Monday 28th July - Thursday 31st July

GMC Prosecution Exploits Vaccine Damaged Children with Autism and Attacks Good Doctors While Covering up the Crimes of Politicians and Pharmaceutical Companies.

Brian is back, in and out of the hearing, sitting palely in the corner like a scab on the sore of these festering proceedings. Apparently he is not so interested in the fate of Professor Walker-Smith, he now chooses his time to be present, even the beginning of Miss Smith's cross examination didn't seduce him. Still the air is a lot clearer when he isn't there, the low smog of sulphur happily dispersed.

On Tuesday 29th of July, Mr Miller stopped taking Professor Walker-Smith through his evidence-in-chief relating to the Lancet paper's 12 children. I haven't covered this evidence in detail because I have reported on it previously, instead I reduced the evidence to bullet points in my last article.

It has occurred to me that some readers who have read my last two reports might think that in not relating the evidence about the 12 children more specifically, I was doing a disservice to these children and their parents. I want to stress that the evidence brought against the three defendants in relation to the Lancet children, has nothing whatsoever to do with the children themselves. This evidence only reflects upon the children in as much as Miss Smith and prosecution are saying that on the whole the children did not have serious bowel problems and they were manipulated into being subjects of research, while the defence is saying that in each case, there was sufficient evidence of serious illness for the children to be examined on the basis of clinical need. The prosecution do not really want to discuss the real children, except to infer that the three defendants performed unnecessary procedures on them.

The GMC has used the children in the most cruel manner by refusing a voice either to them or their parents. No doubt if one asked the GMC why they have not called the parents to give evidence, they would say, 'We believe that the parents were duped, that they gave up their children to Wakefield and the Royal Free in the vain hope that their autism might be remedied but what actually happened was that the three defendants experimented on these children trying to prove that their autism was caused by MMR'. This of course is hogwash, they didn't want to bring the parents of the 12 children into the hearing because all of them would have sung the praises of Dr Wakefield, Professor Walker-Smith and Professor Simon Murch .

One might well ask , how would the testimony of the parents have affected the case? The answer is simple. The appearance of the parents would have reversed the thinking in the case and made it clear to the panel how sick the children were, how their regressive autism occurred after their MMR vaccination and finally, would have given considerable support to the way in which the doctors at the Royal Free had behaved; ethically and always with the children's interests at heart. Inevitably, the question that remains hardest to answer, is why the defence has not called any of the parents. Not being privy to their reasoning on this, it has occurred to me that it might be the case that the lawyers see the parents as loose cannons, who might at any time in their evidence, tip-over the defence case.

Any rational view of this case, would, I think see the evidence of the parents about the condition of their children and their search to get them properly examined and diagnosed, their contact with Doctor Wakefield and their treatment at the Royal Free, as a very good counterweight to the evidence of the General Practitioners who appeared ostensibly for the prosecution. I say ostensibly because a number of them, like other prosecution witnesses actually gave evidence for the defence, recognising their own limitations and lack of specialisation while expressing their gratitude for the work of the doctors at the Royal Free.

For those who would be happier with a detailed impression of the evidence relating to the 12 Lancet children, they could do no better than read Olivia Hamlyn's account, below, of the morning of Monday the 28th of July. Olivia who was only there for the morning on this day, managed to produce two pages of detailed record, which I reproduce below and which gives a full picture of how the defence is preparing to answer the onslaught of continuously repeated questions which is bound to come from Miss Smith when she begins her cross-examination of Professor Walker-Smith.

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When I arrived it was 10.10am so the hearing had already been in session for about 40 minutes. I had thought that by this time Mr Miller would have finished going through the 12 children which he had begun last Monday. However, this morning was dedicated to child 9 and child 10, and I left half way through child 10, when the hearing adjourned for lunch. The previous few times I have been, not much of huge interest was said. This morning a few things of more interest came up and some charges were touched upon directly, so I'll give a brief account of those things.

The evidence regarding child 9 centred mainly on the correspondence between Dr Clifford Spratt and Professor Walker-Smith, but the main points being made, I think, were that the investigation and treatment of child 9 had nothing to do with research and that Dr Wakefield and Dr Dillon were not involved. Likewise, giving child 9 asacol was merely to see if it might help, not for research purposes. Regarding whether a lumber puncture was clinically indicated, Walker-Smith stated that it clearly was, given that a sibling of child 9 had had the neurological condition, Hoffmann's syndrome.

Mr Miller also touched on Professor Walker-Smith's monitoring of child 9's folate (folic acid) levels, simply for information should it be useful for later research. This, however, never got any further but he stated that it could have been useful for diagnostic or therapeutic reasons. The evidence also focused partly on the monitoring of child 9's lead levels which were unusually high and Walker-Smith expressed puzzlement as to why Dr Spratt continued to involve him in what he saw as the typical remit of a local, community paediatrician. Professor Walker-Smith speculated that it could have been because child 9's bowel pathology might be linked to these lead levels but he also noted that Dr Spratt was asking him questions outside his area of expertise.

Regarding the referral and investigation, Professor Walker-Smith made it quite clear that child 9 was not to be included in what was referred to as the 172/96 study - a study that didn't actually get off the ground but which the prosecution insist was the basis for the 1998 Lancet paper. He stressed that child 9 was not part of any research study. When asked by Mr Miller why he had continued to correspond, on the matter of the lead, with Dr Spratt, Professor Walker-Smith replied that the correspondence was purely for child 9's benefit and that it was appropriate to be involved in this discussion. Walker-Smith made the point that he had general experience as a paediatrician and that he was not about to abandon a patient as soon as the issue at hand moved outside of his area of expertise.

In a letter from Professor Walker-Smith to Dr Spratt written in Sept 97, JWS recommended that child 9 stop receiving the drug he was on and mentioned that he had discussed this with Dr Wakefield. Walker-Smith had to explain why he discussed such a matter with Wakefield and said that it had been a matter discussed by a group of doctors on a trip to Freiburg. The question of how to get objective evidence of whether anti-inflammatory drugs worked, by repeating tests the children had had previously, for example, was a research issue and it therefore had been appropriate to discuss it with Dr Wakefield. He had written to Dr Wakefield on this subject because he didn't see him much. His discussion on the same subject with the other doctors had taken place face-to-face because he saw them more often; this was why there was no paper evidence of his discussions with them. Mr Miller went on to predict what the prosecution's question would be regarding this matter, ie . Why discuss clinical treatment with Dr Wakefield? Walker-Smith replied (and this is something he has mentioned before) that he wasn't aware of the limitation to Wakefield's clinical contract and had thought he was a full time clinical gastro researcher. He also noted that Dr Wakefield was an internationally recognised leader on IBD, its manifestation and treatment, therefore implying that it was perfectly reasonable and sensible to consult him.

That concluded the evidence regarding child 9 and Mr Miller then moved on to child 10. Child 10 was unique in that this was the only child who had significantly raised measles antibodies, and this was remarked upon by his GP. Professor Walker-Smith discussed the diagnostic skills he'd had to acquire where autistic children were concerned, as these children could not communicate with him. Out of this question rose the matter of whether colonoscopies were clinically indicated in these children, the prosecution line being that a number of other less invasive tests should have been investigated first and other causes of the pain should be considered, before opting to carry out a colonoscopy. Professor Walker-Smith simply informed the panel that other sources of abdominal pain, such as stones, would be rare and that these positive diagnostic features (e.g. the behaviour of the children in trying to alleviate their pain) and this type of pain were very familiar to him. He also stated that he could tell the difference between colic associated with stones and that associated with this type of pain, and that various accompanying symptoms would also suggest a gastro diagnosis. Looking at Professor Walker-Smith's evidence all round in relation to colonoscopy the prosecution are going to have difficulty proving these procedures were not clinically indicated.

Professor Walker-Smith also made the point that the tests were certainly not carried out simply because child 10's parents were keen that they should be. He stated that the parents had been painted in a bad light in the hearing but he had understood their position at the time, i.e. there was no way a parent would want their child to undergo such investigations other than to help the child. He also commented that the lab evidence (from usual tests carried out by Dr Davis) of the raised measles antibodies was unique and of interest since the whole unit was interested in the link between MMR, autism and bowel problems.

Moving onto ethics committee approval, 172/96 was given ethical approval but child 10 didn't become a part of that study or any other study, though he would have been eligible.

Regarding the colonoscopy carried out by Professor Simon Murch , on child 10, Walker-Smith stated that the reason for this was the high measles antibody and various other matters. There was then some discussion of the nature of lymphoid hyperplasia and the respective merits of colonoscopy and histological investigations. Finally, before I left, they dealt with the fact that the lumber puncture had taken place after the colonoscopy under the same anaesthetic – the reason for this was that since no other tests were being done, this was the only opportunity. Professor Walker-Smith explained that the lumbar puncture had been clinically indicated because of the history of regression and especially here because of the high measles antibody. The result was normal and, clearly anticipating the prosecution line, it was explained that this result was not something which could have been predicted, thus indicated the necessity of the lumbar puncture.