GMC Hearing Tuesday 15th July - Thursday 17th July

On Tuesday July 15th, Professor John Walker-Smith, an internationally-renowned paediatric gastroenterologist with experience in child health going back over 30 years, and now an emeritus Professor of Paediatric Gastroenterology, began his defence in the fitness to practice hearing brought against him and two ex-colleagues by the General Medical Council (GMC) in London. Nothing emphasises the peculiar nature of these proceedings against Dr Andrew Wakefield and Professor Simon Murch , better than the case against Professor Walker-Smith.

Walker-Smith's career was shaped at the fuzzy end of the medical world dealing with fast developing gastrointestinal illnesses, Crohn's and coeliac disease. Often considered as products of modern living, these conditions, together with child allergy, have environmental triggers, and both have been starved of research funding, especially by the pharmaceutical companies.

Professor Walker-Smith, now 71, has led a completely blameless and modest professional life, building over the past 20 years, one of the most highly respected paediatric gastrointestinal departments, based at both St Bartholomew's and the former Queen Elizabeth Hospital, Hackney'. Most of his experience in the use of procedures such as colonoscopy was gained under the guidance of recognised world experts. Through his professional life he has been responsible for some of the standard texts on child gastrointestinal illness.

Parents of children seen by Professor Walker-Smith at the Royal Free Hospital have nothing but praise for him, as they have for Dr Wakefield and Professor Simon Murch . Parents speak of the three men with robust reverence, eternally thankful for the kindness and concern that they have shown to their children. As an uninvolved observer of the hearing, I have noticed how both Professor Murch and Professor Walker-Smith immediately make contact with any parents who are present, shaking hands, smiling and asking after their children.

So who is accusing and prosecuting Professor Walker-Smith?   Who is standing in judgement over this eminent physician? His peers? Hell, no! As we know, despite the GMC's reluctance to state clearly with whom the complaint originated, it was first prepared and lodged by the medically-ignorant, down-at-heel pro-MMR hack Brian Deer, with the help of the Association of the British Pharmaceutical Industry private inquiry company Medico-Legal Investigations. It was built upon and turned into a prosecution by a GMC with a yellow streak instead of a backbone, desperate to curry favour with the past New Labour, once communist, Minister of Health John Reid; pushed forward by Richard Horton, the editor of the Lancet whose immediate on-line manager, chairman of Reed-Elsevier, is a non-executive director of GlaxoSmithKline, the biggest drug company in the world and one of the defendants in the legal action brought by parents of vaccine-damaged children.   The complaint is prosecuted by Miss Sally Smith, a lacklustre and evidently out-of-her-depth counsel, who, rather than admit that her case has collapsed, goes on and on and on scraping her knuckles on a wall that no longer contains a door. The case is supported by pharmaceutical lobby organisations, inhabited by ex-communist members of the now defunct Revolutionary Communist Party, Sense About Science and the Science and Media Centre. Behind these people rise like golems, the massive forms of corporate government with an industry-designed and profit-motivated public health programme, and the multinational pharmaceutical companies.

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It was tempting to start this account with a football chant, something like 'here we go again', but not everything is the same. For some inexplicable reason, for example, the public gallery part of the hearing has been downsized. Of course, this could be a quite rational decision accounted for by the low levels of attendance at the last hearing. The decision would be even more understandable, I suppose, if the GMC had the knowledge beforehand that Dear Brian was not going to be bodily present, though   his shade spreads well beyond the physical   space of his chair, covering all the chairs in the press section. There again, the GMC is probably, just like us, well aware of the fact that the media have refused to turn up for most of the hearing, so why bother putting out chairs for them?

The whole hearing room has, in fact, been streamlined, lending it a more airy feeling. However, nothing of any real importance has changed, the defence and prosecuting counsel still refuse to speak into the microphones from time to time, rendering some important parts of the proceedings inaudible. Why they should be so incapacitated is beyond me. The Chair of the Panel, Mr Kumar , is always clear as a bell, and despite continuous in-jokes about the accelerated Antipodean speed of his delivery, Professor Walker-Smith has been always audible.

Other things that have changed include Miss Smith, whose commitment to these sorry proceedings has obviously caused her endless tussles with her conscience and many nights without sleep. Or at least, I can only presume that these are the cause of her increasingly more tired appearance. I found myself alone in the lift with her on the first day back, and I was very conscious of the fact that every fibre of her being ignored me – although I must say this seems to be true of all the legal people at the hearing.

Of course, the biggest change in the form , if not the content , of the proceedings was to find oneself watching the back of the 71-year-old Professor John Walker-Smith, rather than the solid, more youthful rugby playing back of Dr Wakefield. I suppose that I had come to certain conclusions about Professor Walker-Smith and his evidence, its mode of presentation, long before last Tuesday. If you don't know the reality of the relationships between people, it is easy to create a false view of them. I suppose that I had it in mind that Professor Walker-Smith might be upset at having been dragged before a court, consequent upon the strong views of the much younger Dr Wakefield. Finally, I must admit to dark thoughts about both the other men appearing with Dr Wakefield, to the expectation that they would swim for the shore, saving themselves at all costs, leaving Dr Wakefield to drown.

After three days of listening to Professor Walker-Smith give evidence in chief, I feel very apologetic and completely humbled, ashamed at having even entertained such renegade views. Also, I have to seriously ponder how it is that I, who generally speaking   know a great deal about the ongoing case and consider that I have a good analysis of its causes and purpose, should allow myself to be so easily led by what can only be considered to be the prosecution agenda that fogs this case.

Professor Walker-Smith began his evidence with a request to call Dr Wakefield 'Andy' throughout his evidence. This demonstrated a positive refusal to be drawn into distancing himself from his co-defendant by calling him Dr Wakefield as his counsel had to do. This was a very intelligent move by Professor Walker-Smith, because it made clear from the beginning that he considered himself in the same boat as Dr Wakefield and Professor Murch , and that however the prosecution tried to separate and distance the defendants, they saw themselves as a team that had been involved in common work and now had a common defence .

Throughout Tuesday, Wednesday and Thursday afternoon – the Panel didn't sit on Monday, Thursday morning and Friday (we an only celebrate the fact that the GMC doesn't run a hospital!) – Mr Miller took Professor Walker-Smith through the salient points of the case against him. Professor Walker-Smith didn't once lose his footing in speaking to this defence . If the case against Dr Wakefield had seemed unbalanced and at times incoherent when it was presented to him, now as we watched Professor Walker-Smith go through his evidence-in-chief, we could see clearly that the case was simply without foundation, fabricated and totally implausible.

All of Tuesday afternoon, was taken up with glancing over Professor Walker-Smith's lifetime work, the first decades of which were spent between Britain and Australia. Walker-Smith was quickly revealed as a man whose life had been dedicated to becoming an honourable physician who came to specialise in childhood digestive illnesses. As some readers might know, this is a much maligned and ignored area of medicine, for a number of reasons but principally because nutrition and the effect of different foods on the human system has never been something in which doctors are interested, and which , like allergy and food intolerance, has been constantly ignored by the pharmaceutical and processed food industry research funding.

In the early Seventies, Walker-Smith left Australia and settled in London, where he was to stay at the St Bartholmew's over the next 22 years, gradually learning more about and defining his specialty as paediatric gastroenterology. While working at Barts and Queen Elizabeth hospitals he also worked in conjunction with doctors at Great Ormond Street Children's Hospital. This practice was, he described, a complex job, working as it were at the frontiers of medicine where there were few sensational or sudden advances, and where change came only after long periods of hard clinical and research work.

It was fascinating to hear him recount how he came to make the move from Barts to the Royal Free Hospital, offering in the process an analysis of hospital politics in an age of privatisation . The account showed a side of medicine that lay people rarely get to see, let alone have explained to them. In the end, it appeared that Professor Walker-Smith had managed to move his whole department from its two locations in Queen Elizabeth and Barts to the Royal Free. Not for the first time hearing observers got a look at the surreal way in which our corporately-directed society forces the best doctors to act as administrators as they try to preserve the best of the system.

As the hearing has gone on, I have found myself intrigued by the detailed sociological insight into the lives of the doctors concerned.   While the three doctors are presented as professional shysters, self-absorbed money grabbers involved in a wacky campaign to experiment on children, what we are actually watching are three men who have spent decades negotiating the administrative hospital maze, seeking out ways in which they might contribute to child health. From their evidence we gain a clear understanding of the fact that while chance, initiative, originality and experience play a role in the lives of able people, institutions and organisations such as hospitals and universities and their bureaucracies are often unable to change pace, ending up as 'enemies of promise'.

If we look back at a number of the prosecution witnesses, we can see clearly that they fit much more exactly into the prosecution-assigned characterisation of the defendants – professionals whose whole working lives have been guided not by intellectual curiosity or a desire to solve difficult public health problems, but by conservatism, intellectual insecurity and an eye for the main professional chance, often in co-operation with corporations or the international medical establishment.