by Dr Jayne Donegan, MB
“Vaccination has been the most important health advance in the twentieth century and will continue this role into the twenty first as new vaccines are found for an increasing range of disease conditions.”
This is the mantra which is quoted with unceasing enthusiasm by the medical profession and policy makers. As a doctor of 24 years (I qualified in Medicine at St Mary’s Hospital Medical School, London in 1983) and a GP, it used to be my opinion also. I was a strong supporter of the National Childhood Vaccination Program. In the 1980s I counselled numerous parents who were worried about side effects associated with the whooping cough (Pertussis) vaccine. I acknowledged that there were side effects associated with this vaccine but that as doctors, were taught that adverse reactions were an order of ten less than the risks associated with catching the disease and that – essentially – having the vaccine would stop children catching the disease.
In common with many doctors and health professionals, I regarded parents who did not want to vaccinate their children as misguided and socially irresponsible to the extent that I unquestioningly had my children (born 1991 & 1993) vaccinated with all the childhood vaccines then recommended (DTP Polio Hib) up to and including MMR – I allowed my elder child to be given out-of-date BCG vaccine, having been reassured by the Community health doctor that it was quite safe (she had an extremely severe reaction to it).
I started studying homoeopathy in 1990 and even this did not dampen my enthusiasm, in a way, vaccination seemed to me to be a bit like homoeopathy – give a small dose of some thing and it makes you ‘immune.’
I even knew a few doctors who thought that vaccination was problematic (and fluoride, and aspartame) and I thought that they were, to be frank, ‘bonkers’.
Nonetheless, I have always tried to be a 'thinking' doctor and to make my own evaluation of the data presented to me. So when the Government decided to vaccinate seven million school children with the measles and rubella vaccine, the Measles Rubella Campaign of 1994, I carefully read the information that was provided.
The Department of Health told us that there was to be measles epidemic, although they did not supply any published references to support this claim. When the measles vaccine was introduced in the UK in 1968, as it was a vaccine containing a live virus, doctors were told that it would mimic infection with the wild virus and so only one shot would protect children for life. In 1994, we were informed that children who had had only one dose of measles vaccine were not necessarily going to be protected and so they would need a booster. I did not find this too disturbing, as it is not said that vaccines are 100 per cent effective. However I became more concerned when we were told that children who had had two doses of the measles vaccine would not necessarily be protected when the epidemic came.
When the MMR vaccine was introduced in 1988, many children had already had the single measles vaccine and doctors were advised to vaccinate them with the MMR nonetheless, supposedly to make them immune to mumps and rubella and to boost their measles immunity. Now with a predicted epidemic on the way we were told that that these two doses would be insufficient. So I had been telling parents that there were side effects associated with vaccines but that they would basically protect their children against the diseases but now, it seemed, that this was not the actually the case, even with TWO doses of what was then regarded as a one dose vaccine. And, after all, what is the point of a vaccine if it only 'protects' the individual when there are no cases of the disease around?
Another factor that I found disturbing was that we were told that the best way to vaccinate was en masse because this would break the chain of transmission. I therefore wondered why babies are vaccinated at the age of two months – wouldn’t it, by the same logic, make more sense to vaccinate all unvaccinated children every two years and break the chain of transmission?
These inconsistencies in the information sent out by the Department of Health lead me to start my own independent research into the subject.
As questioning vaccination was a process that, in effect, called into question much of what I had been taught as a medical student and a doctor, I did not rely on what can loosely be called, 'anti-vaccination' books. I went to the Office for National Statistics in Pimlico and got out all the dusty old books from when public records began to be kept in 1837 and wrote down the mortality figures for the diseases against which we vaccinate. I had to bring my then four and three year old daughters with me. The librarians were very kind and tolerant. They even put out jugs of orange juice for them! Thankfully there is a CDROM available for deaths from 1900 which I bought so that I could continue my research at home. I prefer to use death rates rather than disease incidence as we doctors are not that good at diagnosing infectious diseases with any accuracy. The reported incidence depends on many factors, not least changes in diagnostic criteria, vaccination status and how much publicity a disease has been given at the time in question. When it comes to death, we are able to diagnose it most of the time, and sometimes we even manage to get the cause right as well!
I was shocked to discover that vaccines hadn’t made the great impact that I had been lead to believe on people’s health, usually with graphs starting a few years before the vaccines were introduced; instead of showing the figures from fifty or a hundred years before, when you would see that 95-99% of the reduction in deaths from, for example, measles and whooping cough had already occurred before the vaccines were introduced.
I approached the vaccination issue anew, my interest in the subject fuelled by my concern for child health safety. I continued my reading of refereed scientific and medical journals, but with a new and more critical eye. I soon began to realise that what is held up as 'science' is not a truthful quest for knowledge on an even playing field, quite the contrary, you get the science you pay for. This is how it works: first of all you have to get someone to pay for your study – so it has to be on a subject they like. Then you have to produce results that they like – or the results may be canned and never see the light of day. Then you have to get a journal to publish it – which they won’t if it seems contrary to what they regard as appropriate, and then it has to get through the review by the referees – people who work in the field in which your study/ paper deals and who do not like what does not support the status quo, depending on the strength of the status quo, and vaccination is a very strong one.
Some studies get published by means of tweaking their conclusions for example, in an outbreak of paralytic polio in Oman in 1988-9 that started shortly after (they say 'despite') an immunisation program that raised the coverage with three doses of oral polio vaccine (OPV) from 67% to 87% in twelve month old children (hint, oral live polio vaccine can give you polio). They actually state that the outbreak occurred, “in the face of a model immunisation ” and that “the region with the highest attack rate (paralytic polio) had one of the highest coverage rates (vaccination) whereas the region with the lowest coverage (vaccination) had the lowest attack rate (paralytic),”and that there was “no correlation between vaccine coverage rates and attack rates by region”. This means that those in highly vaccinated areas were no more protected than those in less vaccinated areas. By the time they get to the concluding paragraph, however, the authors are calling for more vaccines in the schedule, more mass campaigns, new vaccines despite the fact that the one used was found to be of its usual efficacy and so on, and let's face it, what is the point of a vaccine if it doesn't protect you when there is an epidemic? (Sutter RW Patriarca PA, Brogan S, Malankar PG, Outbreak of paralytic poliomyelitis in Oman: evidence of widespread transmission among fully vaccinated children, Lancet 1991;338:715-20.)
This is how you get papers published. So the ‘science’ that we all look up to and the ‘scientists’ that we all trust are made up of nothing more than people who are trying to make a living and pay their mortgages - you get the science you pay for and he who pays the piper calls the tune.
To find out about many issues in medicine, education, social policy today, you have to delve deeper. You have to carefully sift through papers, looking at the methods, results and forms of statistical analysis, not just the conclusion - not all of them are handed to you on a plate like that the one above. You also need to undertake some from of study of other medical or philosophical disciplines in order to realise that you are not just a little defenceless human surrounded by the myriad of micro-organisms, with which we and the planet swarm, all seeking to kill you, otherwise you just become terrified of the diseases AND the vaccines and do not know where to turn.
The path that I was now taking has led me to completely change how I view health and disease and makes my practice of medicine much richer, empowering and, ultimately, more health giving for my patients – and, of course, myself.
In my own family I wondered how on earth anyone had ever managed to convince me to vaccinate my children against, in particular, measles, mumps and rubella, all of which I and my contemporaries had had as children and which our mothers had considered such a normal part of childhood that if they heard of a child coming down with one of them, they would rush us over to visit them so we could, hopefully, get it too – and even then it didn't always work – you can sleep in the same bed as someone with one of those infections and still not 'catch' it!
The fact that I had so 'stupidly' vaccinated my children also engendered large amounts of guilt. How could I, a supposedly 'well informed' medical professional, have been so dumb? Acknowledging that guilt is not good for anyone's immune system, I set about 'antidoting' all of the vaccines that they, and I, had been given, homoeopathically; made sure that they were given no more; and was careful not to suppress any fevers or mucus discharges (endless snot), to encourage their bodies to undertake their own cleaning-up operation.
I started to write articles for various organisations who give information to parents about vaccination and this led to my being asked by a mother to act as an expert witness in her case. She had been taken to court by the absent father of her child to get a special order from the court to force her daughter to be vaccinated with all of the vaccines in the schedule. Her case was then joined to that of another mother in a similar situation and they were to be heard together.
The mothers had been originally refused public funding by the legal aid board to have an expert as they were told that nobody who was an expert would support their position. However this was overturned by a District Judge who insisted that have one. Medically qualified experts from abroad were disallowed, as were non-medically qualified experts from the UK. Initially I did not want to take on the case as I was under no illusions as to the difficulties involved and of how my expertise would be viewed compared to that of hospital consultants and professors. I also have a very heavy schedule of my own and did not feel that I could put aside the time. Then I realised that if I did not agree to prepare a report, the Court would have no expert giving the opinion that there were other ways of promoting child health than vaccination and no-one to say that this was a reasonable approach, so I agreed to take on the case.
The anonymised transcripts of the proceedings in 2002 and the written reports of Dr Conway and Professor Kroll were released for public use in the GMC hearing.
The expert for the fathers, Dr Stephen Conway, a Consultant Paediatrician and member of the Joint Committee for Vaccination and Immunisation was of the opinion that each of the two girls should both be vaccinated with all the vaccines available, even pertussis vaccine for the nine year old which was not on the recommended schedule of 2002 for that age group. His short report for each child cited no references for his statements regarding either the diseases or their vaccines. Simon Kroll, Professor of Immunology at St Mary's Hospital, advised that every vaccine except pertussis and Hib vaccine in the case of the older child, should be given. If a reduced schedule were more acceptable to the mothers he advised that diphtheria and polio could be omitted. He cited no references nor provided any except for those in his appendix on MMR vaccine, a vaccine which he was very keen should be given.
In both these reports greater claims were made to efficacy and benefits of the vaccines than were justified, whilst downplaying the risks to the individual. Their reports were to a large extent dealing with the concept of 'herd immunity' rather than looking at the best interests of each individual child. Both Dr Conway and Professor Kroll were members of the Joint Committee on Vaccination and Immunisation (JCVI, a conflicting interest which was unexplored in the case. Members of the JCVI are unlikely to draw attention to problems with vaccines because they make the recommendations for their use. And if Dr Conway and Professor Kroll were seen to be recommending, on a clinical basis, that vaccination was not necessary at all for individual children, they would be seen to be contradicting government health policy based on JCVI recommendations and acting counter to the policies aimed at achieving what is called ‘herd immunity’. So it is difficult to see how either could reasonably fulfil their briefs without uncritically pursuing the party line on vaccination which is, in fact, just what they did.
This meant that I was presented with answering a one-sided case for vaccinating the two children concerned. The issue before the Court was whether it was in the interests of the two little girls to be or not to be vaccinated, the clinical issues, the risks and benefits, the family, social and psychological aspects. For the most part, the evidence they presented and to which I was retained to reply, was irrelevant and misled the Court as to the issues.
As experts, Dr Conway and Professor Kroll were under a duty to assess independently the data and results presented in medical papers. They instead uncritically accepted the conclusions of the authors of the papers. Neither Dr Conway nor Professor Kroll gave balanced accounts of the risks and benefits of vaccination. Neither dealt properly with the adverse effects of vaccination and the associated problems. Both of their reports dwelt on the potential severity of childhood illnesses and minimised the side-effects of vaccines. Both promoted the health gains of the 20th Century as being due to vaccination. This is a factually unsustainable and erroneous view (despite being a deeply held view throughout the medical profession). Both erred in failing to acknowledge that the improvements in health overall over the last century to date were attributable substantially to factors having little to do with vaccination. Neither supported the view that a well nourished 21st Century child would cope well or easily with previously common childhood diseases. Both Dr Conway and Professor Kroll gave little weight to the ability of a healthy child to be sufficiently nursed through ordinary childhood infectious diseases and there was no consideration regarding any other health promoting measure than vaccination.
The way the cases were presented by Dr Conway and Professor Kroll meant I had to go back to first principles: to the diseases, their ecology, their changes as a result of improvement in public and municipal health, what had happened to their incidence, morbidity and mortality before the vaccines were introduced and after the vaccines were introduced.
In the absence of any clear, open, objective and well designed studies on vaccine safety, I had to present evidence to show that the vaccines are not so safe or effective as Dr Conway and Professor Kroll’s sweeping assertions implied. I specifically did not cite homoeopathic, naturopathic or other holistic literature as I thought that these might have less credibility in a court of law, being regarded as ‘fringe’ literature, so the evidence that I presented was obtained by carefully sifting through what studies had been published in refereed medical journals, in particular looking at the methods, results and methods of data analysis, rather than just reading the abstracts or the conclusions.
This also meant that I had to write an enormously long report and I had to provide all the references because none, except in Professor Kroll’s Appendix regarding MMR, had been provided with either of their reports.
The enormity of the task presented to me was overwhelming in terms of the scale involved: to give the court a fair picture in the light of what had been submitted by the other two experts, and I had less than three weeks in which to do it. Had the reports of the other experts been balanced, my task would have been substantially less. I would have produced a far shorter report with vastly fewer references.
A meeting was scheduled for the experts at the end of June to identify areas of agreement, Dr Conway did not attend. Professor Kroll and I agreed about the vaccines that he had said could be omitted.
Although I am an expert in my knowledge of vaccination and disease ecology, I am not an expert in being a witness. I relied heavily on my instructing solicitors. However I was not sent the Civil Procedure Rules part 35 which gives guidance and list the duties of expert witnesses and I had no meetings with them or the barristers involved in the mothers' case. I met them all for the first time in the court in Winchester in July 2002.
The first a day and a half of the case was spent hearing an appeal by a newspaper company arguing for the right to have anonymised press coverage of the hearing in the public interest (denied). Then the fathers' expert, Dr Conway, a seasoned expert witness, entered the box and commenced his evidence. It quickly became apparent that much of his oral testimony had not previously been made available in his report and that it was largely a line by line critique of my report. The Trial Judge was clearly annoyed at this tactic and adjourned the hearing ordering Dr Conway to provide a further written opinion to which I should have the opportunity to respond. He ordered Professor Kroll to do likewise and that they should both provide copies of any references that they cited
The trial was re-scheduled to take place on 9th December 2002.
In the new reports in reply to my initial one, both Dr Conway and Professor Kroll supported their opinions with the conclusions of the authors of published papers, but they did not mention when the authors qualified the reliability of the data, before going on to conclude that the vaccines concerned were safe and/or effective. They did not make any criticism of the studies that they quoted notwithstanding any disparity or conflict between the conclusions of some of the studies and the data and results reported.
Dr Conway produced a 62 page report with 44 detailed medical references in reply to mine. It was ready on the 7th September 2002, over three months before the trial, but I was did not receive it until the 20th November 2002. By the time it was sent to me I was left with barely two weeks in which to reply. Even worse, Professor Kroll's report did not reach me until the evening of the 4th of December. I had seven hours overnight from returning home from a meeting at 11pm until 6 am to respond.
Notwithstanding the enormous difficulties involved, I worked all day and many nights to produce my reply promptly, professionally, and to a high standard meeting the incredibly tight deadlines.
The reports involved were complex and technical and no time was available to adequately prepare the mothers’ case. The reports needed to be read, the information assimilated, views exchanged and comments made. There was no time for conferences between myself, lawyers and Counsel to prepare adequately, including the cross-examination of the other expert witnesses. However, an adjournment was not sought.
The vaccination issue was not pursued by Counsel for the mothers for fear that the Judge would not take criticism of vaccination seriously, so I was only examined on my approach to advising parents.
Dr Conway was cross examined to expose a conflict of interest - serving on a Roche drug company panel - and to show that there is a range of opinion about some vaccines medically. For example Dr Conway and Professor Kroll had differing recommendations regarding polio, diphtheria, Hib and pertussis in the older child. Also, a vaccine coverage of less than 80% for MMR means that some ‘normal’ parents choose not to vaccinate. There were questions regarding BCG. Dr Conway had written a paper in the past saying that BCG vaccination was not financially worthwhile. He indicated that his position was now different. Attention was directed to the distress that would be caused to a parent if their children forcibly vaccinated against their will and how this should have an impact on the advice given.
Professor Kroll was cross examined regarding the issue of MMR and autism. This was not a subject I had covered in my already lengthy reports as it was due to be clarified in a then pending legal case (which was not able to proceed as its funding was cut by the Legal Services Commission).
Dr Conway and Professor Kroll were not cross examined critically regarding the the opinions that they had presented as facts in their statements. The inevitable result was that Counsel for the fathers at the hearing had a free hand without effective challenge.
As I have said previously, in the absence of any clear, open, objective and well designed studies on vaccination safety, the observations and recommendations produced in my reports had been made using information gained by carefully sifting through what studies are published in refereed medical journals and other sources; in particular looking at the methods and the results of studies, rather than the conclusions which often do not reflect their findings. Analysing the data in this way raises serious questions about the safety and efficacy of vaccination. It is notable, however, that the authors of the papers from which I quoted, almost without exception, conclude by urging vaccination or repeated doses of vaccinations.
Counsel for the fathers, made great play of the fact my opinions ‘contradicted’ the conclusions of the authors of published papers, repeatedly emphasising that I had not stated when my opinion did not concur with the conclusions of the authors of papers. However an expert must ignore the views of the authors of papers and their conclusions and is obliged to consider each paper afresh and give the expert’s own opinion. This aspect of the cross-examination made a considerable and misleading impression on the judge.
From this it can be seen how Judge Sumner in the High Court came to make his decision to rely only on the evidence of Dr Conway and Profesor Kroll. Further, the comments in the Court of Appeal by Lord Justice Sedley, which were widely reported in the press, that my reports were “junk science”, were inappropriate and made without my having been given any opportunity to be represented and to answer such a serious but misplaced allegation. The Court went on to order that the two girls be given the full range of recommended vaccines.
On the basis of the comments made by Lord Justice Sedley as
reported in BBC Online (it is comforting to know that the GMC is monitoring
the suitability of doctors to practice in the UK by reading BBC Online!) the
General Medical Council accused me of serious professional misconduct which
meant they could strike me off the medical register, stop me practising and
deprive me of my livelihood if found guilty. It took them more than two
years after accusing me in July 2004 to get round to producing any
substantive charges. These were served late in September 2006, with a
three-week hearing scheduled to start on the 6th of December 2006.
The charges - apart from those stating that that I am a registered medical practitioner; I was instructed as an expert witness to produce reports which I then did produce and that I was aware that the provision of my report might affect the outcome of the litigation – were:
"6. In the reports provided you,
a. Gave false and/ or misleading impressions of the research which you relied upon,
b Quoted selectively from research, reports and publications and omitted relevant information,
c. Allowed your deeply held views on the subject of immunisation to overrule your duty to the court and to the litigants,
d. Failed to present an objective, independent and unbiased view;
7. Your actions in head 6. above were,
b. In direct contravention to your duty as an expert witness; unprofessional,
c. Likely to bring the profession into disrepute;
And that in relation to the facts alleged by you have been guilty of serious professional misconduct."
The vaccination expert for the GMC, Dr David Elliman, Consultant in Community Child Health at Great Ormond Street took four and a half months to write his 82 page, 61 reference, critique of my evidence. I was given less than three months to write a reply to it. His report was a line by line criticism of almost every thing that I had said. My defence team told me that they had never seen one like it.
He stated that I had been selective in my choice of references; that my quotations, and that the conclusions drawn by me, from these references frequently did not accord with the conclusions reached by the author and/or researcher.
Dr Elliman criticised what he regarded as my misinterpretation and/or misunderstanding of the references to which I referred and stated that some of the source material that I had used in my reports (textbooks) was not appropriate as a primary source for a report such as I was asked to provide.
He said that I had misquoted; taken material out of context; quoted material that did not actually appear in my references; and been misleading.
At the GMC hearing Dr Elliman was forced to admit that much of his evidence against me was 'quibbling.' For example, he said that I was misleading when I wrote: "some people develop nerve damage causing either muscle weakness or altered sensations" as a side effect of tetanus vaccination. The package insert actually said, "a few." Writing ‘some’ people instead of ‘a few’ is not misleading.
Although this was the level of much of his criticism, it sounded pretty damning when presented all together, page after page, by a Great Ormond Street Consultant with a specialised knowledge of immunisation, in the absence of any reply by me.
Thankfully, the cost of my legal fees was met by my Medical Indemnity Insurance, I was very grateful that I had paid the premiums for all of those years. I had been told by my defence team that the GMC would have to give me at least three months to reply to their expert’s report. I would need at least this much time if I didn't want to repeat what had happened in the original case - trying to keep to impossible deadlines and not being able to have all my information appropriately formulated, tabulated and circulated and discussed with my team before the case.
However, the GMC expert’s report arrived late, less than three months before the hearing was due and I was suddenly told that I wouldn't, after all, have three months in which to reply and that I had no right of appeal.
The situation worsened. My defence team changed their tune. They began to say, “the case is not really about vaccination at all, it is just about your lack of expertise as a witness”, “We don’t need three weeks to settle this case, just three days, then you can get on with your life again after all this stress." "You just have to admit the first few charges because there is no way we can say that you are not guilty of them and we will then argue strongly that what you have done does not constitute serious professional misconduct…”. It is extrememly hard to remain immune from ongoing pressure such as this, especially when the case has been such a heavy burden on, and disruption of, family and professional life, and for such a long time - over two years.
I was told that a deal had been made with the GMC’s barrister: if I admitted to the charges, I would be unlikely to be struck off. All I had to do was admit to the charges of selective quoting, omitting relevant information and being misleading, and let the panel read Dr Elliman’s report - without any rebuttal by me. I was told that it would be very dangerous to my case to have him in the witness box as the panel would be so impressed by his being a Great Ormond Street Consultant - and he so critical of my reports - there was no knowing what damage he might do if he appeared in person.
The plan then changed further: I was told that he would appear in person, and I would still have no right of reply.
Having been unhappy about this plan already , I became more so.
Throughout this case I have had very supportive family and friends. They told me that I musn’t under any circumstances agree to any such deal, which seems obvious now, but at the time I was made to feel by my legal team that if I wanted to defend my case and point out all the inaccuracies in Dr Elliman's report, it was because I was a fanatical person who wanted to stand on a soap box and take on the world.
This attitude was all the more extraordinary because I had made it clear to my team from the very outset that I was more concerned about my reputation than my registration. I had said to them that I would prefer to be struck off maintaining that I had told the truth, than to keep my registration and be ‘that doctor who mislead the Court.’
Two weeks before the case was due to be heard I sent my Medical Indemnity Organisation a long letter, listing my grievances and asking for a second opinion. Instead of a second opinion, my defence team withdrew! I was left, two weeks before the hearing, unrepresented!!
In a panic I had to find another lawyer and quickly. I was fortunate to be able to do so in the person of Mr Clifford Miller. Clifford Miller is not a medical claims or medical defence lawyer, he is a patents lawyer with a sharp, incisive mind, an attention to detail second to none and an encyclopaedic knowledge of vaccination, health and disease trends and the statistics regarding these world wide. He is a scientist by training, having a BSc in Physics from Imperial College and an in depth knowledge of the scientific method, what constitutes scientific ‘proof’ and how this differs from what is accepted as ‘proof’ in a court of law.
My Medical Indemnity Organisation, thankfully, agreed to pay for his services.
He transformed my case. He engaged Ian Stern QC and immediately got my December case adjourned by the GMC much against their will – having taken over two years to produce substantive charges, they now started to complain about ‘delay’. He saw the facts of the case as they were, realised, unlike my previous lawyer that there is another side of the story regarding health, disease and vaccination and that there is plenty of material in refereed medical journals and official health statistics to shows this. He set me to write a detailed rebuttal of Dr Elliman’s report which took half of November, and all of December 2006 and January 2007, working into the early hours to complete.
Having been given the correct instructions, Counsel, Ian Stern needed no further encouragement. He immediately ascertained that the case would flounder in the mountain of paperwork and references so he went through Dr Elliman’s report with a fine tooth comb and extracted 67 points of criticism which he regarded as the 'essence' of the case. He read every scientific paper and textbook reference produced by every expert in the case, word by word and constructed a framework in which these could be presented to the panel at the hearing in an intelligible way. There were so many documents involved that a junior counsel, Sandesh Singh, was engaged:. He proved to be invaluable not only during the preparation of the case but also during the hearing with his ability to remember, locate and cross reference any sentence or phase uttered by anyone at any time in the proceedings. There were also numerous conferences to discuss the issues – all in all, it was a completely different experience to that of the original case and I now saw quite clearly how much the mothers and myself had been let down.
Clifford Miller also instructed Dr Peter Fletcher, a former Chief Scientific Officer at the Department of Health, to act as my expert witness. Dr Fletcher read my report and was of the opinion that I had not been misleading. On the contrary, commenting on Professor Kroll and Dr Conway’s reports he described them as: “… unequivocally focussed upon the benefits, and therefore the safety, of the vaccines and have given absolutely minimal attention to their adverse effects even when they have been clearly included in official literature such as Data Sheets, Package Inserts and Patient Information Leaflets” (Day eight)
However, the GMC was not going to make life easy for me. I live in London. The GMC is based in London. I am the sole care and supporter of two children whom I also home educate. The GMC therefore decided that the case would be held in their offices in Manchester. They even tried to schedule the case for May 2007 – right in the middle of GCSEs. It would be bad enough trying to do GCSEs if your mother went off to a different city for three weeks leaving you to fend for yourself even if she weren’t home educating you, how much more so when she is your teacher as well. I had to get a letter from Education Department of Barnet stating that I would be in dereliction of my duty to educate my children if I went way and left them at such a time.
The hearing was eventually scheduled for three weeks in August, still in Manchester. At this point I decided not to fight any more, it was not a good use of my energy or focus. I know that what goes around comes around and I needed to be able to concentrate on my children, myself and their exams. As my professional indemnity only covered legal fees, not travel or hotel expenses, nor the cost of any childcare, I was going to be out of pocket for these as well as being unable to earn any money for all of that time(hint.. if your life is made really difficult then even if you are not found guilty, you may be put off saying those same things again..).
The whole team arrived in Manchester for the 7th of August. Tom Kark QC, Counsel for the GMC started by listing my alleged misdemeanours and stating:
“You see, I am going to suggest that the aim that I suggest you had, which was to persuade the judge not to order vaccinations, coloured almost every page that you wrote and that in some areas you misquoted or left material out which was quite subtle. In other ways it was more blatant.”
These allegations were widely reported in the media – ‘GP accused of Misleading Court over MMR Danger’, ‘GP ‘Misled Court Over MMR Jabs’
However, a week later, after Dr Elliman had finished being cross-examined by my barrister, Mr Stern, his 67 main points of criticism had been shot down to two. I conceded these as genuine mistakes – which, in the context of a 119 page report, particularly one written under such time constraints, was regarded as not unreasonable, and less than those made by other experts in the case. By the time Mr Kark was summing up at the end of the GMC's case, he had changed his tune, every page of my report was no longer ‘coloured’ in order to persuade the judge not to order vaccines. Now he was saying:
“It is not said by the GMC that the whole of what Dr Donegan wrote in her reports was wrong or unsupported. A good amount of what she wrote was not misleading.” (Day Ten)
Regarding Dr Elliman’s evidence he now said:
“The case is not about the experts or the relative qualities of Dr Elliman or Dr Fletcher.”
Which begs the question: why did the GMC engage an expert to write a four and a half month report in the first place if it were not about, ‘the experts’?
There is much interesting information which can be obtained by reading the transcripts of Dr Elliman, an expert who speaks for the Department of Health on vaccination safety and efficacy, when he is in the hot seat and being asked penetrating questions by an expert interrogator such as Ian Stern QC, without being able to hide behind sound bites, edited interviews, or sweeping statement not backed up by evidence.
It is notable that under cross examination on Day Two, Dr Elliman was forced to concede, that there have been no randomised placebo controlled trials of any of the vaccines in use in the last 20 to 30 years where vaccinated children are compared with unvaccinated children given an inactive placebo (sterile water or normal saline). In the one placebo controlled trial that he cited for MMR, the ‘placebo’ contained, amongst other ingredients, neomycin and phenol red. Neomycin is listed in the British National Formulary as ‘too toxic for parenteral (by injection) use’. (Day Two)
Evidence for the safety and efficacy of all these vaccines come from epidemiological studies which are by nature controversial, and which do not satisfy the criteria for scientific proof.
Dr Elliman, in his report, refused to comment on the sections of my report dealing with:
Factors Affecting Immunity; Are Childhood Infectious Diseases A Good Thing?; Treatment Of Childhood Infectious Diseases; and The Best Interests Of The Child, saying that they had, ‘little relevance to the subject in hand.’ It is no wonder that the Government relentlessly pursues the vaccine agenda when its own experts regard anything other than vaccination to be of ‘little relevance’ to health.
How polarised were my views? I wrote in the summary of my first report,
“It is always in the best interests of the child for the parents to make an informed decision themselves as to whether or not to vaccinate their child or not. In the event that the parents are not able to agree, I think that it is in the child’s best interests that this difficult decision is made by the parent who has:
a) day-to-day care of the child in terms of feeding, clothing and nurturing them to support their global well being and their physical, emotional, intellectual and spiritual development.
b) to nurse and support the child through the diseases that they contract, whether they be diseases for which there are vaccinations available or those for which there are not.”
If the fathers had wanted to vaccinate the children and their absent mothers were asking the court to intervene to stop them and the mothers had used me as their expert, I would have presented a report which would have contained the same recommendations as the one I did present. In the summary, in a meeting of experts, and in court I would have supported the fathers’ need, as the parents with day to day care, to be the ones to make the decision, and not to have the family structure weakened by having a decision imposed from above. This continues to be my opinion today.
After the awful experience I had had in the witness box in the initial case, being raked over the coals by a hostile barrister, I was understandably nervous about repeating the process. This time was very different. I had had time to prepare with my team, to be thoroughly au fait with all my references and cross references and to understand that I did not have to answer questions with a straight ‘yes’ or ‘no’ as I had been pressured to before and which had made me say things that were not what I meant. I also had some good friends, new and old, who sat in the rather cramped space set aside for observers and gave me moral support by their presence there.
The panel was composed of one doctor and three non medically qualified members. It was not at all obvious throughout the three weeks where their sympathies lay. One of my patients to whom I have given vaccination advice was kind enough to come into the offices of my Medical Indemnity Organisation in London to give evidence for me by video link, which failed, so they had to make do with a telephone call. The panel asked careful questions of every witness, including myself. They were guided in their deliberations by the GMC’s very experienced legal assessor, Robin Grey QC and astutely chaired by Mrs Sheila Hewitt whose experience is in running industrial tribunals.
At the end of the case the panel spent two days deliberating in camera before appearing on Thursday the 23rd of August to announce their findings. I was cleared of all substantive charges. I found this quite hard to take in at the time, especially as they had not, at this stage, completely agreed on the satisfactory wording for the reasoning behind their decision. This were not given until 2pm of the next day (Day Thirteen).
The findings were, in summary that :
"You demonstrated to the Panel that your reports did not derive from your deeply held views and your evidence supported this. You explained to the Panel that your approach in your report was to provide the court with a alternative view based on the material you produced in your references. That material was largely drawn from publications that were in fact in favour of immunisation.
It was clear from your evidence and the evidence of your witness that your aim is to direct parents to sources of information about immunisation and child health safety to help them to make informed choices.
You told us that there are many books by doctors and others in this and other countries who seriously question vaccination and they cite a lot of history, proofs and medical papers to support their arguments. You did not use any of those publications because you did not think that the Court would regard those as satisfactory support or references for your recommendations. You largely used what was available in refereed medical journals."
"the Panel is sure that in the reports you provided you did not fail to be objective, independent and unbiased."
"Accordingly, the Panel found that you are not guilty of serious professional misconduct."
I was and am quite overwhelmed by the degree to which I have been exonerated. It is, in my opinion, the correct result, but one for which I had never even dared to hope.
I took my Medical Indemnity Organisation’s very strongly worded advice not to talk to the media. As all their cover is discretionary I felt I had no choice but to follow this advice. As a result there was very little coverage or publicity given to the fact that I was completely exonerated and some of that which was reported was incorrect.
I am very pleased that they paid my legal fees, the case cost over one hundred thousand pounds to defend, I could never have financed it myself. The GMC is not a court, so even if you win, you don’t get any of the costs back, so when the defence bodies defend a case, for them, it is just money down the drain. This gives the GMC carte blanche to accuse anybody they like of Serious Professional Misconduct as they never have to pay for anyone except their own team if they are wrong.
What was the advice that most helped me during those three long weeks at the hearing in Manchester? The day before I travelled up I was sent an email by Patrick Quanten, a GP who voluntarily deregistered himself from the GMC and gave up practising as a doctor when his local health authority started to investigate him because he was not prescribing ‘enough’ (!) drugs. He advised:
“ You could look at it as "good experience". Through our own experiences we learn how life really is for us. Maybe at some level it is important for you to go through this. Don't see it as a battle. Don't try and win anything. Sit back and enjoy the ride, because this force is much bigger than you and is not concerned with concepts such as "truth" and "fairness". Just let it happen and concentrate on how the system operates. You will learn a lot.
Whatever happens next, you will benefit. That is if you are not too busy fighting. Wait and watch out for the opportunity.
That is what I am truly wishing for you.”
These wise words did a great deal to sustain me through the three gruelling weeks that followed, as well as the support of friends and well wishers.
What ‘take home message’ that can be gained from my experience?
Perhaps it is that if a parent says, “I’m worried about the safety of vaccination,” they are told, “You don’t understand, you’re not a doctor.” However if a doctor says, “I’m worried about the safety of vaccination,” they are told, “We’re charging you with serious professional misconduct.”
Pleased as I am with the successful conclusion of my hearing, it has taken an inevitable and heavy toll on my children, our family and my professional life.
© Dr Jayne LM Donegan MBBS DRCOG DCH DFFP MRCGP MFHom November 2007
Dr Donegan may be contacted for vaccination information, homoeopathic consultations, general medical dietary and lifestyle advice or for copies of her vaccination report (£8-00 incl. P&P) 020 8632 1634 (answerphone: please leave contact details)
Clifford Miller http://www.cliffordmiller.com.
Patrick Quanten MD http://freespace.virgin.net/ahcare.qua/index.html
Transcripts of Fitness to Practice Hearing August 2007 http://www.whale.to/vaccine/donegan3.html
Jayne Donegan’s website http://www.jayne-donegan.co.uk/
Dr Aubrey Blumsohn Scientific Misconduct Blog http://scientific-misconduct.blogspot.com/2007/08/trial-of-dr-jayne-donegan.html
Panel Findings on GMC Website http://www.gmc-uk.org/concerns/hearings_and_decisions/ftp/20070824_ftp_panel_donegan.asp