Tuesday 26 September 2017

The Councillor's lost Daughter part two

Carina Burn had been removed from her parent's care without them being informed. Carmarthenshire County Council Social Services, on the evidence of 2 carers who claimed to be able to communicate with Carina, that she was now a competent adult, having previously been regarded at regular assessments  as a person with severe learnng and communication difficulties. Eventually it was proved that the whole thing was a hoax and the carers only pretended communication with their client. How were they able to maintain the fraud for months? How were the police, the Council officers and a senior doctor, all professionals, completely fooled by carers with little experience or training?

The ombudsman has produced an analytical and critical report in response to a complaint against Carmarthenshire County Council by Mr and Mrs Burn. It was never revealed to or discussed with any elected councillors in CCC, to my knowledge. As a member of the Health and Social Care Scrutiny Committee at the time, the matter was never discussed and my personal inquiries as to the measures taken to  both prevent a recurrence and the concerns of the Burns about the carers involved still being employed locally,  were ignored. The ombudsman's report was available on request to every member of the public who knew the reference number, but not to those elected members supposedly overseeing the performance of the Council's Social Care department.

The only person concerned who stood before a disciplinary panel , was the doctor, psychiatrist  Rowan Wilson, who had been deceived into confirming Carina Burn's supposedly adult capacity and verifying her testimony. Why CCC chose an old age psychiatrist with no experience with autistic conditions to make this assessment has never been explained.

His General Medical Council hearing reveals evidence explaining how he was fooled, not only by the carers but also by a social worker.  GMC Fitness to Practice hearings have the standing of a civil court and are conducted in a similar way.

The hearing. GMC ref no: 3547955 was a public hearing conducted 12th-15th November 2012. Carina is referred to as CB in the records, which her parents have allowed me to access. There was press coverage at the time.
GMC Offices Manchester

The panel findings were that Dr. Wilson conducted an examination of CB on the 8th November 2010 at the request of  Carms CC, using facilitated communication ("FC") in circumstances where patient CB was diagnosed as autistic and when he had no prior experience or informed knowledge of  FC.

Furthermore when conducting and reporting the assessment Dr Wilson failed to establish CB's cognitive capacity, accepted FC as a reliable technique without enquiry and failed to consider the discrepancy between CB's diagnosis of autism and her apparent language competency using FC. He also failed to test the validity of CB's use of FC. He then produced a report concluding that CB had full adult mental capacity when he had insufficient information so to conclude.

Mr Climie, Dr Wilson's defence barrister did not dispute the serious clinical mistake which had led to CB being kept in Care and denied access to her family. He submitted that there was a very significant element of malice attached to the allegations and mentions the dispute between the parents and carers over the disappearance of money without receipts and CB not attending the activities agreed for her. He mentions that Dr Wilson was unaware of these details.

Dr Wilson was asked to undertake an assessment of CB. Her social worker informed him that "CB has made disclosures to the police about her parents. Her parents are in full denial of this and are disputing  that she has the capacity to make this disclosure, let alone use the communication that she has recently been using very efficiently. They also believe that she cannot make decisions on where she lives or that she has the right to choose if she sees her parents or not."

Dr Wilson's subsequent report is full of wonder that this clearly disabled, childlike young woman without speech is able to remember names, describe her care home and "speak" through FC with a clearly adult voice.He was informed by the social worker and carers that she had a "far greater mental capacity than is actually the case".Using that information he had written a report that CB had the full capacity to make her own welfare decisions. 

FC is a controversial technique and Dame Butler-Sloss, when president of the Family Division ,ruled that FC could not be relied upon in family proceeding where allegations of abuse are concerned. Through their solicitor the parents raised these concerns with CCC and pushed for a proper expert assessment of Carina which was eventually arranged in March 2011.As I have previously described Dyfed Powys Police seem to have kept the parents on police bail at the request of a social worker up to this point ,with no evidence ever found of abuse.

Professor Howlin, an expert in Autistic Spectrum Disorders and a practitioner of FC, examined  Carina on the 1st March 2011 and showed that she lacked capacity due to her autistic spectrum disability, but could use FC to make simple statements appropriate to a young child. She wanted to go home. The carers and social worker who had been "using" FC , had no communication with Carina whatsoever .Carina was 19 years old but Professor Howlin assessed her language communication  as between  2 and 4 years of age.

At the GMC hearing Dr Wilson admitted his errors. The panel affirm that he should have made an independent assessment rather than operating under a number of assumptions, that he should have been aware of the serious consequences which could flow from a mistake and that the actions amounted to serious misconduct.

Dr Wilson expressed remorse and this was considered genuine. He had also taken some training in assessing Autistic Spectrum Disorders and had changed his outlook to such assessments, Despite the serious misconduct finding, the GMC found that this had been one incident which was unlikely to be repeated and so no restriction was placed on his practice.

The panel considered that he "will always remember the distressing consequences of {his} assessment of CB" and also that it was a salutary lesson which he would not forget.

Dr Wilson accepted the opinion of international Expert Professor Patricia Howlin without question. Carmarthenshire County Council Social work department, unfortunately. did not. Carina's imprisonment continued with the same carers still "communicating" for her using FC.

How she was finally released is the next instalment.

Siân Caiach

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