A woman from south London has been jailed for fraud and child abuse after lying about two of her children being ill, forcing them to undergo multiple surgeries and hospital treatments. This was part of an elaborate plan to claim over £375,000 in benefits by exploiting her children.
The background is undoubtedly disturbing, and the mainstream media has been quick to pick up on the criminal prosecution and jail sentence of seven-and-a-half years for the mother. However, the case also raises interesting questions for the medical professionals involved in the children’s treatment, as well as the medical profession as a whole.
Over a period of ten years the mother took the children to appointments across a wide range of disciplines, claiming that they were suffering from serious illnesses. She deceived doctors and education professionals. As a result the children had numerous unnecessary treatments, including surgery to fit gastronomy tubes for feeding. They were prescribed unnecessary medication and issued with medical equipment worth more than £145,000.
The mother forced her children to fake symptoms of illness, training them in one instance to mimic autistic-like behaviour. The children were made to play along with the charade, even when it meant wearing nappies until the age of seven. Doctors were duly duped. They were described by the Crown as taking much of what the mother said at “face value”.
This case highlights the difficulties doctors face when treating children. The mother’s claims were described as appearing believable and persuasive, although the children were rarely seen to be unwell at the appointments. Where the sole information source is the parent, doctors must listen carefully; explore inconsistent accounts; and keep an open mind about the cause of the child’s illness. The mother repeatedly resisted attempts for further tests or investigations. Judge Elizabeth Smaller noted that the failure of communication channels between the different medical professionals was a contributing factor to the length of the deception.
A second interesting aspect is the duty on doctors to report suspected child abuse or neglect. Doctors must inform an appropriate person or authority promptly of any reasonable concern that children or young people are at risk of abuse or neglect, when that is in the child’s best interests or necessary to protect other children or young people. Sir Keir Starmer (former director of public prosecutions and now MP) has previously advocated a mandatory reporting law, with professionals who fail to report concerns being liable for criminal prosecution.
Would any of this have made a difference in this case? This case highlights the difficulties faced by medical professionals in an increasingly fragmented, stretched and busy NHS. Ensuring continuity of care is increasingly difficult. Is it inevitable that, occasionally, cases will slip through the net? Or can better lines of communication and reporting structures make this unrepeatable? Doctors must continue to fulfill their professional duties and approach every patient with inquisitiveness – without making the consultation an inquisition.