This site uses cookies.

How Will the New Advice for Paediatric Experts Affect the Availability of Experts for Defence Work in Family Courts? - Dr Mark Burgin

29/11/18. Dr. Mark Burgin BM BCh (oxon) MRCGP DCH raises concerns that the new guidance for paediatric expert witnesses tightens the availability of experts prepared to consider the emotional evidence that might support parents.

The British Psychological Society were involved in developing advice for psychologists which has now been extended to other paediatric experts. (1,2)

The advice is intended to provide information to stakeholders on the use of paediatricians and supplement Part 25 of the Family Procedure Rules (FPR) and PD 25B.

The guidance recommends that experts are instructed where it is necessary to resolve the proceedings justly on matters requiring specialist expertise outside the knowledge of the court.

There is little discussion in the document on how emotional assessments should be performed and whether secondary care practitioners can provide the necessary expertise.

I have written about how a primary care expert can use the biopsychosocial model to give an assessment of risk from examination of the child and the parent-child relationship. (3)

 

Limits to evidence

Paediatricians are limited to giving evidence on the child’s clinical findings and the likelihood that they are consistent with child maltreatment or child safeguarding matters.

Their role is further restricted as different specialists have different expertise and the expert should "stick to their own clinical field when presenting their expert evidence in the Family Court."

Examples of consultants that could be called are general or community Paediatricians, Radiologists, Neuroradiologists, Neurologists, Metabolic/bone, Haematologists and Ophthalmologists, Neurosurgeons, Pathologists or Forensic Pathologists.

Justice may require all the above specialist experts to deliver their expertise in a complex case but the guidance inconsistently suggests only one specialist might be called.

General Paediatric expert witnesses should be able to consider all the evidence including statements and reports before providing an opinion but are not psychologically trained.

 

Team work

The guidance states that when child maltreatment is suspected a senior paediatrician (ST4 or above) should carry out the assessment.

The guidance notes that there are no child protection specialists in the UK so the specialist should be able to perform a “comprehensive review” of the child’s well-being including emotional.

As this is unlikely to be within the expertise of a single practitioner the guidance recommends that they draw upon the clinical expertise of the paediatric team.

The problem with this approach is that child mental health services involvement is typically restricted to GP, Health visitor and school nurse.

Even if a psychologist was attached to the team they would be involved in the safeguarding procedure and psychological and emotional assessments are different.

 

Conflicts in Family Work

Paediatricians that are called as a professional witness appear to be subject to the same rules as an expert witness as they “must remain within their expertise”.

This is further reinforced by saying that holding a controversial view is evidence of partiality which is an extreme interpretation of the expert witness’s overriding duty to the court.

Regulation of the expert is laid out in the guidance and includes the need to undergo peer review, follow the latest guidance but oddly there is no need to sit a knowledge test.

Experts are chosen based upon experience and publications so there is a risk that they will only be drawn from a narrow group of ‘establishment’ paediatricians.

Primary care practitioners will have seen families in better times and can offer a balance to evidence that may be obtained at a time of stress.

 

Conclusions

The restrictions on those who can perform expert work in family courts have been significantly tightened by this guidance.

The gaps in assessments have not been addressed although primary care experts such as health visitors can still be appointed at the Court’s discretion.

Ruling inadmissible evidence such as emotional assessments that might support the parents may raise concerns amongst lawyers about the potential for unjust decisions.

Primary care practitioners are community based and have expertise in using the Biopsychosocial model to fill the gap left by hospital-based teams and social workers.

 

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk

 

  1. RCPCH 2018 Paediatricians as expert witnesses in the Family Courts in England and Wales: Standards, competencies and expectations August 2018 Guidance from the Family Justice Council and the Royal College of Paediatrics and Child Health

  2. BPS January 2016 Psychologists as expert witnesses in the Family Courts in England and Wales: Standards, competencies and expectations Guidance from the Family Justice Council and the British Psychological Society

  3. Burgin 2018 how the biopsychosocial model can assist the family court when assessing risk by providing a clear structure. www.pibulj.com

Image ©iStockphoto.com/johavel