GMC Hearing 2010
1: Eye Witness Report from the GMC Wakefield, Walker-Smith, Murch Hearing
2: Counterfeit Law: And They Think They Have Got Away With It
3: Counterfeit Law, Part 2: A Tale of Two Trials
4: Counterfeit Law, Part 3: Houdini Horton
5: Return to the House of Lies
6: Journalist with No Medical Training Solves Mystery of Enterocolitis!
7: The Bolted Horse
Counterfeit Law: And They Think They Have Got Away With It

"Part of me isn't surprised by this apparent new development (the resignation of Dr Wakefield from Thoughtful House). The simple math of Thoughtful House's board suggests that there will be at least one or two people of caliber and integrity, who know that all the cranksite stuff about a witch-hunt, sinister forces and all that shit, are just that: shit. Wakefield has been nailed, absolutely fairly, properly, but belatedly, with no hidden agendas or vested interests. Apart, that is, from the public interest".

Brian Deer February 18, posted on Respectful Insolence

    
Occasionally I look at how my reputation is faring on the internet. There, amongst pages about my writing and campaigning over the last thirty years, is Brian Deer's character assassination of me, Liar for Hire, (1) whenever I see this, I spend a few moments checking reality. I go back to the beginning and remind myself that it began with the parents: ordinary, able, loving and honest individuals whose lives and children were suddenly plunged into the maelstrom of inflammatory bowel disease, regressive autism and other forms of vaccine damage.

Despite the fact that many of these parents knew that their children's illnesses began following the MMR vaccination, in Britain some of the best healed professional people, as well as some of the seediest like Brian Deer, have closed ranks on them, denied vaccine damage and tried to erase both parents and children from the organic life of British society.

Worse still, some of these people, such as the GMC prosecuting counsel, have accused the parents sotto voce of a sly plot, a vendetta to enrich themselves by suing vaccine manufacturing pharmaceutical companies, either that or diagnosed in them a kind of Munchausen's syndrome by proxy, as a result of which they forced their children upon Dr Wakefield. In the midst of this moral crime wave, amongst academics, regulators and medical profiteers, amongst media, science and political personalities, Dr Wakefield emerged as a kind of hero; a lone voice that put his faith in science and scientific method, a good doctor whose reputation was dragged through the fake mud of a Hollywood film set.

The battle over the moral character of Dr Andrew Wakefield has for the moment become a stumbling block on the road to recovery and treatment of the children adversely affected by vaccines. Inevitably the most difficult of decisions is now presented to parents: do they cold shoulder the advancing political reality and draw in their wings around the nest to protect their children or do they immerse themselves in politics and put the diagnosis and treatment of their damaged children on hold? - Perhaps there is a way to do both things simultaneously.

I would contend from my relatively privileged position, that the first strategy will walk us all into the snows of oblivion like blind beggars in a Bruegel’s painting. The second strategy will set us on a path of energetic confrontation with our enemies, but every marginal victory will help the children. There is no doubt in my mind which battle needs to be won in order for us to reach back and tighten our grip on the hands of the damaged children. Now more than ever we have to win the political battle in the public arena.

*   *   *

My last two posts have been about corrupt detail of the GMC hearing; I have written them as part of my reality check. In times when even the strongest and most committed feel weakness like a nausea, travelling back can reassure us of the manipulation that has taken place. As a writer, of course, I am used to the details of my work getting lost in the slipstream of a struggle. As days go by, things that are important in context get jammed on the towpath and we find it difficult to keep the overall picture in view.

At the end of August 2008, I wrote an essay, (2) In the Interests of Conflict. In it I tried to bring-up the issues of conflict of interest to the heart of the GMC hearing and lay it at the feet of the Panel Chairman Dr Surendra Kumar. I consider conflict of interest massively important, because this is the hidden mechanism by which corporate science manipulates reality. This is the secret armoury of funding and public relations that hides in the bunkers beneath an apparently level playing field.

The whole battle against Dr Wakefield and the parents has been shot through with conflict of interest, some of which might be refuted, some of which might be made to appear trivial and some of which might be dismissed as coincidental. I believe, however, that my essay about the Panel Chairman, like some of John Stone's investigative work, raised irrefutable issues that should have brought the GMC hearing to a juddering halt.

*   *   *

In the late nineteen eighties, at roughly the same time that the MMR vaccine was introduced by the British government, Dr Andrew Wakefield took up a post at the Royal Free Hospital. He was a well-respected gastroenterologist charged with the task of heading a new department of experimental gastroenterology. One of the areas he was to research was the increase in Crohn's disease amongst young people. Wakefield, who had travelled from Canada where he had been researching bowel transplantation, would win awards for his work on the aetiology of Crohn's disease.

In 1992, the British government backhandedly admitted that two of the three types of MMRs they had introduced in the late 1980s had been dropped following serious adverse reactions created by the Urabe strain of mumps virus used. Thousands of children, principally in Canada, Japan and Britain, were made ill by this vaccine. However, in Japan and Canada parents of vaccine damaged children were quickly compensated. In Britain, a morally bankrupt Department of Health sided with the pharmaceutical industry to claim that the adverse reactions suffered by these children were so slight as to be of no consequences. (3)

By 1993, parents seeking help with one aspect of MMR's adverse reactions, a novel new condition of Inflammatory Bowel Disease (IBD) followed by regressive autism, began to attend the Royal Free Hospital. As these children began presenting there, Dr Wakefield contacted the DH to inform the head of vaccine and immunology Dr David Salisbury that he considered MMR could be creating a public health crisis and asked for a meeting. It took Salisbury almost six years to arrange such a meeting.

In 1992, the parents of MMR vaccine damaged children began preparing a legal claim against three pharmaceutical companies. By the end of the 1990s the number of parent claimants attached to this lawsuit had grown to around 2,500 and Dr Wakefield had been assigned by the claimants' lawyers to give expert evidence for the parents. In 1998 the Lancet published the case review paper and later that year Deer wrote the first of a series of articles character assassinating previous expert witnesses who had appeared for vaccine damaged claimants and casting doubt upon other cases of vaccine damage claimants.

In 2004 after a decade of organisation and legal finessing, , the first batch of claimants cases, were due to come before the High Court. However, in a move to support the pharmaceutical companies and deny thousands of parents their rights under civil law, legal aid was withdrawn from all the cases. Under a post-industrial New Labour government, a century of civil law enabling citizens to sue powerful interests was snatched from the people.

2004 was the fulcrum year, the year when the legitimate legal claims of citizens against three pharmaceutical companies were turned on their head and a zealous, immoral and criminal campaign was begun by the government and the pharmaceutical companies to wipe out all reports of vaccine damage and anyone who might stand as an expert on this issue. Only months after Deer's Sunday Times attack on Dr Wakefield, Dr Richard Horton whose line manager at Elsevier the Lancet's publisher was Sir Crispin Davis also a board member of GlaxoSmith Kline, published a pulp fiction paperback which lauded the absolute safety of MMR.

*   *   *

Immediately after Brian Deer's 2004 article in the Sunday Times and following the instructions of John Reid, the then Secretary of State for Health, Deer submitted his papers as a complaint against Dr Wakefield to the General Medical Council. The journey of Deer's speculative and shoddily researched article to the GMC prosecution is crammed with abuses of the legal process, I detail some of them below before I discuss what I believe to be the most important issue of conflict of interest.

Since 1988, there have been two ways in which cases arrive at a Fitness to Practice Hearing at the GMC. There is the official route, by which a complaint made by a patient or relative can be filtered by readers and preliminary hearings to arrive in front of a panel, and there is the unofficial route by which cases promoted by the Association of British Pharmaceutical Industries (ABPI) arrive. This second path, made available by the GMC to Big Pharma, gives control to the industry over cases involving doctors who might be carrying out research for the industry which results in unethical behaviour, or damage to trial subjects or patients, or finally those cases of doctors who might have embarked upon research or treatments which threatens the competitiveness of pharmaceutical products. These cases are researched, investigated and then legally formulated in conjunction with GMC lawyers by a private detective agency solely funded by the pharmaceutical industry named Medico-Legal Investigations (MLI). While cases prepared internally by the GMC have resulted in mixed findings over the last two decades, cases prepared by the pharmaceutical industry usually result in guilty verdicts.

Neither the GMC nor its hearings make statements about the origins of cases that are brought against doctors, unless of course this is evident from the presentation of the complainant in the hearing. In the Wakefield, Murch and Walker-Smith hearing, the GMC consistently denied that Brian Deer was the complainant in the case and claimed spuriously that the case against the doctors had been brought by the GMC itself. As the defence lawyers approached the case as if it were any 'normal' case, the hearing never approached the issue of who had investigated and assembled the information of the case. However, we know from a number of sources that in investigating his case against Dr Wakefield, Brian Deer was helped by MLI. In the past MLI have used complainant journalists to progress cases into the GMC.

GMC Fitness to Practice Hearings, are constructed to all intents and purposes, like criminal or civil trials that take place in jury trials. To some extent this sets them aside from the usual extra-legal tribunals, such as those that deal with issues like unfair dismissal. It is, however, the way in which the hearings differ from a proper trial that must concern us; these differences are startling. The first and perhaps most seminal difference is that while the judiciary in Britain is separated from the political executive, the GMC acting as the prosecuting authority pays for the employment of all parties, other than the defence, including the jury (Panel), in any hearing.

In a real criminal trial, which the Wakefield hearing tried to emulate, all the investigation prior to charges being brought are carried out by the police. Over time such investigations have become trammelled by rules and regulations, such as the judges rules in Britain and the Miranda ruling in the US.

It is interesting that although the GMC lawyers gathered a series of unproductive and dubious prosecution statements from a whole variety of people, they depended quite heavily for their information of the three defendants, not just upon their evidence but on written statements obtained under threat by Brian Deer and Dr Richard Horton. None of the defendants had access to lawyers when they were pressured into making these statements. All three doctors answered questions put to them by Deer, under the threat that the Sunday Times was about to break a story that would ruin them, with a sincere desire to help put together a complete story of the work that had been done at the RFH. None of the doctors knew that what they said would be used against them in a legal hearing.

When it comes to the structure of the court, this tries to mimic a real court. There are defence counsel and prosecutors, there are defendants and a 'jury' called a Panel, there is a Legal Assessor to the Panel who tacitly takes the place of a judge in advising them. The difference between a real judge and the Legal Assessor is that one of the real judge's most skilful tasks is to advise the jury in public session on what weight should be placed on the evidence. In the GMC hearing the Legal Assessor had no such role; God knows how the Panel understood or contextualised the evidence they heard over two and a half years. It us clear by the ultimately shambolic verdict that the Panel failed or refused to grasp the most basically transparent defence evidence, upon which nearly all the verdicts rested, that 'the Lancet paper' was only a case review report and not a 'study' or 'trial' of any kind. Such defence evidence had to be agreed by the Panel because they had to allow the defence the benefit of the doubt on any unproven allegations.

In the proper court, not only are the jurors chosen from the population at random, but the counsel for either side are allowed peremptory challenges, to ascertain any kind of bias in the jurors that might apply specifically in relation to the case being heard. In Britain, this right to peremptory challenge has been completely eroded over the last decades, ending with the 1988 Criminal Justice Act. However, in an important case, involving for instance a police officer charged with causing a death, the judge will usually warn the jury of conflict of interest and ask anyone who has been a police officer or who had a relative who was a police officer or anyone who worked in a civilian capacity within a police station to declare this. Having concluded these tests, the jury themselves chose their foreman or woman in camera and this person helps the other jurors negotiate their verdicts and offers them to the court.

In the case of a GMC prosecution, the Panel consists of professional jurors paid per day by the GMC, the prosecuting authority. Any conflict of interest they might have had were reflected only in cursory notes about their roles outside the GMC, displayed on the GMC web site. In relation to the specific case, none of the Panel were asked about whether they agreed with mass vaccination, whether or not they or any of their relations had autistic children or for that matter what their employment was prior to offering themselves as Panel members. There was no elected foreperson of the jury because the GMC imposes a Panel Chair. Again, details of the Chair's interests are noted on the GMC's web site, with no particular sharpness or alacrity. The Panel Chairman and any other Panel members might take the advantage of making a declaration at any time during the hearing.

In the Wakefield, Murch, Walker-Smith hearing, the GMC first chose a Professor Dennis McDevitt as Panel Chairman, however, campaigners forced the GMC to make McDevitt stand down when they made public the fact that in 1988, McDevitt had been a member of the very JCVI committee that had agree the safety of Pluserix MMR, manufactured by Smith Kline & French (now GlaxoSmithKline). In fact, following serious adverse reactions, this vaccine was belatedly withdrawn in 1992. A number of the children who suffered adverse reactions to Pluserix were claimants in the court case for which Dr Wakefield had been asked to give expert witness evidence. Nor only this, but McDevitt had received research funding from both Glaxo and Smith Kline French before both companies joined to become GlaxoSmithKline the MMR vaccine manufacturers. Even the GMC was unable to get away with such a high level of duplicity and conflict of interest.

The question that preoccupied me during the first three months of the GMC Fitness to Practice Hearing was this: if the GMC had gone to these lengths to shoo-in the first clearly biased Chair of the Panel, having been found out, were they likely to just give up and enter a second 'clean' candidate for Panel Chair? I had serious doubts, so I began researching an essay to see if superficially Dr Kumar had any vested interests.

It should be understood that the Panel Chair in GMC hearings is the most influential member of the jury, the person most in need of neutral and independent thinking, a person, like all other jury members, who has to be free from any taint of bias or preconception about the guilt or innocence of the defendants. It goes without saying that the GMC, the prosecuting agency in this case, was duty bound to summon all its resources in testing all panel members in this hearing in great detail in order to discover and make public any possible conflicts of interests.

*   *   *

Anyone who took the trouble to go to the GMC web site and look at the declarations of possible panel members, could have ascertained that Dr Kumar was connected to the following organisations:

Principal General Practitioner. President, British International Doctors Association (formerly ODA). Interests:  Medical Defense matters & Medico-politics. Member: General Practitioner's Committee (BMA), UK National Screening Committee (Dept of Health). Fellow: Royal College of GPs (FRCGP). Fellow BMA.  Member Independent Review Panels of MHRA (Medicine & Health Care Regulatory Agency). Member of Clinical Executive Committee (CEC) of Halton & St Helens PCT. Member of Medical Protection Society.


The above list is as far as the GMC 'Conflict of Interest' policy takes us in the case of Dr Kumar. In fact, this list is woefully inadequate as one of Conflict of Interests and, in fact, discloses nothing specifically that might lead defence counsel to embark upon more detailed enquiries about Dr Kumar. However, I considered that this superficial review of Dr Kumar's involvement in the medical culture of the GMC, needed in such a sensitive case to be thoroughly investigated.

That Kumar's conflict of interests were not seriously probed or challenged was mainly the fault of the defence counsel, who throughout the case appeared to want to be polite and accommodating in relation to the prosecution. One can only assume that from the beginning of the case the defence lawyers denied the politics of the case and stuck doggedly to what they considered their 'legal' brief.

I have had considerable experience of defence lawyers in political cases, working as a Mackenzie friend throughout the 1970s and 1980s. The problems always begin with defence lawyers isolating the case from its social and political context. From the beginning, Dr Wakefield had considerable political support that should have been mobilized as a defence campaign which the lawyers kept informed. Instead, Wakefield's solicitors and counsel swore Wakefield to secrecy and convinced him that the hearing was an easily winnable legal battle. Meanwhile, Brian Deer and the Sunday Times, the pharmaceutically controlled lobby groups, blog sites and tabloid newspapers continued a relentless campaign against him well beyond the legal detail of the hearing.

Perhaps more important than this, while the Chairman of the panel intoned that the hearing was nothing to do with vaccination, the government pressed on with its very public vaccine programme which made it appear that vaccination was a matter of life or death and anyone who stood in its way was possibly a murderer. Dr Wakefield's case was a political case and the lawyers should have seen this and refused to play ball without the most intense public investigation of such things as conflict of interest. As it was, the defence entered the hearing exuding bonhomie and acting as if the whole matter was just a terrible misunderstanding.

It was very noticeable that at the beginning of this hearing in 2007, there was no structured mechanism for introducing conflict of interest information, all of which should have been provided by the GMC and been the basis for challenges by defence council. Dr Kumar did make an almost mute point of telling the hearing, in general terms and quite hastily, that he had previously sat on committees that were part of the Medicines Control Agency (MCA). (4) It was also the case that at any point in the hearing when a named person known to Dr Kumar, or a particular place of work, cropped up, he told the hearing that he knew or had worked in the vicinity of this person or this location. (5)

In looking at what might be considered Dr Kumar's vested interests that might have been declared at the start of the Wakefield, Murch and Walker-Smith fitness to practice hearing, I have concentrated on four areas: Kumar's previous involvement with the GMC, his work on two committees of the MHRA, his work for the Department of Health, his work as Chairman of the British International Doctors Association (BIDA), and the previously declared information about shareholdings in GSK.

*   *   *

Between 1999 and 2005, it was recorded that Dr Kumar was a consistent activist within the GMC, the prosecuting authority in this case, and had, as he made clear in his list of posts and affiliations on the GMC site, prior to 2004 been a GMC council member and served on the following committees: the 'registration committee', the 'health committee', the 'professional conduct committee', and the 'racial equality and diversity committee'. As an Associate of the GMC since 2003, he has also been a panel member on 'fitness to practice' hearings.

We have to bear in mind that the Panel in these cases is the jury, a small group of individuals capable of bringing in a verdict of dishonesty, that stands to a doctor with as much authority as the finding in a criminal law trial. Clearly the jury should be absolutely untainted by any involvement with either the defendants, the prosecutors or the many central issues of the case. In this case we have to consider whether being so intimately involved with the GMC it is possible that Kumar might have been au fait with the GMC's position on the prosecution of Dr Wakefield. His choice as Chairman was in effect no different from the Crown Prosecution Service, the English prosecuting authority, ensuring that one of its staff was on a jury in a criminal trial.

Since the late 1990s, Dr Kumar had been involved in two British medicines regulatory bodies, the Medicines Control Agency (MCA) and its main committee, the Committee on the Safety of Medicines (CSM). The MCA became the Medicines and Health Care Regulatory Agency (MHCRA) and in 2005 the CSM became the Commission on Human Medicines. Dr Kumar was definitely on the CSM in 1998 and this is the committee membership that he alluded to at the beginning of the hearing. (6) Members of this committee discussed the safety of drugs and vaccines.

Following the restructuring of the MCA after it became the Medicine and Health products Regulatory Agency (MHRA), Dr Kumar sat on two of this body's most influential committees. The Independent Review Panel for Advertising (IRPA) and the Independent Review Panel for Borderline Products (IRPBP). (7) Both the advertising of pharmaceutical products and the definition of what is a medicine are two of the hottest topics presently involving pharmaceutical companies in Britain and the first group is certainly relevant in relation to the advertising of MMR. Both the IRPA and the IRPBP has a policy of members declaring personal and non-personal interests. (8)During 2003, 2004 and 2005, and through 2006 into 2007, when the GMC hearing began, the MHRA records show that Dr Kumar held shares in GSK.

On hearing of the MHRA for the first time, it might seem to many people that it is a 'normal' government regulatory agency. Few people would guess that the MHRA, while being the most important regulatory body for medicines in Great Britain and the organisation which, for example, processes Yellow Cards that notify the DH of averse reactions to drugs, is actually a trading company completely subsidised by the pharmaceutical industry.

The MHRA took over from the MCA in 2003. The MHRA is a Government Trading Fund that might just as well be called a business or a corporation. A Trading Fund is an almost entirely separate economic entity that earns money by the provision of services and, like any kind of company, it must balance the books at the end of each year. However, unlike a number of other Government Trading Funds, which provide services, earn money and accept fees from diverse ‘beyond government’ sources, the whole of the MHRA income is provided by one funding source; the pharmaceutical industry. Further, a percentage of staff and executives of the agency, have come into it from the pharmaceutical industry.  It is therefore not surprising that, funded and partly staffed by the industry, its policies are shaped to please this sector. When considering conflict of interests, the workings of the MHRA have to be seen in light of the fact that the agency is completely beholden to the pharmaceutical industry.

Dr Kumar sits on the UK National Screening Committee that is chaired by the Chief Medical Officer for Scotland and advises Ministers and the National Health Service (NHS) in all four UK countries about all aspects of screening policy and implementation. Screening programmes are of immense importance to the contemporary drugs industry as the ongoing embittered battle over the Gardasil vaccine against human papillomavirus (HPV) for pre-pubescent girls is showing.

The Department of Health (DH), a central aspect of the NHS has been at the very forefront of the battle against Dr Andrew Wakefield. Anyone seeking information about MMR from the DH web site was at the time of the start of the hearing directed through links to Brian Deer's web site and, apparently speaking for the New Labour government and the DH, Deer gives his version of the crimes of Dr Wakefield. The DH gives no links to other web sites of a similar kind and there is not the slightest attempt at balance. (9)

If at the time I wrote my essay An Interest in Conflict, you had gone to 'MMR the facts' via the NHS site and put Brian Deer in the search box, the site would have served you 50 items which mention Deer's work. The first item was this:

'MMR news: 14-Nov-04: Sunday Times: MMR scare doctor planned rival vaccine. Doctor whose work provoked a worldwide scare over MMR failed to reveal that he was developing his own commercial rival to the vaccine.' 'MMR scare doctor planned rival vaccine, Sunday Times - Brian Deer.' 'It has emerged that a patent was filed on behalf of Dr Andrew Wakefield for a measles vaccine and other products that would have stood a better chance of success if public confidence in MMR’s safety was undermined. To read the full Brian Deer article in the Sunday Times, please visit Times Online'.

Now, the fact is, despite it being promulgated by the lobby groups, the Sunday Times and the government, this story promoted by the NHS is not true. Of all the allegations made by Brian Deer, this is one of the most apparently prejudicial while being completely untrue. The 'competitive vaccine' referred to was Transfer Factor, which Dr Wakefield experimented with in the hope that it might help children overcome serious adverse reactions to measles and other vaccines. The GMC enquiry was so little enamored of this 'evidence' that it dismissed it almost entirely, concentrating instead on whether or not Dr Wakefield, or either of the other two defendants were acting ethically in prescribing Transfer Factor to one child who was recorded in the Lancet paper.

Looking briefly at another connection between the NHS, Brian Deer's web site and the GMC hearing, if you travelled to Brian Deer's web site through the NHS 'MMR News' you would have found an analysis of the Lancet paper by a Professor Trish Greenhalgh. This off-the-cuff analysis repeats almost word for word the prosecution case put by the GMC. The fable suggests that the Lancet paper case-series review, was in fact a badly conducted full blown research project organised to prove that MMR caused autism in vaccinated children.

Greenhalgh's explanation of the Lancet paper (10) is quite extraordinary in that it followed the line of Deer and the GMC rather than the paper itself. Greenhalgh’s interview answers give a very clear view of how Dr Wakefield's detractors, from the beginning, tried to portray the Lancet paper as the record of a full-blown study, rather than a short 'case series review'. They also give us an insight into the case that the GMC began prosecuting and how this case was broadcast by the NHS and the DH.
 
So the happy coincidence of Dr Kumar's involvement at a relatively high level in the NHS, although it might be dismissed as purely co-incidental, would appear inevitably to prejudice his view of the Lancet study if we understand that the NHS and the DH was from the beginning promulgating the GMC's prosecution view of Dr Wakefield's work.
 
To show how far up the system the honesty paralysis went within the NHS, at the beginning of the GMC hearing, we might quote John Stone:

After the publication of Brian Deer's story the Chief Medical Officer, Sir Liam Donaldson remarked to the BBC Today Programme (23 February 2004 - three years before the GMC trial began): 'Now a darker side of this work has shown through, with the ethical conduct of the research and this is something that has to be looked at'. On the same day the Prime Minister said to ITV [commenting on Brian Deer's article]: 'I hope now that people see the situation is somewhat different from what they were led to believe'. (11)

Since 2002, Dr Kumar has been the National President of the British International Doctors Association (BIDA). Prior to that he was, from 1990-1996, the General Secretary of the organisation. BIDA was established in the United Kingdom with the objectives of promoting the interests of Ethnic Minority Doctors and Dentists working in the United Kingdom. However, what doesn't become clear on the BIDA web site, unless you look closely, is the fact that the organisation is funded not only with membership fees but also by pharmaceutical companies. BIDA's magazine is also subsidised by drug company advertising. This information is declared by Dr Kumar in his conflict of interest declaration for the MHRA but not for the GMC.

Not only is it the case that anyone adjudicating in the Wakefield fitness to practice hearing has had from the beginning the power to raise or lower the price of vaccine manufacturers shares, there is inevitably a question that has to be answered about the individuals' commitment to that company and how these shares were obtained, were they given as payment by the company or bought from them?

*   *   *

I can remember that morning clearly. We had returned to the hearing after one of those interminable delays and I was staying not far across the Euston Road in the Indian Student YMCA. I had a cheap down to earth room without anything resembling breakfast, and was not in any sense looking forward to yet another day in the hearing. Over the last break I had managed to finish the essay about the conflict of interests inherent in the hearing and particularly those of the Panel Chairman. I suppose that I was slightly apprehensive; on a previous occasion I had released an essay during a break, only to return to find Brian Deer raging against me outside the GMC building.

I went into the building, feeling as always somehow dwarfed by the architecture of post-modern humiliation, chatted to the funereally dressed young woman behind the polished granite desk, picket up my name tab on a red lanyard, stepped with experienced precision through the automatically opening glass half door turnstile to the lift. The lift was a place of concern for by this point you had passed through the cordon sanitaire of the GMC foyer and could well come face to face with one of the prosecution team, or a panel member.

The third floor that morning seemed eerily quiet and it was from that point onwards that I began to suspect the worst. Sitting in the outer lounge I glanced through the Daily Telegraph and got a cardboard cup of green tea from the machine. I eventually slipped through the glass doors into the carpeted corridor and then into the four rows of chairs that constituted the public gallery. I sat down, got out my pen and notebook, placed my coat over the back of the chair and sat quietly waiting.

Usually when the defence lawyers and the defendants came in, they glanced in my direction, after all I had attended as many days of the hearing as they had and I was considered a familiar face. On that day, there was a long wait before anyone came into the hearing room and the lawyers particularly, although sometimes smiling slightly, kept their heads down. As the last members of the panel entered the room, the Legal Assessor, a neat piggy faced man, was still in animated conversation with Dr Wakefield's counsel. It was then that I knew that something was about to happen and that something might involve me; after all I was the only outsider there.

Everyone took their seats and the little man with the pink face pulled at his cuffs, looked into the still air in front of him and then launched into me.

A judge in real life, the Legal Assessor described my essay as an 'unhelpful intervention', adding, 'if this person thought that he was helping anyone he was mistaken'. Of course, in saying this, he entirely missed the point, I have no interest in 'helping anyone', just in speaking up for the parents and their vaccine damaged children and, the more abstract cause of 'justice'.

The assessor, however, employed by the GMC, was more pragmatically concerned than I was. One of his objections to my essay was:

If anybody thought that they were helping anyone, they were not because it has involved lawyers having to read and consider it, it will have involved unnecessary expense, unnecessary work and possibly even unnecessary concern.

Inevitably my mind rolled back over the junk journalism that Deer had produced during the hearing, including a long article that newly accused Dr Wakefield of fixing the results of his research. One of my worst crimes, it appeared, was that I had made the intervention with my essay 'at this point in the hearing', that is, after a year of the prosecution's prevaricating, repetitious time wasting.

The best that can be said is that this was considerably unhelpful and entirely inappropriate at this stage in these proceedings.

He implied that, had I made my observation about Dr Kumar's conflict of interest at the beginning of the hearing, it would have been considered in a more kindly light.

The Assessor made the point that Dr Kumar had declared his conflicts of interests at the beginning of the hearing. Of course, neither the legal assessor or anyone else involved, could have read from the transcript Dr Kumar's exact words when, during the hearing, he explained that he held shares in GSK, the vaccine manufacturer.

The Assessor went on to accuse me of a criminal act for which unfortunately his tribunal was unable to prosecute me.

Unfortunately, this is not a court of law and does not have the benefit of contempt law, otherwise I might give firmer advice to the Panel as on how to deal with such interventions. The Panel members who were shown this of course were concerned about the propriety of their position.  It is an entirely unhelpful intervention.

For the rest of the day I caught Kumar leaning forward slightly and glancing side-stares at me, still the only person in the public gallery, as if he were reminding himself of my features. I wondered what he was thinking and was amazed at the seeming effrontery embodied in those glances.
 
As I was writing for CryShame, the parents' organisation at this time, the Chair of CryShame, Allison Edwards, following this cover-up by the Panel chairman and the Legal Assessor, supported my attempts to get the GMC to make a clear statement about their conflict of interest policy. After an exchange of correspondence, the GMC admitted that they didn't actually have such a policy.

Brian Deer, clearly primed by someone to reply to my relatively academic finding of Dr Kumar's GSK shares, responded with a vitriolic personal attack:

Some of the latter (parents), in their pain, have now turned nasty: with me as a target for their hatreds. Although almost literally a handful of people, and some with no link to MMR or autism at all, they've insinuated themselves among affected British families and are causing distress with false allegations. Among these is a claim that my Sunday Times and Channel 4 investigation - which nailed the scare and helped to restore public confidence - was covertly supported by the drug industry.

A string of recent outings for this sickening falsehood are authored by a 61-year-old graphic artist called Martin Walker, who apparently lives in Spain, but last year surfaced at the mammoth hearings of the GMC in London. He claims to be a "health activist", and, although generally of little consequence, is a relentless peddler of smear and denigration, with a track record of latching onto the vulnerable. These he beguiles - like he's their new best friend - and then, if past form is a predictor for the future, attempts to sell them self-published books. (12)

*   *   *

My last two posts have been about corrupt detail of the GMC hearing; I have written them as part of my reality check. In times when even the strongest and most committed feel weakness like a nausea, travelling back can reassure us of the manipulation that has taken place. As a writer, of course, I am used to the details of my work getting lost in the slipstream of a struggle. As days go by, things that are important in context get jammed on the towpath and we find it difficult to keep the overall picture in view.

At the end of August 2008, I wrote an essay, (2) In the Interests of Conflict. In it I tried to bring-up the issues of conflict of interest to the heart of the GMC hearing and lay it at the feet of the Panel Chairman Dr Surendra Kumar. I consider conflict of interest massively important, because this is the hidden mechanism by which corporate science manipulates reality. This is the secret armoury of funding and public relations that hides in the bunkers beneath an apparently level playing field.

The whole battle against Dr Wakefield and the parents has been shot through with conflict of interest, some of which might be refuted, some of which might be made to appear trivial and some of which might be dismissed as coincidental. I believe, however, that my essay about the Panel Chairman, like some of John Stone's investigative work, raised irrefutable issues that should have brought the GMC hearing to a juddering halt.

*   *   *

In the late nineteen eighties, at roughly the same time that the MMR vaccine was introduced by the British government, Dr Andrew Wakefield took up a post at the Royal Free Hospital. He was a well-respected gastroenterologist charged with the task of heading a new department of experimental gastroenterology. One of the areas he was to research was the increase in Crohn's disease amongst young people. Wakefield, who had travelled from Canada where he had been researching bowel transplantation, would win awards for his work on the aetiology of Crohn's disease.

In 1992, the British government backhandedly admitted that two of the three types of MMRs they had introduced in the late 1980s had been dropped following serious adverse reactions created by the Urabe strain of mumps virus used. Thousands of children, principally in Canada, Japan and Britain, were made ill by this vaccine. However, in Japan and Canada parents of vaccine damaged children were quickly compensated. In Britain, a morally bankrupt Department of Health sided with the pharmaceutical industry to claim that the adverse reactions suffered by these children were so slight as to be of no consequences. (3)

By 1993, parents seeking help with one aspect of MMR's adverse reactions, a novel new condition of Inflammatory Bowel Disease (IBD) followed by regressive autism, began to attend the Royal Free Hospital. As these children began presenting there, Dr Wakefield contacted the DH to inform the head of vaccine and immunology Dr David Salisbury that he considered MMR could be creating a public health crisis and asked for a meeting. It took Salisbury almost six years to arrange such a meeting.

In 1992, the parents of MMR vaccine damaged children began preparing a legal claim against three pharmaceutical companies. By the end of the 1990s the number of parent claimants attached to this lawsuit had grown to around 2,500 and Dr Wakefield had been assigned by the claimants' lawyers to give expert evidence for the parents. In 1998 the Lancet published the case review paper and later that year Deer wrote the first of a series of articles character assassinating previous expert witnesses who had appeared for vaccine damaged claimants and casting doubt upon other cases of vaccine damage claimants.

In 2004 after a decade of organisation and legal finessing, , the first batch of claimants cases, were due to come before the High Court. However, in a move to support the pharmaceutical companies and deny thousands of parents their rights under civil law, legal aid was withdrawn from all the cases. Under a post-industrial New Labour government, a century of civil law enabling citizens to sue powerful interests was snatched from the people.

2004 was the fulcrum year, the year when the legitimate legal claims of citizens against three pharmaceutical companies were turned on their head and a zealous, immoral and criminal campaign was begun by the government and the pharmaceutical companies to wipe out all reports of vaccine damage and anyone who might stand as an expert on this issue. Only months after Deer's Sunday Times attack on Dr Wakefield, Dr Richard Horton whose line manager at Elsevier the Lancet's publisher was Sir Crispin Davis also a board member of GlaxoSmith Kline, published a pulp fiction paperback which lauded the absolute safety of MMR.

*   *   *

Immediately after Brian Deer's 2004 article in the Sunday Times and following the instructions of John Reid, the then Secretary of State for Health, Deer submitted his papers as a complaint against Dr Wakefield to the General Medical Council. The journey of Deer's speculative and shoddily researched article to the GMC prosecution is crammed with abuses of the legal process, I detail some of them below before I discuss what I believe to be the most important issue of conflict of interest.

Since 1988, there have been two ways in which cases arrive at a Fitness to Practice Hearing at the GMC. There is the official route, by which a complaint made by a patient or relative can be filtered by readers and preliminary hearings to arrive in front of a panel, and there is the unofficial route by which cases promoted by the Association of British Pharmaceutical Industries (ABPI) arrive. This second path, made available by the GMC to Big Pharma, gives control to the industry over cases involving doctors who might be carrying out research for the industry which results in unethical behaviour, or damage to trial subjects or patients, or finally those cases of doctors who might have embarked upon research or treatments which threatens the competitiveness of pharmaceutical products. These cases are researched, investigated and then legally formulated in conjunction with GMC lawyers by a private detective agency solely funded by the pharmaceutical industry named Medico-Legal Investigations (MLI). While cases prepared internally by the GMC have resulted in mixed findings over the last two decades, cases prepared by the pharmaceutical industry usually result in guilty verdicts.

Neither the GMC nor its hearings make statements about the origins of cases that are brought against doctors, unless of course this is evident from the presentation of the complainant in the hearing. In the Wakefield, Murch and Walker-Smith hearing, the GMC consistently denied that Brian Deer was the complainant in the case and claimed spuriously that the case against the doctors had been brought by the GMC itself. As the defence lawyers approached the case as if it were any 'normal' case, the hearing never approached the issue of who had investigated and assembled the information of the case. However, we know from a number of sources that in investigating his case against Dr Wakefield, Brian Deer was helped by MLI. In the past MLI have used complainant journalists to progress cases into the GMC.

GMC Fitness to Practice Hearings, are constructed to all intents and purposes, like criminal or civil trials that take place in jury trials. To some extent this sets them aside from the usual extra-legal tribunals, such as those that deal with issues like unfair dismissal. It is, however, the way in which the hearings differ from a proper trial that must concern us; these differences are startling. The first and perhaps most seminal difference is that while the judiciary in Britain is separated from the political executive, the GMC acting as the prosecuting authority pays for the employment of all parties, other than the defence, including the jury (Panel), in any hearing.

In a real criminal trial, which the Wakefield hearing tried to emulate, all the investigation prior to charges being brought are carried out by the police. Over time such investigations have become trammelled by rules and regulations, such as the judges rules in Britain and the Miranda ruling in the US.

It is interesting that although the GMC lawyers gathered a series of unproductive and dubious prosecution statements from a whole variety of people, they depended quite heavily for their information of the three defendants, not just upon their evidence but on written statements obtained under threat by Brian Deer and Dr Richard Horton. None of the defendants had access to lawyers when they were pressured into making these statements. All three doctors answered questions put to them by Deer, under the threat that the Sunday Times was about to break a story that would ruin them, with a sincere desire to help put together a complete story of the work that had been done at the RFH. None of the doctors knew that what they said would be used against them in a legal hearing.

When it comes to the structure of the court, this tries to mimic a real court. There are defence counsel and prosecutors, there are defendants and a 'jury' called a Panel, there is a Legal Assessor to the Panel who tacitly takes the place of a judge in advising them. The difference between a real judge and the Legal Assessor is that one of the real judge's most skilful tasks is to advise the jury in public session on what weight should be placed on the evidence. In the GMC hearing the Legal Assessor had no such role; God knows how the Panel understood or contextualised the evidence they heard over two and a half years. It us clear by the ultimately shambolic verdict that the Panel failed or refused to grasp the most basically transparent defence evidence, upon which nearly all the verdicts rested, that 'the Lancet paper' was only a case review report and not a 'study' or 'trial' of any kind. Such defence evidence had to be agreed by the Panel because they had to allow the defence the benefit of the doubt on any unproven allegations.

In the proper court, not only are the jurors chosen from the population at random, but the counsel for either side are allowed peremptory challenges, to ascertain any kind of bias in the jurors that might apply specifically in relation to the case being heard. In Britain, this right to peremptory challenge has been completely eroded over the last decades, ending with the 1988 Criminal Justice Act. However, in an important case, involving for instance a police officer charged with causing a death, the judge will usually warn the jury of conflict of interest and ask anyone who has been a police officer or who had a relative who was a police officer or anyone who worked in a civilian capacity within a police station to declare this. Having concluded these tests, the jury themselves chose their foreman or woman in camera and this person helps the other jurors negotiate their verdicts and offers them to the court.

In the case of a GMC prosecution, the Panel consists of professional jurors paid per day by the GMC, the prosecuting authority. Any conflict of interest they might have had were reflected only in cursory notes about their roles outside the GMC, displayed on the GMC web site. In relation to the specific case, none of the Panel were asked about whether they agreed with mass vaccination, whether or not they or any of their relations had autistic children or for that matter what their employment was prior to offering themselves as Panel members. There was no elected foreperson of the jury because the GMC imposes a Panel Chair. Again, details of the Chair's interests are noted on the GMC's web site, with no particular sharpness or alacrity. The Panel Chairman and any other Panel members might take the advantage of making a declaration at any time during the hearing.

In the Wakefield, Murch, Walker-Smith hearing, the GMC first chose a Professor Dennis McDevitt as Panel Chairman, however, campaigners forced the GMC to make McDevitt stand down when they made public the fact that in 1988, McDevitt had been a member of the very JCVI committee that had agree the safety of Pluserix MMR, manufactured by Smith Kline & French (now GlaxoSmithKline). In fact, following serious adverse reactions, this vaccine was belatedly withdrawn in 1992. A number of the children who suffered adverse reactions to Pluserix were claimants in the court case for which Dr Wakefield had been asked to give expert witness evidence. Nor only this, but McDevitt had received research funding from both Glaxo and Smith Kline French before both companies joined to become GlaxoSmithKline the MMR vaccine manufacturers. Even the GMC was unable to get away with such a high level of duplicity and conflict of interest.

The question that preoccupied me during the first three months of the GMC Fitness to Practice Hearing was this: if the GMC had gone to these lengths to shoo-in the first clearly biased Chair of the Panel, having been found out, were they likely to just give up and enter a second 'clean' candidate for Panel Chair? I had serious doubts, so I began researching an essay to see if superficially Dr Kumar had any vested interests.

It should be understood that the Panel Chair in GMC hearings is the most influential member of the jury, the person most in need of neutral and independent thinking, a person, like all other jury members, who has to be free from any taint of bias or preconception about the guilt or innocence of the defendants. It goes without saying that the GMC, the prosecuting agency in this case, was duty bound to summon all its resources in testing all panel members in this hearing in great detail in order to discover and make public any possible conflicts of interests.

*   *   *

Anyone who took the trouble to go to the GMC web site and look at the declarations of possible panel members, could have ascertained that Dr Kumar was connected to the following organisations:

Principal General Practitioner. President, British International Doctors Association (formerly ODA). Interests:  Medical Defense matters & Medico-politics. Member: General Practitioner's Committee (BMA), UK National Screening Committee (Dept of Health). Fellow: Royal College of GPs (FRCGP). Fellow BMA.  Member Independent Review Panels of MHRA (Medicine & Health Care Regulatory Agency). Member of Clinical Executive Committee (CEC) of Halton & St Helens PCT. Member of Medical Protection Society.


The above list is as far as the GMC 'Conflict of Interest' policy takes us in the case of Dr Kumar. In fact, this list is woefully inadequate as one of Conflict of Interests and, in fact, discloses nothing specifically that might lead defence counsel to embark upon more detailed enquiries about Dr Kumar. However, I considered that this superficial review of Dr Kumar's involvement in the medical culture of the GMC, needed in such a sensitive case to be thoroughly investigated.

That Kumar's conflict of interests were not seriously probed or challenged was mainly the fault of the defence counsel, who throughout the case appeared to want to be polite and accommodating in relation to the prosecution. One can only assume that from the beginning of the case the defence lawyers denied the politics of the case and stuck doggedly to what they considered their 'legal' brief.

I have had considerable experience of defence lawyers in political cases, working as a Mackenzie friend throughout the 1970s and 1980s. The problems always begin with defence lawyers isolating the case from its social and political context. From the beginning, Dr Wakefield had considerable political support that should have been mobilized as a defence campaign which the lawyers kept informed. Instead, Wakefield's solicitors and counsel swore Wakefield to secrecy and convinced him that the hearing was an easily winnable legal battle. Meanwhile, Brian Deer and the Sunday Times, the pharmaceutically controlled lobby groups, blog sites and tabloid newspapers continued a relentless campaign against him well beyond the legal detail of the hearing.

Perhaps more important than this, while the Chairman of the panel intoned that the hearing was nothing to do with vaccination, the government pressed on with its very public vaccine programme which made it appear that vaccination was a matter of life or death and anyone who stood in its way was possibly a murderer. Dr Wakefield's case was a political case and the lawyers should have seen this and refused to play ball without the most intense public investigation of such things as conflict of interest. As it was, the defence entered the hearing exuding bonhomie and acting as if the whole matter was just a terrible misunderstanding.

It was very noticeable that at the beginning of this hearing in 2007, there was no structured mechanism for introducing conflict of interest information, all of which should have been provided by the GMC and been the basis for challenges by defence council. Dr Kumar did make an almost mute point of telling the hearing, in general terms and quite hastily, that he had previously sat on committees that were part of the Medicines Control Agency (MCA). (4) It was also the case that at any point in the hearing when a named person known to Dr Kumar, or a particular place of work, cropped up, he told the hearing that he knew or had worked in the vicinity of this person or this location. (5)

In looking at what might be considered Dr Kumar's vested interests that might have been declared at the start of the Wakefield, Murch and Walker-Smith fitness to practice hearing, I have concentrated on four areas: Kumar's previous involvement with the GMC, his work on two committees of the MHRA, his work for the Department of Health, his work as Chairman of the British International Doctors Association (BIDA), and the previously declared information about shareholdings in GSK.

*   *   *

Between 1999 and 2005, it was recorded that Dr Kumar was a consistent activist within the GMC, the prosecuting authority in this case, and had, as he made clear in his list of posts and affiliations on the GMC site, prior to 2004 been a GMC council member and served on the following committees: the 'registration committee', the 'health committee', the 'professional conduct committee', and the 'racial equality and diversity committee'. As an Associate of the GMC since 2003, he has also been a panel member on 'fitness to practice' hearings.

We have to bear in mind that the Panel in these cases is the jury, a small group of individuals capable of bringing in a verdict of dishonesty, that stands to a doctor with as much authority as the finding in a criminal law trial. Clearly the jury should be absolutely untainted by any involvement with either the defendants, the prosecutors or the many central issues of the case. In this case we have to consider whether being so intimately involved with the GMC it is possible that Kumar might have been au fait with the GMC's position on the prosecution of Dr Wakefield. His choice as Chairman was in effect no different from the Crown Prosecution Service, the English prosecuting authority, ensuring that one of its staff was on a jury in a criminal trial.

Since the late 1990s, Dr Kumar had been involved in two British medicines regulatory bodies, the Medicines Control Agency (MCA) and its main committee, the Committee on the Safety of Medicines (CSM). The MCA became the Medicines and Health Care Regulatory Agency (MHCRA) and in 2005 the CSM became the Commission on Human Medicines. Dr Kumar was definitely on the CSM in 1998 and this is the committee membership that he alluded to at the beginning of the hearing. (6) Members of this committee discussed the safety of drugs and vaccines.

Following the restructuring of the MCA after it became the Medicine and Health products Regulatory Agency (MHRA), Dr Kumar sat on two of this body's most influential committees. The Independent Review Panel for Advertising (IRPA) and the Independent Review Panel for Borderline Products (IRPBP). (7) Both the advertising of pharmaceutical products and the definition of what is a medicine are two of the hottest topics presently involving pharmaceutical companies in Britain and the first group is certainly relevant in relation to the advertising of MMR. Both the IRPA and the IRPBP has a policy of members declaring personal and non-personal interests. (8)During 2003, 2004 and 2005, and through 2006 into 2007, when the GMC hearing began, the MHRA records show that Dr Kumar held shares in GSK.

On hearing of the MHRA for the first time, it might seem to many people that it is a 'normal' government regulatory agency. Few people would guess that the MHRA, while being the most important regulatory body for medicines in Great Britain and the organisation which, for example, processes Yellow Cards that notify the DH of averse reactions to drugs, is actually a trading company completely subsidised by the pharmaceutical industry.

The MHRA took over from the MCA in 2003. The MHRA is a Government Trading Fund that might just as well be called a business or a corporation. A Trading Fund is an almost entirely separate economic entity that earns money by the provision of services and, like any kind of company, it must balance the books at the end of each year. However, unlike a number of other Government Trading Funds, which provide services, earn money and accept fees from diverse ‘beyond government’ sources, the whole of the MHRA income is provided by one funding source; the pharmaceutical industry. Further, a percentage of staff and executives of the agency, have come into it from the pharmaceutical industry.  It is therefore not surprising that, funded and partly staffed by the industry, its policies are shaped to please this sector. When considering conflict of interests, the workings of the MHRA have to be seen in light of the fact that the agency is completely beholden to the pharmaceutical industry.

Dr Kumar sits on the UK National Screening Committee that is chaired by the Chief Medical Officer for Scotland and advises Ministers and the National Health Service (NHS) in all four UK countries about all aspects of screening policy and implementation. Screening programmes are of immense importance to the contemporary drugs industry as the ongoing embittered battle over the Gardasil vaccine against human papillomavirus (HPV) for pre-pubescent girls is showing.

The Department of Health (DH), a central aspect of the NHS has been at the very forefront of the battle against Dr Andrew Wakefield. Anyone seeking information about MMR from the DH web site was at the time of the start of the hearing directed through links to Brian Deer's web site and, apparently speaking for the New Labour government and the DH, Deer gives his version of the crimes of Dr Wakefield. The DH gives no links to other web sites of a similar kind and there is not the slightest attempt at balance. (9)

If at the time I wrote my essay An Interest in Conflict, you had gone to 'MMR the facts' via the NHS site and put Brian Deer in the search box, the site would have served you 50 items which mention Deer's work. The first item was this:

'MMR news: 14-Nov-04: Sunday Times: MMR scare doctor planned rival vaccine. Doctor whose work provoked a worldwide scare over MMR failed to reveal that he was developing his own commercial rival to the vaccine.' 'MMR scare doctor planned rival vaccine, Sunday Times - Brian Deer.' 'It has emerged that a patent was filed on behalf of Dr Andrew Wakefield for a measles vaccine and other products that would have stood a better chance of success if public confidence in MMR’s safety was undermined. To read the full Brian Deer article in the Sunday Times, please visit Times Online'.

Now, the fact is, despite it being promulgated by the lobby groups, the Sunday Times and the government, this story promoted by the NHS is not true. Of all the allegations made by Brian Deer, this is one of the most apparently prejudicial while being completely untrue. The 'competitive vaccine' referred to was Transfer Factor, which Dr Wakefield experimented with in the hope that it might help children overcome serious adverse reactions to measles and other vaccines. The GMC enquiry was so little enamored of this 'evidence' that it dismissed it almost entirely, concentrating instead on whether or not Dr Wakefield, or either of the other two defendants were acting ethically in prescribing Transfer Factor to one child who was recorded in the Lancet paper.

Looking briefly at another connection between the NHS, Brian Deer's web site and the GMC hearing, if you travelled to Brian Deer's web site through the NHS 'MMR News' you would have found an analysis of the Lancet paper by a Professor Trish Greenhalgh. This off-the-cuff analysis repeats almost word for word the prosecution case put by the GMC. The fable suggests that the Lancet paper case-series review, was in fact a badly conducted full blown research project organised to prove that MMR caused autism in vaccinated children.

Greenhalgh's explanation of the Lancet paper (10) is quite extraordinary in that it followed the line of Deer and the GMC rather than the paper itself. Greenhalgh’s interview answers give a very clear view of how Dr Wakefield's detractors, from the beginning, tried to portray the Lancet paper as the record of a full-blown study, rather than a short 'case series review'. They also give us an insight into the case that the GMC began prosecuting and how this case was broadcast by the NHS and the DH.
 
So the happy coincidence of Dr Kumar's involvement at a relatively high level in the NHS, although it might be dismissed as purely co-incidental, would appear inevitably to prejudice his view of the Lancet study if we understand that the NHS and the DH was from the beginning promulgating the GMC's prosecution view of Dr Wakefield's work.
 
To show how far up the system the honesty paralysis went within the NHS, at the beginning of the GMC hearing, we might quote John Stone:

After the publication of Brian Deer's story the Chief Medical Officer, Sir Liam Donaldson remarked to the BBC Today Programme (23 February 2004 - three years before the GMC trial began): 'Now a darker side of this work has shown through, with the ethical conduct of the research and this is something that has to be looked at'. On the same day the Prime Minister said to ITV [commenting on Brian Deer's article]: 'I hope now that people see the situation is somewhat different from what they were led to believe'. (11)

Since 2002, Dr Kumar has been the National President of the British International Doctors Association (BIDA). Prior to that he was, from 1990-1996, the General Secretary of the organisation. BIDA was established in the United Kingdom with the objectives of promoting the interests of Ethnic Minority Doctors and Dentists working in the United Kingdom. However, what doesn't become clear on the BIDA web site, unless you look closely, is the fact that the organisation is funded not only with membership fees but also by pharmaceutical companies. BIDA's magazine is also subsidised by drug company advertising. This information is declared by Dr Kumar in his conflict of interest declaration for the MHRA but not for the GMC.

Not only is it the case that anyone adjudicating in the Wakefield fitness to practice hearing has had from the beginning the power to raise or lower the price of vaccine manufacturers shares, there is inevitably a question that has to be answered about the individuals' commitment to that company and how these shares were obtained, were they given as payment by the company or bought from them?

*   *   *

I can remember that morning clearly. We had returned to the hearing after one of those interminable delays and I was staying not far across the Euston Road in the Indian Student YMCA. I had a cheap down to earth room without anything resembling breakfast, and was not in any sense looking forward to yet another day in the hearing. Over the last break I had managed to finish the essay about the conflict of interests inherent in the hearing and particularly those of the Panel Chairman. I suppose that I was slightly apprehensive; on a previous occasion I had released an essay during a break, only to return to find Brian Deer raging against me outside the GMC building.

I went into the building, feeling as always somehow dwarfed by the architecture of post-modern humiliation, chatted to the funereally dressed young woman behind the polished granite desk, picket up my name tab on a red lanyard, stepped with experienced precision through the automatically opening glass half door turnstile to the lift. The lift was a place of concern for by this point you had passed through the cordon sanitaire of the GMC foyer and could well come face to face with one of the prosecution team, or a panel member.

The third floor that morning seemed eerily quiet and it was from that point onwards that I began to suspect the worst. Sitting in the outer lounge I glanced through the Daily Telegraph and got a cardboard cup of green tea from the machine. I eventually slipped through the glass doors into the carpeted corridor and then into the four rows of chairs that constituted the public gallery. I sat down, got out my pen and notebook, placed my coat over the back of the chair and sat quietly waiting.

Usually when the defence lawyers and the defendants came in, they glanced in my direction, after all I had attended as many days of the hearing as they had and I was considered a familiar face. On that day, there was a long wait before anyone came into the hearing room and the lawyers particularly, although sometimes smiling slightly, kept their heads down. As the last members of the panel entered the room, the Legal Assessor, a neat piggy faced man, was still in animated conversation with Dr Wakefield's counsel. It was then that I knew that something was about to happen and that something might involve me; after all I was the only outsider there.

Everyone took their seats and the little man with the pink face pulled at his cuffs, looked into the still air in front of him and then launched into me.

A judge in real life, the Legal Assessor described my essay as an 'unhelpful intervention', adding, 'if this person thought that he was helping anyone he was mistaken'. Of course, in saying this, he entirely missed the point, I have no interest in 'helping anyone', just in speaking up for the parents and their vaccine damaged children and, the more abstract cause of 'justice'.

The assessor, however, employed by the GMC, was more pragmatically concerned than I was. One of his objections to my essay was:

If anybody thought that they were helping anyone, they were not because it has involved lawyers having to read and consider it, it will have involved unnecessary expense, unnecessary work and possibly even unnecessary concern.

Inevitably my mind rolled back over the junk journalism that Deer had produced during the hearing, including a long article that newly accused Dr Wakefield of fixing the results of his research. One of my worst crimes, it appeared, was that I had made the intervention with my essay 'at this point in the hearing', that is, after a year of the prosecution's prevaricating, repetitious time wasting.

The best that can be said is that this was considerably unhelpful and entirely inappropriate at this stage in these proceedings.

He implied that, had I made my observation about Dr Kumar's conflict of interest at the beginning of the hearing, it would have been considered in a more kindly light.

The Assessor made the point that Dr Kumar had declared his conflicts of interests at the beginning of the hearing. Of course, neither the legal assessor or anyone else involved, could have read from the transcript Dr Kumar's exact words when, during the hearing, he explained that he held shares in GSK, the vaccine manufacturer.

The Assessor went on to accuse me of a criminal act for which unfortunately his tribunal was unable to prosecute me.

Unfortunately, this is not a court of law and does not have the benefit of contempt law, otherwise I might give firmer advice to the Panel as on how to deal with such interventions. The Panel members who were shown this of course were concerned about the propriety of their position.  It is an entirely unhelpful intervention.

For the rest of the day I caught Kumar leaning forward slightly and glancing side-stares at me, still the only person in the public gallery, as if he were reminding himself of my features. I wondered what he was thinking and was amazed at the seeming effrontery embodied in those glances.
 
As I was writing for CryShame, the parents' organisation at this time, the Chair of CryShame, Allison Edwards, following this cover-up by the Panel chairman and the Legal Assessor, supported my attempts to get the GMC to make a clear statement about their conflict of interest policy. After an exchange of correspondence, the GMC admitted that they didn't actually have such a policy.

Brian Deer, clearly primed by someone to reply to my relatively academic finding of Dr Kumar's GSK shares, responded with a vitriolic personal attack:

Some of the latter (parents), in their pain, have now turned nasty: with me as a target for their hatreds. Although almost literally a handful of people, and some with no link to MMR or autism at all, they've insinuated themselves among affected British families and are causing distress with false allegations. Among these is a claim that my Sunday Times and Channel 4 investigation - which nailed the scare and helped to restore public confidence - was covertly supported by the drug industry.

A string of recent outings for this sickening falsehood are authored by a 61-year-old graphic artist called Martin Walker, who apparently lives in Spain, but last year surfaced at the mammoth hearings of the GMC in London. He claims to be a "health activist", and, although generally of little consequence, is a relentless peddler of smear and denigration, with a track record of latching onto the vulnerable. These he beguiles - like he's their new best friend - and then, if past form is a predictor for the future, attempts to sell them self-published books. (12)
*   *   *

Returning finally to myself and my 'reputation', I feel that Deer's execrable writing above hopefully does him more damage than it does my reputation and it goes without saying that, though I value my reputation quite highly, it is dust in the wind compared to the monumental reappraisal that the parents of vaccine damaged children have had to effect in their lives since they were struck by this manufactured tragedy.

What astounds me now more than anything has nothing to do with any sense of personal hurt, but the sustainability of the gross lies told by Deer and his criminal contemporaries in the government and corporations. Since the verdict against Dr Wakefield, Professor Murch and Professor Walker-Smith, Deer has affected the most odious and duplicitous persona, hailing himself as the promoter of the parents' cause and expressing empathy with them after their painful victimisation by Dr Wakefield.

That political forces in Britain are able to air brush out a whole society of vaccine damaged children and their parents while censuring the academic history of a man who speaks out for them, is quite extraordinary. I spend days now wondering how we might reassert the presence of the parents and their children, making public the crimes of those centrally involved. (13) Were it not for the fact that I know this struggle is for the future of science, justice and the chimera that we call democracy, I would be tempted to move on.

Recently on television I watched an interview with an Italian anti-mafia judge and marveled, not for the first time, at the moral strength of such people. The British legal community is so desperately lacking in individuals of moral standing that no one has stepped forward to challenge the corruption with which the pharmaceutical mafia and the corporate State are mocking science, justice and the parents of vaccine damaged children. In the case of Dr Wakefield, the GMC has brought the legal and regulatory process into utter disrepute, raising the age-old question of Quis custodiet ipsos custodes? Who guards the guards?



Endnotes

(1) http://briandeer.com/mmr/mli-information.htm.

(2) All my essays over the period of the Wakefield case were published in Medical Veritas, Volume 6, Issue 1, April 2009.

(3) http://www.wesupportandywakefield.com/documents/The%20Urabe%20Farrago.pdf

(4) As related below, in 2003, the Medicines Control Agency (MCA) became the Medicines and Healthcare products Regulation Agency (MHRA).

(5) This practice coincides with a note about spontaneous declaration that I was sent by the GMC after making an enquiry about their policy:

There are, however, occasions relating to Fitness to Practise hearings when a conflict, or potential conflict, of interest may arise and which would not be recorded in the Register of Interest. This would include occasions where the doctor appearing before the panel, or a witness, was known to one of the panelists or where one of the panelists had prior knowledge of the events that led to the doctor's appearance before the panel. You will appreciate it is impossible to list such conflicts in the Register of Interests. The procedure on those occasions is that panelists are required to declare those interests as soon as they are aware of them. Panelists are usually able to declare such interests in advance of the start of the hearing but there are instances where conflicts only become apparent during the course of a hearing e.g. as the evidence is adduced or when a witness is called.

(6) 1998  Summary of the Meeting of the Committee on Safety of Medicines held on 11th February 1998.

(7) The Medicines (Advertising and Monitoring of Advertising) Amendment Regulations 1999, SI No. 267, came into force on 5 April 1999 and completed the implementation of Directive 92/28/EEC. Regulation 13 and the Schedule contain a procedure for a review of the Health Minister's preliminary decision on whether an advertisement complies with the Medicines (Advertising) Regulations 1994, as amended ("the Regulations"). The Health Ministers proposed that the review would be undertaken by an Independent Review Panel.

(8) 2005, Independent Review Panel for Advertising: Declaration of members current personal and non-personal interests.
http://www.mhra.gov.uk/Committees/Medicinesadvisorybodies/IndependentReviewPanelforAdvertising/AnnualReport/index.htm

(9) http://www.dh.gov.uk/en/Publichealth/Healthprotection/Immunisation/index.htm ....to.... MMR Explained ... to... http://www.mmrthefacts.nhs.uk/

(10) http://www.mmrthefacts.nhs.uk/search.php?keywords=Wakefield
[MMR news]: Analysis of the 1998 Lancet Wakefield paper
Professor Trisha Greenhalgh explains why the Wakefield 1998 Lancet paper should never have been published on scientific grounds.

(11) Cited by John Stone in his bmj response: http://www.bmj.com/cgi/eletters/328/7438/528#56300

(12) The majority of Deer's attack on me and my rebuttal are published in Medical Veritas.

(13) One way everyone can help is by buying copies of the first two Silenced Witnesses books in which the parents tell the stories of their vaccine damaged children.