Munchausen Syndrome by Proxy (Hansard, 18 December 2003)

§ The Countess of Mar
asked Her Majesty's Government: Whether, in the light of recent Appeal Court judgments, they will reconsider the position of individuals who have mistakenly been labelled as having Munchausen syndrome by proxy.

§ The Parliamentary Under-Secretary of State, Department for Education and Skills (Baroness Ashton of Upholland)
My Lords, following the judgment in Sally Clarke's appeal case, the Attorney-General has established a working group to consider whether any cases in which Dr Williams has given significant evidence require a more in-depth review. We await the result of the group's considerations. We have not yet seen the written judgment in Angela Canning's appeal case. Once it is given, which we understand will not now occur until the new year, we shall study it carefully.

§ The Countess of Mar
My Lords, I am grateful to the Minister for that reply. Is she aware that, apart from the cases in which children are murdered, when the mother usually goes to court and is either found guilty 1285 or not guilty, there are many thousands of women who have been accused of or labelled as having Munchausen syndrome by proxy, without any clinical or legal assessment? They have no recourse to the courts and, each time they protest, they are told that they are in denial and that it is a sign of having Munchausen syndrome by proxy. This is an equivalent of the stigma of witchcraft in the Middle Ages; there is no trial, and one is guilty until one can prove that one is not guilty, and one has no way in which to prove that one is not guilty. What recourse do those people have to clearing their names? How do they get free of that awful stigma?

§ Baroness Ashton of Upholland
My Lords, the Appeal Court judgments were on cases in which the individuals were charged with murder, and were not linked in any way with Munchausen syndrome by proxy.
In my previous Answer to the noble Countess, Lady Mar, who I know feels very passionately about this issue, I described the approach that we have taken as a multi-agency approach to ensure that professionals from different sectors of our agencies are involved in determining whether there is anything to be investigated, and those matters should not be investigated lightly.
In the light of recent events, the issue of record-keeping is prominent in all our minds. I remind noble Lords that I have said on previous occasions that it is important that record-keeping is understood to be a vital component in child protection, including ensuring that when groundless accusations are made, that too is recorded. That is the best defence for families and children.

§ Baroness Walmsley
My Lords, will the Minister confirm that, whatever is done, the protection of children is always pre-eminent? Given the medical differences of opinion, what are the Government doing to encourage more medical research into the issue? I am sure that the Minister is aware of the working party chaired by the noble Baroness, Lady Kennedy of The Shaws, which is drawing up guidelines for professionals to follow in the event of a cot death. Will she tell us when that report is likely to be published and whether it will receive input from the parents to whom the noble Countess, Lady Mar, has referred?

§ Baroness Ashton of Upholland
My Lords, I agree wholeheartedly with the noble Baroness that child protection must be the pre-eminent factor in all these cases. If we could create a perfect system, we would. On the question of medical research, it is important that we consider all the issues and, in the case of Appeal Court cases, sudden infant death syndrome is an issue and area in which we clearly have work to do.
I am unable to give the detail on the working group chaired by the noble Baroness, Lady Kennedy of The Shaws, but I shall write to the noble Baroness, Lady Walmsley, and put a copy in the Library.

§ Earl Howe
My Lords, does the Minister share my concern that there are only very limited routes of appeal for families who have been split apart by the family courts on the grounds of Munchausen syndrome by proxy? Should there not be better and genuine appeal mechanisms, bearing in mind the closed nature of the family courts and the fact that the threshold of proof that applies in them is lower than that which applies in the criminal courts?

§ Baroness Ashton of Upholland
My Lords, I know that the noble Earl feels very strongly about the issue of privacy within the family courts. However, confidentiality is the other side of that coin. In seeking to look at how the family courts operate, we need to be clear that we protect in the best possible sense the interests of all those involved. I know that the noble Earl is very interested in the mechanisms. I can say to noble Lords that we will examine those issues very carefully. However, I am reluctant to be drawn while issues are being investigated and while we are awaiting the results of the cases before the Court of Appeal.

§ Lord McColl of Dulwich
My Lords, does the Minister agree that Munchausen syndrome by proxy does exist—many cases have been proven as such— and that it would be a pity to suggest that it does not?

§ Baroness Ashton of Upholland
My Lords, the label which we prefer to use is fabricated or induced illness, instances of which have indeed been proven to the satisfaction of all professionals. It is a very difficult matter to prove. The latest guidance produced by the Department of Health—which, as I said, now comes under the jurisdiction of my department in this regard—is therefore critical in ensuring that professionals work together when someone is suspected of fabricating or inducing an illness in a child which may lead to irreparable harm to that child.