Expert Witness Journal Dec 24 - Journal - Page 76
nutshell what SIHIS does is to establish a multi-disciplinary team (MDT) of well regarded consultant level
specialists. The MDT will co-ordinate the investigation
of every case of suspected inflicted head injury in a
child as soon as it arises. The MDT will, by definition,
include a paediatric radiologist or neuro-radiologist.
Other specialties such as ophthalmology, genetics and
haematology will also be involved.
The pilot is being funded by the Department for
Education, as part of their responsibility for children’s
social care. As of last month there had been 42 cases
through the pilot, and it is thus still early days to give
any comprehensive analysis of its operation and impact.
In closing I hope that what I have said has given you
some impression of the road that has been travelled by
us all in our developing understanding of the various
manifestations of child abuse. I hope that I have also
demonstrated that today, just as for me in that courtroom in Birmingham 40 years ago, Roy Astley was the
key to unlocking the truth in a case of suspected abuse,
so too are you, today, in your work with children and,
if it goes there, with the courts.
Operating on a hub and spoke model, where a case
may arise even in a small district hospital, it will be referred in to the SIHIS team at the regional hub as
soon as the possibility of an inflicted head injury is
raised. The team will investigate and produce a templated clinical report and this report will be the main
clinical assessment for the treating team and, if the
diagnosis is of inflicted injury, it will form the basis of
any investigation by police and social services.
We need paediatric radiologists to continue to engage
with the Family Court as experts. Without that expertise we as judges, lawyers and social workers are
blind and cannot proceed. We are doing what we can,
and it is a good deal, to make the experience of acting
as an expert a more clement experience than it may
have been in the past. I hope that, if you do not do so
already, you may put yourself forward to act as an expert in the Family Court in the future. The importance of the work is hard to understate. The stakes for
the child and their family are high, and the need for
clarity as to the causation of any potentially sinister
symptoms is at a premium. In short, we need you!
This model is seen as having real benefits for children
in these anxious cases by providing, at a very early
stage, a thorough and authoritative assessment which
may lead either to a case being regarded as inflicted
injury, or, as has apparently been the case thus far, in
giving a reliable diagnosis of accidental causation or
a manifestation attributable to some underlying
condition.
At present, unless the child is referred to a tertiary
centre at the time of their admission, it is unlikely that
experts of the calibre of the SIHIS team would be involved in any coordinated manner for some many
months, and only then as part of the process of expert
instruction in the criminal or family court.
EXPERT WITNESS JOURNAL
Sir Andrew McFarlane
7 November 2024
74
DECEMBER 2024
