[back] Wakefield GMC Hearing 2007
by Martin Walker MA for http://www.cryshame.co.uk
August 19th - August 29th
'One useless man is a shame, two is a law firm, and three or more is a Congress' ---John Adams (1735 - 1826 )
In order to find a definition of what the prosecution scenario now amounts to, and loving Karl Marx's slightly paraphrased words, 'history repeats itself, first as tragedy, second as farce', I had a quick look through the dictionary for a description of a state of extreme farce. I didn't find those words but on looking up 'farce', I came upon exactly what I needed to describe the present state of the prosecution case; a crude characterisation , together with ludicrously improbable situations.
On Tuesday of last week, Miss Smith was well into her cross examination of Professor Walker-Smith, child 'J' being the focus of her attention. Child J's consultant and GP were doctors close to a prosecutors heart (yes, Sally, that's the organ that most people have in the upper left quarter of their thorax). In fact J's doctor appears to have been a right pain, someone opposed to alternative medicine - although where this fits in here one couldn't tell - and utterly unwilling to refer 'J' to the Royal Free, despite J's parents' forceful instructions for him to do just that.
Inevitably, Miss Smith agreed with the approach to alternative medicine - although, I say again, where this fits in here one couldn't tell - and quite certain that the doctor was, by being a doctor, ipso facto the natural guardian of 'J' and any other children these parents might have had. I have to say again here, that what Professor Walker-Smith evidently saw as paternalism, 'a patriarchal doctor who knows best, not letting the mother meet me, to discuss her son', looked from the sidelines again, like this peculiar situation common to both fascism and communism where the State itself assumes parental authority of all children.
Walker-Smith argued strongly that, as the Royal Free could offer a diagnostic service for this child, the GP and the consultant should have happily referred him to the Royal Free. Miss Smith argued just as strongly, that as the child had, according to her, minimal gastrointestinal symptoms, the GP and consultant were quite within their rights to hamper any referral suggested by the parents.
Miss Smith was insistent that child 'J' had no gastrointestinal problems. On the contrary, said Professor Walker-Smith, the parents were determined that he should be examined for gastrointestinal matters and the parents had been very pleased with the advice that he was ultimately able to give them. Miss Smith was at her farcical best in the discussion of this case, absolutely determined that not only was there nothing wrong with the child - except his classic autism, which Walker-Smith knew nothing about - but that the apparently neurotic parents had wrestled medical control of the case from the GP and consultant, to conspire with Walker-Smith to force a colonoscopy and other invasive procedures upon him.
It occurred to me while I listened to Miss Smith's surreal interpretation of the case, just how confident she must be that she is not going to get found out, in the immense and ultimately unbelievable saga that she relates about the health of these children. She must, it seems, be absolutely confident that the media will be kept in check and no one will report the terrible ruse that she has perpetrated now for 100 days. She must be utterly convinced that there will be no proper enquiries into the matter and that she will never be found out in the role of inquisitor manque that she has adopted . She is probably, however, quite safe, after all she is protected by a New Labour government that killed in the region of 100,000 Iraqi civilians while grinning like hyenas and lying about weapons of mass destruction; these are, after all, masters of the political game.
In relation to 'J' Miss Smith repeated her usual rubbish about Professor Walker-Smith's failure to take blood samples and measure inflammatory markers. And she repeated her insistence that child 'J' was autistic and therefore could not be diagnosed with any other condition or treated for anything. By this point in the hearing, Miss Smith's arguments had become so monumentally tedious that it was very hard to stay awake and continue thinking. The only thing that kept me awake was the feeling that one was watching history of a kind being made. Whatever the outcome, I will be able to tell my children not only that as a young man I saw Cyril Washbrook hit a six straight through the glass face of the pavilion clock at Old Trafford, but that near to my dotage I witnessed Miss Smith orchestrating the most immaculate deception, since that perpetrated by the actor, Norman Shelley, later of the Archers, who acted out Winston Churchill's speeches while pretending to be Churchill, on BBC radio.
Good strategist that Miss Smith sometimes appears to be, she ended her cross examination on Thursday with an all out attack on any apparent link in the Lancet paper between any illness and MMR. This was good strategy because she hoped to leave this apparent misjudgement, the one that she pretends to believe was behind the Lancet paper and all the crimes committed by the three defendants, in the minds of the jury at the end of her cross examination. Intelligent strategy as well because, as it was clear that Professor Walker-Smith, had a considerably different attitude to doctors and the law than did Dr Wakefield, she knew that she was digging in divisively fertile ground.
Unfortunately Professor Walker-Smith was quite helpful to Miss Smith as she continued to excoriate the departed Dr Wakefield, although he had the perspicacity to acknowledge at one point that he and Dr Wakefield had different agendas; 'Andy's agenda and that of the clinicians was completely different'. Once Miss Smith had moved through the Professor's abhorrence of medico-legal proceedings and of doctors receiving money from the legal aid board, she moved in for the kill.
The final and most chilling part of Miss Smith's cross examination scurried right to the heart of the prosecution case, there she squatted on her haunches and chewed at that tough muscle. Her case was this: The publication of the Lancet paper obviously had serious public health consequences and therefore it should neither have been written nor published. I must say it was at this point that my esteem for Miss Smith rose suddenly unbidden. Previously I had never thought of her as an apostle of censorship, a female version of Franco or Mussolini, now, of course awakened to her cause, I could see the familial and especially facial resemblance to the latter.
Whatever the science lobby groups or other of Dr Wakefield's detractors have said about his work lacking scientific rigour and about the Lancet paper being heavily faulted, was as nothing compared with Miss Smiths out-front anti-science diatribe with which she ended her cross examination. 'This paper ..' , she cried, '…is full of implications that the vaccine was responsible. There is a question mark raised over the role of MMR'. One was of course pleased that Miss Smith pointed this out, though surprised that she didn't immediately strip off and cackling in a high register, mount a broom stick and begin to circle a pyre of copies of the Lancet and other documents in a smoke filled hearing room. I can almost hear her incantation.
Wakefield, Wakefield!
Your time is nigh.
Your good work is undone
As I cry fie.
On Friday, despite a slightly earlier start and finish, Mr Miller progressed well with his re-examination. In this, all our questions, so intricately confused by Miss Smith were asked and answered in the straightest language. The re-examination did have a slightly awkward start when Professor Walker Smith, obviously confused by the change in interrogator, began interrupting Mr Miller's questions as he had done Miss Smith's.
Miss Smith also found it difficult to throw off her old role and continued to be almost accidentally farcical. When Mr Miller introduced some new documents that Miss Smith had not seen, she objected. The legal assesor , Mr Nigel Seed a man of no mean stature, being both a QC and a Recorder, in answer to Miss Smith, issued one of those apparently off-hand condemnations at which Judges are so good. When the matter was put to him, he addressed Miss Smith in these terms: 'On day 98 of these proceedings this is (Miss Smith's objection) a monumental waste of time'. Miss Smith, evidently chastened, sat down, while the defence team smiled like the cats who had just had the proverbial cream.
Mr Miller went through a number of the Lancet paper children, pointing to the suspected symptoms of bowel disorder. He also addressed Dr Wakefield's purpose in writing and publishing the paper and looked at the MRC meeting that followed, giving Professor Walker-Smith an opportunity to reclaim some ground on Dr Wakefield's behalf. So it was that the matter of single vaccines and the now infamous typing errors - Zuckerman had given evidence as he tried to crawl backwards out of the hearing, that the use of the word 'monovalent ' used twice in a letter to Dr Wakefield, and to which he had apparently given his support, had actually been a double typo which should have read ‘polyvalent'. As well it was pointed out that although the MRC meeting was supposed to have been organised so that the Royal Free team could put their point of view, the meeting was hijacked from the beginning by government and pharmaceutically loyal attendees.
Mr Miller's re examination, reminded me of the television as it used to be, thirty years ago. When the programme was suddenly interrupted by terrible static and chains of white blips wiped out the picture like a snow storm (Miss Smith) it took a deft hand at the back of the set, together with the occasional two handed shake to restore a more or less perfect black and white picture ( Mr Miller). Mr Millers re-examination also makes one vaguely hopeful that the panel will receive this good picture and see what Miss Smith and the prosecution has tried to do.
Mr Miller's second day of re-examination took place on the morning of Tuesday 26th, after which the panel retired to go through their papers and look again at Professor Walker-Smith's evidence so that they might question him on Wednesday 27th.
In an unusual move this morning, the panel asked that the prosecution make contact with two of the parents (fathers) of children seen separate from the Lancet 12. It was not clear to anyone why they wanted to interview these parents, although one suspects that they want to find out any differences, or similarities in treatment between those children seen for clinical need and cited in the Lancet paper, and those seen after the Lancet 12.
The Panel did manage to ask all their questions between 9.30 and 13.00 on Wednesday 27th of August. As has been the case on other occasions it was very difficult to understand where the panel members were coming from or how their opinions were forming. Clearly the central assertion made by the prosecution that the Lancet case series review was actually the botched and ethically unapproved research study 172/96, remained uppermost in the minds of most panel members.
It is actually very difficult, from the panel's questions to understand how heavily they have invested in the prosecution case. Oddly, the questions from the two medical members of the panel, Drs Moodley and Webster seemed somehow more pragmatic and understanding of Walker-Smith's defense, than other panel members.
Dr Kumar the other medical member, who asks his questions last, appeared to spend his first batch of questions trying to isolate the role of Dr Wakefield from the evidence of Professor Walker-Smith. Before changing tack completely to ask questions that were evidently within Professor Walker-Smith's experience. He asked initially about the Wakefield Clinic stamp that had appeared on some documents but which had nothing to do with Professor Walker-Smith, about Dr Wakefield's presence at Walker-Smith's clinics, and about whether or not Dr Wakefield took notes or contributed to clinical decisions.
It was, however, the conscientious Ms Golding, one of the lay panel members who pursued the most confusing line of questioning about Dr Wakefield's lack of pediatric experience. Professor Walker-Smith handled the initial question very well, as he had throughout his evidence, explaining that it was common practice around Britain, where there were no pediatric gastroenterologists, for adult gastroenterologists to work with children. Unfortunately Ms Golding pursued her question which somehow seemed to disintegrate into a statement that suggested Dr Wakefield had no qualifications at all relevant to the work at the Royal Free .
I left the hearing feeling very concerned that no one had corrected the impression that might have been reinforced in the minds of other panel members about an unqualified Dr Wakefield. It seemed to me important the point was made again, that not only had he been researching gastroentestinal disease since the late 1980s, with an emphasis on Crohn's disease but that he had prior to that been a bowel transplant surgeon in Canada. In effect Dr Wakefield was an ideal research medic to work alongside Professor Walker-Smith, the massively experienced pediatric gastoenterologist .
Obviously there were many and more varied questions than I have suggested here but without knowledge of their weight or value and without understanding their direction there seems little point in exploring them. At the end of the panel's examination of Professor Walker-Smith, it was decided that it was too late for his defense team to bring forward the first of the three witnesses they intend to bring on his behalf. And after the panel had voiced their decision not to call the two fathers, about whom they had asked on Tuesday, the hearing drew to a conclusion. The panel chairman announced that Professor Walker-Smith would bring his three witnesses between the 3rd and 19th of November. Everything being well I will return to report this next section of the hearing.