordpress.com/icd-11-me-cfs/

    DSM -5 is up for public comment, and the previous submissions are worthy of review:

    http://dxrevisionwatch.wordpress.com/dsm-5-proposals/dsm-5-proposals-sub-page-3/ in which an egregious example of psychologising is attributed not to a psychiatrist but to a neurologist:

    E.g.; Dr Peter Hudgson was a Consultant Neurologist at the Newcastle General Hospital and stated on camera (3):
    I dont know what M.E. is, but what Im absolutely certain is, it is not an organic illness. I dont want to make too much of the sexist issue, but, er, something like four-fifths if not more of the people I deal with are women in early middle age who have unsatisfactory marriages; who have children that are making life difficult for them


    Attributing the failures/and or abuses of GPs, Neurologists and other specialists to the sole influence of UK Psychiatry is false proposition, if UK psychiatrists have undue influence its because other professionals find that to be a convenience or are simply not interested, and that is a professional failing on their part and needs to be addressed just as much as any harmful contentions by UK psychiatrists. And the only way to address those failings is via reasoned engagement, no matter how discomforting such a process may be.

    IVI
  9. Marco

    Marco Old blackguard

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    Near Cognac, France
    Well said.

    To which we need to add the opportunity afforded by the flawed reasoning that 'medically unexplained' equates to not organic and therefore psychosomatic.
  10. alex3619

    alex3619 Senior Member

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    Logan, Queensland, Australia
    I agree with this. This is a systemic failure of the medical profession, the research community and governments. While certain elements within psychiatry have run amok, they have been allowed to do so. The system seems dead set against quackery, which they should be, but when something akin to quackery is practiced by their own they turn a blind eye. Nearly all cases of medical abuse require that medical practitioners and officials ignore that abuse, or seek to justify it. This is systemic, and in my view is more about institutions and prevailing attitudes than specific failures. Medical experts and researchers who speak out are isolated and disempowered in my view - its all about preserving the status quo, which is why the term "evidence based medicine" is so ironic. Doctors are running scared, its not just patients.

    Bye
    Alex
  11. Wildcat

    Wildcat Senior Member

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    @ In Vitro Infidelium. I suggest your thoroughly read the Tymes Trust Reports and BBC survey that I posted, dated 1999, Tymes Trust Report 2003 and again another Report presented to the APPG in 2008.

    On one hand you gratuistously accuse ME sufferers of "shouting" at psychiatrists, on the other you dismiss the work of the most established ME childrens charity that is not known for extravagent rhetoric or overstating its case. You can't have it both ways.
  12. Snow Leopard

    Snow Leopard Senior Member

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    The problem is that on one hand the psychiatrists are promoting their supposedly non dualistic model, while at the same time telling other medical researchers and specialist practitioners (such as neurologists) not to bother. If Sharpe et al. actually cared, then instead of merely reporting that neurologists were not interested, they would be actively trying to get neurologists to participate in research.
  13. Wildcat

    Wildcat Senior Member

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    In Vitro Infidelium: Attributing the failures/and or abuses of GPs, Neurologists and other specialists to the sole influence of UK Psychiatry is false proposition, if UK psychiatrists have undue influence its because other professionals find that to be a convenience or are simply not interested, and that is a professional failing on their part and needs to be addressed just as much as any harmful contentions by UK psychiatrists. And the only way to address those failings is via reasoned engagement, no matter how discomforting such a process may be.

    .


    On the contrary, the influence and actions of a handful of extremely powerful British psychiatrists is responsible for constructing ME as a medically unexplained condition and keeping it in a limbo that has left ME sufferers, especially children, at the mercy of uninformed and misinformed health, social services, and education professionals



    The [Heath Insurance] industry drew on the work of two of the Woodstock conference [Malingering and Illness Deception] participants, Professor Simon Wessely of King's College and Professor Michael Sharpe of Edinburgh University, in an attempt to reclassify ME/CFS as a psychiatric disorder.6 Success would allow payouts to be restricted to the 24 month limit for psychological claims and save millions of dollars.


    .


    Jonathon Rutherford, Professor of Cultural Studies, Middlesex University, Guardian writer, and Editor of Soundings (a Journal of Politics and Culture), 2007:

    http://www.lwbooks.co.uk/journals/articles/rutherford07.html


    New Labour, the market state, and the end of welfare
    Jonathan Rutherford

    Jonathan Rutherford looks at the connections between government and the insurance business in their joint project to reduce eligibility for sickness benefits.
    Soundings 2007


    In November 2001 a conference assembled at Woodstock, near Oxford. Its subject was 'Malingering and Illness Deception'. The topic was a familiar one to the insurance industry, but it was now becoming a major political issue as New Labour committed itself to reducing the 2.6 million who were claiming Incapacity Benefit (IB). Amongst the 39 participants was Malcolm Wicks, then Parliamentary Under Secretary of State for Work, and Mansel Aylward, his Chief Medical Officer at the Department of Work and Pensions (DWP). Fraud - which amounts to less than 0.4 per cent of IB claims - was not the issue.


    The experts and academics present were the theorists and ideologues of welfare to work. What linked many of them together, including Aylward, was their association with the giant US income protection company UnumProvident, represented at the conference by John LoCascio. The goal was the transformation of the welfare system. The cultural meaning of illness would be redefined; growing numbers of claimants would be declared capable of work and 'motivated' into jobs. A new work ethic would transform IB recipients into entrepreneurs helping themselves out of poverty and into self-reliance. Five years later these goals would take a tangible form in New Labour's 2006 Welfare Reform Bill..


    ..In the 1980s Unum - along with the two other major life and accident insurance companies, Provident and Paul Revere - had been doing well from providing 'own occupation' income protection schemes for mainly upper income professionals. Insurance against loss of earnings caused by accident or sickness was seen as a lucrative market with strong growth potential. Profit for insurance companies mainly lies in the revenue generated by investing the monthly insurance premiums, and interest rates were high so the companies enjoyed high levels of profitability; they monopolised the sector by sharing a similar disability income policy that offered liberal terms.


    Two factors threatened future profits however. The first was falling interest rates, and the second was the growth in new kinds of 'subjective illnesses', for which diagnostic tests were disputable. The old industrial injuries were giving way to illnesses with no clear biological markers - Myalgic Encephalomyelitis (ME) or Chronic Fatigue Syndrome (CFS), Fibromyalgia, Chronic Pain, Multiple Sclerosis, Lyme Disease. In the early 1990s the new kinds of claims began to rise just as interest rates fell: profits were threatened. Unum's 1995 'Chronic Fatigue Syndrome Management Plan' sounded the alarm: 'Unum stands to lose millions if we do not move quickly to address this increasing problem'.4


    It was actually Provident [UNUM] that was quickest off the mark, introducing an aggressive system of 'claims management' that would become the industry norm. It could not influence interest rates, but it could reduce the number of successful claims it paid out. Its Independent Medical Examination (IME) was skewed in favour of the company through the work undertaken by its claims adjusters and in-house doctors.


    Illnesses were characterised as 'self-reported' and so thrown into question. Only 'objective' test results were accepted. Some disabling conditions were labelled as 'psychological', which made them ineligible for insurance cover beyond 24 months. Doctors were pressured to use the 'subjective nature' of 'mental' and 'nervous' claims to the company's advantage.5 Specific illnesses were targeted in order to discredit the legitimacy of claims.


    The industry drew on the work of two of the Woodstock conference [Malingering and Illness Deception] participants, Professor Simon Wessely of King's College and Professor Michael Sharpe of Edinburgh University, in an attempt to reclassify ME/CFS as a psychiatric disorder.6 Success would allow payouts to be restricted to the 24 month limit for psychological claims and save millions of dollars. By 1997 Provident had restructured its organisation to focus on disability income insurance as its main business. It acquired Paul Revere, and then in 1999 merged with Unum under the name UnumProvident.

    .
  14. In Vitro Infidelium

    In Vitro Infidelium Guest

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    I haven't in anyway dismissed the work of the Thymes Trust - I'm simply questioning its relevance to this thread or even what you appear to be arguing for. TTT does in the main follow a course of positive engagement which is precisely what I've argued for - but the TTT report you quote doesn't deal with abuse by psychiatrists, it records one case of abusive behaviour by a GP and generalised critique of children's services, which as valid as it is does not of itself underminethe arguments of Peter White as produced at thestart of this thread, nor the subsequent claims of psychiatry as an abusive process. And you have not addressed the issue of how at a societal level child protection services 'should' operate in respect of children whose parents claim disablement of the child when medical evidence is lacking - that is not a problem that will go away and certainly can't be disposed of by claiming institutional psychiatric abuse.

    IVI
  15. Wildcat

    Wildcat Senior Member

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    October 2001. House of Lords Debate about false accusations of child abuse, and misuse of Child Protection Law. The debate introduced by Earl Howe, who outlined the two triggers for investigations of Munchausens by Proxy: the first a phenomenon known as recovered memory, the second, the condition known as Munchausen Syndrome by Proxy or MSBP. MSBP is one of a number of terms used to describe the fabrication or deliberate creation of illness in a child by a parent or carer.
    .


    Posted here are the speeches by Earl Howe (edited, as indicated) and by the Countess of Mar with particular reference to MSBP investigations of families of children with ME.



    http://www.publications.parliament.uk/pa/ld200102/ldhansrd/vo011017/text/11017-06.htm


    Hansard. Lords. 17 Oct 2001

    Earl Howe rose to call attention to the damage caused to families by false accusations of child abuse; and to move for Papers.

    The noble Earl said: My Lords, the abuse of children, whether violent, sexual or emotional, is a criminal and wholly repugnant act. As a society it is incumbent upon us to do all that we can to protect children from such abuse and to ensure that the perpetrators are dealt with in an appropriate fashion.
    17 Oct 2001 : Column 646

    Nothing I am about to say should be interpreted as a desire to underplay or belittle such conduct. Indeed, quite the contrary.

    My concern can be summed up very simply. It is that alongside the worrying numbers of genuine child abuse cases there is a parallel cause for worry, which is that many innocent people are being wrongly accused of child abuse and whose lives in consequence are being turned upside down without due justification.
    I should like to talk today about two of the triggers for false accusations. The first one is a phenomenon known as "recovered memory"..

    ..I come now to the second major trigger for false accusations that particularly concerns me, and that is the condition known as Munchausen Syndrome by Proxy or MSBP. MSBP is one of a number of terms used to describe the fabrication or deliberate creation of illness in a child by a parent or carer.

    In the first type, a parent--most often the mother--invents an account of illness in the child, for example by reporting falsely that the child is suffering from chronic diarrhoea. Often this leads to the child being subjected to a range of unnecessary clinical tests. In the second type, the parent is claimed to have deliberately induced illness in the child, for example by poisoning. Again a referral to a doctor often leads to extensive clinical tests which are necessary only because of the parent's interfering actions. MSBP therefore encompasses a wide range of behaviour, from an excessively anxious parent inventing an illness or exaggerating quite minor symptoms, right through to inflicting deliberate physical harm.

    The danger of such a broad spectrum of behaviour being packaged into a single portmanteau term, MSBP, is that in the hands of those who are not sufficiently trained or experienced to know better, it is a label that is all too easily applied without due care. This is all the more true when one considers the so-called profile of characteristics that are said to mark

    17 Oct 2001 : Column 648
    out a person suffering from MSBP. These characteristics include such things as privation during childhood, repeated bereavement, miscarriage, divorce and past health problems. An over-intense relationship with the child and a desire to be the perfect parent are other supposed markers.

    Regardless of the fact that there are very many perfectly innocent, sane people around who might have such characteristics, the very idea of a tell-tale profile of this kind is an open invitation to apply the MSBP label without properly looking at what may or may not be happening to the child. Put at its simplest, there is all the difference in the world between a Beverley Allitt, whose severe personality disorder led her to murder young children, and a mother who invents reasons why she and her child should visit the doctor. Yet under the all-embracing banner of MSBP, and in the hands of the untrained, the two are treated as being practically indistinguishable. It does not matter whether one calls the condition "MSBP" or "factitious illness by proxy", or by any other name. The point remains the same.

    In quite a number of the cases I have encountered, when an allegation of MSBP has been made, the mother, in protesting her innocence, has pointed to unexplained symptoms or behaviour in her child. She may have raised her concerns about these with the doctor on more than one occasion. Unfortunately, the act of denial is itself seen as a marker of MSBP--a "Catch 22" if ever there was one. But the danger of having, as it were, an identikit profile of an adult considered likely to be an abuser or potential abuser is that judgments can be made too much by reference to perceptions of the parent and not enough--sometimes not at all--from a proper and thorough examination of the child.

    I have been made aware of cases where MSBP has been alleged without any outward sign whatever of harm to the child, beyond some odd or atypical behaviour. Often, the allegations have been pursued doggedly by social workers over a long period, and it is only after months of anguish, when children have been placed on the "at risk" register and proceedings have been brought in the family courts, that the parents have been completely exonerated--exonerated, that is, if they are lucky; but exoneration, when it comes, is frequently by way of a specialist diagnosis of an unobvious clinical condition in the child: a congenital disorder, a birth injury, an allergy, autism, Asperger's syndrome, an adverse reaction to a vaccine, attention deficit and hyperactivity disorder, chronic fatigue syndrome, and so on..

    If MSBP is a valid term at all, it identifies what
    17 Oct 2001 : Column 649
    amounts to a serious psychiatric disorder. That kind of diagnosis should be left to those who are properly trained to make it; namely, qualified psychiatrists.
    We should remember that all the indications from research are that MSBP is very rare. But it is worth noting that the scientific basis for MSBP as a recognised condition is, at best, thin. As a theory it rests on a small number of anecdotal cases. It has never been tested under clinical conditions and none of the evidence has ever been approved by a national medical or scientific body. Even the connection with the Beverley Allitt case turns out on investigation to be illusory. An official inquiry into the Allitt case rejected any association between MSBP and the murders that Allitt committed. Despite that, the supposed relationship between the homicidal Allitt and MSBP has remained firmly embedded in the public consciousness.
    None of this is to deny that there are people who intentionally set out to inflict harm on children in a covert fashion. Where real physical harm is inflicted secretly on a child there is no difference between this type of violence and any other sort. The point, however, is that before jumping to conclusions about MSBP, social workers and doctors ought to look at what is actually going on, or not going on. They should investigate the family's circumstances in the round, including all relevant medical information, in a professional, informed and unbiased manner. They should carry out an assessment of the family's needs in accordance with Section 17 of the Children Act. Quite often, that process is hardly even attempted.

    The damage that can be done by the mere suggestion of MSBP is enormous. Chinese whispers begin--what one researcher has referred to as "the first gossamer breath" of rumour--about unexplained illness in a child and about a fussy parent. These can swiftly turn that parent into a potential murderer in the eyes of the community. Members of the family become local pariahs. Social workers are sometimes not clever at handling situations of this kind. Children are made to live in constant fear of being parted from their parents. The climate is like that of a witchhunt in which the voice of reason and all sense of proportion is lost.
    There is a considerable weight of published research on these matters. It is this that gives me good grounds for believing that we are dealing with a substantive problem. In that context, the Government's recent consultation document on safeguarding children in whom illness is induced or fabricated, despite some laudable features, is deeply flawed--principally because it fails almost wholly to acknowledge that the topic is highly controversial and that erroneous diagnosis is a real risk.

    There are several lessons to be learnt from the points I have outlined. Clearly, lessons need to be learnt about the training of social workers, and about making it far more skills-based than at present. There is a good case for making social workers personally and legally accountable for what they do. Presently--perhaps uniquely among professional people--they are not.
    17 Oct 2001 : Column 650
    There is a need to improve the monitoring and inspection of social work and the ways in which resources are directed by social services departments. The channelling of considerable resources into chasing the falsely accused and the pursuit of flimsily based allegations have the effect of removing resources from where they are really needed; namely, in the active prevention of real physical violence, such as was inflicted on Victoria Climbie. We need to consider whether the rights of parents to present evidence at child protection conferences should be strengthened in some way. We should attempt to determine whether the complaints system is adequate in cases where a number of agencies, not merely the NHS or social services, are involved. There is also a need to examine the law: for example, to ensure that it is the duty of local authorities, in the first instance, to help and support families in difficulties. Somehow we need to strike a better balance.

    I hope that the Government will take these issues in hand and examine them seriously. It is a subject which a Select Committee, either in this House or in another place, could examine to advantage. Having made a personal study of these matters, I believe them to be of deep significance for the well-being of countless children and families up and down the country. My Lords, I beg to move for Papers.



    17 Oct 2001 : Column 660

    The Countess of Mar: My Lords, I am grateful to the noble Earl, Lord Howe, for introducing this debate. I echo all the condemnation of actual abuse of children. I declare an interest as patron of a number of ME associations. I shall restrict my remarks to children suffering from ME. My sister is a social worker, but I have not involved her in any of my parliamentary work.

    I first became involved in the subject three years ago. I was approached by a paediatrician who was very concerned about the wellbeing of a boy who had been diagnosed with ME. I shall not go into detail because, as I have been told repeatedly, Ministers cannot intervene in individual cases. Time is also restricted.

    Like the noble Earl, I have had a large number of letters from parents and grandparents accused of child abuse. Their children or grandchildren have been put on the "at risk" register, taken into care or made wards of court. What I read and have been told profoundly distresses and disturbs me. I am reminded of the witch hunts of previous centuries. This time, the victims are frequently nice middle class families whose only fault is to be concerned about their child, who has ill-defined symptoms from which he or she does not rapidly recover. For various reasons, some social workers--I repeat that it is some, not all--are not prepared to consider that those conditions might be organic. Suspicion leads to referral, which leads to a huge investment in social services, health services and court resources. There is no presumption of innocence, as there is in other similar situations, and there seems to be no requirement for social services to prove guilt.
    A terrible injustice is done to the families involved.

    Virtually without warning, the parent or parents find that they have been unjustly and unnecessarily investigated under the child protection proceedings of Section 47 of the Children Act 1989. Somehow, the Act has been so misconstrued as to enable some social services departments, paediatricians and organisations such as the NSPCC to abuse their powers, through misplaced zeal and ideology or through sheer incompetence, to create tremendous distress and psychological damage to parents, children and the wider family, sometimes destroying
    17 Oct 2001 : Column 661
    the family structure. There is no measuring the levels of anxiety or the harm done to children and their carers while the whole weight of the law is brought to bear on them.

    Even when accusations of child abuse against a parent or parents have subsequently been withdrawn, often after prolonged and costly legal action, the stigma of being branded a child abuser by the local authority remains with the parents. Once a social services referral is placed on their Samson database, the details remain for ever, no matter what the outcome of later inquiries. The referral becomes common knowledge in the local community. Those who work with children, either as carers or teachers, are refused employment and those who have been active in the community or in voluntary work find that they are no longer required, especially if children or young people are involved.

    These are people who have been proved innocent, yet they are treated like criminals. What is more, their sentence never ends. Their child, who is wrongly perceived as having been abused, is pitied. Parents are afraid to seek medical treatment for themselves or their children. If they are brave enough to go to the doctor, their complaints are often dismissed as somatisation.

    I know that many social workers, doctors and voluntary workers do wonderful work with seriously deprived children and their families. I know that they bridle against the incompetence of a small number of their colleagues. We need to think again about what we expect from social workers and to ask whether we are expecting too much. The communal hysteria that is generated around child abuse must have an effect on those who work with children. Are we being reasonable in our expectations? I think that perhaps we are not.

    When I originally asked for an inquiry, I had no idea that the problem was so widespread. I am grateful that the Minister in another place has agreed to meet me with some of the parents concerned, but I fear that that may not resolve the problem. There is a need for an inquiry to resolve the problem, even if it is a Select Committee inquiry, as the noble Earl has suggested. Abused parents need to be able to tell their stories. Solutions need to be sought and these dreadful injustices must be put right as far as possible. There needs to be a cleansing.


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  16. In Vitro Infidelium

    In Vitro Infidelium Guest

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    Medical Specialism turf wars are endemic in most health systems and and the interplay between specialisms is often both fraught and not overly honest, but laying the responsibility on just one party is creating falsity - i.e X is more poweful and more influential and more able to exercise responsibility than Y. In this case the falsity suggests that Psychiatry has exceptional power/influence over all other specialisms. It's great for trying to find someone to blame, but it creates a 'bogeyman' that has characteristics of power and terror, which in reality do not exist.

    We can see on this thread, Wildcat assembling the elements of the giant's castle 'wherein dwells the evil that must be slain before we can be free/rich etc', the effect of which isn't just to create the monster image, but to actually make the real problems contained in the assemblage, unassailable. Faery Stories are profoundly conservative, they are about establishing a security of a status quo, these big bad wolf psychiatry tales are ultimately about NOT changing anything, rather than promoting discourse and action to effect change. If that's what people want then fine, but let's all be aware that is what is involved.

    IVI
  17. Wildcat

    Wildcat Senior Member

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    @ In Vitro Infidelium. Its your dismissive reference to a handful of "horror stories" that I have responded to. The "stories" that we hear about are the tip of the iceberg, especially as regards mistreatment of children with ME, ie the cases that 'go public' or because the extremity of legal actions against the families ensure they are reported in the media. In the case of Euan Proctor the Isle of Man held an Inquiry (the McManus Inquiry) to ensure that no Manx child would be subjected to such ill considered sectioning again, and in the case of 'Child X' the legal matters were such that the media were interested.

    .

    Would you care to address your statement that the Tymes Trust Reports merely amount to one case of abusive behaviour by a GP and generalised critique of children's services to either Jane Colby of the Tymes Trust or the Countess of Mar?
  18. Wildcat

    Wildcat Senior Member

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    In Vitro Fidelium: "Faery Stories are profoundly conservative, they are about establishing a security of a status quo, these big bad wolf psychiatry tales are ultimately about NOT changing anything, rather than promoting discourse and action to effect change. If that's what people want then fine, but let's all be aware that is what is involved."


    Get real, In Vitro. Whats your issue in 'defending' psychiatry per se, whilst avoiding the massive recorded evidence that its the actions and statements of *specific* British psychiatrists over two decades who have controlled the medical and public percepeption of ME?
  19. Wildcat

    Wildcat Senior Member

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    In Vitro Fidelium: "We can see on this thread, Wildcat assembling the elements of the giant's castle 'wherein dwells the evil that must be slain before we can be free/rich etc', the effect of which isn't just to create the monster image."



    @ In Vitro Fidelium: Such fantastical and imaginative 'narrative portrayals' of my posted evidence do your arguments no favours wahtsoever.




    Anyone reading this thread will see that I have "assembled" no such thing as "Faery Stories" or a "giants castle" or any form of such narrative nonsense.


    I have merely posted respected Reports by the BBC and the ME childrens charity The Tymes Trust (one a presentation to the All Party parliamentary Group on ME), and material from Hansard, and published evidence relating to the *specific* British psychiatrists who have without doubt (according to substantial amounts of documented evidence re their published statements and research and actions) influenced, indeed controlled, the British ME policy for over 2 decades.

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  20. Enid

    Enid Senior Member

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    Can I just throw in a point about Snow Leopard's interesting post re Sharpe et al REPORTING Neurologists were not interested. Not quite true. My own carried out a full battery of neurotests - patchy high signals in the brain amongst other abnormalities. He finally accepted ME in principle and said "they think it's viral ....find someone who knows....will release all my scans/results.....we don't (can't treat) here. He was clearly baffled by the range of symptoms - loss of consciousness, muscle seizures, cognitive and GI problems etc. and simply did not understand enough to treat. (should say I received a private letter of apology). This does not seem to me to be someone not bothering or not interested - rather someone hoping to learn. Sharpe's sweeping claims are incorrect - perhaps he should let them speak for themselves.

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