Moira Woods
January 7 2003

Statement/interview to Irish Medical News

The Medical Council has seen fit, one year on, to issue a report further commenting on the case brought against me.

This is apparently because the Council felt it should spread blame, in a sense, or at least issue an admonishment that "lessons can be learned from the wide range of governance issues which appear not to have been addressed" by the establishment of the SATU in the Rotunda Hospital.

I find this deeply ironic, in view of the fact that

(a) the basic problems which the council now suggests should be addressed were the very issues the SATU tried in vain to address twenty years ago because of lack of co-operation from, among others, the medical profession;

(b) the report itself was deeply flawed in what it omitted and thus led to widespread misunderstanding in the publicity which followed it;

(c) the council's failure to curb this inaccurate publicity has created a climate of fear which has seriously undermined the professionals now working in this field.

However, I fully reject the committee's report and I stand my judgments in the cases considered in the inquiry.

This is not a matter of pride or defiance. No doctor is infallible. Mistakes and oversights are a daily risk for all doctors, and I am no exception. But as regards these cases, which have been under intensive review during this inquiry, I remain adamant that I had no option but to act as I did, on the evidence presented to me, and on my interviews with the children concerned.

Regrettably, much of the media comment on the report reflected what I think is a fundamental misunderstanding of what is involved in investigating alleged child sexual abuse. Those charged with this responsibility are rarely able to establish proof of abuse to a standard required for criminal prosecution. This is especially true if the children are very young, which is often the case.

Investigation of sexual abuse is about child protection. It is beyond doubt, given all the documented cases of sexual abuse we now know about, that the medical profession in all its disciplines was found wanting in this area in the past.

I am aware that some 50 doctors have protested to the council at the manner in which the cases brought against me were handled and the consequences of the unchecked inaccurate publicity. I very grateful to them, and to the many doctors, social workers and others who have contacted me privately to express their support and solidarity.

In their evidence to the Medical Council hearing, both international experts Dr Howard Baderman and Dr. Anthony Baker stated that they would have acted similarly in ALL of the cases. For some reason, this information was not included in the report presented last January to the council.

The experts stressed, again and again, that there were no 'procedures' at the time; that different professional workers were involved in different countries, and that communication between these people, who had personal experience with others of different disciplines, and with those from other countries, was the way that learning evolved.

The 'protocol' was an evolving and changing document, and in cases of children at risk an urgent decision had to be made.

This is the fundamental difficulty in csa work which was repeatedly misunderstood in the media reports, which spoke of the need to "establish proof" before removing a child from risk. Abused children rarely tell what is happening to them, and frequently are not believed when they do. Abusers consistently deny their activities. It is rarely possible to establish proof when assessing such cases. Where it is possible, the cases become a matter for criminal prosecution. In the vast majority of cases, professionals must assess the risk and make a judgment of probability in deciding whether it is safe for a child to return home.

In ALL the cases considered by the Medical Council during my hearing, social workers and other professionals were involved. In ALL cases 'additional information received after preliminary findings had been reached only confirmed in more detail the original opinion.

The new report states: 'The first meeting of the Working Group agreed that doctors working at the SATU would be employed by the Rotunda Hospital and would operate under the direction of the Master of the hospital. The SATU began work in January 1985; its work was envisaged as undertaking the forensic examination and medical treatment of adult victims of suspected sexual assault in the EHB area.

Little consideration was given to the possibility of the treatment or examination of children within the unit. Within a month of its establishment, the issue of the treatment of children was considered at the third meeting of the Working Group. That meeting considered that a children's unit would be required with special expertise and training and that relevant children's hospitals should be consulted about establishing such a unit. Such units ultimately came into being in 1988.'

In fact, although the unit was functioning from January 1985, only professionals knew of its existence. It was not officially opened until April 1985. As I had seen a number of children before the setting up of the unit, ---and, as even within the first three months 13 children were seen -- I expressed the view to the Master that there was going to be a problem with children.

As a result, the first training course in CSA was held in February. This was attended by social workers, psychologists, gardai, and some paediatricians. Although a suggestion was made at one of the early Rotunda meetings that maybe a similar facility to the SATU should be set up in a children's hospital, it was in no way a reflection on the staff at SATU, who at that stage were the ONLY doctors who had had any training.

I would like to comment on the attitudes of the three children's hospitals, both to invitations to attend that first course and to subsequent interaction.

Temple Street: Two paediatricians from Temple Street were concerned and wanted to help. They attended the weekly meetings at the Rotunda, and were of tremendous assistence in admitting children as emergencies. The Professor of Paediatrics was also a strong ally in helping us. In fact, in any cases of children under the care of these paediatricians, I was always called to Temple Street to examine the children. The staff of St. Francis Clinic telephoned and asked how they could help, and initially we were able to refer all cases for treatment there. They also supported us unequivocally.

Harcourt Street: There was an immediate positive response, with doctors from there attending the first course in the Rotunda. Subsequently, there was also positive contact with the Rotunda.

Crumlin: The Professor of Paediatrics stated that this problem did not exist in Ireland; 'one in a million' were his words.

The units that came into being in 1988 at Temple Street and Crumlin were not created as a result of weekly Rotunda meetings. They were as a result of unmitigated efforts on the part of the Master and myself to try to make the Department of Health realise that they had a problem on their hands. I recall bringing up one of the appoinment diaries to let them see the numbers of children that were attending. Finally they set up a Working Party on Child abuse, of which I was a member. It was WE who kept insisting on the model of interagency co-operation, a suggestion that was resisted strongly by one faction of the medical profession.

In fact, one the most distressing phenomena about working in the area of SA, of both adults and children, is the apathy, disbelief and sometimes antagonism expressed by other members of the medical profession. This point has been stressed by other professionals, from other countries - one of whom said, "If you are not experiencing this, you are not dealing with the problem".

Those doctors who did offer their assistance, which was invaluable, were honourable and courageous, especially at that time.

The Garda Siochana were the only professionals who responded positively, and as a matter of policy. They instigated Training Courses in Templemore. There were no guidelines in place when I was appointed the first director of the Sexual Assault Treatment Unit (SATU) in 1985. Our work was influenced by the international guidelines on best practice then in place in those units which were developing a child-centred programme for the detection of this crime in Canada, Australia, Britain and the United States. I served on the steering group set up by the Department of Health to establish the first guidelines in 1987, and helped to train groups according to those guidelines in health boards across the State

I was not altogether surprised when I learned that complaints had been made against me to the Medical Council.

In the recent comment on this inquiry, only two journalists -to my knowledge - drew attention to the association of the anti-abortion group, Human Life International (HLI), with the Medical Council inquiry. As a doctor who campaigned for contraception legislation in the 1970s and against the first referendum on abortion in 1983, I had crossed swords with such groups on a number of occasions before the X case became public.

As has now been publicly revealed by others, I was the doctor at the centre of that case. The first complaint against me was lodged with the Medical Council in March, 1992 -- just one month after the X case was first reported in The Irish Times - though it concerned a question of abuse referred to the SATU in 1986.

During the period leading up to X case trial, HLI openly expressed its support for the families who had made the complaints. HLI also mounted a campaign accusing me of manipulating Miss X, then 13, into seeking an abortion in order to force the introduction of abortion into Ireland.

From this, and from related information, I have drawn conclusions as to why I became the subject of the complaints which led to this inquiry. But there are wider implications for others in the future. This inquiry is now over. Its net effect will be to increase fear among professionals of committing themselves to any statement on child abuse, physical, emotional or sexual.

How are they to work effectively in a climate of fear? Will they be protected as members of a team? Contrary to media reports suggesting I worked alone, I worked with the health boards, social workers, legal personnel, gardai, and psychologists. Are all those who were involved in the cases considered in the inquiry now open to the possibility of an investigation into their work?

Are the consequences of this inquiry what we wish to see? Is it right, for instance, that a confidential report by a committee of a professional body can be promptly and widely leaked, and often inaccurately reported, without any sanction, despite a High Court order?

Is it right that the children involved in these cases were clearly and repeatedly identified -- by details widely reported and in some cases by name -despite that same High Court order? Is it right that the Medical Council took no action to prevent the publicity, or to correct the inaccuracies?

These are the relevant questions now for the wider professional community, if we are to put the children who need help first. That is still the priority.