a)      Alienation of parent(s)/guardian(s) from and by the hospital system.

• Employ arrogant, incompetent and abusive gastro-enterologists who are not up to date in the care of children with multiple health problems, and then give them these children to ‘look after’.

• Create loopholes in the system that ensure that these children’s entire medical care is coordinated by a doctor from this particular field of medicine (or any other specialist field except for paediatrics) and then watch as they fail to diagnose disorders from outside their specialty e.g. Asperger’s/Autism, Dyspraxia, Dysarthia etc and do not treat the child holistically (see F**** case)

·         Have the threat of notification used by some doctors to intimidate parent(s)/guardian(s) into having unnecessary tests, investigations, and surgical operations and then accuse the parent(s) of tricking them into doing them (See F**** case).

·         Continually ignore the contradictory advice of allied health professionals, then claim that there has been extensive liaison with them (see F**** case)

·         Fail to review the child’s previous medical examinations/tests and then claim that the organic illness is all in the her head and that her parents have MSBP because they believe her and support her quest to obtain the reason for her pain, nausea and subsequent reluctance to eat. (ref: C***** case).

·         Continually fail to heed the parent’s concern that things are going drastically wrong, then turn around and blame them for it (see Flynn, D***, C******* and C***** cases)

·         Attend DoCS’ initiated protection planning meetings and ensure that anyone who could support the parent’s view is not in attendance (see F**** case).

·         Arrive at a ‘suspicion of’, or ‘confirm’ an allegation of MSbP and fail to comply with your obligation, legal or otherwise, to inform the CPU and make a mandatory notification to DoCS.

·         Employ doctors as heads of Child Protection Units (CPU) that do not do their job and merely ‘rubber-stamp’ the notifications without adhering to their Child Protection Policy and Procedures Manual 1997 by reviewing the child and conducting any psycho-social/psychiatric or development assessment (See F**** case).

·         Create a medically defined disorder, or form of child abuse that:

1.       only doctors can confirm or refute and which you cannot prove you don’t have.

2.       is highly subjective, the ‘manifestations’ of which are open to interpretation misinterpretation, and reinterpretation and upon which few people agree.

3.        automatically discredits and makes suspect anything the mother/parents/guardians says in her/their defense.

·         Knowingly supply medical reports to DoCS that are false, misleading, inaccurate,  incomplete and contradictory. (DoCS won’t notice and if they do they won’t do anything about it)

·         Employ doctors that adhere to the old boy’s club and create a few ‘honourary boys’ from the girls and then watch as they allow their colleagues to essentially abusive children and their families, say it’s in the child’s interest…….and won’t involve themselves in the muddy waters of child abuse.

·         Create a form of medically defined child abuse that is easy to apply, and effectively absolves the hospital of any legal claim of medical mismanagement/negligence.

·         In progress…………..

b)       Flaws in, or non-adherence to, the Dept. of Community Services (DOC’s) of NSW., Australia policies and procedures.

§         Employ relatively inexperienced and unqualified DoCS’s workers and promote them to Assistant Manager status and watch their incompetence gather momentum. (They are cheaper, and what the hell they're only kids and they don’t vote)

§         Acculturate them with the idea that only doctors are ‘experts’, and parents are not to be trusted, especially when it’s MSBP.

§         Under-resource the Dept. of Community Services then introduce mandatory notification. Continue to under-resource the Dept. while the number of mandatory notifications rise.

§         Empathise the need for ‘file closures’ rather than the thoroughness of investigations.

§         Create flaws in the system where the performing of inadequate investigations can flourish unheeded, and where officials can suppress vital evidence in child protection matters.

§         Do not hold DoCS’s officials accountable for major breaches in DoCS’s policies and procedures even though you produce colourful brochures about ethics and professional conduct that promise that you will act. 

§         Do not conduct thorough investigations and prosecute doctors who knowingly and flagrantly breach major sections of the Children (Care and Protection) Act 1987 which you are supposed to police (see F****, D***, C****** cases).

§         Largely ignore and disregard, and do not investigate client’s complaints even though they reveal illegal, and very real and flagrant breaches in DoCS’s practices (D*** case) 

§         Hold other government departments such as the HCCC partly responsible for the professional errors of your own staff. (see F**** case)

§         Facilitate the continuing medical mismanagement of it’s State wards, when it supports and concurs with the current ‘treating’ doctor’s views that they are the only one capable of treating the child (What insidious arrogance, deceit and folly. You know the case we mean Carmel….see the C***** case) 

§         Have DoCS’s officials threaten mothers with the loss, or promise the return, of the child if the mother ‘confesses’ to MSBP.

§         Do not employ any suitably qualified  and experienced paediatric medical investigators to work as DoCS’s officials, even though it can save the department thousands in child care court cases and foster care arrangements (that way you don’t have to ‘find’ out how false, contradictory, inaccurate and incomplete the doctor’s medical reports are. False economy don’t you think?….).

§         As a senior DoCS’s official, do not facilitate the involvement of anyone who could challenge or contradict the ‘evidence’ of the doctors during DoCS’s initiated protection planning meetings. In particular, do not tell the child’s GP about the notification, do not facilitate the involvement/participation of the child’s parents,  and keep Kate Ryder, a Patient Support officer (H.C.C.C) away. Lie to her about the nature of the meeting, so she won’t insist on coming (ref: F**** case).

§         Employ senior DoCS’s officials who, when they make statutory requests for information from other government departments and know that the organisation is trying to deceive them, do not follow up on and try to obtain the information that they know exists (ref: F**** case).

§         Never assess the child following a notification (ref: F**** case). (This only confirms that you know this to be a vexatious and malicious notification which you should prosecute for the protection of other children)

§         Employ doctors to review, and essentially ‘confirm’ MSBP cases, but do not establish guidelines for this review and do not hold the doctor accountable for the inadequacy of that review. (Incidentally, we would like to know how a doctor can review and confirm a suspicion/allegation of MSBP without accessing the child’s medical records?…beats us. Ref: Sydney Children’s Hospital’s own medical file tracking record in the F**** case)

§         Naively rely on the integrity and honesty of your reviewer, even though the ‘reviewer’ used to work with the doctors who made the allegation and is still in contact with them (see F**** case).

§         Do not review any other MSBP and medically defined child abuse cases that suspect doctors have been involved in. (You might see a pattern of practice that you don’t want to see and will be forced to act upon).

§         Quietly, close MSBP cases without review or action against suspect DoCS’s officials and suspect doctors, and effectively put at risk all of those children you are entrusted to care and protect.

§         Do not give parent’s access to a child’s ‘Notification Intake Sheet’ even though your Dept’s. only obligation is to protect the identity of the notifier (ref. C******* case).

§         Do not have a code for MSBP. That way you can claim ignorance of the proliferation of the use of this category of child abuse (It might be time for questions in Parliament….).

§         Allow the Dept. of Community Services to effectively block the access of the Community Services Commission to it’s own departmental files. (Incidentally, how can the watchdog watch, when it cannot even see…?)

§         Don’t prosecute the few corrupt doctors who have perpetuated most of the abuse because at least one of them has been involved in hundreds of child abuse cases. This might prove to be a bit costly and a tad embarrassing for DoCS to simply hand back a number of illegally obtained State wards to furious, but relieved parents. (You have inherited a real problem Ms Niland which we recognise was not of your making. However, we will be watching closely to see how you deal with, and resolve this problem. Now you know that DoCS has a problem it is what you do about it which will be the measure of you as a person. Choose wisely Ms Niland, as no job (and it’s just a job) is worth sacrificing you personal and professional integrity and reputation, as once sold it can never be redeemed. You will still have to look at yourself in the mirror every morning…and into your children’s eyes every night….)

c)      Flaws in the judicial system

§         Promote a culture that believes in the integrity, and honesty of doctors and the assumed accuracy of medical reports. (If you can’t trust doctors who can you trust, and as a society we need to believe in something….)

§         Have a form of abuse that discredits and makes automatically ‘suspect’ the main defendant- then purport to work within a system that is ‘evidence’ based and ‘value-free’

§         Have magistrates that do not necessarily believe in the thoroughness of DoCS’s investigations (who does?) just so long as they believe that all doctors are ethical, and responsible and they are the ‘experts’ who have prepared considered, complete, accurate and flawless reports (who needs DoCS…). 

§         Have the child represented by an over-worked, disinterested, under-valued, young,  and immature court appointed lawyer, who is inadequately briefed, does not have the time to prepare the case properly, and has no medical knowledge. He/she will not be able to represent the child properly. (D*** case)

§         Only schedule 5 to 13 minutes of court time to hear the case then wait for the magistrates learned and  ‘considered’ opinion. ( ref. on one ‘typical’ Wednesday in Campbelltown court, one judge, in one court heard 65 child care matters. Given that they start late, finish early and take time for breaks you can imagine how much time they spend on each case….)

§         Don’t let the mother/parents (defendants) call witnesses or question the medical evidence of doctors (A******* case).

§         Don’t call the doctors as witnesses to be cross-examined about their contradictory reports (D*** and A*****’s case).

§         Have DoCS’s officials suppress, or accidentally forget to submit vital documents to court, especially when they contain evidence that is contradictory and undermines the reliability of earlier statement made by your key prosecution witness (D*** case).

§         Don’t allow the defendant’s solicitor access to the ‘DoCS’s “Notification Intake Summary”. (it doesn’t matter. On the actual day the court will not allow them to represent the child anyway) (see D*** case). (Incidentally, how rigorous do you think the average lawyer would be in an investigation/preparation of the case if he/she thought they were defending someone with MSBP?)

§         Have closed courts that purport to ‘protect’ the child and do not allow public scrutiny of events. Nobody will know what’s going on. Only the mothers/parents will know and they’ve already been discredited.

§         If the woman/parents (defendants) wants to appeal the decision, do not provide her/them with legal aid/financial assistance then call it ‘Justice’. (what’s the point she’s guilty anyway and who needs procedural fairness and natural justice’. Procedural fairness simply costs court time and valuable DoCSs resources when DoCS’s officers could be out protecting other ‘victims’ of MSBP…and starting the cycle all over again).

§         Create a section of the Children (Care and Protection) 1987 Act that does not allow ‘evidence’ presented in child’s courts to be used by the mother’s/parent’s lawyers in other court cases (Doctors can then lie with impunity).

§         Charge a fee of $75 for child court transcripts. Wipe over them after three years.

§         Fill in the blank space……

*  and these are just some of the cases we know about, so you can describe this document as being in progress………

4.    Build in advantages for the doctors

•       Kudos, affirmation, and peer recognition for being able to identify yet another case of MSBP.

•       Yet another case for the ‘research’ paper, as without child abuse cases there cannot be ‘experts’ on the field, lucrative or attractive jobs in child protection, or material for academic papers.

•       Have a form of child abuse that discredits, socially isolates, and emotionally abuses mothers/parents.

•       Have a disorder that easily creates an avenue and potential for ‘blame shifting’, in order to conceal cases of medical mismanagement and medical negligence. With the existence of MSBP, doctors are able to conveniently shift the blame onto mothers and hold them responsible for the medical ‘(mis)treatment’ of the child, and effectively blocks avenues for litigation. 

•       Have a rare disorder that creates and confirms an ‘expert’ status on doctors who ‘discover’ a number of cases. You can only enhance and maintain your expert status by ‘diagnosing’ cases. (the ignorance is such that some doctors still think they can ‘diagnose’ MSBP. You  cannot diagnose a form of child abuse, it isn’t a disease). Then wait for the invites to national and international child abuse conferences in Australia and overseas to present papers and give talks.

•       Create a disorder that affords some doctors enormous power over the lives of others. Only doctors can confirm MSBP.

•       Create a disorder that affords some doctors opportunities to form State based, national and international ‘networks’ and links with other doctors who work in child protection…. (The ‘blind spot’ of MSbP?).

•       Create a disorder that affords some doctors financial benefits. Doctors obtain a number of direct and indirect financial benefits from MSbP. e.g direct payment for medico-legal reports, payment for National and international court appearances, tax deductions for travel to conferences etc…..

•      (Fill in the blank spaces)

DIRECTIONS

Stir in all of the ingredients well

Add a few more ingredients to slightly change the recipe to give regional variation and more substance for research papers, and more importantly to conceal what you are doing.

§         Adapt the recipe to suit the requirements of your own system and viola…..

Another ‘substantiated’ case of MSbP…

N.B. Author’s footnote

While it is hard  to contemplate that there are advantages for the doctors in the existence and proliferation of MSBP cases, and that some doctors may well take advantage of the use of this form of child abuse for personal gain, it is important to acknowledge that not all doctors are ethical, honourable, or honest. Past history and currents events has taught us, and continues to teach us, that some doctors think nothing of murdering their wives (Dr. Crippen), and predominantly other women for power and just because they can (Dr. Shipman U.K.) , perform unscientific and grotesque medical experiments on children and others (Dr. Mengele)., fraudulently falsify medical research on women and babies for status, prestige and public recognition (Dr William McBride)., and even leave their mark as initials, carved on the body of their female surgical patient (Dr. Zarkan The Daily Telegraph. 24^th January, 2000).

 Updated April, 2000