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It is a view seldom promoted by the medical profession, but one of its members recently broke rank and drew attention to what she referred to the "high levels of damage" caused to families by unfounded abuse allegations.¹

Mary Pillai used the experiences of 22 families caught up in civil or criminal proceedings. In none of the cases was there evidence to support the abuse claims made against the parents, each time by a daughter with mental health problems.

Pillai, a forensic medical examiner for Gloucestershire police, cautions that it would be unwise to draw quantitative conclusions on the scale of the problem because her work centred on a self-selected group.

But one crucial fact emerged: no attempt was made in any of the cases by the professionals involved to find out whether an incident or injury had in fact occurred, as would be expected under section 47 of the Children Act 1989. Indeed, on reviewing paperwork, Pillai found that doctors had written statements which were taken as fact by other professionals when they were in reality "uncorroborated opinion". Case conferences, where evidence of this nature was discussed as part of the process leading to registration, were described by families as "a kangaroo court with no validated information".

Pillai raises two features that have been covered elsewhere in discussion of false and unjustified allegations: namely the "profiling" of families and alleged abusers and the reliance by accusers or investigators on "denial" as an indication of guilt.

The paper also covers territory already covered elsewhere relating to repressed memory and whether children lie when claiming to have been abused. But one new argument is that there should be formal accountability within the body that co-ordinates child protection, the area child protection committee (ACPC), for the integrity of information that is presented at each stage of the child protection process.

"Professionals tended to respond to complaints by deferring responsibility for serious failures to other involved agencies," says Pillai. Yet the ACPC is not a statutory entity, she says, and "therefore cannot be challenged."

There is no mention here of what has been observed anecdotally elsewhere: that those who play a part in the child protection process, when challenged, say the courts are ultimately responsible for the more serious decisions that may be made.

But there is an attempt to set down what the costs are to families and the state of legal proceedings involved in child protection. The costs to the 22 families ranged from £10,000 to £100,000. One family estimated the total cost to all authorities involved to be £300,000. There is anecdotal evidence elsewhere that complex child protection cases may cost upwards of £1m to all parties involved. Pillai suggests that a figure of £1.6bn quoted to be the current spend on child protection is only a fraction of the total cost to the public purse.

Pillai claims that there is "a culture of support and empathy with those making allegations of abuse", which has evolved "reactively" out of child abuse scandals.

There have been few attempts to investigate outcomes for families involved in false allegations of abuse. There is revised guidance and framework for the assessment of families² but Pillai is not convinced that, in the situations she describes, the families and alleged "victims" will fare any better.

Brian Morgan is a health and social care writer.

¹ Mary Pillai, "Allegations of abuse: the need for responsible practice," Medical Science Law, Vol 42 (2), 2002

² Department of Health, Framework for the Assessment of Children in Need and their Families, The Stationery Office, 2000; go to: www.doh.gov.uk/scg/cin.htm