Cot death, infanticide & child protection

GENERAL MEDICAL COUNCIL

FITNESS TO PRACTISE PANEL (PROFESSIONAL CONDUCT)

Monday 12 November 2007

Regent’s Place, 350 Euston Road, London NW1 3JN

Chairman: Dr Jacqueline Mitton

Panel Members:

Mrs Leora Lloyd
Mr Alexander McFarlane
Mr Arnold Simanowitz

Legal Assessor: Mr Robin Hay

CASE OF:

SOUTHALL, David Patrick

(DAY NINETEEN)

MR RICHARD TYSON of counsel, instructed by Messrs Field Fisher Waterhouse, solicitors, appeared on behalf of the Complainants.

MR KIERAN COONAN QC and MR JOHN JOLLIFFE of counsel, instructed by Messrs Hempsons, solicitors, appeared on behalf of Dr Southall, who was present.

(Transcript of the shorthand notes of T. A. Reed & Co.
Tel No: 01992 465900)

I N D E X

Page No

FRANCINE BEVERLEY SALEM, continued

Questioned by THE PANEL 1
Further cross-examined by MR TYSON 23
Re-examined by MR COONAN 26
Further cross-examined by MR TYSON 29

PLEASE NOTE: Copies printed from e-mail may differ in formatting and/or page numbering from hard copies

THE CHAIRMAN: Good morning. Are you ready to continue?

THE WITNESS: Yes, I am ready.

FRANCINE BEVERLEY SALEM, continued
Questioned by THE PANEL

THE CHAIRMAN: Mr Coonan, anything before we begin the Panel’s questions?

MR COONAN: No, thank you.

THE CHAIRMAN: So this is the point at which the Panel have the opportunity to ask you questions. I will introduce them to you before they speak. We are going to begin with Mr McFarlane, who is the medical member of the Panel. Mr McFarlane?

MR McFARLANE: Good morning, Ms Salem. Thank you very much indeed for coming. I have a number of questions for you. Right at the very beginning, from what I believe from your CV, in terms of your career working in child protection, you had been working for approximately ten years before this case came up, was that right?
A In 1988 I qualified, and yes, since that time, I had been working in the child protection arena, yes.

Q That is right. You said that although you had a theoretical working knowledge of Munchausen’s Syndrome by Proxy, there had only been one previous case of that within your social services department, and that had been handled by somebody else, so you had no sort of hands-on experience, is that correct?
A That is correct, yes.

Q Thank you. We have also heard that Professor Southall’s name came up via word of mouth, was that right, somebody knew of him within the department?
A Not from our point of view, no.

Q Could you explain further?
A Certainly Professor Southall’s knowledge of this field was why we chose him.

Q So you knew of him and of his work in this field?
A Yes.

Q The fact that he was relatively near in Stoke was also an advantage?
A Yes.

Q Thank you. In terms of how the M family presented themselves to you, we have heard that this was almost a lucky find, that a new person had come into the hospital, had had access to the Part 8 report regarding M1, and was also aware that M1’s mother was working in the hospital and had had protracted sickness absence. This sort of discovery of these sorts of problems by serendipity, for want of a better word, is this a common way that these things present?
A No, it is not at all.

Q So it was an uncommon presentation?
A Yes.

Q Thank you. We understand that you telephoned Professor Southall initially, and I am aware that this is ten years ago. Are you able to help us as to how long this initial telephone call lasted?
A I am afraid really I would be guessing.

Q That is fine. Could I ask you, please, to go and look at C1, behind tab D, page 375? If we are looking at the level of the upper punch hole, the notes that you wrote on 23 January 1998, you have been taken to this paragraph several times, I understand that your sort of method of working would be to take notes; am I right in presuming you do this on little bits of paper as you have done before and then you write it out in neat full hand for the record, is that what happens?
A On these contact sheets? No, these contact sheets would be done straight on to the form.

Q So straight on here. I would like to take you to a sentence, just after where it says “PI Illness”, it says:

“He believed that we had a ‘major’ child protection issue here and suggested that we needed him ‘on board’.”
A Yes.

Q Could you explain that further?
A Obviously, the quotation marks are actual quotes from the discussion, and he was quite clearly saying that there were concerns in relation to risk to M2, and that we needed further advice from him.

Q So he felt that he was the one to do this, and you could not get this from anywhere else, which is why there was this need?
A He did not mention that we could not get it from anywhere else, no, but he certainly felt that his knowledge would be helpful.

Q Right. That is most useful. I understand you only met him on two occasions? You had a meeting with your team manager --
A Team manager, yes. Oh, and the interview with Mrs M, yes.

Q That is right. You did not meet him subsequently after that?
A No.

Q At this interview with Mrs M, you explained to us that sometimes when you hold interviews, you do them under what you call memorandum conditions.
A Yes.

Q Could you explain that just a little bit further for me, please?
A Yes, of course. It usually is in relation to children and young people when they have either witnessed or been subject to some form of abuse or incident really. It is a joint operation that we do with the police, so we are jointly trained, so a young person can choose either to speak to a social worker or speak to a police officer, so it is whoever they feel most comfortable with. Usually, you know, there is obviously a particular way that you ask those questions in an open way, starting off with a rapport, then having open questions, and closed questions if need be, in order not to lead a young person to make their statement. It is usually to facilitate an easier statement taking rather than sitting there and writing it down for a young person it is sometimes easier for them. It is also on occasion, if the judge allows, enables them to use a videolink when they actually do give their evidence.

Q Is also one of the reasons for doing this that if evidence from this interview is then presented to a court of law, it could stand up to criminal and legal scrutiny, in terms of rebutting the presumption of innocence of an accused party?
A Sorry, I am not with you, the last bit.

Q Well, the evidence granted from that would be of such strength it could be used as quite convincing evidence in a court of law.
A Yes, and it certainly is equivalent to a written witness statement.

Q Thank you. So when you had this interview with Mrs M, was this done under memorandum conditions?
A No, it would not be, because she is an adult.

Q We have heard that when M1 came into the room, she appeared a little flustered. I understand that Professor Southall was asked to make an independent report for the County Council, and he asked you to come along. You were, as it were, wearing your child protection hat, and you had been involved with taking out the emergency protection order. So could your presence there perhaps have been seen - that the independence of this interview might have been lost, or the integrity of the independence might have been lost because you happened to be there?
A I suppose right at the beginning of your question, it has been suggested that she was flustered, I did not say that, and that certainly was not my interpretation. With regard to the independence, I suppose it could be looked at both ways, because Mrs M knew myself, and whilst we had had a difficult start, the core assessment process had improved relations, and I think it could have been seen both ways really.

Q There were three people at that interview. We have now heard three versions of what went on. In terms of discussion regarding the fact that M1 could have met his death by means of a criminal act, I am talking of murder, did Professor Southall discuss the three scenarios with you before the interview, or were these three scenarios introduced for the first time at the interview with Mrs M there?
A I do not recall him discussing it beforehand.

Q But we understand that whilst you were there, he did not discuss the manner that was proposed in terms of injecting M1 with the substance and then hanging him up, and that if this had been promulgated by him, you would have reported that to a senior?
A Yes.

Q Have you ever been in an interview subsequently when you have had to report somebody to a senior?
A Yes.

Q Thank you. I want you to turn to another page, but before I give you the reference, I would like you to cast your mind back as to how you thought when you first read it, if you see what I mean. The reference is behind tab Z, page 30. If we look at the fourth full paragraph down, starting at the middle, a sentence saying:

“A discussion ensued about this ...”

It talked about this process of sedating and hanging M1 and the fact that this was discussed. This report was dated 30 May 1998, and unfortunately, the copies of the contact sheets that we have been given sort of peter out in April 1998, so we do not know of any of your views. What did you think of when you read that for the first time, I presume, right at the very end of May or the beginning of June in 1998?
A You are referring to the fourth paragraph down?

Q Yes, it says:

“A discussion ensued about this, including the concept that at ten years old, it would be quite difficult to deliberately suffocate or asphyxiate M1 and then pretend to hang him. Probably some form of sedation would be involved.”
A I do not recall what I thought at that moment in time.

Q Right, what do you think of it now?
A I think it reflects the clear discussion that took place.

Q Even though it said that there was a discussion there that there were some various actions here which he said were not mentioned but then seem to have crept into the report?
A Do you mean about the asphyxiation and the suffocation?

Q Also the deliberately drugging.
A I am sorry, I do not understand what I am being asked. Are you asking me what I think now or then or --

Q I asked what you thought then, and you said you could not remember, so I am asking you what you think now.
A I think that was obviously reflecting what Professor Southall was thinking when he wrote the report.

Q So you did not accord any particular significance to it?
A Particular significance in what respect? I am sorry, I am not grasping it at all, if you just bear with me.

Q Of course. We have to look at particular Heads of Charge, and one of the things was that we have been led to believe by one person that some things were said at an interview which included drugging M1 and hanging him up. It seems to me that the first time that this seems to have appeared is in this report on 30 May. You said yourself that if this was brought up in discussion at the interview, this would have flagged up a significant flashing light on your own warning panel to refer it on to a senior.
A Yes.

Q Here, the concept is introduced into a report; I am just wondering, would it have a similar effect?
A I interpreted this as what Professor Southall was thinking when he asked those questions.

Q Right. So what you are saying is it is just he is putting down his thoughts on paper, and is of much less significance?
A Yes.

Q That is most useful.
A Sorry, I got there in the end.

MR McFARLANE: You did. Can I thank you very much indeed, I have no further questions.

THE CHAIRMAN: Next is Mr Simanowitz, who is a lay member of the Panel.

MR SIMANOWITZ: Good morning, Ms Salem.
A Good morning.

Q You will be pleased to know that a number of the questions I was going to ask have been dealt with by Mr McFarlane. That is not unusual, we do not discuss the questions beforehand, and we probably have similar concerns. It also means that my questions may be a little less organised than I had hoped they be. But if I could actually start by pursuing the last question that Mr McFarlane was dealing with, what I do not understand is that these matters that are in that paragraph that we have just talked about, seem to be very serious matters, significant matters, and Professor Southall says they were discussed. What I cannot understand is firstly why you cannot remember that, and secondly, why it is not in your note.
A I do not know why I cannot remember that, and I apologise, obviously it was some time ago. I believe that what I wrote down at the time was a reflection of what took place.

Q You are not suggesting that this did not take place, because you did not write it down?
A No, I am saying that I cannot recall it. I wrote down what I could of that meeting.

Q That really leads me on to the whole question of your memory and the evidence that you gave. You began by saying, when you were asked, that you did not have an independent recollection, you would have to rely very heavily on your notes.
A Mm.

Q Yet there are situations where, when you were asked questions by Mr Coonan, and indeed by Mr Tyson, you went into great detail about certain matters. How do those stack up, as it were?
A I think generally, your memory relies very much on - well, my own experience of memory is not remembering perhaps the detail, but certainly you remember particular events, anything that was unusual, and you remember a general overview, but I do not remember the minutiae.

Q That does make sense, but that is why I come back to the first question I asked. You talk about significant events, and Mr McFarlane asked you what you thought about this paragraph. Do you not regard that as very significant?
A The particular paragraph?

Q The whole question of hanging up, asphyxia, drugging; it seems to me that is extremely significant, and yet when you say you remember significant events, you do not remember that. Again, I wonder whether you can clarify that.
A I cannot clarify it any more, I have sort of answered the questions as best I can.

Q Clearly you cannot take it any further, thank you. I just want to talk to you a little bit more about your experience, and we have heard the detail. How often have you given evidence in court or a tribunal such as this?
A Not a GMC Tribunal; only once in a work environment tribunal, and many times in court.

Q Your evidence in court, that would be in a situation where, like here, you were cross-examined?
A Yes. Well, within care proceedings, yes.

Q And that can be quite extensive evidence?
A Yes, certainly this particular case lasted five days, and I was giving evidence for several days, yes.

Q So you could be described as an experienced witness giver, would that be right?
A Yes.

Q As far as I can see, the issue of Munchausen or PII came up quite early, but that could relate to a number of problems; it could be emotional, it could be physical, and it could be, as was suggested in this case, murder. What was the first time that the suspicion of murder came into your mind?
A I do not know exactly, but obviously it would have been early on in the process.

Q It was before you came to the interview, is that right?
A On the 27th, yes.

Q If you can look at tab (v), page 96, towards the bottom of the page, seven lines up, referring to Professor Southall:

“He is still of the opinion that mother has a Munchausen’s Syndrome and that this will lead to M2 being at serious risk of harm from her.”

Was that serious risk identified? Did you know what was being referred to?
A I believed that was physical risk.

Q And that was because why?
A Because of her presentations at school, the alleged mood swings, the threats by M2 to harm himself, all those things, and the significance of that in relation to M1.

Q Were you at that stage thinking in terms of murder, the possibility of murder, given what had happened to M1?
A I think the possibility of, yes.

Q You had that in mind. So would it be right to say that when Dr Southall spelled out the three scenarios, and one of them was that Mrs M had killed M1, that didn’t come as a surprise to you?
A I do not think it was put quite like that, but no, it was not a surprise, because there were three ways that M1 died.

Q You say you do not think it was put quite like that; how was the third possibility put?
A Well, it was more open than that, in my opinion, that he was murdered, rather than Mrs M did it.

Q I just want to touch very quickly on the issue of bullying. I think you said, and in your notes it was said that one of the things that worried you and social services generally was the fact that although Mrs M was making these allegations, there was no evidence from the school that there had been bullying.
A Sorry, in relation to M1 or M2?

Q In relation to M2.
A Right, yes.

Q Is it not right that almost the last people to know about bullying at school are the teachers?
A I would not be able to comment as to whether that is a correct assertion or not.

Q Well, presumably you have dealt with a lot of cases of children being bullied.
A Yes.

Q So what is your --
A But obviously I do not know what the research or the recent information --

Q In the cases you have dealt with where bullying has come up, do the teachers always know about the bullying?
A Yes, they do.

Q They always know?
A They do not always know, but they usually have an idea.

Q I want to come to the circumstances of the interview and running up to the interview. If you look at D21E, this is not your note, it is a note of the strategy discussion, and I am not quite sure what you are saying about this; does this reflect what you knew about the strategy discussion, or do you challenge issues in that note?
A This is my writing.

Q It is your writing?
A Yes.

Q The police confirmed that they were not re-investigating M1’s death, but they did wish to speak to Mrs M regarding ambiguities in her statement, and how the belt was wrapped around his neck. So you knew they were going to deal with that matter, yes?
A Yes.

Q Did you think it appropriate, if the police were going to deal with that matter, for Dr Southall to deal with that matter in the interview with Mrs M?
A I did not think it was inappropriate, no, and certainly, it was in a voluntary capacity that they were going to speak to Mrs M.

Q I understand that, but I can see that a joint investigation can sometimes be tricky. I think you said yourself that certain things are dealt with by the police and others are dealt with by you. But here was a situation where the police quite clearly said they were going to investigate that, they were concerned about it, they were going to investigate it. Do you think that there were crossed wires or it was unnecessary, or again, I use the word inappropriate; if the police were going to deal with it, even in a voluntary manner, do you not think that that was a matter that should have been left to the police?
A I do not, but you are going to ask me why, are you not? So I have to --

Q You anticipated my next question.
A I do not, because from my point of view, what we often do is assess risk, and that is what we have to do in order to protect children. In order to do that, we have to have all the information. So that is why I did not feel it was inappropriate.

Q Again, I am sorry to push you on this, I am just trying to get your mindset, which are two words that have been used before. You felt you needed to have all the information, but you knew this was going to be pursued by the police?
A Only if Mrs M agreed.

Q Well, only if she agreed, and only if she agreed, that still applied to the interview with Dr Southall. If she had agreed, the police have their ways of asking questions, then there would be no need, you would have had all the information, that bit of the information. You still think it was appropriate for that to be dealt with in that interview?
A I do not think it was inappropriate, no.

Q Could I turn to the judgment which I hope is C4, page 7. It is not a single exhibit, it is in the Council’s exhibits. Just before letter E starts, there is a paragraph which says:

“It was prepared at a time when the local authority perceptions of the problems were very different from what they are now ...”

And then later on:

“Things have moved on ...”

Are you with me?
A Yes.

Q In what way have the perceptions changed?
A That was through the process of the core assessment, which obviously I have, and they had moved on in relation to the information that we had found out in relation to the matrimonial relationship, and obviously the problems therein, and the unavailability of the male parent, and the lack of addressing some of the bereavement issues which had been recommended.

Q I understand that. Just going back a few lines, the judge is saying:

“I do have a written report of Professor Southall which is expressed by him to be ‘very preliminary’ ...”

We know what was in that report. What he is saying is that the local authority perceptions are very different, and I wonder whether you could distinguish the two perceptions. It seems to me, if I can help, Dr Southall’s perception was of risk to harm, and that is the basis on which the EPO was granted, that was his perception. Now the judge is saying: “Your perceptions have changed from that” and what I want to know is what is the changed perception? Ignore “moved on” for a moment, but what was the change in perception? What was your perception of the problem at that stage?
A That it had opened up more concerns in relation to the emotional welfare of M2, but also not just M2 but the impact that had had on M1 during his lifetime as well.

Q But does it not suggest that Dr Southall was worried about immediate risk of harm, and we get this from the result of the judgment, that an interim care order could not be made because that risk was not there, or you did not have evidence of that because Dr Southall was not there, so that seems to support the fact, and I am just trying to find out what it was, that the perception had changed from immediate risk of harm to all these other matters that you are dealing with, is that right?
A Certainly, but I did not feel that the judge criticised us for having taken that action within the judgment.

Q I am not suggesting for a moment that he criticised; what he is saying is at that time you had a certain perception which warranted an EPO; now you do not have that perception; it is not only because Professor Southall is not there, you do not have that perception any more and therefore it does not warrant an interim care order, because your perception has changed.
A He did say in his judgment that more investigation was needed to be made, did he not, so he did not feel it had been ruled out all together or had been looked at totally, but certainly the ICO was not granted and, you know, there was an agreement for work to be undertaken for the next 12 months, which was done.

Q Yes, I understand that. I am not sure that I do understand at the moment what your perception was.
A Sorry. That there were wider issues.

Q That there were wider issues?
A Yes.

Q In addition to the issues you had before?
A They had not been totally ruled out, had they, at that point, no.

Q Can you look at D21G? I must confess to being somewhat confused over this question of a re opening of an investigation and your referring to a review, which is referred to elsewhere, but here, on 16 April 1998, again, although your name features at the top I understand this is not your attendance note, is that right?
A My name features at the top as it does with all the contact sheets, because I am the social worker.

Q But it is a social services contact sheet?
A Yes, it is.

Q Was it your team managers?
A Yes, it was.

Q And there are two statements, nearly halfway down the page: “The police now confirm that they will be re opening an investigation into M1’s death”, and then there is a paragraph and then another line: “The purpose of this meeting was to inform Social Services Department of this decision and to find out where we were up to in our inquiries”. On the basis of that I am just wondering how you can say you did not think they were re opening the investigation?
A I am not saying that I did not think that would mean; I am saying this contact sheet is incorrect.

Q Your team manager was incorrect?
A Yes, and certainly the contact sheets in the rest of my file reflect the fact that it was a review of the evidence.

Q It is quite a serious mistake, is it not?
A Yes, it is. Totally.

Q In reply to a question that Mr Tyson asked you about what needed to be investigated, you said: “I have a lot of experience and know what to investigate”. That is true, isn’t it?
A I have a lot of experience?

Q Yes. You said, “I have a lot of experience and know what to investigate”.
A I cannot actually remember saying that but, yes, if you have written it down ---

Q Yes, it was said and you would say that is correct, that you do have a lot of experience and you do know what to investigate?
A Yes.

Q Was that the same position when you had not long been a senior social worker? Would you say that that was still the same in 1998? It seemed to me you were answering the question as of now.
A Yes. Certainly I was made - as you can see from the CV, I was a senior social worker in Telford and Wrekin in 1994, so I had been a senior for four years by then. I had not just been made up to one.

Q So you would equally have answered that question “I had” ---
A Yes.

Q I wanted to clarify that, because you put it in the present.
A Yes.

Q I think this is my last question. Could you look at tab (gg), going back to the other trial, C1, page 25. Just over halfway down the paragraph starts: “Mrs M was adamant”?
A Yes.

Q “Was adamant that M1 had taken his own life”. What does the word “adamant” connote for you?
A That she was sure.

Q But in what circumstances would you be “adamant”? Well, let me put it another way and make it easier. To write down that someone is “adamant” means that they have been asked the question more than once. They have been asked, they say something, they have been challenged and the note says “She was adamant”. Do you not agree with that?
A I am not because I do not agree no because she was clearly saying that the result he was the bullying was resulted in M1 hanging himself.

Q I can see she was clearly saying. Maybe it is the use of English but it seems to me that when someone is “adamant” that is in the face of a challenge. Would you not agree with that?
A Not always, no.

MR SIMANOWITZ: Thank you very much. Those are all the questions I have.

THE CHAIRMAN: I now introduce Mrs Lloyd, who is also a lay member.

MRS LLOYD: Good morning, Ms Salem. I have to apologise in advance because I have rather a lot of questions for you as a result of needing to be absolutely clear about the evidence that you have given, or that has been put before us which you have been taken to. We were shown D21B, which is sections of the Children Act 1989. Could you just clarify whether it was this Act which highlighted responsibilities of GPs and hospital staff, et cetera, to report suspected NAI to social services departments?
A The Children Act 1989?

Q Yes, in this Act?
A Certainly. And it was ---

Q That is fine. You have answered the question, thank you. You were asked this morning by my colleague but you were also asked it before, when you were asked why you approached Professor Southall as opposed to X or Y, you said: “It was obviously because of his knowledge in the area of PII”. What I am going to ask you is could you clarify how you knew of Professor Southall’s knowledge in this area?
A I think it is from written information and research.

Q Can you be more specific, please?
A I suppose undertaking training and things like that, certainly Professor Southall not just Professor Southall but other doctors --

Q I am only asking you about Professor Southall.
A have that reputation, do they not, so it would seem logical to have gone to Professor Southall at that time.

Q I still do not understand, if you know of somebody, the various means by which you come to know of them. Can you draw from your memory about how you came to know of him?
A Certainly the work that he had done previously -

Q What work?
A In that area. I do not know, I cannot remember, but I think it would have been by reputation and that knowledge, really.

Q Through whom?
A I do not think it was a particular whom; I think it would be through research material rather than through anybody in particular.

Q Thank you. I will leave that there. Did your department or you have access to other experts in the field of PII?
A We would have done, yes.

Q Did you?
A Do you mean did we take that up or did we have knowledge of ---

Q Yes. Did you have knowledge of and did you use other experts in PII?
A No, we did not, but we did have knowledge.

Q Thank you. On day 17, page 73F, and you do not need to turn this up because I will paraphrase it for you, you were talking about Professor Southall being open and honest with Mrs M in the interview, and then you went on to say that he was more open and honest, in fact, the term used was “more so”, than some of the other professionals and you gave as an example health professionals, and you said they were not willing to challenge and they would say things in conferences but not when Mrs M was present. Could you clarify, please, what situations you, Mrs M and these health professionals were in, when you observed this?
A Obviously I would have to go and look at my files but there was occasion when somebody like the school nurse, perhaps, would be more open in discussions rather than when Mrs M was present actually at the case conference, is what I meant, that they would say perhaps things outside of the case conference arena than were willing to have written down.

Q And given this observation you made, did it in any way raise any concerns with you about the credibility of these health professionals?
A No, it is not so much their credibility: I think it is their confidence and their willingness to have an open relationship, and it was something that we have come across quite often, where people want to maintain a good relationship with a parent and therefore will not be open and honest.

Q Going back to the telephone call from Professor Southall when he asked you to be present with Mrs M, C1, page 101, and you need not turn it up unless you wish to, you said that he telephoned you to ask you to be present during the discussion with Mrs M. Could you clarify why you have used the term “discussion”?
A I do not know why I chose that particular phrase. I did not attach any significance to it at the time.

Q Did Professor Southall tell you what he had been asked to do as the instructed independent expert nominated by the local authority during this call?
A I cannot recall the contents. I think I have been asked that before; I cannot recall the contents of that discussion.

Q Did you get a copy of the instruction, because you were one of the people mentioned on it as one of the people involved. It was C1.
A We would normally get a copy of it.

Q Did you get a copy of it?
A Can I check the file?

THE CHAIRMAN: Is there any reason why the witness should not refer to that?

MR TYSON: I ask for clarification - is the witness wanting to look at her own individual documents she brought?
A Yes. To see if I have a copy.

MR TYSON: I have no objection.

MR COONAN: In fact I think she should be encouraged to look at the file. May I just say this: some of the questions which have been arising this morning make me a little concerned that counsel and the Panel have not been given full access to this file, and there may be material in there which bears on some of these matters. I am beginning to get concerned because we have not been permitted to see the rest of the file.

I say no more at the moment, but there may be a little more to run on this

MR TYSON: Can I endorse what my learned friend says that there is a bundle of documentation which you have not yet been burdened with which shows the efforts that these instructing me made to get the contents of this file, and we were given, as it were, edited highlights only, if I can put it that way. I see my learned friend nodding on that observation.
A We do usually get copies of all legal correspondence. I cannot find it in here at this moment in time but probably when everybody is not looking at me I will be able to put my hands on it.

THE CHAIRMAN: Would a bit more time help? Can I ask Mrs Lloyd whether she would particularly like ---
A It would be usual that we would get it.

MRS LLOYD: I think it would be useful to know if Ms Salem did get a copy because she is mentioned as one of the people involved in the case and I think it is relevant to the question I am asking.

THE CHAIRMAN: Yes. Ms Salem, do not feel flustered, do take the time you need to look in the appropriate place and see if you can find it while we wait.
A It is difficult. I have the letter instruction to Dora Black --- (Pause.)

MR TYSON: Madam, may I respectfully suggest that we revisit this matter perhaps at a later time after a break so that the witness can look for it during the break?

THE CHAIRMAN: Actually I have an indication that, despite the fact that we are in the middle of Mrs Lloyd’s questioning, she has got some way to go and a break would be appreciated at this point anyway, so perhaps that is appropriate. I know exactly the problem - it is often hard to lay your hands on something when you feel all eyes are on you.

Let us take a short break now until about quarter to, and that will give Ms Salem an opportunity to check whether she has it or not. Ms Salem, it is in your hands you must not discuss it with anyone during the break.

(Short break)

THE CHAIRMAN: Mrs Lloyd, are you ready to continue the questioning?

THE WITNESS: I am afraid I have to confess I cannot find it at this moment in time.

MRS LLOYD: On Day 18/25/C you were being asked questions about why you felt it was appropriate for you to attend the meeting with Professor Southall on 27 April, you said you discussed it with your team manager to get a second opinion. Could you clarify why you wanted a second opinion, please?
A Because that would be standard practice really if you are going anywhere you speak to your team manager. It is about accountability of where you are and what you are doing.

Q Could you clarify what you told your team manager for him to agree that it was appropriate for you to attend?
A I told him what was in the contact sheets that I had been asked to attend the discussion with Professor Southall and those reasons why that are after it.

Q When you were asked about the request from Professor Southall to be present at the interview and whether you had personally experienced before being asked to be present at a consultant paediatrician’s interview, you said you had not in relation to MSBP but you felt it would be useful in terms of your core assessment.
A Yes.

Q Could you clarify briefly, and I stress briefly, what your department’s pro forma was for your core assessment in terms of the components and headings of your core assessment?
A Can I refer to it and I could tell you exactly then?

Q Yes, that would be very useful.
A Obviously it starts off with the basic information, a chronology of all events, genograms of family, the purpose of the core assessment, initial causes for concern. It then includes the summary hypothesis that was referred to at the original strategy meetings. Then we have an individual profile of M2. Then we go on to have individual profiles of each parent, so we have Mrs M and M1. We meet with family members to talk through their own parenting from birth right through really to give us an understanding of what their experience of childhood was. We went right through all the marital disharmony as well. We also visited M1’s paternal aunt, maternal grandparents who actually came up from down south, what family support networks there are to see whether they are socially isolated. I talked to Mrs M obviously regarding M1 from pregnancy right up until death really. What the attitude of the parents was towards the assessment, willingness to change, which is an important part of that, then within this I also looked at the concerns in relation to bullying at the school as well because obviously we had made extensive enquiries at that time and there were issues relating to domestic abuse within that because obviously that was a feature. Then it talks about the expert witness reports as well, there is discussion about that. Then a conclusion and there should be recommendations. That is an old style. The new style is obviously very different and looks at the assessment framework.

Q Thank you very much. That was very useful. Returning to the interview, could you clarify whether Professor Southall asked you to take notes at the interview on 27 April?
A I cannot honestly say.

Q Could you clarify whether Professor Southall took notes at the interview?
A The only notes that I remember are when the drawing of the room, I remember that aspect of it.

Q How was that done?
A In conjunction with Mrs M.

Q How? What did she use to do it?
A On a piece of paper.

Q Where? What did she use to lean on?
A (After a pause) I do not know. There was a table at the side of her but whether or not she was leaning on that, I do not know. I remember sort of them discussing where the stairs were in the bedroom and that and it coming to life in the picture.

Q In answer to my question in terms of whether Professor Southall made notes and how he made them ---
A I cannot remember. That is the only thing that stuck in my mind is note-taking at that point.

Q Can you remember how long you and Professor Southall were in the room before Mrs M arrived?
A I honestly cannot at all.

Q Could you clarify whether you discussed the interview before it commenced?
A I cannot specifically remember having a discussion beforehand about the interview.

Q Did you have a discussion after it concluded?
A No, I think that is where the action plan, you know with the written notes, I think that is where that came from afterwards.

Q Did you exchange any notes following the interview?
A No, I would not. You have obviously seen my spelling and my handwriting, no.

Q Taking you to D21/H, which is your handwritten notes of the interview, you said that your secretary typed up your notes. Could you clarify whether these are the handwritten notes you gave to your secretary?
A They would not be, no. These were just an aide-memoire and I went back and would write it up in proper sentence as you saw it and she would just copy type what I had written.

Q Your long-hand written notes would be given to your secretary. Would they be destroyed?
A Yes, they get shredded.

Q On Day 17/44/C-G you were asked how many times you had met Mrs M before 27 April before the interview and you said the day you removed M2 and then on 12th and 23 February. You said on the first occasion she was extremely upset and cross.
A Yes.

Q The second and subsequently calmer and more co-operative. Could you clarify what the subsequent occasions were that you met her, please?
A Can I refer to my contact sheets? (Short pause)

MR TYSON: I do not know whether it would assist if the witness referred to our bundle C1/1(v) at pages 98 and 99 relating to those particular dates?

MRS LLOYD: I am not actually asking the witness about those dates. It appeared that you had met her on three occasions – the occasion you moved M2 and you said two subsequent occasions which you gave the dates for. All I am trying to clarify is how many times you had actually met her before the interview because it was not clear to me by your evidence. Perhaps I can ask you that directly. How many times do you think you met her before the interview?
A There had been a few times because of the looked after process. Once a child becomes looked after there is documentation and other forms that need to be filled in so I would have seen her a few times and then there is a placement planning meeting – all those sorts of things that relate to the LAP.

Q I will leave it there, thank you. On Day 17/67/C you were asked about your role at the interview. You said Professor Southall was leading and did most of the talking. You were there as an observer and also clarified a few points. Could you clarify what you were observing, please?
A I was observing the interview or the discussion. That is what I was there for and information-gathering as well.

Q Staying with Day 17/69/E, you described yourself when you initially gave evidence as an experienced senior social worker in child protection at that time. On Day 17/69/E you said you had a clear recollection of your thoughts about being surprised and taken aback by Mrs M’s attitude towards Professor Southall. You said she was “aggressive, bolshy, talked back to him, she was rude and assertive.” Given that you and Professor Southall had a role in removing M2 from Mrs M and she was on her own in the company of you both, firstly could you clarify why you were surprised and taken aback at her attitude, given your experience in the field with parents with child protection issues?
A Because I was surprised at her attitude towards the discussions. I was not expecting it, no, and, yes, I was an experienced social worker and parents do get angry and quite rightly so, but I was surprised at some of the responses that she gave.

Q Given that she was displaying such behaviour and the fact that you and Professor Southall were involved because of her alleged behaviour regarding MSBP and the risks she posed to M2, can you clarify why you did not make any notes of this behaviour in your handwritten note or as part of your typed report, given that you had observed this? Why was it not in your report?
A Because as I think you can see it is a factual report, is it not, and that is my opinion.

Q It is a factual report but you are a social worker and social workers, as I understand it, deal with behaviour issues. MSBP is a behavioural issue, whatever else you would like to describe it as. You were witnessing quite strong behaviour and you were assessing – this is part of your core assessment to determine about this person’s suitability to have her child.
A Yes.

Q I am trying to understand that given that you observed that and you made such a strong point in your evidence to us, I am trying to understand as a social worker why you did not actually comment on that in your report?
A I do not know why I did not. I certainly did not feel it necessary to do that in that report.

Q Day 17/70/A, you said you had a recollection of how Professor Southall dealt with the three scenarios. You said Professor Southall explained that there were three ways that M1 could have died. Given your observational role, can you clarify how Mrs M reacted when Professor Southall said, “Or was murdered”?
A There was not a huge reaction. I do not mean that in a horrible way. There was not any upset as such at that time because of the way he said it. He said, “This is what I am thinking. There are three ways.” It was very factual the way he was putting it across. It was not accusatory; it was this is the three ways.

Q Day 17/68/B, you said you were sitting by the side of Professor Southall on his right-hand side.
A To the side of him, yes.

Q He would have to have turned round to see you.
A I was not sat right next to him.

Q That was your evidence on that day. I am just asking you to clarify that.
A Yes.

Q You said he would have to have turned round to see you. On Day 17/72/G-H you were asked whether Professor Southall expressed disbelief at what Mrs M was saying and you said no. Could you clarify how you can be so sure categorically that he was not being dismissive when you could not see his facial expressions?
A Certainly I could not see his face. If he was doing something I could not observe, then obviously that would be the case. I had not thought of that.

Q In relation to the entry by Ruth Williams – Day 17/76/B and D21/J which may be easier for you to look up – this entry was about Mrs M’s feeling about the interview and Mrs M stated: “He had already made up his mind.” You were asked whether it was obvious to you that Professor Southall had made up his mind. This is my reference to D17/76/B. You said that it did not strike you as that. My question is could you clarify what Professor Southall had not made up his mind about?
A That Mrs M was …

Q It might be easier if you look up the reference on D17/76/B.
A Yes, I have that here.

Q You were being asked questions by Mr Coonan and the question was whether it was obvious to you that Professor Southall had made up his mind because this is something that Mrs M had relayed to Ruth Williams and you said it certainly did not strike you as that, no. What I am asking is if you could clarify what he had not made up his mind about because I certainly was not clear what you were being asked.
A The MSBP is what I understood it to be.

Q You were also asked on Day 17/75/C from the standpoint of social services next move, did you find that the interview had had value and you said, “Yes, most definitely.” Could you clarify what you meant by that?
A Because it gave us information for the core assessment which meant that I did not have to go over that information with Mrs M herself again.

Q Quite a lot of the documents we have seen when you are referring to the concerns you and your department had – “we had concerns about this” – could you clarify whether you personally had concerns about the coroner’s report?
A I did have concerns about the coroner’s report and the way the initial enquiries had been undertaken, yes.

Q Can you clarify whether you personally had concerns about the pathologist’s report?
A I do not know.

Q You said that you had concerns about the coroner’s report so I will ask you about that. Given the fact that you had concerns, did you or your department make your concerns known to the coroner?
A No, but we did discuss them with the police.

Q Can I ask you why your typed report – C1/(gg)23 – ends with the description of the belt? Was that the last topic discussed at the interview?
A It must have been because that was the last notes that I remembered.

Q Finally, Ms Salem, on reflection, is there anything you feel you should have done differently with regards to your involvement with Professor Southall’s interview with Mrs M?
A Yes, I should have clarified whose responsibility it was to inform Mrs M that I was going to be there because I had made an assumption that it would be Professor Southall’s because it was his interview.

Q Anything else?
A Obviously made fuller notes definitely, but other than that, no.

MRS LLOYD: Thank you.

THE CHAIRMAN: Ms Salem, it is now my turn and I also am a lay member of the Panel. I have a few questions which I am afraid have not yet been answered by the other panellists’ questions.

First of all, if I can take you to tab B/358, the reason I wanted to ask you about this is I sense that in social work things that get written down are written in cautious language, if I can put it that way. So what is really in your mind is perhaps expressed, if not in euphemisms, in something which may have hidden meaning. Am I correct in saying that?
A I think you do have to be cautious about what is written down because apart from the fact that obviously young people, once they get to 18, they can access our files and obviously it can be used in court processes as well. We try and share as many of our reports with families as we can.

Q Sometimes you step back from calling a spade a spade, as it were.
A Yes, most definitely.

Q That is why I wanted to ask you under paragraph 8 exactly what you meant if you now know what was in your mind when you wrote these words:

“I do not believe that the questions around the circumstances of M1’s death have been answered which only heightened my own concerns for M2’s safety and welfare.”

Particularly at that time when you wrote this were you thinking in terms of the fact that there was the possibility that Mrs M had in fact murdered her son at that time or was it different concerns?
A I would very much say that there were concerns about the enquiries that had been made around the time of M1’s death that I did not feel had been fully investigated and had left questions which needed really to be answered and certainly the similarities with M2 then saying that he was being bullied and he wanted to take his life, the similarities I felt presented a risk.

Q Can I push you any further than that onto what was in your mind? Was it just a vague thought about risk or were you leaping ahead or were there other reasons because of things that you had heard from other colleagues, for example, that were making you think in terms of the possibility of murder?
A I would certainly echo the concerns regarding the circumstances of MI’s death and the potential for that, whether or not it was murder or something within that family that we did not know about drove M1 to suicide.

Q What I was looking at is when I first read this and various questioning has been done about it I had assumed that your reasoning was that rather than murder that there had been some kind of emotional abuse which had actually led to the suicide rather than it being murder and I wondered whether that was in fact closer to what was in your mind than the thought of murder?
A Yes, certainly murder is most dreadful and you would never want to think that, certainly not at the hands of a parent, but yes, the emotional side of it there was obviously from my point of view more questions about M1’s care at that time which was not put down to bullying in my opinion that needed to be answered.

Q I will leave that question there. In your own notes of the interview and the evidence you have given, you simply said that Professor Southall went through three scenarios, and your notes do not actually give any more detail about how he went through them. Can you give us any more help at all, from proper recollection rather than assumption, about how he went through them, what you mean by “went through”?
A Yes, as I said to Mrs Lloyd, it was, from my recollection, what I felt was an open approach to Mrs M, in saying, you know, “This is what I think, the three ways that M1 could have died”, and went through the three scenarios, but any more than that, I am afraid, I could not help.

Q My other related question on that was that I am not entirely sure what you mean by open in this context. It seems to me there are two interpretations of open. One is open questions of the sort which are not leading questions; and being open in the sense of being frank about actually putting things on the table, of mentioning things that are hard to mention.
A Yes.

Q Have you meant open in either or both of those ways?
A In the latter, in being frank.

Q Right. So you are saying that he mentioned things that might be difficult or sensitive to mention?
A Yes, absolutely.

Q So the question is, obviously, as you are aware, the different perceptions about how this interview went, that frankness; you say you recollect that it was frank. Do you have any more recollection at all as to what was in that frankness, what was said, that made you think that it was frank?
A Well, the manner in which he said it was obviously very calm, and was not accusatory, in my opinion.

Q That to me is slightly different. I accept what you are saying, that that was your recollection. I was sort of asking you about the content rather than the manner.
A I do not have any more detail, other than what I remember about how it was said, and obviously I rely on my written notes. I do not remember Mrs M getting upset by it at that point, and certainly there was a frankness about what he was saying.

Q The way you put it was that it was scenarios.
A Yes.

Q So you did not note then that there was anything other than being put forward as hypotheses?
A No, absolutely not.

Q Is your recollection that that is how it was put?
A Yes.

Q In fact, you told us that a lot of things in the interview about specific content you cannot remember, obviously for good reasons at this distance.
A I am sorry.

Q In your evidence, you were quite insistent in many places, when you were asked very specific questions about was the tone, you know, accusatory, or what happened, were there emotions displayed and so on, you answered without hesitation.
A Mm.

Q I wanted to clarify now, looking back on the way that you gave your evidence, are you sure that you are recollecting what happened contemporaneously, rather than now making assumptions about how such an interview ought to have been conducted?
A No, when I was asked obviously by Hempsons about this matter, I did worry that I would not be able to remember certain aspects of it, but I can recall the tone in which the interview took place. Certainly as an experienced worker, I have enough belief in myself and knowledge in myself that I would have been able to challenge anything that was inappropriate, and that was not and never has been in my mind.

Q In fact, I think you were asked by Mr McFarlane earlier whether you had in fact on other occasions challenged situations in interviews where you had been present, and you simply said you had.
A I have. I have challenged police officers, I have challenged teachers. I have investigated police officers, teachers, GPs. I have been able to challenge, and certainly there have been results of those challenges as well.

Q Thank you. Finally, I apologise if these are not totally in a logical order, but I want to go back and see if you can throw any more light on where the idea of the possibility of a murder scenario actually had its birth. What you told me earlier, in answer to a previous question, was that you were thinking more in terms of emotional abuse driving a child to suicide. If you go to tab (o), page 18, which is where the hypotheses are, it was said at one point that these hypotheses were carried through into the scenarios, but in fact the highest level at which this is taken is item 8.4 there, in hypothesis 1:

“If M2’s talk of suicide is fabricated by mother to seek attention ...”

Would she perhaps give him the opportunity to commit suicide? This is more in the emotional abuse - and that is as far as these hypotheses go. You told us that these hypotheses were brought to the meeting?
A Yes, they were, they were presented at the strategy meeting.

Q Do you recall whether it was taken any further at that meeting that the consequences of MSBP were taken any further than this highest one at 8.4 at that meeting?
A I cannot honestly remember.

Q You cannot remember, but you would agree that it was not set out in any of those scenarios there?
A No.

Q The other final question was: you said that the suspicion first came, or you first heard about it through Mrs Bickley.
A The referral came from Mrs Bickley, yes.

Q I wondered about what you heard from Mrs Bickley, because we have heard some evidence about the conversations that led up to Mrs Bickley bringing this case to you.
A Right.

Q You are aware of the fact, are you not, that Miss Gray had spoken to Dr Southall, and Dr Southall had then suggested that she should contact social services, which presumably led to the conversation with Mrs Bickley; were you aware of that?
A No.

Q You were not aware of that?
A No.

Q If we look at D21D, the referral details. Mrs Bickley has been speaking to the new Director of Nursing, Miss Gray.
A Yes.

Q So as far as you were aware then, you were aware that Mrs Bickley was alerted by Miss Gray?
A Yes.

Q Were you at any time told that Miss Gray had already spoken to Dr Southall?
A No, she had a subsequent discussion with Professor Southall after the referral had been made, but I was not aware of one before, no.

Q It was never mentioned to you. Did Dr Southall himself ever tell you in the conversation that you had with him that he had discussed the matter at the very beginning with Miss Gray?
A Not that I recall. I know there was a subsequent discussion, because she told me that she was going to speak to Professor Southall, but I do not remember one beforehand, no.

Q So you were never informed either directly by Dr Southall or by any colleague of anything that had transpired between Dr Southall and Miss Gray?
A Not that I recall, no.

THE CHAIRMAN: You did not. Thank you, that is very helpful, and that completes my questions. Sometimes at this stage, Panellists who have gone earlier, when there is long questioning, have thought of another one. I will just check to see whether they have. Yes, Mr Simanowitz has.

MR SIMANOWITZ: There are actually a couple of questions that I forgot to ask. One was just clarification of a word which I could not make out. I am not sure that it is important, but I would like to be clear. That is in C1, tab (d), page 372. It is right at the bottom of the page:

“Mrs Pane was aware of Mrs M’s ...”

A It is supposed to say “tenacious”. I did say my spelling was not very good.

Q Thank you very much. The other question was: you said in evidence that it was slightly unusual for an expert to be instructed by one agency. Two of the experts were instructed by everyone, but Dr Southall was only instructed by you. You said that was because he had had preliminary involvement. Just because he had had preliminary involvement, why did that mean the other agencies could not instruct him?
A When we are doing a joint instruction to an expert witness, usually, everybody has to agree on that person, and that person has to be seen as independent, whereas Professor Southall, because we had already sort of conferred with him, and he had advised us, would not have been very independent.

Q He would not have been regarded as independent?
A Yes.

MR SIMANOWITZ: Thank you very much.

THE CHAIRMAN: At this point, I need to ask whether either counsel have questions for you arising from the questions from the Panel. Mr Tyson?

Further cross-examined by MR TYSON

Q Ms Salem, me again.
A Yes.

Q I do not know how to take that. You were asked by a number of Panellists, and particularly just recently the Chairman, about your initial knowledge of how the case, as it were, came to social services. I was wondering if you would be assisted in your recollection if we looked at your witness statement, which we see at tab (u), I think it is, in C1. Do you see that? Can I take you to page 2 within it, and to the third paragraph down:

“I first became aware of the M family on 20 January 1998 following a referral from the Director of Nursing at the orthopaedic hospital, a Miss Gray, where Mrs M works. It is my understanding that Mrs M had been spoken to regarding her high number of absences from work. The reason for these absences given by Mrs M was that she was looking after her son, M2, who was being bullied at school and had threatened to kill himself. In light of the nature of the death of M2’s brother in 1996, the Director of Nursing felt concerned enough to contact the initial assessment team.”

A Mm.

Q It would appear from that, was it not, that you were aware from the very start, ie from 20 January, that these concerns came from the Director of Nursing?
A I knew Mrs Bickley had been contacted by the Director of Nursing, yes.

Q Can I suggest to you that you knew from 20 January 1998 that the Director of Nursing had concerns about what I think was then described as parental induced illness?
A Yes.

Q That is right, is it not?
A Well, she brought these concerns to our attention, via Mrs Bickley.

Q Yes, which are parental induced illness concerns.
A Yes, I do not think she actually used that word, did she?

Q Well, I am asking you.
A No, she did not use those --

Q I know you recorded the use of that expression.
A Yes.

Q Looking again at paragraph 2, bearing in mind you highlight the role of Miss Gray, is it not likely, and say if you cannot recall, that the name of her friend, Dr Southall, would have come out in those kind of conversations?
A I did not know that Anne Gray was a friend of Professor Southall’s.

Q Going to another matter about which again you were asked by the Chairman, this relates to your initial assessment report which we have at tab (b). Can we look at the section that the Chairman asked you about on page 358? I just wanted to make sure that I got my note right. You were asked what the risk to M2 was that you thought. I wrote down, “It echoes concerns about M1’s death, whether it was murder or something else drove him to suicide”; is that the state of your mind at the time? You were considering amongst the possibilities murder?
A I think nothing could be ruled out at that point, no.

Q Let us put it in another way: in your mind, did you rule in certainly as a possibility even at that time murder?
A Yes, I had an open mind to everything, yes.

Q You were asked by Mrs Lloyd about the record that you wrote, which we are now all familiar with, of your note of the interview. Just to remind you, it is at (gg), beginning at page 23. I wrote down what you told Mrs Lloyd was this, that you were asked about it and you said, “It is a factual report”. Perhaps I can explore that with you. Is it right that it records the facts as how you saw them that came out in the course of that interview, is that right?
A Yes.

Q It does not contain any note of your observations on, as it were, how it went?
A No.

Q It merely records, to the best of your ability, what was said and the areas discussed?
A Yes.

Q So it deliberately, as a matter of policy, does not include, for instance, things like Mrs M taking some of the questions amiss and being rather aggressive, and things like that?
A No, it does not.

Q Does it follow from that then that we do not get any assistance from this report as to the tone and manner of either of the principal participants, either Mrs M or Professor Southall?
A Not from this report, no.

Q Because it is deliberately factual rather than adding any of your personal gloss on it, if I can put it that way.
A I think as social workers, we are trained to show opinion from fact, so it is more of a policy than me not putting any gloss on it.

Q I am not complaining. So if we are looking at areas like tone and manner, we have to rely on your recollection as opposed to anything that you, as it were, noted in your factual report, is that fair?
A Yes, although if there was anything untoward, it would then be in the contact sheets, because I would have had a discussion with the team manager about it.

Q Last question, which relates to questions arising out of Mr Simanowitz’s questions to you about how scenario three was put to Mrs M, two points: first of all, it is fair to say you just merely record in your note at page 25 that one of the matters - I will help you, it is page 25, between the two hole punches. You merely record baldly that one of the scenarios was that he was murdered. It is fair to say, is it not, that there was a discussion about that concept, was there not?
A I believe there was, yes.

Q That would help explain the words, “Professor Southall then went through”. Again, do I rightly note what you were saying to the Committee that you cannot now recall the precise way in which each of those three scenarios was gone through?
A No, other than what is on here, no.

Q Well, what is on there is nothing, basically, is it?
A I think it is better than nothing.

MR TYSON: I have no further questions, thank you, arising out of the Panel’s questions.

THE CHAIRMAN: Mr Coonan?

Further re-examined by MR COONAN

Q Thank you, madam. Ms Salem, can we just look, please, at the typed report again, (gg), page 23? In answer to a number of questions raised by the Panel, and also just during your last answers, you agreed again that this was essentially a factual report, and does not contain any note as to how the interview was conducted. Can we just look, please, at a number of aspects of this? If we look at page 23, in terms of the facts, you have a narrative, and there are a significant number of words in inverted commas. We can look down, for example, at paragraph 6 on page 23, in paragraph 9 on page 23, a series of direct quotes. Is that you recording as fact the direct quotes?
A Yes.

Q Then on page 24, mostly reported speech, save in paragraph 3, there is a phrase in quotes. Then on page 25, paragraph 1 on the third line, and then in paragraph 7, just picking these out, there may be more, paragraph 8 and so on. Were these factual accounts of what Mrs M was actually saying to Dr Southall?
A Yes, they were.

Q Looking at paragraph 9 on page 25, was that an accurate account as to how that exchange went?
A Yes.

Q And if there had been listen to this carefully if there had been a direct, unvarnished accusation of murder do you understand how I am putting that?
A Yes.

Q Would you have been able to record that in direct quotes?
A Yes, I would.

Q We see on page 23, paragraph 3, your observation that Professor Southall then went through three scenarios?
A Yes.

Q Can you remember now who used that term “scenario”?
A I cannot, but I do know it is probably not one of my words.

Q Is it Mrs M’s?
A No.

Q What is your conclusion?
A My conclusion would be that it is Professor Southall’s, but I do not recall.

Q Now, you were asked by the Chairman about Professor Southall’s frankness, and basing yourself on such recollection that you have of the interview, and leaving aside content for the minute, was there anything about Professor Southall’s frankness in speaking to Mrs M that was, in your view, inappropriate?
A No.

Q When you told us that you had challenged others you mentioned teachers and I think you mentioned GPs -
A Police officers and social workers.

Q Police officers, and social workers, when you talk about challenges in those circumstances are you talking about challenges in the course of an interview?
A Yes.

Q And what have you done about those challenges when you have adopted that approach?
A Well, certainly I have spoken to my line manager and I have spoken to their line manager and things have been rectified.

Q I do not want names but were they in respect of matters that you thought were inappropriate?
A Yes, most definitely.

Q I want to ask you about just two aspects of two questions Mrs Lloyd put to you. Mrs Lloyd was asking you about how you knew of Professor Southall, and you described how it was through work that he had done and research material. Again, could I attempt to clarify that? When you talk about research material, what is that sort of material? Available to whom?
A Available to social workers through our, sort of we have a community care magazine which is a social work based magazine which brings us up to date with recent research. That sort of thing.

Q And in relation to the question of whether or not it was appropriate or not for Dr Southall to be asking Mrs M questions about the pole and the belt, insofar as you knew from the document shown to you that the police may be asking questions about that, help us about that topic. Why, in a social work context, pursuant to the Children Act, would it be something that you would, in any event do, even if the police were minded to consider it themselves?
A Because we have to manage the risk, we have to manage the risk of the child that was left, the M2 child, and therefore we need as much information as we possibly can on which to do that.

Q And just help us about the post judgment situation, please, Ms Salem: the Panel have the whole of the judgment available to them, you have the advantage maybe of other documents in your file, I do not know, but can you just tell the Panel, please, what your position is in relation to this: were Social Services still concerned with exploring the possibility of physical injury due to M2 at the hand of the mother under the umbrella of Munchausen’s?
A Yes. The judgment quite clearly said it needed to be further explored, and certainly M2’s name remained on the Child Protection Register for another 12 months.

Q After the interim care order application?
A Yes.

Q The child still remained on the Register?
A Yes, while the therapeutic input was completed.

Q Lastly, Ms Salem, when you have given evidence as you have about the facts set out in (gg), pages 23 26, on the one hand and about your recollection of the tone and manner in which it was done, have you been telling the truth?
A Yes.

MR COONAN: Thank you very much.

MR TYSON: Madam, it is unusual, and I accept this, but my learned friend has just elicited questions about the Child Protection Register, and as a matter of fact you will probably know that if a child is on the Child Protection Register it can be on for a number of reasons, whether the concern is physical harm to the child or emotional harm to the child, or other matters. I wonder whether I can ask the witness, though I readily accept it did not arise out of Panel questions but out of my learned friend’s questions, whether the entry on the Register from time to time has changed in any way from initial concerns of harm to M1, physical harm, to any other concerns.

It is a matter that is doubtless in this witness’s file, of which we have had selected extracts, but I was wondering whether, and I readily accept it is out of time and I am asking your indulgence, I could ask the witness questions arising out of the description on the Register.

THE CHAIRMAN: Mr Coonan?

MR COONAN: I did not, as you could see, deliberately elicit the answer but Ms Salem gave the answer. I take the view that it is a matter for the Panel as to whether or not they wish to hear about this, and the potential relevance of it.

In closing, I just have a little worry that questions of this sort, on the face of it seemingly relatively innocuous, can have the result sometimes of opening up all sorts of satellite questions and areas, and that is the one thing that really does concern me.

THE CHAIRMAN: Perhaps I will turn to the Legal Assessor to see what his advice for the Panel is.

THE LEGAL ASSESSOR: As Mr Tyson has indicated it is not a usual course for further questions to be asked but, as Mr Coonan agrees, it is entirely a question for the Panel. You may think that if it is helpful to you in the course of your inquiries you have, of course, power under the rules to admit any form of evidence you think is helpful. My advice to you is that you should permit a question such as this, as it has been raised in evidence, but that you should have a caution in regard to any satellite questioning which may arise. So my advice to you is that to admit the question at this stage but, should there be satellite questions, you will need to review the situation at that stage and doubtless Mr Coonan will have some observations.

THE CHAIRMAN: Are the Panel content to take the Legal Assessor’s advice? (Agreed.) Could you re state the question, please, Mr Tyson?

Further cross-examination by MR TYSON

Q Do you have in the files before you the various entries over the year in question of what was on the Child Protection Register, particularly the reasons for the child being on the Child Protection Register, over time?
A I can tell you that in February 1998, 9 February 1998, M2’s name was placed on the Child Protection Register under the category of emotional abuse. I would have to go through the files to find out exactly the review conference minutes.

Q So February 1998. Was that the first time the child appeared on the Register?
A Yes.

MR TYSON: Madam, I need not take it any further.

THE CHAIRMAN: Is there anything else arising before the witness stands down?

MR COONAN: Not arising out of that, Madam, no.

THE CHAIRMAN: So we can release Ms Salem?

MR COONAN: Almost. Mr Tyson and I have had a short discussion during your adjournment and there is one matter arising out of the files that I think it might be helpful if before formally releasing Ms Salem you permitted us to have another word about. So that there is no mystery about it it touches on the fact that full disclosure has not been made by the County Council of all the material and I just need to consider what steps, if any, ought to be taken about that.

THE CHAIRMAN: Are you asking for a short adjournment before releasing Ms Salem?

MR COONAN: Yes. I think it would be safer if that was done now.

THE CHAIRMAN: Mr Tyson, are you in agreement with this?

MR TYSON: I understand my learned friend’s concerns and to a significant degree share them and would like to have a further discussion about them. The issue is, and it is quite clear, that there are a number of months, even, which we do not have any particulars about, what was going on in, as it were, March and April in the contact sheets, for instance. We were not given disclosure of those. We now have the original files and it may or may not be, depending on conversations I have with my learned friend, that a request might be made that certainly counsel could look at the contact sheets which have not hitherto been disclosed, that is where we are at, bearing in mind the sensitivities and it is not our file,0 and whether we can make a request and whether this, indeed, witness is in a position to give consent on behalf of her Authority for us to look at it, and whether she would have to obtain advice from her Authority and, in particular, the legal department of her Authority, whether even if we requested to look at it we would be so permitted.

THE CHAIRMAN: How much time do you anticipate you need, Mr Coonan?

MR COONAN: I was going to suggest maybe about 15 minutes, and I was also going to suggest that I be permitted to raise the matter with Ms Salem just to see where we stand, and I can report back, and Mr Tyson as well can be kept in the loop, as it were.

THE CHAIRMAN: So the matters that you need to discuss with the witness while she remains on oath are limited and clear, and Mr Tyson has agreed to that?

MR COONAN: Yes.

MR TYSON: Yes, if the line of my learned friend’s questioning of this witness would be: “To whom do you need to get permission for us to look at this? Please can you see if you can get any”, then those are entirely appropriate and the kind of questions I would expect him to ask.

THE CHAIRMAN: I do not see any problems, and the Panel will adjourn for a short while. Perhaps you could call us back when you are ready.

You have heard the conversation, Ms Salem. I afraid I am not now in a position to release you just yet, if you can bear with us. You have just heard that you can discuss these limited matters with Mr Coonan, so we will adjourn briefly and wait until we are called back.

(Short break)

MR COONAN: Could I say we have addressed the matter that I referred to a few minutes ago and it has become clear to both Mr Tyson and myself from Ms Salem, she was able to advise us, that the question of disclosure of the material was in fact the subject of specific advice by independent counsel instructed by the local authority, and for present purposes neither I nor Mr Tyson seek to go behind that. Ms Salem does not have authority to disclose any other material in any event, so we both feel in the presence of that information bound by that position.

I therefore do not seek to take the matter any further.

THE CHAIRMAN: So I can now release Ms Salem?

MR COONAN: Yes.

THE CHAIRMAN: Ms Salem, this is the point at which I thank you again for coming and giving evidence and formally release you from your oath and say you may stand down, and thank you.

The witness withdrew

THE CHAIRMAN: I understand there may be housekeeping matters you would like to run past us, Mr Coonan?

MR COONAN: There are two short pieces of evidence to deal with first. The first is I want to produce a document by agreement with my learned friend.
(D22 marked and distributed.)

The only comment I would make about it at this stage is that the context for this document can be found in respect of the questions asked by Mr McFarlane on day 16, page 14, letters E F.

The next matter is that I would invite my learned friend to make a short formal admission in respect of one matter.

MR TYSON: Madam, may I ask you to go to C3, subsection 7, (d)(vi)? We are into protocol area now.

That document should be entitled, “North Staffordshire Hospital NHS Trust Child Protection Policy and Procedures”, and the date of that document is 1997. Can I ask the Panel please to go to page 20, which is appendix 2 of that document, and read at the top left hand corner, “Background, 1. 1.1 This Policy should be read in conjunction with the following Trust policies”, and then the second bullet point down is “Clinical Record Keeping (Policy No 10)”.

Madam, that is the context. I now make a formal admission to be recorded.

The formal admission that I make is this:

“Attempts were made by Field Fisher Waterhouse to obtain Policy No 10 from the North Staffordshire Hospital’s NHS Trust but the Trust were unable to locate a copy.”

MR COONAN: Thank you very much.

Madam, that is the case for Dr Southall.

THE CHAIRMAN: Thank you. Are there any housekeeping matters that either of you wish to raise with us?

MR TYSON: Madam, I have a housekeeping point in relation to the heads of charge which I would like amended to deal with a typographical error in appendix 3. You will see in the third column under “Breach” I have put in both relation to child D and child M1 and M2 that the breach is under paragraph 14 of the heads of charge. Madam, it should be under paragraph 17 of the heads of charge.

THE CHAIRMAN: Thank you for that. I have been puzzling about it myself and now all is revealed. Perhaps I should have said something, but it was merely a typographical error.

MR TYSON: The responsibility for that is entirely mine dealing with several drafts going through and not following the consequences, if I can put it that way. I apologise that there is that mistake and I ask formally, and I do not anticipate my learned friend will object, that the number “14” in the third column should be replaced by the number “17”.

THE CHAIRMAN: I take it there is no objection? This is a mere formality, since it sets the record straight.

MR COONAN: Madam, that is right. I raised it with Mr Tyson this morning, in fact.

MR TYSON: In terms of the timetable for the future outcome of this case, my learned friend, as you have heard, has formally closed his case which means there is going to be no further witness evidence for you to hear. You will be aware, because you have done some extremely diligent, if I may say so, reading back into this case, that there is a lot of one year old reading to absorb and to deliver.

Can I ask, as a personal request, that, due to the volume of material and the age of it, I have a day to make final preparations for my final speech? What I anticipate that would mean, and my request to the Panel is this, is that I start my closing speech on Wednesday at 9.30. I anticipate my closing speech would be over a day, but under two days. If I am right on that that would mean that on the Thursday I would complete my closing speech.

I would naturally accept that my learned friend also ought to have, as it were, his day of preparation, which I would anticipate would be the Friday, and that you would hear his closing speech on the Monday and the Tuesday thereafter. If my learned friend’s speech was in excess of one day, if I can put it that way, you would have still nine days left to complete this case.

I would anticipate, putting it no higher than that because it is a matter for you, that you may possibly have completed your determination on Part 1 by the end of that week I know not. If that were so and if, and it is a big “if”, you were to find any of the outstanding heads of charge found proved, even on that timetable that I have outlined you would still have a week or five sitting days to deal with any matters that had to be dealt with under Part 2, so I put my request for, as it were, an extra day in the context of the fact that, in my submission, the Panel, out of the time it has been allotted for this case, would still have ample time to deal with its deliberations, certainly on Part 1 and, in my submission overwhelmingly, also on Part 2.

It is in that context I make my request to make my closing speech to you at 9.30 on Wednesday.

THE CHAIRMAN: Thank you, Mr Tyson. Mr Coonan, is that the case? That you would indeed prefer for it to be set now that you will not make your closing speech before Monday?

MR COONAN: It would certainly be of assistance to me because if my learned friend is going to take, and indeed I fully understand he may, a day and a half, I would need, in order to assist the Panel if nothing else, to reflect upon what he has said in order to enfold those into my final submissions, so I would need a little time myself, and my learned friend very properly, if I may say so, appears to acknowledge that.

So yes, if the Panel were content, I would much prefer to start afresh first thing on Monday morning, and I concur with my learned friend’s estimate that there would then follow, certainly from where we stand, adequate time for the Panel to complete the case.

THE CHAIRMAN: Thank you, Mr Coonan. In a moment I will confer with the Panel, if I may, in private, to find out whether they accept the proposals.

As the Committee Secretary has pointed out, as we are all aware we did initially set aside a fifth week in case there should be unforeseen issues that were going to make this case run on. If you remember a year ago we did not want to run the risk of having to adjourn again part heard.

However, where we have got to now I think suggests that the four weeks, apart from something completely unpredictable like illness, would be fully adequate, and the question is whether we now want to say that we are definitely do not want that fifth week, that we can foresee that, and that would formally release diaries and rooms and so on. I am just canvassing views on that. I hear what you say and I think I can predict your answer, but I put it to you.

MR COONAN: Madam, it may be that if there is a great imperative to deal with diaries now that may be one thing, and I can understand why members of the Panel might feel that. Certainly that extra period is still free, certainly for me and no doubt for Mr Tyson.

For my part I would not advocate or indeed take any steps myself to clear that last week, I would keep it open for the moment, just because, as you talk in terms of unpredictability, supposing Mr Tyson ends up being two and a half days in his speech I am not suggesting he will but just supposing he was that may give us a measure of the material that, for example, I would have to deal with, but it may be that to start clearing diaries as of today may be a little precipitous, I do not know.

THE CHAIRMAN: Thank you for that view. Mr Tyson?

MR TYSON: My recollection is that nothing has been placed into my professional diary since the last week was cut off, but I can make inquiries immediately after this to confirm that with my clerk.

THE CHAIRMAN: You mean the fifth week is still available, should it be needed?

MR TYSON: I told my clerks that I am available for other work in that fifth week. Whether they have found any for me is a matter I should inquire now about, but my anticipation is that I am still free for that week.

THE CHAIRMAN: Without consulting the Panel I must agree that, being a very risk averse person, I have some sympathy with the view that Mr Coonan has put, and that is that if we were to lose any days unexpectedly over illness or something of that sort then having that insurance policy is quite reassuring and I have a sort of feel that it might be premature, but I can consult the Panel.

I am sure we will not be more than a few minutes.

STRANGERS THEN, ON DIRECTION FROM THE CHAIR, WITHDREW, AND THE PANEL DELIBERATED IN CAMERA.

STRANGERS HAVING BEEN READMITTED:

THE CHAIRMAN: Mr Tyson, the Panel is very happy to accede to your request that you do not begin your closing speech until Wednesday and that we say to Mr Coonan, because we are unable to anticipate exactly what will happen and I guess that even you would say you probably cannot be totally sure how long your speech is, that we will not ask him to begin any earlier than Monday. Whether we run into Friday is something we will not know until Thursday. Is that satisfactory?

MR TYSON: I am extremely grateful for the Panel’s indulgence. May I say on another matter that the 15th is still in my diary as being here.

THE CHAIRMAN: Thank you. The Panel concurred that we all felt that at this stage we should hang on to it until matters are nearer to a conclusion. We will now formally adjourn until 9.30 on Wednesday morning.

(The Panel adjourned until Wednesday 14 November 2007 at 9.30 am)