Sally Clark: The Expert Witness

Sir Roy denied serious professional misconduct won his appeal against being struck off the medical register

Professor Sir Roy Meadow has won his High Court appeal against the decision by the General Medical Council to strike him off the medical register and is one of the most influential and respected paediatricians of his generation.

Many experts say his work has saved countless children from unnecessary suffering. However, his distinguished career has been blighted by controversy. After decades as a leading thinker in the field of child abuse, Sir Roy has become notorious as a central figure in three high profile miscarriages of justice. He gave expert evidence in the trials of Sally Clark, Angela Cannings and Donna Anthony. All three women were convicted of killing their children - and all three have subsequently been exonerated by the Court of Appeal after lengthy periods in prison.

Mrs Clark, a solicitor, was jailed for life in 1999 for the murder of her two sons Christopher and Harry. At her trial, Sir Roy said the odds of two children from such an affluent family dying of natural causes were one in 73 million. His claim was later disputed by the Royal Statistical Society, which wrote to the Lord Chancellor to say there was "no statistical basis" for the figure. Others have said that once genetic and environmental factors are taken into consideration, the odds of a second cot death in the same family are closer to 200 to one.

Mrs Clark was eventually freed when she won her appeal in January 2003.

Sir Roy stood by his evidence at a General Medical Council hearing into his actions, but he admitted he had been insensitive to compare the odds of both boys dying naturally to those of four different horses winning the Grand National in consecutive years at odds of 80-1.

The retired paediatrician was found guilty of serious professional misconduct in July 2005, and was struck off the medical register. But Sir Roy appealed, and the GMC's verdicts have now been overturned.

Other cases

Angela Cannings served 18 months in prison for the murder of two of her baby sons. She was freed in December 2003. At her appeal QC Michael Mansfield heavily criticised Sir Roy's evidence at the original trial. He argued that, were the trial to take place now, it was unlikely the Crown would call Professor Meadow as a witness, or, if they did, it would "have to be done with a health warning attached to it".

Sir Roy's evidence in the Donna Anthony trial was similarly criticised. Ms Anthony was found guilty of killing her daughter Jordan, aged 11 months, and her son Michael, aged four months, in 1998. The prosecution in her case, relying on Sir Roy's evidence, had claimed the babies had been smothered, and that Donna Anthony had been trying to draw attention to herself. Sir Roy, and another expert witness, told the court the chances of two cot deaths in a case such as hers were one in a million.

But Ms Anthony had always claimed her children had died of cot death.

Munchausen Syndrome by Proxy

Sir Roy first came to prominence in 1977 after publishing a paper in The Lancet medical journal on a condition he dubbed as Munchausen Syndrome by Proxy. This is a form of child abuse in which a parent induces real or apparent symptoms of a disease in a child. Perhaps the most high profile example was the case of nurse Beverly Allit, who murdered four children and harmed nine others. Professor Meadow worked on this case.

But even his work in this field has been subject to controversy.

In the House of Lords, Earl Howe, the Opposition spokesman on health, accused the professor of inventing a 'theory without science' and refusing to produce any real evidence to prove that Munchausen Syndrome by Proxy actually exists.

Meadow's law

Possibly, Sir Roy's most telling contribution is an observation in a book that became universally known as "Meadow's Law". This states that:

"One sudden infant death is a tragedy, two is suspicious and three is murder, unless proven otherwise."

Sally Clark was convicted on evidence from Sir Roy Meadow

Over the years he gained a reputation for being particularly severe when confronted with cases of multiple child deaths in one family. Many supporters, however, have championed Sir Roy, calling him a man of great skill and compassion. A spokeswoman for the Royal College of Paediatrics and Child Health "His work has undoubtedly saved the lives of many children. The judge also overturned the GMC's ruling that the paediatrician was guilty of serious professional misconduct. The case against him centred on his testimony at the 1999 trial of Sally Clark for the murder of her babies. She won her appeal against her imprisonment in 2003. During Mrs Clark's trial, Sir Roy said the probability of two natural unexplained cot deaths in the family was 73 million to one. The figure was later disputed by the Royal Statistical Society and other experts said that once genetic and environmental factors were taken into consideration, the odds of a second cot death in the same family were closer to 200 to one.

Sir Roy also gave evidence as an expert witness in the trials of two other women, Angela Cannings and Donna Anthony, who were both freed on appeal after being convicted of murdering their children.

He retired from clinical practice in 1998, but wanted to restore his reputation with this appeal. But the GMC has expressed concern, saying the verdict raised questions over whether doctors were immune from its investigations.

Fears

In a statement released after the verdict, Sir Roy said: "I am relieved that the court has quashed the GMC's decision. Children can only be protected from abuse if those who suspect abuse are able to give their honest opinion without fear of retribution.

"This is an important decision for paediatricians and all doctors, nurses, teachers and other professionals who may have to express difficult and sometimes unpopular opinions in the course of giving evidence in court. "They should be able to do so without the fear of prosecution by the GMC or other professional regulators." But Angela Cannings said she was "disappointed and disheartened" by the decision. High Court judge Mr Justice Collins explained his decision to overturn the GMC's verdicts by saying: "It is very difficult to think that the giving of honest, albeit mistaken evidence could - save in an exceptional case - properly lead to such a finding." The judge also ruled Sir Roy's actions could not "properly be regarded" as serious professional misconduct.

'Neutering'

In a statement, the GMC said it did not want its work to inhibit doctors from acting as expert witnesses. But it added: "Where there has been serious judicial criticism, we have sought to act to protect the public interest from experts who fall significantly short of accepted standards."

The GMC had said evidence given by Sir Roy in Mrs Clark's case had been misleading, although she was actually freed after it became apparent that another witness at her trial, pathologist Alan Williams, had failed to disclose key medical evidence. John Batt, a friend of the Clark family, expressed concern over the High Court verdict. "It's not right that the professional bodies should be neutered because of an immunity of their members for anything that is said in court."

Sanction was 'too draconian'

Dr Christine Tomkins, deputy chief executive of the Medical Defence Union, which has supported Sir Roy, said: "The MDU has been defending doctors for over 120 years and seldom have we come across a judgment that we consider to be as unfair and disproportionate as the GMC's erasure of Professor Meadow from the medical register. She added: "It is in the public interest that doctors should be able to provide expert opinion in cases where there are allegations of child abuse without fear that they will be the subject of a finding of serious professional misconduct for expressing a genuinely held belief."

Tom Magner, of the Society of Expert Witnesses added: "This verdict gives a heart-warming message to expert witnesses that they need not fear vexatious complaints." Professor Sir Alan Craft, President of the Royal College of Paediatrics and Child Health, said: "This is a welcome result for Professor Meadow, the RCPCH and every paediatrician and doctors in general. "If the original decision had stood there is a real danger that doctors across all specialities would have become reluctant to undertake vital expert witness work."

Sally Clark: Served three years after being wrongly convicted of killing her two sons

Angela Cannings: Served 18 months after being wrongly convicted of killing her two sons

Donna Anthony: Served six years after being wrongly convicted of killing her son and daughter

Trupti Patel: Acquitted of killing three of her children

Sir Roy Meadow: Educated at a grammar school in Wigan and Oxford University

Worked as a GP in Banbury and became a senior lecturer at Leeds University

Took up chair in paediatrics and child health in 1980 at St James's University Hospital, Leeds

Former president of British Paediatric Association

Former president of the Royal College of Paediatrics and Child Health

Knighted in 1998 for services to child health