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The Appeal of Prof John Walker-Smith Against the United Kingdom General Medical Council (Wakefield Case)

Walker-smith.jpg.displayOn Monday the appeal begins of Prof John Walker-Smith against the decisions of the GMC as one of the three doctors in the Wakefield case. It should be stressed that Prof Walker-Smith’s appeal is purely on his own behalf and that Andrew Wakefield was forced to withdraw from the appeal due to cost. A third doctor, Prof Simon Murch, was permitted by the GMC to return to work on the basis that he was only Prof Walker-Smith’s junior at the time.

A key issue at the GMC hearing was the prosecution claim that the Wakefield 1998 Lancet paper was in reality a study that had been commissioned by the UK Legal Aid Board relating to pending litigation over the MMR. The three doctors, on the other hand, contended that the projected LAB study was never performed, and that Lancet paper was “an early report” of cases seen on the basis of clinical need, as indeed it had stated. Paradoxically, the GMC panel also found the doctors to be guilty of breaching the terms of the LAB protocol in virtually every respect, instead of accepting the plausible evidence of the doctors that it was simply not the same paper. The panel found:

“The Panel has heard that ethical approval had been sought and granted for other trials and it has been specifically suggested that Project 172-96 was never undertaken and that in fact, the Lancet 12 children’s investigations were clinically indicated and the research parts of those clinically justified investigations were covered by Project 162-95. In the light of all the available evidence, the Panel rejected this proposition.”

However, the panel never elaborated on what evidence it was they were citing, and another problem was that the panel mis-described  ‘Project 162-95’ which was not a project at all but the ethical permission granted to Prof Walker-Smith to retain biopsy samples taken in the course of clinical routine for further scientific investigation, when he brought his clinic to the Royal Free Hospital in autumn 1995. Indeed, parents of the Lancet paper children had signed this ethical permission in the course of their children’s routine clinical investigation. Of course, if the panel had stated this openly before the assembled media in January 2010 they would certainly have had some further explaining to do, which may have been avoided by the ruse of calling 162-95 a “project”.

A fundamental problem with the GMC findings is that they are supposed to be to the highest standard of legal proof which in the UK is “beyond reasonable doubt”. However, in finding as they did they simply set aside the oral evidence of Prof Walker-Smith and the other two doctors about the clinical condition and history of the patients (amongst other matters). The panel never found Prof Walker-Smith to be guilty of dishonesty, but nevertheless his evidence was systematically ignored. This was despite the fact that Prof Walker-Smith is an acknowledged world expert on pediatric gastroenterology – the main pioneer in the field with Prof Allan Walker of Harvard - and far more qualified to speak about it than anyone else present at the hearing apart from Prof Murch (and certainly the panel).

It is an interesting feature that neither the prosecution or the defence called the parents as witnesses (of course none had ever complained). The prosecution might have found it harder to maintain that patients were not sick and the procedures inappropriate if they had called them, while the defence no doubt took the view that it was not for them to prove anything, and in a normal hearing they might have been right.

It is difficult to believe that the British establishment will allow a single chink of light to be shed on these matters. Ken Clarke, who was Health Secretary in 1988 when GSK’s Pluserix MMR indemnity was signed, is now head of judiciary (Justice Minister and Lord Chancellor), and when he ran as leader of the Conservative Party in 2005 it was with Sir Christopher Gent, chairman of GSK, as his principal backer. Against this the presiding judge, Sir John Mitting has a long history frustrating the government bureaucracy in his decision-making and is not obviously conflicted.  But in January 2010 an Oxford journal was already calling the result of the GMC. We note the date of publication of David Galton’s parody ‘Kafka’s trial revisited’  ten days ahead of the GMC panel’s findings on fact. We are about to discover what – if anything – has changed in two years.

Comments

Angus Files

I wonder if Deer if he complains are his complaints obtainable under a FOI?He has got various info under foi himself for years but us under the same request (the other side) tries for same and we aren't going anywhere and we are refused...

not complaining or anything but what they put about comes about,

Angus

Jenny Allan

Brian Morgan
The High Court appeal of Professor Walker-Smith against the GMC verdict is a momentous occasion. Mr Justice Mitting will need the judgement of Solomon and the wisdom of Jehovah. Behind the scenes there will also be enormous establishment pressures, no doubt attempting to stress the importance of so called 'public interests' before the interests of personal justice. Against that, the High Court is SUPPOSED to be impartial.

From Patricia's link below (thanks Patricia):-
http://news.uk.msn.com/mmr-row-doctor-decision-fair

"The General Medical Council (GMC) admitted to a judge that "inadequate reasons" may have been given by a disciplinary panel that found Professor John Walker-Smith guilty of serious professional misconduct. Those reasons related to conflicts over expert evidence.

But Joanna Glynn QC, appearing for the GMC, said: "In spite of inadequate reasons it is quite clear on overwhelming evidence that the charges are made out."

Professor Walker-Smith is asking Mr Justice Mitting at London's High Court to rule that he was denied a fair hearing. On the fourth day of his challenge, the judge said that the case had been "complex and difficult from the start - it greatly troubles me".

New GMC Queen's Counsel Joanna Glynn seems to be admitting the GMC's original reasoning was flawed, whilst at the same time insisting the verdicts were correct!! This is a paradoxical admission and I cannot imagine what Mr Justice Mitting is making of this GMC stance. I am not surprised he is 'troubled'. Of course Ms Glynn must have been 'burning the midnight oil' looking at all those transcripts; she is being paid to defend the GMC's position as best she can. The GMC appears to have dispensed with the services of Sally Smith, GMC Counsel during the original hearings.

There has already been a great deal of public dissection of those 3 year GMC transcripts, thanks to Sheldon, not least by AoA editors and commenters:-
http://sheldon101blog.blogspot.com/2011/04/wakefield-disciplinary-hearing.html
Access to GMC transcripts

The estimated costs of the 3 year GMC hearing are around £7million. Professor Walker-Smith's High Court 2 week appeal hearing will not cost as much as that, but the bill will still amount to £tens of thousands. I believe the 'loser' pays both sides' costs; this would normally be paid by the insurance companies, but there is a 'cap' on their liability. Few persons can afford to go to court without total liability cover.

Brian Morgan (freelance journalist)

"Is it too late for Dr Wakefield to appeal if we donate the legal funds for him?"

I am not a lawyer, but have experience of successful application as litigant-in-person in a case involving medical expert testimony where the identity of the expert was previously kept secret.

In the case being discussed in this thread I suggest there could be an application for leave to appeal out of time (of course I await qualified opinion on this). There are though numerous references on lawyer websites to the procedure.

On the matter of cost, the application could be in person, at very small cost. What does puzzle me is why the GMC finding was not appealed at the time, with the cost being born by the defence society. I've never been given an answer to this. Perhaps those close to the doctor involved have information?

Perhaps answers may emerge during the current appeal? That would certainly be a very welcome development, opening up the discourse, potentially, to argument in the High Court rather than in a quasi-judicial General Medical Council hearing - though cases could be referred back there.

But one concern of mine I think does need investigating - people who privately help fund a failed hearing in England and Wales may be liable for the other party's costs - please would the experts tell us if that is the case now?

Patricia

http://news.uk.msn.com/mmr-row-doctor-decision-fair

Today in the high court. GMC counsel defends their decision. Judge worried by the complexity of the case.

Joan Campbell

http://www.youtube.com/watch?v=Qtz-iGDM6c4&feature=plcp&context=C331634aUDOEgsToPDskKOc2ZOInBbonYhqrO1TY6k
We would have liked to support JWS again like we did on the findings of facts but we respect him for his wishes not to be waving banners outsise the Royal Courts of Justice. Joan

aspiesmom

Is it too late for Dr Wakefield to appeal if we donate the legal funds for him?

AussieMum

Good-luck Prof. John Walker-Smith, court case are unpredictable at the best of times.

I wish you every success.

Elizabeth Gillespie

Benedetta

rtcontracting
What it boils down to is this.
we live in modern times, we have computers, cars, cell phones, running water, all these things.

And so we assume that like everything else modern -- we have modern courts system with modern laws,human rights, and rules.

Keep in mind that this was not a modern court system ---it was the medical system policing their own.

And it might put it in prospective for you.

For rtcontracting

Thanks for all the unpleasant innuendo (because that is what it is).

rtcontracting

Barry:

Nor am I clear on how Dr. Wakefield - The Defendant, was supposed to have somehow morphed into Dr. Wakefield - the Defence Lawyer

RTContracting, can you please explain explain the protocol that would supposedly have been available to Dr Wakefield, had he 'decided' to call witnesses in his own defence?

**********

Wakefield didn't have to become a Defense Lawyer. That was the job of his two defense lawyers (Mr Coonan and Mr Sheldon).

I have no idea about the protocol to call a witness, but somehow Prof. Walker-Smith's lawyers figured it out. They called 5 witnesses. Wakefield's lawyer's didn't call a single one (but then again, they only had 217 days to figure it out).

In fact, when given the opportunity to cross-examine Mrs. 12, they responded "I have no questions." It's almost as if they didn't think that the parent's testimony helped their case.... Weird.

Barry


.... One of the parents, Mrs. 12, testified on day 28 at the GMC hearing.

She was called as a witness for the prosecution.

For some reason, Dr. Wakefield didn't call a single witness in his defense.....

************
There was no "prosecution", because none of this was conducted in a REAL court of law. It was a 217 day "fitness to practice" HEARING, staged by the GMC to investigate "charges" of professional misconduct against Dr. Wakefield. Charges based solely on the word of a free-lance journalist, and completely in spite of the absence of complaints from the parents of the Lancet 12 patients.

Maybe I'm just another dumb north american, but I'm not really clear on how the GMC managed to justify this needless inquisition. Nor am I clear on how Dr. Wakefield - The Defendant, was supposed to have somehow morphed into Dr. Wakefield - the Defence Lawyer... in a forum that completely subverted judicial process.

RTContracting, can you please explain explain the protocol that would supposedly have been available to Dr Wakefield, had he 'decided' to call witnesses in his own defence?

Cherry Misra

With all the gloomy feelings that arise from considering this apalling situation, I can say one positive thing: If three good doctors should have to suffer in this lifetime, they should know that they have suffered for a great cause, not a small one : The cause of millions of children all over the world who fallen from the axe of autism It is unlikely that the world will forget their sacrifice and tribulation.

Cherry Misra

Ottoshnaut- Beautifully spoken. Thankyou.

For RT Contracting

However, many of the prosecution witnesses supported the doctors in their evidence, including Mrs 12 (who was under the impression that that was why she had called). When later on Brian Deer tried to exploit the evidence of Lancet paper signatory Susan Davies in BMJ, she wrote in denying his construction.

Of course, this hearing does not involve Dr Wakefield.

Twyla

I pray that the judge has courage and intelligence.

rtcontracting

One of the parents, Mrs. 12, testified on day 28 at the GMC hearing.

She was called as a witness for the prosecution.

For some reason, Dr. Wakefield didn't call a single witness in his defense.

Patricia

http://www.cryshame.co.uk/index.php?option=com_content&task=view&id=120&Itemid=199

it could be helpful to remind ourselves of Mr Miller´s closing speech at the GMC hearing.

Ottoschnaut

To paraphrase Robert Bolt:

In a nation of laws the laws must stand and not be cut down like trees when convenient. Without laws, no man can stand in the winds that than will blow.

If a man of the stature of Professor Walker-Smith is jeopardized by his simple pursuit of the truth, it is a time to test whether laws rule the land, or otherwise.

The persecution of Walker-Smith is a reckless endeavor by those who are desperate to discredit him. Walker-Smith defines integrity; those who attempt to signify otherwise have obvious ulterior motives, either political or monetary.

They are literally pitiful fools, thinking they can convince the world of a lie. Their techniques would make Goebbels blush, or be very proud. Propaganda is not truth, no matter how many times Deer repeats his lies, no matter the venue he repeats his lies, they are still lies.

They are truly beyond shame, they have none, and beneath contempt.

For Patricia

At the GMC hearing it was Mr Miller (first name unknown) and it will very like be the same at the High Court. He was very good.

Garbo

My prayers go out to Prof. Walker-Smith. I fear that the establishment having put all its eggs in this basket bodes ill for him. It is tragic. GSK and its minions will pound and pound and pound this nail until it is good and pounded. They care not one whit for the truth; they just want to deter any further research.

There will still be millions of sick children, more regressions, more parents talking to more parents, and more people demanding treatment and research. Why they think that the GMC will make it all go away is beyond me. They really aren't very bright, are they? Cruel, but not bright...

Patricia

Do we know the name of Prof Walker Smith´s counsel?

Jenny Allan

I am saying my prayers for this honorable man and excellent clinician. My family OWES him big time.

Glax Britannicus

Benedetta

Clarke is a difficult figure to interpret. Certainly he is massively conflicted. Would he seek to influence the outcome in this matter? You know, I am not actually sure.

Benedetta


And how in the heck can justice be done with people like Ken Clarke that goes from making sure the vaccine companies are safe from laws suits if they sell a cheaper Urabe (defective) mumps vaccine all the way to the Justice Minister and Lord Chancellor. Talking about blocking justice!

When Jesus comes back or the people have had enough of things like this; By the grace of God, may there be laws (enforced) that people in public office can't move around , or are limited to cetain areas that have nothing to do with the other, or limit their years of service. Right now, we are drowning in a cesspool of corruption.

We now have people trying to profit off of global warming/climate change -positioning their companies into receiving money for "NOT" making carbon dioxide.

We have the our government selling guns to drug dealers??? We have no idea why??? Unless it was to make the general population decide they DO want gun control??? I don't know?

We have IACC inside NIH that still give all the money to genetic research for autism, but never looks at immune/mitrochondrial/vaccine and instead makes--- deals I am sure is just money laundering on a higher scale.

We have the CDC making some kind of underhanded deal with some guy over in Denmark to make sure that he does a study on whether vaccines cause autism -- and wink, wink make sure these studies do not!!!

Meanwhile; I can't get on an airplane without being stipped searched and treated like a criminal, I can't get a picture from Wal Mart recopied of my children's great grand mother when she was a girl back in 1890 because of copy right laws for photo companies, ANDDDDD I can't get a decongestant for my sinus infection without giving Social security number, birthdate, finger prints and right hand.


For Patricia

PS I have to admit Prof Walker-Smith does not look like a terrorist!

For Patricia

I suppose if Judge Mitting is prepared to make a determination based on law irrespective of other political imperatives that is encouraging.

The value of nothing

There is perhaps the possibility that the judge might come to some compassionate decision, while conceding nothing of substance: that would be disrespectful both to Prof Walker-Smith's high intellectual competence both then and now.

Patricia

Legal conceit indeed, born of lies, cover-ups, obsufcation and panic, not to mention the massive egos of Godlee and Deer hell bent on chasing their own wild conspiracy theories. (And they have the gall to hurl "conspiracy theorists" at us!).

What a Farce. What a Public Disgrace! What a shameful way to treat such decent and distinguished men.

As for Sir John Mitting....I am not convinced his motives are entirely lucid either. His recent decisions over the freeing of certain dangerous terrorists appear to be derived from even more confusion.

Oh dear. We need more than a small miracle here.

cmo

I had not seen a photo of John Walker Smith... he does not look like someone who would harm an Autistic child who has had diarrhea for two years. He makes Brian Deer once again, look like a bit of a hick.

How does the UK medical establishment... starting with approving a MMR vaccine banned in Canada ( for causing meningitis ) ... ever EXPECT to be taken seriously by the UK public as their "very successful witch-hunts" are NOW showing flaws ???

Will the UK media still try to avoid providing the truth to the public in these procedures ???

The Lancet should reprint the 1998 Wakefield paper, 10 of the authors should go back on record that the "possibility that the MMR causes Autism" is STILL a possibility. The three separate MMR vaccines should be made available. Dr. Wakefield should have his UK medical license restored.

If the MMR vaccine has harmed even one child, the mechanism by which it occurred needs to be determined, not hidden from the public.

victor pavlovic

If there is any justice in this system, even a bit, then Prof John Walker-Smith should come out ahead on his appeal, if not we already know what we are up against here, pure evil.

Jen

The price of everything: That was well put!

The price of everything

We have here the farcical position in which by now the association between autism and bowel disease is well established and yet we are supposed to believe as part of some great legal conceit that the children in this paper had no symptoms, and a great team of top ranking doctors and scientists hallucinated the problem.

Angus Files

Shocking that such a distinguished world wide doctor`s work is called into question shame on them all...nothing so bad as those who can see but just don`t want to..

Angus

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