A bastion of the establishment—indeed, a past president of the Royal College of Paediatrics and Child Health—is brought down by a plucky mother and her family after her wrongful conviction for murder. It reads like a Hollywood script. But many people involved in child protection are deeply worried about the recent decision by the General Medical Council (GMC) to strike Roy Meadow off the medical register.

Meadow was struck off after having appeared in court as an expert witness in the murder trial of a mother who was alleged to have deliberately killed her two young boys. The case against Sally Clark was subsequently found unsafe after she had served more than two years in prison.

The Lancet recently argued that the verdict of serious professional misconduct against Meadow was not only unjust, but would damage the future of child protection services in Britain by discouraging paediatricians from acting as expert witnesses in such cases.

Around 30,000 children under the age of 16 are on child protection registers. About 40 per cent are on the register for neglect, 20 per cent each for physical and emotional abuse and 10 per cent for sexual abuse.

Current estimates in England and Wales are that 30-40 infants die each year as a result of covert homicide—about 10 per cent of the current annual total of sudden unexpected deaths in infancy. Clearly the vast majority of deaths that are categorised as sudden infant death syndrome (or SIDS) do not involve abuse. But, by definition, in most cases the experts do not know why the child died—as a result it’s very difficult to counsel a family or a mother about the chances of a repeat tragedy within the same household.

It is on this issue that the GMC case, as well as the media criticism of Meadow, turns. In court during the Clark case, Meadow quoted from a report published by Her Majesty’s Stationery Office titled “Sudden Un-expected Deaths in Infancy, The CESDI SUDI Studies 1993-1996,” in which the chances of a child dying from SIDS were broken down by various household characteristics, such as presence of a smoker, single-parent family and socioeconomic standing.

Using the figures supplied in the booklet, Meadow quoted that the chances of two children dying of SIDS in a married middle-class household, such as Clark’s, came to 1 in 73m. This now infamous figure from the booklet was arrived…

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