Even The Shallows Dry Up: The GMC Hearing June 22nd and 23rd.

And it was another of those explanations that sounded good, but not if you were there. Not if you had the evidence of your gut to back you up.

Andrew Holmes, Criminal Records.
Sceptre (2008) London.

By Martin J. Walker

At mid morning on Tuesday June 23rd, Mr Miller finished his closing speech on behalf of Professor Walker-Smith. It was a bravura performance.

Having dealt with the Lancet Children singularly throughout the previous week, on Monday Mr Miller turned his attention to Professor Walker- Smith's involvement in the Lancet paper. Generally speaking the prosecution case in relation to the Lancet paper - not the individual children cited in it - is that this paper was entirely organised by Dr Wakefield in defence of his supposed view that MMR created autism. The paper was promoted at a 'press briefing' when Dr Wakefield uttered the words that ended his career in England when he suggested that parents might want to use single vaccines until the adverse reactions associated with MMR had been researched at the Royal Free.

In terms of content, the prosecution claimed that the paper was actually a very badly carried out research trial with missing controls. According to Miss Smith the paper was the result of research project 172/96. This view was completely wrong, untrue and a misrepresentation, the Lancet paper had always been a case review study that examined the symptoms presented in 12 sequentially referred children and tied to diagnose a specific illness. The defence had said from the very beginning of the GMC trial that the paper not only did not set out to prove anything about MMR but that each child cited in it had already been treated clinically and the case review was, as case reviews are, an overview of the twelve cases and an attempt to describe a novel illness. Clearly in writing up the paper, especially because the cases were self-referred, the authors had to mention the fact that a number of parents had told Dr Wakefield that the onset of first gastrointestinal problems that were followed by ASD like developments had coincided with their child having received the MMR vaccination.

Mr Miller had an easy case to argue on the Lancet paper because Professor Walker-Smith, though being one of the paper's authors, had a completely different and much more conservative view of how results of work at the Royal Free should be publicised and reported. Walker-Smith's difficulties with Dr Wakefield went back to the publication of an article in Pulse which had reported a number of things that Dr Wakefield had apparently not discussed with his colleagues. What was not made transparent during this trial was that Dr Wakefield had been fighting his corner with the Department of Health for some time before the Lancet paper was published and that he had originally written to David Salisbury, the head of vaccination and immunisation, asking for a meeting which for six years had been refused. While Professor Walker-Smith simply continued his clinical work when he arrived at the Royal Free, Dr Wakefield was already deeply embedded in less tangible battles over government vaccine policy.

These minor differences in approach between Dr Wakefield and Professor Walker-Smith did little to enhance the prosecution case and could easily be admitted to. In fact, as I have said many times in my reports, the fact that the prosecution have tied Walker-Smith and Dr Wakefield so closely together has definitely damaged the prosecution case against Dr Wakefield.

So much more conservative were Professor Walker-Smith's views about science and medicine that he refused to even attend the 'press briefing' saying that he didn't think that this was the way to conduct either clinical practice or the announcements of research results. Unfortunately the most vital information about the press briefing that it was organised by Professor Zuckerman, the academic head of the Royal Free Medical school, and not by Dr Wakefield, did not seem to come across clearly at any point in the hearing.

Mr Miller explained at some length that the authors of the Lancet paper made it clear that the paper did not prove or attempt to prove a link between MMR and autism. What the paper did suggest and what the post paper investigation of another 40 cases showed was that there was a link between IBD and behavioural problems. The Lancet paper, in fact, made a direct refutation that the cases cited in it proved a relationship between MMR and behavioural difficulties. The GMC and its prosecution, however, proved as obdurate and determined to re-enforce untruths upon the defendants as had the media over the last five years or so.

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At around 10.10 on Monday morning there was a minor incident in the hearing room, which made me laugh almost out-loud. During the closing speeches, members of the panel have had their full boxes of files on the desk between them. The legal assessor sits next to a lay member and just after ten, one whole box of files was dislodged from the table and fell to the floor. Like everyone else in the room, writing or reading, or listening to Mr Miller I didn't see exactly what happened. The legal assessor, however, sits not far from the public gallery and when he stood he was facing me. Being a writer, descriptions spring immediately to mind when you observe such an incident. The Legal Assessor shot out of his chair and for a few second his gaze was transfixed by the files on the floor. There was a look of utter shock and bemusement on his face as if he was an elderly gent in a care home who had suddenly woken to find that he had dropped a burning cigarette on the floor and flames were licking round his feet. I couldn't discern what was on his mind for he sat down again almost immediately while GMC staff busied themselves with picking up the files.

That afternoon had another incident when at the end of the day the hearing rose early because one of the panel members had toothache. I saw one of the counsel outside the hearing room later, congratulating himself on having diagnosed slight changes in the expression of the tooth aching panel member, 'You get to know them so well', he said almost gleefully. Mr Miller, always the soul of politeness and discretion, apologised before beginning the end of his closing speech the next morning. He hoped, he said that it was not the quality of his presentation that had brought on the toothache. It is untoward incidents such as these which while being trivial in relation to the substance of the hearing add the colour of reality TV to this impossible long, stifling, opaque and sometimes surreal trial.

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Martin J Walker is an investigative writer who has written four books about aspects of the medical industrial complex. He started focusing on conflict of interest, intervention by pharmaceutical companies in government and patient groups in 1993. Over the last three years he has been a campaign writer for the parents of MMR vaccine damaged children covering every day of the now two year hearing of the General Medical Council that is trying Dr Wakefield and two other doctors. His GMC accounts can be found at  www.cryshame.com, and his own website is, HERE.

Comments

[michael framson]

Was it really the "house of cards" this trial was built from that finally fell to the floor?

[Gatogorra]

Thank you for the update.

The legal assessor *did* have a fire licking at his feet. Seems some on the government's team know it.

[anonymous000012002]

Thanks Martin for the insightful, detailed accounts of the GMC hearings. They are much appreciated.

[Twyla]

And let's hope they can see past their embarassment at this whole shenanigan being a complete waste of time and money. Are they independent enough to make a fair decision?

As always, thank you so much for your ongoing reporting, Martin Walker -- a lot of work and time taken away from the rest of your life -- and you don't even have a child with autism! Thanks so much for your intelligence and humor. Thanks also to the attorneys who have worked so hard representing these doctors!

It's amazing how when it comes to autism, case studies are condemned as bad science. If you had a basket of mixed fruit you could study them individually and discover the qualities of lemons, limes, apples, and oranges. Or you could do an epidemiological study comparing two similar baskets of mixed fruit, and conclude that fruits have a variety of colors and qualities and that there is no statistical significance to the variations.

Of course the reason why case studies are frowned upon is that there are such strong vested interests lined up against understanding autism causation. But the masses without vested interests for some reason fall in line behind the ideas that studying individuals is not science, and that only large epi studies published in pharma-funded journals are real science.

[Alli Edwards]

Excellent stuff Martin, I throughly enjoy reading your accounts of the hearing at the GMC - and the tension is now building ready for when the panel go off to deliberate in a week or so, after the last doctors defence summation is presented. You highlight beautifully the near impossible task they have of sifting through those numerous thick files that line the walls and surround the panel and legal teams. The uniqueness of this incredibly long case against not one, but three top doctors, is based on lies and deceit topped off with confusion, boredom and exhaustion. Let's hope they can see past their own aches and pains to the pain of the children.