One of F.R.A.M.E (International)'s primary concerns  about medically substantiated cases of child abuse such as Munchausen syndrome by proxy (Msbp) and Shaken Baby cases is that the health practitioners who allege, and subsequently confirm the accusation of such abuse, notify the child to the child protection agency DoCS and are relied upon to provide 'expert' medical opinion in such cases should the matter be referred to the Children's care court, are invariably the very people who have been medically treating the child. This necessarily creates a conflict of interest with regard to medical practitioners.

From F.R.A.M.E's  experience of three such cases at Sydney Children's Hospital., Randwick accusations and confirmation of such child abuse have arisen:  1) when parents have threatened legal action against the hospital for the medical mismanagement of their child, 2) following the breakdown of the therapeutic relationship between the parents and the treating specialist, and 3) when one mother had already transferred her child's care over to the New Children's Hospital., Westmead.     

As DoCS officers have little or no health related experience with which to investigate such cases, and DoCS has failed to establish an independent paediatric investigation unit that calls on the experience and expertise of a wide range of medical and allied health practitioners and scientists to test the validity and reliability of such accusations, confirmations and supporting evidence., such cases have largely gone unchallenged and are poorly investigated. Even when DoCS officials seek to obtain medical information in respect of notifications they lack the professional competence or motivation to analyse the information properly and to arrive at a reliable and credible analysis of the data.

Following the notification of one child to DoCS in respect of the confirmation of Msbp, and presumably in response to the notifier's assertion to DoCS that the mother had been 'presenting herself unnecessarily to doctors' and had been presenting the child to 'different doctors and specialists', DoCS sought to obtain the 'Medicare' or Health Insurance Commission data.  

On receipt of the data, the DoCS investigation officer(s) not only grossly inflated the number of specialists that the child and mother had seen, but they also failed to check on the specialty of the doctor concerned or to take into consideration the referring agent. A large percentage of the doctors that the child and mother had seen were procedural specialists such as radiographers, pathologists, and anaesthetists and most of the referrals were made by the same few doctors (See de-identified Parent's letter to Carmel Niland June 21, 2000)... The Health Insurance Commission sought to distance themselves from this fiasco with the following statement:

            "Please note this information was sent to DoCS without 

             any comments from the HIC regarding the number of 

             practitioners who provided services to either... 

             (Name of Parent and child omitted)"

In establishing this section of the website, F.R.A.M.E recognises and acknowledges the 'culture' of medicine, the pressure on individual practitioners to conform to established beliefs and stereotypical thinking and to accept, without question, the perceived individual and collective 'wisdom' of child protection and other specialists. 

F.R.A.M.E recognises how hard it is for junior health practitioners to question, challenge and confront senior specialists, even when they know them to be wrong and when they realise that they have been duped into making notifications and/or providing false misleading and inaccurate information to DoCS in respect of the notification. 

also recognises the reluctance of some health practitioners to publicly admit when they are wrong, especially when hospital and individual personal and professional reputations are at stake and when the doctors face being sued. Finally, F.R.A.M.E recognises that specialists not in support of the allegation/ confirmation of abuse face being discredited, marginalised, implicated and considered to be complicit in the abuse should the child subsequently die or endure  future disability.

In establishing this space within this site, and with the aid of information from the child's clinical file and from published research papers, F.R.A.M.E aims to test such cases by opening them up for public and wider scrutiny. In doing so, F.R.A.M.E aims to create a more level playing field for the children, siblings and parents/carers who are made subject to such allegations/confirmations of abuse and notifications of abuse by:

• Providing additional information, or alternative opinions with which to correct misunderstandings and false beliefs that are held by health practitioners and DoCS officials.

• Prevent the articulation of false, contradictory, and incomplete statements by health practitioners and DoCS officials to each other, to DoCS and to the Children's care courts.

• Prevent malicious and vexatious accusations/confirmations and notifications of abuse.

• Generate discussion/debate about the use/misuse of such categories of child abuse. 

• Challenge the perceived collective wisdom and assumed informed knowledge base of certain health practitioners and DoCS officials.

• Highlight the inconsistencies and consistencies inherent in such cases and in the evidence presented.

• Scan and publish controversial statements that appear in children's clinical, child protection file and DoCS file, letters, reports and from court transcripts for public and wider scrutinty.  

• Publicly hold errant practitioners and senior public officials and parliamentarians accountable for their actions and their failure to act in such cases.

• Facilitating the peer support/affirmation of health practitioners concerned about the the use/misuse of  such categories of child abuse as Msbp and Shaken Baby syndrome.

We aim to do this by opening this section of the site up for medical and allied health practitioners and scientists to: 1) discuss such cases, 2) contribute to the formulation of alternative explanations or hypotheses to child abuse, 3) possibly provide differential diagnoses, 4) comment on the reliability and validity of the statements articulated by  health practitioners and others to DoCS and to the Children's child court if necessary and 5) invite health practitioner and other contribution to the drafting of  such things as: 1) new child protection, 2) clinical standards, and 3) medical review guidelines. 

F.R.A.M.E will ask contributing health practitioners to this site to disclose their identity, clinical and/or child protection experience, employment history, and past research history, prior to accepting contributions. 

F.R.A.M.E will not publish defamatory statements, the names of individual children, and in keeping with the principles of natural justice, will allow the individual health practitioner and/or hospital the right of reply. In addition, as children under 16 years of age cannot consent to the publication of details from their clinical, child protection and DoCS files, the material that we will supply will be de-identified until such time as they can be consulted and can consent to publication.