Case No. ZW15C00276

IN THE FAMILY COURT

(Sitting at Barnet)

 

 

Regents Park Road

London N3 1BQ

Date: Thursday, 25^th February 2016

 

 

Before:

 

HER HONOUR JUDGE MAYER

(In Private)

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B E T W E E N :

 

LONDON BOROUGH OF BARNET

Applicant

 

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(1)  MOTHER

(2)  FATHER

(3) CHILD X and CHILD Y

(by their guardian)

Respondents

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A P P E A R A N C E S

MISS H. MARKHAM and MRS. C GEORGES (instructed by HB Public Law) appeared on behalf of the local authority.

 

MISS K. BRANIGAN QC and MS. S. KING  (instructed by Messrs Freemans Solicitors) appeared on behalf of the First Respondent (Mother).

 

MR. F. CASSIDY and MR. S. LIBERADZKI  (instructed by Messrs Osbornes Solicitors) appeared on behalf of the Second Respondent (Father).

 

MISS L. BRIGGS and MR. A. HOGARTH  (instructed by Messrs Lawrence & Co Solicitors) appeared on behalf of the Guardian.

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J U D G M E N T (As approved by the Judge)

 

_________

See [2017] EWFC B118

JUDGE MAYER:

 

          Executive Summary.

 

1                   Both parents were involved in benefit fraud in 2004, where the mother fabricated the existence of a child and the father claimed benefits for his two children who have never lived in the UK.  Each parent knew of the other's activity.

 

2                   For all intents and purposes, the parents shared the care of X and Y, and spent significant times together as a family.  In the past five years, the father stayed in the family home at least two nights a week and had sole care of the children some 25% of the time.

 

3                   The mother fabricated and exaggerated symptoms in respect of both children.  She has done this throughout the children's lives. She gave untruthful information to persons in the medical profession, and to those involved with the children in the course of their education/care.  Consequently, the children were subjected to a great number of unnecessary medical appointments, unnecessary attendances at A&E, unnecessary journeys in ambulances and, at times, to unnecessary admissions to hospital.

 

4                   Both children were unnecessarily medicated. They were both unnecessarily immobilised by spending time in wheelchairs.

 

5                   The account X gave Mrs. M in the week between 23rd and 30th April 2015 reflects the truth of what the mother has done to him.  The account of  Ms.B, of the mother hurting Y on 18th June 2011, does not prove at the requisite standard of prove that the mother deliberately and maliciously hurt Y.

 

6                   It is unclear how much caring the mother has done and how much care was provided by members of her family and the father.  From a very young age, the children spent long times away from home at nursery and at school. Their school day often included breakfast club and after-school club; they therefore stayed at school from 8am to 6pm.  On occasions, they also attended school on Saturdays and Sundays.

 

7                   The mother deliberately lied on applications for DLA for both children. She did it so as to obtain pecuniary benefit.   Both children are receiving DLA, Y at the highest rate for both care component and mobility component, X at the highest rate for care and medium rate for mobility.  Based on available medical information neither child should be receiving any DLA.  The mother also applied for the children to be registered disabled and be eligible to have special educational statement. None of this was justified.

 

8                   The father knew that the mother was lying about the children's disabilities since he checked at least some of her applications for DLA, some of the letters she wrote; he also attended a tribunal hearing on 3rd December 2014.  He did not step in to protect the children from the mother's conduct.

 

9                   It is accepted that the father was not told by anybody in the medical profession or the children's schools about the concerns about the mother.

 

10              That said, the father appears to have deliberately distanced himself from the children's schools and avoided interaction with medical information about the children.  He did not have concerns about the accounts the mother gave him, although if he is to be believed he himself never observed the medical conditions which the mother described.

 

11              There is no evidence that the father has ever physically harmed either child.

 

12              It is accepted that since the father acquired primary care of the children there has been a reduction in their attendances for medical appointment and emergencies. This coincided with the time the local authority commenced proceedings.

 

13              The local authority neglected this case and this family, and the social worker, who was allocated for six years, demonstrated alarming ineptitude in the face of clear and obvious concerns expressed by many over a long period.  A number of opportunities to intervene and spare the children unnecessary medical intervention have been missed.

 

Judgment.

 

1                   X, born on 4^th October 2007, therefore aged 8.5 and Y, born on 13^th January 2009, now aged 7, are siblings. They are third respondents to this application and are represented by their guardian, Jackie Anderson.

 

2                   Their mother is the first respondent.  The father is the second respondent.

 

3                   The Applicant local authority is the London Borough of Barnet.  On 10^th July 2015 they applied for orders pursuant to s.31 of the Children Act 1989.

 

4                   This hearing, which was a fact finding exercise, dealt with the threshold criteria.

 

  The Background.

 

5                   The mother is aged 39, the father is 52.  Both parents were born in this country, although the father's parents are African and the mother's ethnicity is a mix of Asian (her father) and white British. The father has two children from a previous relationship.  They are grown up and live, and always have lived, in Africa. X and Y are the parents' only children.

 

 

6                   A number of chronologies have been compiled in this case. These are some of them:         

 

                                                                            (i)            A medical chronology in respect of each child by Smedico Legal, the medical chronologers.  The one in respect of X runs to 137 pages (attachment 1); in respect Y to 100 pages (attachment 2)

 

                                                                         (ii)            A nursery and school chronology in respect of X, prepared by Smedico Legal (attachment 3)

 

                                                                       (iii)            A nursery and school chronology in respect of Y prepared by Smedico Legal  (attachment 4)

 

                                                                       (iv)            Counsel's chronology, which was updated in the course of the hearing (attachment 5)

 

                                                                         (v)            A chronology in respect of applications for Disability Living Allowance ("DLA"), Special Educational Needs ("SEN"), charity and registering the children as disabled applications (attachment 6)

 

                                                                       (vi)            A chronology of the children's uses of wheelchairs (attachment 7)

 

                                                                    (vii)            A chronology prepared by the head of safeguarding service of the London Ambulance Service (“LAS”) of ambulance call outs between November 2007 and 6 August 2014 (attachment  8)

 

7                   I incorporate these chronologies into this judgment for their full terms and effect.  They are an integral part of this judgment.

 

8                   In the background to the evidence I deal with salient events only.

 

9                   The parents met in November 2000, married in April 2001. By the time they married the mother was some 14 weeks pregnant; she apparently miscarried within days of the wedding.  The mother is HIV positive. She was diagnosed in 2003, although she attributes contracting the virus to events some years earlier.

 

10              On day eight of the evidence the father disclosed that he, too, was HIV positive.  Although he discovered the mother's condition in 2003/4, he did not have himself diagnosed until 2013, because he considered that a cough may be a symptom of the virus. The parents say they separated when the father discovered that the mother was HIV positive, something she concealed from him, and that was around 2003/2004.

 

11              The parents remained on sufficiently good terms to have two children after their separation. The children were apparently conceived by artificial insemination, the father being the sperm donor.  He has parental responsibility for both.  The parents, indeed, are still married.

 

12              In 2004 the mother received a caution for fraudulently registering a fictitious child. The mother claimed benefits for her for some four years.

 

13              It would appear from the incomplete CRIS information that neither parent was prosecuted for defrauding the Department of Work and Pensions by claiming benefits for the father's two children, who were said to live with the parents in the UK.

 

14              In evidence, the mother could not remember this period very well; the father denied any involvement. I deal with this below. 

 

15              The mother has a long, florid and complex medical history.  The chronology compiled from her incomplete medical notes and amounting to 104 pages, arrived in the second week of the hearing.  It was agreed by the parties and approved by me that save as may be relevant to issues I have to decide in respect of the children, the mother's medical notes will not be examined at this hearing.

 

16              X was born in October 2007, at 37 weeks gestation. Y was premature, born at 30 weeks.

 

17              Both children suffer from some genuine medical conditions, with which I deal below.  Y, in particular, suffered from a delay in her development, as would be expected in the case of a premature baby; she has mild cerebral palsy, as well as an obvious squint.  X is hypermobile. Both children were mildly atopic. Both children require glasses.

 

18              Both children attended nursery from a very young age, for very long hours.  I do not have all the mother's applications for help with the children, but I am satisfied that both children have become children in need at a very young age due to the mother's health needs.  As such, they have had a number of extra provisions by way of extra tuition, summer schemes, after school clubs, breakfast clubs, etc.  In fact, these two children spent long hours away from home from a very young age.         

 

19              It is clear that the mother sought medical attention in respect of both children at a very high frequency. This started very shortly after their respective births.

 

20              Concerns were first expressed to the local authority regarding the mother's behaviour in relation to medical issues in 2011. By June 2011, there was a professionals' meeting held at H, the nursery X had attended from January 2010 and Y from January 2011, about the mother's fixation on and misrepresentation of the children's health issues.

 

21              Since that time there have been repeated referrals made by, and expressions of concerns received from professionals in the health and education sectors, in relation to possible fabrication, exaggeration and misrepresentation of the children's health needs by their mother.  It is plain from the records that the children's respective nursery staff were expressing very real concerns and worries about both children from an early age. They have also expressed concerns about the behaviour of mother. They noted that the father delivered the children on many occasions, yet he did not make contact with the staff; neither did the staff make contact with him to discuss any of their concerns. 

 

22              From an early age mother was declaring to nursery and medical professionals that both children had behavioural issues, developmental delay (in Y's case there was a basis for those claims), that she, the mother, was struggling to cope with their behaviour and that they had a number of serious ailments, including severe allergic reactions and escalating and severe asthma.  In Y's case it was asserted that she was having epileptic seizures and/or vacant blank episodes, and severe asthma.  In X's case it was asserted that he had muscular dystrophy and ADHD, as well as a life threatening allergy to nuts.        

 

23              From shortly after the children's respective births and until 2015, there have been numerous applications and appeals in respect of benefits for both children. The information given by the mother (who is the sole signatory to all the applications, many of which were subject to scrutiny in the course of this hearing) was, according to the local authority and the various professionals involved in the case, wholly inconsistent with both the medical opinion prevailing at the time, and the nursery/school's observation of the children's presentation and behaviour.  The mother said that she was dyslexic and consequently asked the father to check the forms, and certainly one of her letters.  The father's case is that he looked at the spelling but did not look at the contents.

 

24              By 2012, both children were at F nursery. There was a very clear discrepancy between mother's description of her children and the experience of the nursery and, later, school staff.  This led to the very early referrals to the allocated social worker, NM. The expressions of concerns came from a number of sources.

 

25              NM was allocated as social worker to the children since they were children in need. She was allocated from the time of at least Y's birth until July 2015.  Despite the concerns expressed by Dr  F, Consultant Paediatrician looking after Y, the children's GP surgery and teachers concerned with both children in 2012, all clearly asking social services to review the concerns, the social worker was inactive. Such was the concern, that the inclusion officer and SENCO at F, Ms L, made a Multi-Agency Safeguarding Hub ("MASH") referral in 2013. The referral was not pursued. The social worker continued being inactive, so much so that in February 2015 she intended closing the case. 

 

26              Between November 2007 and January 2015, there have been at least 20 999 calls out to London Ambulance Service.  The majority of these the symptoms described to the operator were not seen at the time the paramedics arrived. Due to the children's medical history as given by the mother, most of the call outs ended with the children being delivered to A&E, at all times of day and night.

 

27              There have been number of attendances at different hospitals. The list includes Barnet General, Edgware Community Hospital,  Royal Free Hospital, Royal National Orthopaedic Hospital in Stanmore, Luton & Dunstable and Great Ormond Street.  There have been endless visits to the GP, to Walk-In medical centres, and many calls to the NHS 111 service.

 

28              Y has been in a wheelchair, on and off, since 8^th March 2012 until September 2014.  X has been in a wheelchair through most of 2014 and a great part of 2015.

 

29              Concerns escalated in the summer of 2014, when both children were presented at a summer play scheme in wheelchairs, apparently both having sustained similar injuries, which their mother insisted required them to remain immobile.  Whilst at the summer play scheme both children behaved in a manner which raised concern about the mother presenting them as injured, since as soon as she had left they enthusiastically abandoned their wheelchairs and were keen to participate in the activities with the other children.  A scrap book, presented at this hearing by the director of the play scheme, demonstrated how the children involved themselves with activities.  The professional concern, by then of both teaching staff and doctors, about the mother deliberately immobilising the children, curtailing their movement and participation in activities, increased.

 

30              During this time the mother was claiming, and receiving, DLA at the higher rate for herself, with the mobility element being enhanced due to her being classified as unable, or virtually unable, to walk.  This was not known until after the evidence and submissions were concluded.  However, in the summer of 2014, the family went to Disneyworld for two weeks.  I was told that both children were in wheelchairs most of the time.  The mother was not asked whether she, too, was in a wheelchair because, as I say, the information about her mobility allowance was not available, but I must assume she may well have been if she was virtually unable to walk.  This cannot have been much of a fun holiday.

 

31              In October of 2014, a meeting was convened between the mother, Dr L, Consultant paediatrician, Dr H (the children's GP) and the social worker. This was the first time the mother was taken to task about her exaggerating the children's conditions. This meeting took place as a result of concerns expressed at a strategy meeting, convened on the 23^rd September 2014, which raised the same concerns. Having been told at the meeting with the doctors that the plan for X was, inter alia, that he no longer needs EpiPen, that he no longer needs allergy testing and that he can eat a normal diet, and in respect of Y that she no longer needs appointments in respect of her absences, the  mother continued to claim that the children suffered from some of these conditions.   

 

32              On the 3rd December 2014 there was a review tribunal in respect of Y's DLA. Both parents attended, the mother did the talking, the father clearly did not interrupt, adding just one comment at the end.  Y's mobility element was raised to the maximum on the premise that she was unable, or virtually unable, to walk.  I  deal with the DLA applications in due course.

 

33              The decision to review this case and ultimately to commence proceedings followed allegations which X made against his mother in the last week in April 2015. The allegations were made to Mrs. M, his class teacher.  He did so acknowledging that he was about to leave that school and move to a new primary school.  At that time he was presenting in a wheelchair with his leg in plaster, allegedly with both a dislocated knee and a dislocated wrist.  He claimed that:

 

(a)   There was nothing wrong with his knee.

 

(b)   That the doctor at the hospital was reluctant to put a cast on it, but that his mother had insisted.

 

(c)   That his mother makes him lie about injuries.

 

(d)   That his mother deliberately 'popped' his knee when he came down the slide and that she had also deliberately dislocated his wrist when he was playing with his Lego.

 

34              X's allegations were investigated by the police. The mother was interviewed under caution and denied causing him any harm. She was asked not to return home.  X stayed at home with his father and, I think, maternal aunt, with the mother absent for twenty four hours. She then returned home, with the Police's permission.   Subsequently, on 7^th May 2015 X retracted his allegations and claimed that his class teacher had put pressure on him to answer questions about what had happened and that, as a result, he had made things up.  I heard evidence from the teacher, Ms M, and I deal with this below.

 

35              These were not the first allegations X made about his mother.  In the past he had alleged that his mother has deliberately closed his finger in the door, that she stuffed his mouth full of potatoes (the Local Authority query whether it was to bring on breathing difficulties) and that she fed him pineapple (query whether to bring on an allergic reaction).  He also mentioned to his mother that she lied to him when she told him he was severely hypermobile. It is noted that Y, who has problems with enuresis, is recorded to have said in the past that her mother told her to wet herself.

 

36              At the instigation of the local authority, as of 30^th April 2015 the father has moved to the mother's home and has been living there continually since.

 

37              Although in April/May 2015 the police decided to take no further action in relation to X’s allegations, the local authority initiated child protection procedures on 22nd May 2015, and on 8^th June 2015 an Initial Child Protection Case Conference took place at which both X and Y were placed on a Child Protection Plan under the category of 'emotional abuse'.  It had become evident by then that some of the conditions the mother attributed to the children, such as asthma, allergies and, in Y's case, epilepsy, were reported only by her, having occurred only on evenings, weekends and school holidays, when the children spent time with her, and at times with the father.

 

38              On the 22^nd May 2015, an agreement was signed between the father and the local authority.  The father agreed that under no circumstances are Y and X to be left in the sole care of their mother, and he was to undertake all the care for the children.

 

39              On 10^th July 2015 the local authority issued an application (dated the 9^th July) for care orders. In his statement in support of the application, MC, team manager, conceded that the Local Authority should have intervened in the lives of these children much sooner than they did.

 

40              On 15^th July 2015 AM was allocated as a social worker to the children.

 

41              On the local authority's application for an ICO and removal of the mother from the family home, I made an interim supervision order with the condition that the father does either supervise the mother's care at all times, or makes arrangements for another adult to do so.

 

42              For some three months, between the commencement of the proceedings until 17^th October, A&E medical treatment was not sought for either child. The number of GP appointments (two, I believe) during this period was significantly reduced.

 

43              The court appointed two experts to assist with the evidence: Dr Nathan Hasson, a Consultant Paediatric Rheumatologist, and Dr Kathryn Ward, a Consultant Paediatrician.

 

44              On 14^th October the parents informed the school that the children had dental appointments and had to be removed early.  In fact, and notwithstanding the court having appointed an expert in paediatric rheumatology, they took X to see Professor G, a Consultant Rheumatologist.  The notes of this visit have been available.  Clearly, X's hypermobility problems had been discussed in front of him, the mother giving false history about previous dislocations. Three days later there was an A&E attendance by X, and another one followed on 21^st October 2015.

 

45              In November 2015 the mother renewed her DLA application in respect of X, sending Professor G's report to the DWP.

 

46              On the 7^th December 2015, at the IRH, the local authority originally applied for the removal of the mother from the family home, but did not pursue the application, partly due to the proximity of the fact-finding hearing.  Removal was not supported by the children’s guardian, who observed that the children appeared comfortable at home with both parents. The terms of the agreement between the parents and the local authority were tightened; the mother was to be kept away from school and her involvement with the children was curtailed.

 

47              The fact finding commenced on 13^th January 2016 and the evidence ended on 4^th February.

 

          The Positions of the Parties.

 

48              The local authority assert that the threshold criteria are satisfied for the making of an interim order on the basis that there are reasonable grounds to believe that   X and Y have suffered significant physical, emotional and psychological harm as a result of the care they have received from their parents.  This harm has occurred over a period of many years and arises from the mother's over medicalisation of both children, her fixation on her perception of her own health issues, and her misrepresentation, exaggeration and fabrication of health issues in respect of the children.

 

49              The local authority considers that there are reasonable grounds to believe that the children's father has failed to protect them from the harm caused by their mother.  He does not appear to have taken any steps to cH enge the mother's over medicalisation of the children and, notwithstanding the position he has taken in his final responses to the findings sought, there is a real question as to the extent to which he not only truly understands and accepts the risk posed to the children by their mother, but whether he is able to protect them from her were he to be their primary carer.  At best, say the local authority, the father has failed to protect the children; at worst, he colluded with the mother in presenting the children as disabled.

 

50              The local authority put their case in two statements of fact in respect of the threshold, the first, in respect of X, at p.A102, and the second, in respect of Y, at p.A132.  The statements are many pages long.  I attach them to this judgment as attachment 9 (X) and attachment 10 (Y). I do not copy them into the body of the judgment.

 

51              In respect of direct and deliberate harm, the local authority sought findings in respect of X's allegations to Mrs. M, (see para. 32. above). Furthermore, actual harm was caused by over medicating the children, and in X's case in particular immobilising him contrary to advice, thereby weakening his core muscles.  Both children received unnecessary medication - Y: sodium valproate and inhalers, X: EpiPen and inhalers. Both children have been subjected to unnecessary medical procedures, such as EEG (Y), and many x-rays (X).

 

52              In respect of emotional harm, the local authority contend that, as a result of the actions of the mother, and the inaction by the father, the children have begun to see themselves as cripples and disabled, spending time in A&E departments, in Ambulances, in neurological examinations, in wheelchairs, etc.  Remarkably, with all their various condition, the children rarely missed school, where virtually none of the alleged conditions were ever observed.  

 

53              In respect of the father, the local authority's case is that the father colluded with the mother over the years, but if not colluded, then failed to protect the children from the harm she was causing them.  The local authority submitted that he was a closely involved father, and that it is inconceivable he would not have detected a pattern in the mother's modus operandi, since he, himself, never saw most of the symptoms the mother repeated constantly, despite seeing the children very often, having had them to stay at weekends and spending holidays with them.

 

54              The local authority also submit that the father was fully involved in the DLA fraud.  

 

55              The mother denied virtually all the allegations. She conceded that she has made some mistakes and that she may have been over anxious about the children due to her own medical difficulties, but denied fabricating conditions in order to obtain pecuniary benefits or for any other reason.  She did not accept any part of the local authority's case.  An example of what she termed a mistake was her reporting to Y's paediatrician in Barnet Hospital and to at least five other professionals that Y had a seizure when on holiday in Somerset, that she was taken to hospital by ambulance and treated there.  By the end of September/beginning of October 2015, after some toing and froing in correspondence between the Local Authority and the mother’s solicitors (the Local Authority seeking to identify the hospital), the mother admitted that there were neither a hospital nor an ambulance in Somerset. To me she said this was not a lie, but a mistake.  I find that it was a clear and unequivocal lie. She has admitted very few individual lies, and I deal with those below.

 

56              The father's case was that he knew nothing of any of the concerns in respect of the mother.  Despite the fact that he stayed with the mother many times (at least 2 nights a week) and despite having sole care of the children for around 25% of the time, during which he never took either to hospital, a walk in medical centre and only once to a GP, he never doubted the mother’s actions and never asked her (or anybody else) any questions. Since, which is accepted by the Local Authority,  nobody ever expressed to him any concerns about the mother, he never had any.

 

57              It is also his case that he was not involved in the 2004 benefit fraud nor did he know about the mother's lies and exaggerated claims in respect of the children's DLAs.

 

          The law

 

58              The burden of proof is on the local authority being the party who makes the allegations.  It is not reversible and it is not for the other party (or parties) to establish that the allegation(s) are not made out.

 

59              There is only one standard of proof in these proceedings, namely the simple balance of probabilities.   Baroness Hale of Richmond  in the case of Re B [2008] UKHL 35 said this:

 

                   "My Lords, for that reason I would go further and announce loud and clear that the standard of proof in finding the facts necessary to establish the threshold criteria under section 31(2) or the welfare considerations in section 1of the 1989 Act is the simple balance of probabilities, neither more nor less.  Neither the seriousness of the allegation, nor the seriousness of the consequences should make any difference to the standard of proof to be applied in determining the facts. The inherent probabilities are simply something to be taken into account, where relevant in deciding where the truth lies."

 

60              The 'inherent probability or improbability' of an event remains a matter to be taken into account when weighing the probabilities and deciding whether, on balance, the event occurred:

 

"Common sense, not law, requires that in deciding this question regard should be had to whatever extent appropriate to inherent probabilities."

 

         - Lord Hoffmann in Re B above.

 

61              If a fact is to be proved the law operates a binary system in which the only values are zero and 1, and therefore it is open to the Court to make the following findings on the balance of probabilities:

 

                   (a) that the allegation is true.

 

                   (b)  that the allegation is false.

 

62              Findings of fact must be based on evidence not speculation, as Munby LJ observed  in Re A (Fact Finding: Disputed findings) [2011] 1 FLR 1817 at para. 26: 

 

"It is an elementary position that findings of fact must be based on evidence, including inferences that can be properly drawn from evidence and not suspicion or speculation."

 

63              Very importantly, the court must remember the direction given to juries in the  case of R v Lucas [1981] QB 720.  It is not uncommon for witnesses in these cases to tell lies in the course of the investigation and the hearing.  Witnesses may lie for different reasons, such as shame, misplaced loyalty, panic, fear and distress.  The fact that that the person has lied about one thing does not mean he has lied about everything.  I have to be satisfied that the lie is relevant to the finding sought.

 

64              When carrying out the assessment of evidence the court invariably surveys a wide canvas.  It must take into account all the evidence and, furthermore, consider each piece of evidence in the context of all the other evidence.  It should exercise an overview of the totality of the evidence in order to come to the conclusion of whether the case put forward by the local authority has been made out to the requisite standard of proof.   

 

65              The evidence of the parents and any other carers is of the utmost importance. It is essential that the court forms a clear assessment of their credibility and reliability.  They must have the fullest opportunity to take part in the hearing and the court is likely to place considerable weight on their evidence and the impression it forms of them. 

 

66              The assessment of credibility generally involves wider problems than mere 'demeanour', which is mostly concerned with whether the witness appears to be telling the truth as he now believes it to be.  With every day that passes the memory becomes fainter and the imagination becomes more active.  The human capacity for honestly believing something which bears no relation to what actually happened is unlimited.  Therefore, contemporary documents are always of the utmost importance.

 

67              Hearsay evidence given in connection with the upbringing, maintenance or welfare of a child is admissible in Family proceedings under the Children (Admissibility of Hearsay Evidence) Order 1993.  Medical records are hearsay evidence, but admissible under that order.

 

68              Such evidence will have to be assessed by the Judge to see what weight may be attached to it.  As Neill LJ said:

 

"Hearsay evidence is admissible as a matter of l aw, but . . . this evidence and the use to which it is put has to be handled with the greatest of care and in such a way that, unless the interests of the child make it necessary, the rules of natural justice and the rights of the parents are fully and properly observed."

 

69              When estimating the weight to be given to hearsay evidence in civil proceedings, the court must have regard to any circumstances from which any inference can reasonably be drawn as to the reliability or otherwise of the evidence.  Regard may be had, in particular, to the following:

 

                                                  (a)            whether it would have been reasonable and practicable for the party by whom the evidence was adduced to have produced the maker of the original statement as a witness,

 

                                                 (b)            whether the original statement was made contemporaneously with the occurrence or existence of the matters stated,

 

                                                  (c)            whether the evidence involves multiple hearsay,

 

                                                 (d)            whether any person involved had any motive to conceal or misrepresent matters,

 

                                                  (e)            whether the original statement was an edited account, or was made in collaboration with another or for a particular purpose; and

 

                                                   (f)            whether the circumstances in which the evidence is adduced as hearsay are such as to suggest an attempt to prevent proper evaluation of its weight.

 

70              Many hundreds of pages in this case (the written evidence consisted of nearly 8000 pages) were copies of written records.  The list of records (bundles) is in attachment no.11.  There are nurseries' and school records, medical records including from GP surgeries and various hospitals, London Ambulance records, Walk-In Medical Centres and NHS 111, health visitors and physiotherapists. I have reminded myself constantly that these documents are hearsay, and that I need to exercise caution and careful judgment when relying on them.

 

71               The records, albeit incomplete, of the mother's applications for various benefits in respect of the children and herself, are not hearsay. I have found them helpful in establishing the parents' modus operandi.

 

72              I heard evidence from a number of witnesses (the schedule is attached to the end of the judgment).  Some were from the children's educational establishments. To that extent, in my judgment, a significant part of the evidence from the schools does not pose a problem in respect of the hearsay rule.

 

73              In respect of medical practitioners, I commend the parties for approaching the oral evidence sensibly.  It has been agreed, between the local authority and those representing the mother, that it would be impossible to test each maker of a note, and that it is not proportionate to call each record keeper to allow the mother to challenge the accuracy of the notes produced.  On that basis, the witnesses called were, by agreement, to be treated as sample witnesses and, having heard those witnesses, it was agreed that the court may then consider the totality of the evidence as relied upon by the local authority.  A very detailed schedule of the core references, as contained in the medical and education reports, was produced in early January. Those two documents (X's references [attachment 12] at A114-131; Y's references [attachment 13] at A143-161) identify core aspects upon which the local authority rely.

 

74              At the start, the witness template included several Consultants and other medics, including Dr P, Consultant Paediatrician and allergy expert, Mr. A, Orthopaedic Surgeon, Mr. C, orthopaedic surgeon, Ms P from CAMHS, an Ophthalmologist from Great Ormond Street, and Dr S.  After the evidence of Dr Ward, the court appointed expert, these witnesses have been stood down and an agreed summary of their evidence was placed before me.

 

75              I wish at this stage to express my gratitude to the parties for the way they conducted this complex case.  It was a case with information overload which could have easily gone out of hand.  I express particular gratitude to the local authority team who, between three of them, did an enormous amount of work.  As will be seen, I have relied substantially on their preparatory work and work in progress, having checked as far as I could the accuracy of the references.

 

76              Structure of judgment:

 

a.     Miscellaneous

 

i.       Parental relationship.

 

ii.   Historical fraud.

 

b.    Evidence

 

i.       Dr Ward.

 

ii.  The teachers (including actual physical harm to both children).

 

iii. The mother (including applications for DLA).

 

iv. The father.

 

v.  X.

 

vi. Y.

 

vii.     Findings and discussion.

 

         

          Parental Relationship.

 

77              The parents met in November 2000, and married in April 2001.  The mother told me that she was diagnosed as HIV positive some two weeks after the wedding. She did not tell the father.

 

78              As with all other information emanating from the parents, I view the accounts of their relationship with a degree of scepticism.  I make no findings unless they are relevant to the conclusions I have to draw.

 

79              The mother apparently became pregnant virtually at the time she met the father, and apparently miscarried at week 14, which was March 2001.

 

80              In March 2001 she registered A, a non-existent child, and claimed benefits for her.  I deal with the fraudulent benefit claims below.

 

81              The parents say that at some stage in 2003 (October, I believe), the father discovered that the mother was HIV positive.  He apparently saw some pills in the house which he did not recognise, and to his question what they were, the mother told him, having kept it from him for some 2 years, that they were for her HIV.  He apparently left that day.  He, nevertheless, did not get himself checked for the next 10 years. When asked why, he said that he had no symptoms and consequently no worries.  I find that if he was angry with the mother for infecting him with HIV, the anger did not last long. By the latter part of 2004, in my judgment, they were involved in a joined fraud of benefit agencies.

 

82              The parents say that they have never lived together again.  This was qualified in later evidence. The mother clearly claimed benefits as a single person, and I presume that her DLA allowance was on that basis too. In fact, for about a year, the mother moved to live with the father in Luton, since the flat she occupied was infested with mice. The parents maintain that although they shared the house, they did not live there as a couple. This was during 2007/2008; X was a baby, and Y, who was born in January 2009, must have been conceived during that time.

 

83              After their initial separation, they stayed in close contact. The mother expressed to the father her desire to have children, and so they decided in 2006/2007 to have children together. The father told me that he liked children and was content to oblige the wishes of the mother.  The mother suffers from polycystic ovaries, and apparently had many (sometimes reported as seven, sometimes as nine) miscarriages.  They apparently resorted to external insemination; the father, as the donor, described the process in some detail. Whether it is true or not matters little for the purposes of this hearing. The parents clearly maintained that they were separated, kept two properties and, apparently, the father at least had one or two other relationships.  Some records indicate that Y's conception was unplanned, that it was spontaneous and the mother told CAMHS, in October of 2009, that X was an unexpected baby and was therefore very special. She said that X’s father separated from the family after X’s sister was conceived, when X was about 6 months old. The mode of conception per se matters not, in my view. What does matter is that the truth of conception as well as the truth of the parental separation remain shrouded in mystery.

 

84              The parents continued their close relationship after the children were born.  The father, on his own account, visited frequently, saw the children in the evenings and they came to stay with him on weekends. If the mother was hospitalised, he often took over the children's care.  He got on with the mother's family, and shared the care with them. He was, for all intents and purposes, a shared care father. In his statement, he claims to have had a sole care of the children for some 25% of their time. The family spent a lot of time as a family, so much so that the children were heard saying that daddy lived with them all the time, and that on weekends they go to 'daddy's summer house' in Luton.  The parents holidayed abroad once a year, for example in Disneyworld in 2014, a planned trip to Spain in 2015, which did not materialise, and a yearly shorter break in the UK, for example in Somerset in 2013 and Devon, in the beginning of 2014.

 

85              In the recent disclosure of mother's DLA application (after the conclusion of evidence and submissions) it became clear that she claimed that she needed somebody with her every night.  She was asked questions about this in writing by the local authority and her instructions on this were taken by Miss Branigan QC.  The mother said that for at least the past five years she needed an adult to stay with her every single night.  This was not mentioned by anybody until then.  Of course, it is not for the mother to prove anything, but, if what she said was true, it would have been useful to hear about the difficulties she has described with the children from those who have stayed with her overnight.  Nobody came forward.

 

86              What the father knew about the children's true medical conditions is a matter I need to consider later.  I am satisfied that he attended a DLA appeal in December 2014, and made no comments on the mother's exaggerated claims.  The only comment he made was that due to her brain damage Y could hardly walk and fell down every two seconds.

 

87              I am satisfied from the records that the father kept himself away from the children’s educational establishments, and as far as I am aware, he did not attend medical appointments either (3-4 out of about 150), despite him being a hands-on father, closely involved with caring for the children.

 

88              The parents continue presenting as a viable unit (albeit not as a couple). They were forced to live together since May of last year, and appear to have managed it well. Ideally, they would like to return to the previous set up, with the mother being the children’s primary carer. If that is not possible, the father would like to live with the children in Luton. He would hope that it would be for a short period of time only, and that the mother could join them in due course.

 

          Historical Fraud.

 

89              The evidence of the events below comes from recordings in social services' running records of 2004, a report by RD, investigating officer from the corporate anti-fraud team at the LB Barnet, dated 24^th September 2015 (it came in response to a request by the Local Authority solicitor), and a CRIS report from 2004.  The CRIS report was received by the local authority days before the commencement of the hearing (even though it has been asked for much earlier).  This does not diminish its importance.  Complaint is made on behalf of the father that no direct evidence was produced by the local authority to deal with matters some fifteen and a half years ago.  In the context of this case, and having regard to the late arrival of the CRIS report, I do not accept the criticism to be justified. The core facts have not come to the parents as surprise; they have been dealt with in some detail in MC’s statement, dated July of last year. In my judgment, this historical fraud acquired enhanced importance as other matters unravelled.

 

90              I deal with this in some detail, so that there is no doubt about the process I went through to arrive at the conclusions I did.

 

91              On the 21^st March 2001 the mother registered the birth of A, allegedly born on 9^th December 2000.  This was about a month after the parties married. 

 

92              The mother claimed benefits for A from birth until at least August 2004.

 

93              It seems that social services and the police became interested in A because she has never had any medical checks, did not have any immunisations and has never been seen by anybody.  Consequently, they started visiting the mother and making in inquiries.

 

94              On 19th August 2004, social workers (referred to as "SSD”, Social Services Department, in the CRIS report) attended the mother's home and found two boys, introduced as T and S.  The mother introduced them as her stepchildren. She said that until three months earlier they lived in Africa. Their mother died in a car crash and they came to live with their father.

 

95              I pause to say that throughout the 2004 events, the father's two children in Africa have been referred to as two boys; I did not discover until his evidence-in-chief that T is in fact a girl.

 

96              On 25^th August 2004 it was clear, after enquiry, that both the father’s children were refused residence in the UK.  Nevertheless, they were registered as living with him and the mother on 13^th July 2004.

 

97              On the 26^th August 2004, the Immigration and Naturalisation Directorate provided information of a recent application for citizenship which the father has made on behalf of his two children.  This was supported by a letter from a private tutor, one Mrs. T, claiming to have educated the children privately since 1999.  The father claimed they lived in Battersea during that period.  The private education tale would explain why the children may not be known to the educational authorities in Battersea. Concerns were expressed by Social Services Department and the Education Department with regards to the emotional state of these children, who may be living the fantasy created by the mother about the existence of A, whose existence was constantly corroborated by the father.

 

98              Enquiries of the DWP confirmed that the father started claiming benefits for his children on 18th August 2003, a year earlier.

 

99              Later, when the fraud had become obvious, the social worker or the officer in the case ("OIC") (not clear which) spoke to the mother of the father's two children. She told him that the father asked her to send the children to the UK.  She refused.  The father apparently came to Africa in June 2004, unannounced, and again requested the mother allow him to take the children to the UK.  Their mother refused again.

 

100         On 10^th September 2004, the mother maintained that A will be returning from Africa at the beginning of October.  She also said that the Social Services Department can speak to the two older children provided either her or the father are present.

 

101         Social services were concerned about the whereabouts of little A, by then some three and a half years old.  The mother told them that she went to Africa for a family wedding with the father's sister, C.

 

102        On the 22^nd October 2004, the OIC telephoned the mother in the morning trying to make an appointment to see all three children. The mother told him that the father had gone to Africa some four days earlier to bring back little A, since there were apparently some visa problems.

 

103      On the same day, both the OIC and the social worker conducted a visit to an alternative address available for the father (an address he gave when arrested for driving with excess alcohol).  Contrary to information the mother gave, a surprised father was at the address with her.  The mother said that A was in Africa with the father's sister, C, and the two boys were in Liverpool with the father's sister, S.  She explained that the reason they, the parents, have two addresses (one for her, the other for him) is because they are having problems and the Housing Association is trying to evict them.

 

104        This visit is recorded by a social worker in social services' running records of 2004 at F143.  It is clear that the father was there throughout the meeting.  Not only is there a reference to "they" when describing the parents being hesitant in giving away aunt S's address in Liverpool, the father is quoted, when asked whether he was working, as saying that he was not and that he was claiming benefits for the children. At no stage is it recorded that the father objected to the information the mother was imparting about A, or correcting any information about his children, including information about the gender of his daughter.

 

105        When visited by the OIC on the 27^th October, five to six months after the police started their enquiries, the mother continued lying at first, and provided further information in respect of the three children.  The father then arrived in the home.  The note states that the parents were interviewed and admitted that the information both about A and the boys was untrue.  At no stage is there any suggestion that the father said he did not know about any of this.

 

106         On 2^nd November, some five days later, the mother telephoned the police and said the father left her and went to Africa.  There were unsuccessful attempts to trace him.  The police arrested the mother and wanted to arrest him too.  The mother was interviewed on 17^th December and said that the father will not return if prison is indicated.

 

107         Knowing that the mother had been arrested, the father did not return to the UK for two months.

 

108         On 23^rd February 2005, the mother accepted a caution in respect of registering a fictitious child.

 

109         The final entry in this CRIS chain reads thus:

 

"I met with RD and CG of the London Borough of Barnet Anti-Fraud Team and Det. Sgt. PD on Monday, 21^st February 2005.  At the meeting the London Borough of Barnet staff said that they would pursue prosecution against both the mother and the father for over payment of benefits due to their fraudulent claims for housing, child benefit and income support."

 

        Just below, it says:

 

                   "Suspect Interview. 

 

                   On Tuesday, 22^nd February the father attended Colindale Police Station voluntarily and was arrested on suspicion of obtaining property by deception.  I interviewed him with RD of the London Borough of Barnet.  The father confirmed that the child to whom this neglect crime relates does not exist, and confirmed that his wife has falsely registered the birth in order to secure better housing.  Having covered issues relating to this crime allegation, we then question him in relation to child benefit being paid to him and his wife in relation to his two sons,                                                                                                                                                                                                                                                  T and S, who have never lived in the UK.  He was further asked questions relating to his employment and confirmed that he worked for three and a half years for a transport company in Edmonton as a warehouse supervisor whilst claiming income support simultaneously."

 

110         The mother was totally unhelpful when giving her evidence about this. She did not recollect anything, excusing her loss of memory by going through a difficult time at that time.  Looking at the date, the mother cannot explain this whole episode by a trauma as a result of the miscarriage in March of 2001; in fact the registration of A and the miscarriage coincided, and it is clear that the false registration required some planning (she bought a birth certificate for £10 from somebody in Enfield Registry Office). Nor can the mother explain it by discovering that she was HIV positive, since this apparently coincided with tests after the miscarriage. I am satisfied, in her case, that she falsely registered A's birth. Clearly, her accepting a caution is a sufficient proof of the same.  I am further satisfied that she was fully involved in the fraud in respect of the father's two children.  Under persistent investigation, the mother continued lying, including elaborating on her lies, for a period of five to six months.

 

 

111         In evidence the mother said that she did not know that the father made a separate application for child benefit for his two children.  She also said that he made a false application for housing benefit.

 

112         In cross-examination, the father denied any knowledge of any of the above events. He said he did not remember a number of things.  He did not remember, strangely, the children being presented as T and S, he did not remember his wife giving a false address for Aunt S in Liverpool, he did not remember saying that he was claiming benefits for his children and he could not remember saying that his former partner, the African mother of his 2 children, had died in an accident.

 

113         He did not explain why he left for Africa for two months 5 days after telling the truth, and did not return when his wife was arrested.

 

114         He said that the first time he knew of two children being passed off as his was when he received the papers for these proceedings.

 

115         It was submitted on his behalf that the court would be wholly wrong to make findings against the father on unpleaded allegations without first hand evidence being provided.  It is also submitted that, in any event, it is not relevant to the finding that X and Y had been harmed.

 

116         I reject both submissions. Despite the shortcomings of the CRIS report, I am satisfied that that there are sufficient references for me to find that the father was present at conversations and party to them when the three children were discussed.

 

117         It is, in my judgment, highly unlikely that the mother would have made applications of her own in respect of the father's two children, giving all the information she gave about them, without the knowledge and co-operation of the father.   It was equally unlikely, in my view, having seen both parents give evidence, that the mother would have been able to maintain the existence of A for a period of some four and half years without the father knowing about this.

 

118         I find that the father lied to me about his involvement in the 2004 events.  I do not need to make a finding about the mother since she accepted the caution in respect of the fictitious registration.  I find that she was involved with the benefit fraud in respect of the 2 children, even if she does not remember it.

 

119         Far from it being irrelevant to the matters I have to decide, it is, in my judgment, highly relevant.  Not only does it deal with the very important issue of credit, it also deals with the father's modus  operandi.  I deal with this later.

 

          Dr Ward

 

120         Dr Ward, the paediatrics expert appointed by the court, is a Fellow of the Royal College of Paediatrics and Child Health and the Royal College of Physicians.  She is a Consultant Paediatrician at Airedale General Hospital, and has been a Consultant for 30 years.

 

121         She prepared three reports in this case.   The first in respect of X dated 1st December 2015, of 159 pages; the second in respect of Y, which was received by the Local Authority on the 16^th December 2015, of 99 pages.  She also prepared an addendum, dated 18th January 2016.

 

122         Her reports were late arriving. Having regard to the volume of work she has undertaken whilst being a full time practitioner at a busy NHS hospital, the delay is excusable. Despite complaints, I do not find that either parent was prejudiced by the late arrival.

 

123         Although inevitable repetition at times, the length of the reports is justified and reflects the volume of information in this case.  Her reports are thorough, informative and the medical records of the children carefully analysed.  Her oral evidence was of equally excellent quality: careful, fair, measured and thoroughly convincing.  Despite having the chronologies prepared by the medical chronologers, she told me she went to the original notes and made her own chronologies.  Her knowledge of the material in this case was thorough.

 

124         Although she has not listened to the evidence of the other witnesses, I am satisfied that when giving her evidence, she had a thorough working knowledge of their statements and of the references relied on by them.  This relates to both the medical staff dealing with the children and the nursery/school staff.  She also had a working knowledge of the mother's application for DLA and questionnaires the latter filled in for purposes of the same.

 

125         She was asked, at the very end of her cross-examination by the mother, whether anything which has been put to her in the course of the oral evidence changed her views from those expressed in her report.  Her answer was negative.

 

126         Altogether, I thought her a very impressive witness, and accept her evidence, both written and oral, without hesitation.

 

127         Her views in respect both children were that the mother fabricated and exaggerated many symptoms over the years. She did not consider the mother's conduct to be a simple case of over anxiety, nor did she consider her to be a misguided carer believing in symptoms.

 

128          She was referred to the Practical Guidelines for Paediatricians on Fabricated or Induced Illness("FII") by Carers, dated 2009 and reviewed in 2012.  It is a document produced by the Royal College of Paediatrics and Child Health.  In a table representing the spectrum of cases where FII concerns may arise, she considered the mother to fall into example 3, which includes possible personality disorder and high risk of harm. I do not deal with this aspect in this part of the case.

 

129      It is worth noting, and Dr Ward confirmed this, that the spectrum in the above table is not exhaustive, and does not, for example, adequately describe those carers who exaggerate or falsify their child's illnesses to fraudulently obtain benefits such as DLA or other pecuniary advantage.  These carers may not actively seek medical tests or treatment for the child and may actually avoid contact with medical services.  Dr Ward confirmed that the mother's conduct fell outside the category of simply (for want of a better word) fraudulent claimants.

 

130         She could not express an opinion about the mother causing X's injuries in 2014.  She opined that by not complying with physiotherapy regime and unnecessarily immobilising both children, but particularly X, she caused them physical harm, and in X's case weakened his core muscles.  She also opined that administering unnecessary adrenaline (EpiPen), steroids (inhalers), having unnecessary procedures such as EEG and anaesthesia, are physically harmful to the children.

 

131          In respect of X her opinion does not conflict in anyway with that of Dr Hasson.  She, of course, had much more rounded information of X's medical history and was able to comment (rather than diagnose) on matters Dr Hasson was not.  Her view was that the mother deliberately restricted the mobility of the children, throughout all the wheelchair episodes, but primarily in 2014.

 

132         Dr Ward made it clear, in both written and oral evidence, that the children had real, objective medical issues.  She checked the early medical notes in respect of Y, and accepted that Y had a developmental delay and a mild cerebral palsy.  An MRI scan performed on 14th January 2011 showed features of periventricular leukomalacia, an injury to the white matter of the brain.  These injuries are often associated with increased tone in limbs, particularly legs, and delayed motor development.  This would be classified as cerebral palsy. There may be speech and learning delay too. Dr Ward also noted that Y had a strong squint.

 

133         She was satisfied, having read Dr F's annual medical reviews, that Y was progressing well, and that by the time she was four many of the difficulties which were evident in her early years had resolved.  She accepted that Y is still delayed in certain aspects of her development, but the delay (both motor and cognitive) is mild.  Despite some early problems with Y's vision due to her squint, Y's vision is now fully functional, though she has to wear glasses.  There are no indications that her hearing is impaired.

 

134         Dr Ward accepted that X suffers from hypermobility. He, too, needs to wear glasses.

 

135         She acknowledged that both children may be atopic - namely that their immune system reacts to an allergen by producing antibodies called Immunoglobulin E ("IgE"). These antibodies travel to cells that release chemicals, causing an allergic reaction. She accepted that both children may be mildly asthmatic.  She observed, however, that in respect of both asthma and allergy there has never been a positive diagnosis of either child.

 

136         Dr Ward agreed that asthma, epilepsy and allergies were classic examples of fabricated illnesses, since they were episodic and may not be seen by everybody who is involved with the child.

 

137         She said that exaggeration in reporting symptoms clearly happened in presence of the children.  Dealing with Asthma, the mother described maximal symptoms, and required maximal treatment for both children.  There was no evidence to support the symptoms.  In all the years the children were at F School, neither had an asthma attack.  Both children, but particularly X were receiving high doses of inhalant steroids.  She considered that the alleged asthma was limiting X's life.

 

138         For X, the evidence of allergies again is minimal and evidence of prescribed treatment is maximal (EpiPen). There is, in fact, no diagnosis of allergies in the children’s records.  On the contrary, every RAST test X had for declared allergies was negative, the first such test taking place in 2010.  Skin allergy tests were also negative.  It is of note that on a number of occasions the mother was offered further testing for X, but she refused, finding various excuses. Y was never tested.

 

139         There has never been an occasion in which anybody other than the parents observed X having breathing difficulties, let alone anaphylactic event, (a severe allergic reaction which may be life threatening) as a result of reacting to food or latex.  EpiPen has been administered by the mother on numerous occasions, and by the father once.  It has not been possible for Dr Ward, and indeed for me, to work out how many times X had EpiPen administered, but it is certainly a number of times. On the 10^th December 2014 he received 2 injections, one from the mother and one from the father. I deal with this incident below. There is no clear evidence that paramedics called to the home ever administered EpiPen, although I accept that on the mother's descriptions of symptoms over the telephone she was advised to administer EpiPen both by NHS 111 and 999.  Overall, by the time London Ambulance Service arrived on calls, in respect of anaphylactic reaction, symptoms have, apparently, abated.

 

140         Dr Ward explained that EpiPen should be administered only in extreme cases, namely when there is a very severe reaction.  Administration requires training, which I do not believe the father ever had.  Inappropriate administration of inhalers and EpiPen can cause cardio-vascular complications.

 

141         Dr Ward explained that the children were of ages and understanding to believe they have asthma and allergies.  In respect of X, the mother reported to various persons - doctors, paramedics, teachers and the DWP a severe allergy to nuts, allergy to pineapple, apricots, coeliac disease, gluten and latex.  In respect of Y, she was apparently allergic to cows' milk and milk products, and latex, as well as pineapple (though the mother claimed that this may have been a confusion on her part, having confused Y with X).

 

142         I am satisfied Dr Ward did not find evidence to support any of these.

 

143    I am also satisfied that at times the children arrived at school with food which included substances they were supposed to be allergic to - X had a pineapple yoghurt and Y had food containing lactose. It is not clear what they thought when their lunch was removed from them.

 

144         X had an inhaler at school.  Other than on one occasion in four years, when X and lots of other children were chesty, and other than "maintenance dose" (two puffs daily at 11am, when X always said he was fine) X did not need his inhalers.  All his reported asthma attacks happened during weekends, evenings and school holidays.  Y, similarly, did not ever have an asthma attack at school, certainly not of the kind described by the mother to the staff and to the London Ambulance Service (LAS).  There has been some wheezing, but she was not a child who needed 999 and an oxygen mask.  Two days before the Christmas holidays of 2012 the mother told the teacher that Y was going to have a "big one", namely a big asthma attack, within a couple of days. Dr Ward made it clear that there is no mechanism to tell a forthcoming serious asthma attack two days in advance.

 

145         Dr Ward explained that unless there are clear indications to the contrary, doctors have to accept the medical history presented by a parent. The mother regularly gave an inaccurate, enhanced and inconsistent history of symptoms.  The mother also took the children to different hospitals to deal with the same problems.  A classic example is of Y attending both Gt. Ormond Street and Edgware Community Hospital for issues with her vision. Since the mother gave different histories to each of the hospitals, the treatment prescribed by the two hospitals was different and, at times, contradictory.  As a result, Y's squint took longer than necessary to improve.

 

146         Dr Ward pointed out that EpiPen was first prescribed for X by a locum Consultant Paediatrician, Dr T, on 9th December 2009, when X was just two years old.  The mother described X as having a serious allergic reaction to possibly apricots, and possibly nuts in Nutella spread.  She said that his allergic reaction consists of urticarial rash as well as respiratory difficulties. On the basis of this history the Doctor prescribed EpiPen and described the different grades of the reaction and an appropriate treatment for each.  Although EpiPen was prescribed as repeat prescription since, it has never been used by the schools or by the LAS.

 

147         It has not been possible, nor, in my judgment is it necessary for the purpose of this judgment, to deal with every fabrication and exaggeration of the mother in respect of the children's symptoms.  With the assistance of Dr Ward's report and evidence, I have decided to deal with a few examples of the mother's modus operandi. I make it clear that I have checked every reference I deal with and found it correctly reported.

 

148         A classic example of mother's escalation of symptoms without any medical evidence to support is recorded on the 23rd January 2014.  Y was just five years old.

 

149         The first consultation of the day was with a GP, Dr S.  Although there is no record of Y having been sent home from school due to tummy ache, the mother told the Doctor that she was called by school and said pain was on the right hand side of Y's tummy, with a fever of 38°C when she got back home from school.  There was no vomiting, no cough, and a slightly runny nose over the last week.  Last month she was admitted with tummy pains and told she was constipated. She was given Movicol (laxative), but did not get any better.  She was given Lactulose by Dr H (GP) which had not helped.  On examination, nil was found; she was alert, well, apyrexial, chest clear, abdomen soft and not tender, and throat slightly red only. Urine dip negative. The mother was advised to watch closely and seek medical attention as needed, to stop Lactulose and continue Movicol three times daily.  She was advised to ensure adequate hydration and was given a food fibre sheet given for fibrous diet.  This visit to the GP was at around 2 pm.

 

150         On the same day, at 15.58 pm the mother and Y attended Finchley Walk-In Centre.  The presenting complaint was abdominal pain, coryza (stuffy or runny nose, irritation of the mucus membrane inside the nose) and fever.  The mother reported chest infection two weeks ago and told the doctor that antibiotics finished one week ago.   She had a runny nose and a slight cough.  At school, she is said to have complained to teachers of abdominal pain.  There was no vomit.  The mother said that she went to the GP today who advised to carry on with Calpol.  At home, her temperature spiked to 38.1°C.  The mother said Calpol had no effect.  On examination she was “miserable…follow up”, otherwise comfortable, her temperature was 37.3°C.  Obvious purulent coryza around the nose, red inflamed throat, no pus, no features of respiratory distress, no wheeze, abdomen soft and not distended, not tender on distraction, no rebound, no guarding, able to sit up without leverage.  Diagnosis: a chest infection.  Clarithromycin prescribed. Advised to see her own GP for follow up.

 

151         On both occasions the mother reported her temperature was over 38^o. On both occasions her temperature was normal – around 37^o.  There was no evidence that she received antibiotics a week earlier.

 

152         On the same day at 20.49 in the evening a 999 call reported that Y was not alert and was experiencing breathing problems.  History given by the mother to the paramedics (LAS 58) was that she was a known asthmatic and had cerebral palsy, epilepsy, dyspraxia, learning disability and seizures. She also reported that she was receiving Circadin, which I have not seen prescribed anywhere  and which is contraindicated for children of Y’s age.  The mother reported that Y had complained of abdominal pain at 14.00 hours whilst at school.  She had seen the GP at 16.00 hours.  The GP felt that Y's abdomen was hard to touch and queried a bowel obstruction.  That was untrue. At 19.00 hours, Y saw another out of hours GP who diagnosed a chest infection, gave antibiotics, and reported that Y's temperature was 38.5°C (untrue). The mother administered Calpol at 20.00.  On examination, Y was sleepy and smiled when woken up.  She said that her abdomen and chest were painful.  Mother stated that Y was not herself.  Her temperature 37°C, chest clear, no wheeze or crackles.  Y was nevertheless conveyed to the Royal Free Hospital for further assessment having regard to the history mother has given.

 

153      Y arrived at Royal Free A&E Department at 21.44.  It is recorded that she had been seen by two GPs on that day.  The first said that she had a hard, distended abdomen. This was untrue.  The second GP diagnosed lower respiratory tract infection, that she was pyrexial (untrue), lethargic and unsettled with past medical history of cerebral palsy, epilepsy, and asthma.

 

154      Y's temperature was normal when taken by anybody other than her mother.  She did not have epilepsy. Her asthma was, at worst, diagnosed as mild.

 

155      She was seen by Dr D at 22.40 hours.  The history given by the mother included severe abdominal pain, coryza and wheeze.  Two-day history of coryza and wheeze, and occasional non-productive cough.  She reported temperature of 38.6°C yesterday at 13.00 hours, severe abdominal pain, crying at school, inconsolable.  Seen by the GP, advised Calpol.  Continued severe abdominal pain this evening.  Seen by out of hours who noted wheeze and commenced Clarithromycin. Bowels opened once - small pellets, no blood, no vomiting. Tolerated a small amount of food and liquids. On examination: lethargic, no respiratory distress, no rashes, passing urine - incontinent, wearing nappies.  Sleepy but rousable, tonsils red no pus.  Some palpable sub-mandibular lymph nodes, ears clear, coryza, capillary refill time less than two seconds, moist mucus membranes, widespread wheeze in chest.  Good air entry, no recession, abdomen soft, no guarding, no rigidity, “no masses felt”.

 

156         She was reviewed by a Dr B at 23.30 hours.  “Impression: constipation, viral upper respiratory tract infection.  Advised to increase Movicol to four sachets spread evenly throughout the day and to continue and complete course of Clarithromycin”.

 

157         Dr Ward analysed this sequence of events as a worrying history of escalation of symptoms on the mother's part, and misleading information regarding the GP consultation at 16.00 hours. Due to mother's reporting, the second GP prescribed antibiotics, although there were no supporting features of chest infections (chest clear, no wheezing etc.).  There were symptoms and signs suggestive of viral upper respiratory tract infection which should have resolved without antibiotics.

 

158         Dr Ward told me that there was absolutely no indication for a 999 call and an A &E attendance.  Doctors in the A&E department suggested continuing with current treatment with a slight increase in medication for constipation, although there were no abdominal symptoms to confirm constipation. Y was seen at 23.30.  I assume she did not get home much before 1.00 am.

 

159         Dr Ward explained that LAS and A&E doctors will not take chances. They will listen to history and accept it and treat accordingly.

 

160         Another classic example of the mother's modus operandi is at GP159, when the mother attended, on the 13th May 2014, at the fracture clinic at Barnet Hospital. She presented X to Dr N, Orthopaedic Surgeon, as a child with ADHD, asthma and repeated (12 episodes) of subluxation of the right patella. She also gave extensive family history of hypermobility, including her and Y, which is untrue.  Only one previous dislocation was recorded (on1st May 2014). Dr Ward said that if 12 previous dislocations/subluxations are reported, it is not surprising that an orthopaedic surgeon would advise a cast for two weeks.

 

161          Another example of mother's lies is a small but significant one.  On the 11^th  December 2014 the mother reported to Ms L that the previous night X had two  EpiPen  injections: one administered by mother and another by paramedics. Apparently his allergic reaction (such as to necessitate EpiPen) was within 10 minutes of leaving school.  Checking the LAS records at LAS50, it is clear that the paramedics did not see any of the symptoms reported by the mother. X was alert, orientated, no wheeze. They did not give another EpiPen.  Mother reported that he was given Piriton at school at 2 pm.  Although the report on F SCHOOL215 from a clinical director at Barnet Hospital, one TH, suggested that X presented with swollen lips, such were not observed by the paramedics; this was likely to have been the report of the mother. Mother reported that he was supposed to have had skin contact with a child who had nuts. X had no allergy to nuts.

 

162         One last specific example of exaggeration and fabrication is in respect of Y’s hearing. Y attended an audiology clinic on 12th September 2014 at the Royal Free Hospital.  She was referred in June 2014 by a GP regarding failed school hearing test; she attended with her mother.  The mother said that she had noted that Y's hearing deteriorated when she had a cold and when she was calling Y sometimes she had to call three to four times before she responded.  Mother had also noted that Y did not like loud noises and tended to react to these stimuli by hiding under a table.  She said that there was family history of hearing impediments (including, apparently, X).

 

163         Y was reported to by the mother to be prone to coughs and colds and ear infections.  She was reported to be getting over a cold at present. She was reported to be prone to ear infections with ear discharge with the last episode in May 2014 which was treated with antibiotics. Y was also reported to be a loud snorer and mouth breather. Y was reported to be a late talker but now talked in sentences.  She was born at twenty-nine weeks’ gestation by emergency caesarean section.  Y's labour had to be started but mother had a broken pelvic bone and was unstable to normal delivery.  Y spent four weeks in the neonatal intensive care unit.  She had antibiotic treatment, antiviral treatment for two weeks and also jaundice at birth and received phototherapy intermittently over a period of six weeks as an inpatient and outpatient.  In view of the jaundice and general health at birth, Y received a total of nine blood transfusions during her stay on the Neonatal Intensive Care Unit.  Y was noted to have swelling on the brain and was without oxygen for four minutes in total at birth.  Mother also reported that Y failed her new born hearing screen in both ears but was later reviewed at around six months and passed some, but not all, of her battery of hearing assessments.  As far as mother was aware, Y was not followed up after this for hearing test.  I remind myself that in her DLA application in 2013 the mother claimed that Y is unaware of the mother speaking to her or approaching her until she actually stands next to her.

 

164     The findings are recorded as Y having normal hearing across the major speech frequencies in both ears. It is recorded that results were discussed with the mother and, in view of the complex medical history as given by the mother, with some conditions still under investigation according to her, it was agreed to continue to monitor Y for her hearing levels on an annual basis.

 

 

165     Dr Ward listed the inaccurate information given by mother at this appointment as follows: 

 

a.     Y was born at thirty weeks and not twenty-nine weeks.

 

b.     Mother apparently had symphysis pubis and not a broken pelvis.

 

c.      Y was not ventilated for two weeks.            

 

d.     Y did not receive jaundice treatment at home.  

 

e.      Y received one blood transfusion and not nine.

 

f.       There is no evidence that Y was without oxygen for four minutes, or at all, at birth. She was born with good APGAR scores. 

 

g.     Y passed her neonatal hearing screen. There was no history of her having failed or partially failed tests as suggested by the mother. Y had very extensive testing and it is likely that the mother's history influenced this and the fact that Y was given follow-up appointments.

                  

166         Of note is the mother’s knowledge of medical issues and her ability to describe symptoms and events which she must have known would affect future approach to the alleged impediment.

 

167         For the sake of completeness, I copy the list of instances Dr Ward records, where inaccurate information led to investigation, referrals and re-referrals.

 

i.       08.11.07.   X was about four weeks old.  Staff at Barnet Hospital informed by the mother that staff at the Royal Free Hospital had witnessed ten episodes of shaking head and arms and drowsy afterwards, leading to a suspicion that he may have seizures.  EEG requested (mother failed to attend for this on two occasions).

 

ii.     09.12.09.   A report to the allergy clinic of X having developed a nettle rash and stridulous respiratory noise after being given a lamb dinner.  Mother reported that paramedics gave intramuscular adrenaline.  He required intramuscular adrenaline after a reaction when mum used a washing powder that was fragrant.  No record of being given adrenaline by paramedics on LAS records or GP records.  However, this history led to X having blood tests, skin prick tests and a prescription of an EpiPen and antihistamines, as staff at the allergy clinic were dependent upon the history of the mother.   Subsequently there were reports of the EpiPen being administered, although no clear contemporaneous documentation of this has been found in the records, again leaving health professionals having to rely on the retrospective history given by the mother. [BH166-168]

 

iii.  23.02.10.   The mother informed the GP that X had an allergic reaction yesterday and needed hospital assessment and observation, there is no evidence of a hospital attendance in the records.

 

iv.  02.06.10.  Reports of the allergy clinic of having received intramuscular adrenaline on four occasions by ambulance crew, not documented in the records.  The details of severe allergy dependent on the mother's history with no supporting documentation and negative skin prick tests and blood tests.  [GP378-379 & 333-334]

 

v.     21.01.11.   Mother informed the GP that X may have ADHD and may have autistic spectrum disorder.  No evidence that CAMHS staff had suggested these diagnoses.  Instead, CAMHS staff had recorded: "Mum concerned there is an underlying behavioural diagnosis rather than attention seeking behaviour".  The mother subsequently, and on many occasions, repeatedly claimed that X had a diagnosis of ADHD when this had not been made by health professionals.  X, himself, repeated in the summer of 2015 that he has ADHD.

 

vi.  14.03.11.  Mother requesting a letter for school advising medication.  Also requesting letter for DLA to allow closer parking to school.  X on maximum therapy for asthma and mother feels that asthma is still not controlled.  There have been references to an admission to hospital and an asthma attack.  There is no information regarding that in the records.  The mother's description of X's severe asthma and inability to walk was not in keeping with the description by health professionals and professionals at the nursery.  She appeared to be seeking to describe him as a disabled child which he was not. (GP295)

 

vii.   22.03.11 Child Development Centre declared that there was: "no evidence whatsoever, in this setting, of any social communication problem.   There were some signs of anxiety and/or distractibility".  At this time professional expressed concern that maternal anxiety was impacting on X's behaviour and also on asthma management. [GP239-241]

 

viii.10.06.11.   The Nursery raised concerns that mother insisted that X needed various medications for asthma but the school had not witnessed any episodes of asthma.  Mother was also saying that there were behavioural problems.  He had medication prescribed for sleep (not true) and behaviour problems not observed in nursery. [GP292-293]

 

ix.     10.06.11.   There was a GP consultation with an alleged asthma flare-up.  Well, with no signs of respiratory distress or wheezing. [GP292]

 

x.        16.06.11.  There was a professionals’ meeting at H nursery,  which I have referred to elsewhere.

 

xi.     26.09.11.  The mother informed the school that X was treated for asthma at Luton and Dunstable Hospital A&E over the weekend.  Later X alleged that his mother had given him pineapple and that was why he went to A&E.  Later a check by the health visitor confirmed that X did not attend A&E and did not attend the out of hours service during that time.  When cH enged the mother agreed that X did not attend the A&E Services and stated that X did not always tell the truth.  I note that three years later X alleged that his mother told him to lie. He also accused her of lying to him.

 

xii.   24.01.12.  The mother informed Dr L that X had had Prednisolone (a strong anti-asthma steroid medication) and antibiotics prescribed by the GP.  He had only been seen with a viral infection. To me mother denied that X was ever prescribed Prednisolone; he clearly was. [BH142]

 

xiii.   29.12.12. The mother informed the out of hours service that X had very severe ADHD and was receiving medication for ADHD. [FW56-91]

 

xiv.   26.03.13.  Seretide was increased to a very high dose on the basis of mother's history that he had been unable to do football since the Summer because it made him wheezy. [BH133-134]

 

xv.      10.12.13.   LAS were called out at 21.24.  Apparently X was having respiratory difficulties. The history given was that the school called mother to say X had a swollen lip.  There is no record in the school records, nor has this been examined in evidence. The mother reported that X's lips continued swelling. She gave him Piriton, but at 6.15  his face was swollen, and at 20.30 he started having respiratory distress, gasping sound and inability to speak. She called 999 and was advised to give first EpiPen.  Symptoms did not improve, so she was advised to ring 999 again. While the ambulance was on its way she was advised to give second EpiPen. That was given by the father, who did not describe X having restricted breathing when he gave his evidence. The ambulance was dispatched at 21.24 and arrived at 21.41.  When the paramedics arrived, X was described as alert and orientated, airways clear, no wheeze and possible chest infection symptoms. Thus in 22 minutes, between the ambulance departing and arriving, that which a Dr D, at the Barnet Allergy Clinic, had described as anaphylactic reaction on the basis of the mother’s account, had completely disappeared.  Dr Ward considered it highly unlikely.

 

xvi.   17.01.14.  The mother informed Dr P at the allergy clinic that following the reaction of 10th December 2013  X still had lip swelling the following day and was seen by the GP who prescribed a seven day course of steroids.  The GP notes clearly recorded no swollen lips (BH 253) and there is no record of a seven day course of steroids.  Despite her concerns, the mother was unwilling to stay for a skin prick test.  It was noted that Tryptase was not taken in the A&E Department. [GP253 GP103]

 

xvii. In October 2014 the mother met with Dr H and Dr L. The social worker, too, was present.  All the children's symptoms were reviewed and it was made clear that X no longer needed EpiPen, he no longer needs allergy testing and he can eat a normal diet.  In respect of Y, she did not need a wheelchair, nor did she need an appointment for her absences.  The mother continued to cite nuts as allergies and ADHD after this meeting, and continued to give a history of absences on the basis of which Dr R continued his annual reviews.

 

xviii. 14.10.15.  An assessment by Professor G, Consultant Rheumatologist and Honorary Professor at UCL was organised privately by the parents.  The purpose of this consultation at St. John and St. Elizabeth Hospital was to establish a definitive diagnosis for X.  Mother presented a false and misleading history to Professor G, in particular as to his presentation in the first 18 months; pulled elbows and six shoulder dislocations, and in respect of 6 previous dislocations of the shoulder (E161B). This history was given in front of X.

 

xix.   Dr Ward found no evidence that Y has been subject to induction of illness.  However, there have been many occasions when Y's mother had given misleading or inaccurate information to health professionals, exaggerated or fabricated symptoms.

 

xx.      Y has had EEGs on two occasions on the basis of history of "absences" and altered consciousness.  Doctors were justified in undertaking these investigations given the history in a child with an underlying neurological abnormality.  However, the mother has never provided a diary or video evidence, as requested. I deal with Y's alleged epilepsy later.

 

xxi.   Treatment for the alleged patella dislocation was restrictive.  Y was immobilised in June 2014 with a back slab and obliged to use a wheelchair when her mother claimed she had had a posterior dislocation of the left patella and relocated it. This is not confirmed by medical notes.

 

xxii. On 14th July 2014, she was reported to have had a previous dislocation to her knee, this is not confirmed, and on the basis of that the back slab was extended for another seven days.

 

xxiii. On 6th August 2014 when paramedics were called out, they were informed that Y had had a previous blood clot.  This is not true.

 

xxiv. On 18th September 2014 at an Orthopaedic Clinic appointment at Watford General Hospital the mother reported Y had recurrent admissions with chest infections and seizures.  Y had not had numerous admissions for chest infection although she had attended the A&E department.  It was reported that she was under investigation at Great Ormond Street currently for seizures; this was not the case.

 

xxv. On 20th February 2015, Y had a consultation with the GP.  Her mother reported that she had been born at twenty eight weeks gestation and required breathing support for six weeks.  Gestation was exaggerated, as was the report of breathing support.

 

xxvi. On 9th May 2015, mother reported to paramedics that Y had under developed lungs and had been in the intensive care unit in the past.  This was inaccurate information.  She claimed that Y being wheezy and dipping oxygen saturation were late symptoms and it was difficult to obtain clinical improvement once that occurred.  There is no evidence in the records that this had occurred.

 

xxvii.     On 9th May 2015, she attended the A&E Department at the Royal Free Hospital.  Her mother stated that Y had, query, autistic spectrum disorder and was awaiting formal diagnosis. This was untrue.

 

xxviii.  On 23rd May 2015, Y attended A&E at the Royal Free Hospital.  Past medical history of epilepsy was given - not true.

 

xxix.   On 30th September 2015, Y was reviewed by the school nurse.  The mother stated that Y was not to have cow's milk at school and that she was constipated when she had milk and had been told by the GP to avoid medication for constipation. There is no evidence that this was the case.

 

 

168         Dr Ward confirmed that Y has definite health problems but it is well documented that children with existing health problems may be the focus of fabrication.

 

169         Dr Ward's final conclusion in respect of Y was that although Y was a pre-term infant who has evidence of periventricular leukomalacia and mild cerebral palsy, the evidence of professionals suggests that she has made excellent progress in all aspects of development and health.  It is acknowledged that she has residual problems with motor co-ordination, language and cognitive skills. The extent of her difficulties has been exaggerated.  The mother has presented her, on occasions, to professionals in a wheelchair which was a misrepresentation of Y's ability. The long term impact on Y is likely to be a distortion of her own perception of herself and her disability. There is evidence from the school records that Y herself was beginning to take on the anxieties of her mother.

 

170         On 10th June 2015, Y went to the medical room as she was desperate for her inhaler. However, when she arrived she was fine with no wheezing or breathlessness. When asked if she really needed her inhaler, she said that she really needed it although there was no evidence that she was wheezy.  On 15th July 2015, Y presented as crying uncontrollably in school and clutching her lower stomach. When asked what was wrong, she said that she had wet herself.  Staff were disturbed to see how upset she was. 

 

171         I deal with Y’s enuresis separately.

 

172         Y has not been subjected to significant unnecessary investigations or treatments as health professionals have been careful to communicate and to avoid unnecessary treatments.  However, professionals have been unable to prevent the emotional impact of multiple health consultations and exposure to the mother’s anxiety about Y's health.

 

173         In respect of X, Dr Ward emphasised that the multiple instances of exaggeration, fabrication and misleading information which would have caused considerable confusion to health professionals. It is important to take a holistic view of the medical chronology and the impact on X overtime of being presented as a child who was ill and had neurodevelopmental problems. X has been presented as a child significantly more disabled that he is. This pattern was likely to impact significantly on X’s emotional health and ability to cope with illness.

 

The Teachers.

 

174         I heard evidence from Ms C, the nursery class teacher for both children, at F School, Ms B, SENCO at F until April 2012, Ms L, SENCO at F from April 2012 to December 2014, Mrs M, X's class teacher in year 6, September 2014 to May 2015, Ms E, the summer play scheme Co-ordinator 2014,  Ms M, a child and family support worker at Q Infant School ("QIS"), and Ms S, head teacher at QIS.   I read the agreed evidence of Ms L, SENCO at QIS.

 

175         Evidence given orally by those mentioned in the paragraph above  was mostly corroborated by meticulous records from H nursery, F School and the QIS.  I was told by Ms C, and accept, that notes were made almost contemporaneously with events recorded.  I accept that not all the note makers gave oral evidence, however, those who did, could attest to many discussions with those who did testify.  Just by way of an example, Ms C shared a job with Ms J, and Ms L had discussions with Mr H, who acted as SENCO in F School for two terms.

 

176         In addition, to the school records, -I have been assisted by the chronologers' nursery and school chronologies of both children, which are attachments X and Y. 

 

177         I have reminded myself that records are capable of being inaccurate and I should be cautious when coming to conclusions on the basis of records which are not supported by direct evidence.

 

178         I was impressed with each and every one of these witnesses. Each was intelligent, thorough, measured and careful. I thought that each really cared for X and Y.  I am satisfied that each and every one of them told me the truth. 

 

179         I am aware that since 2011, concerns were expressed about the mother fabricating and exaggerating symptoms.  I am satisfied that these concerns permeated the children's educational establishments, and consequently made their teachers and carers more vigilant. It is submitted that teachers read into a situation more than was necessary.  I have examined the evidence with care and I do not find that this was the case.  I concern myself in this section primarily with factual observation rather than opinions.

 

180         The common feature to all the above named was the concern they had for the children due to the behaviour of their mother.  At times, whilst she was giving accounts of the children’s illnesses and anticipated treatments, which included surgeries, breaking bones, weeks in wheelchairs or on crutches, she displayed totally inappropriate affect.  When she reported a new ailment, she would have a broad smile; when she brought Y in in a wheelchair she was described to be grinning from ear to ear.  She was preoccupied with health issues; she would approach teachers at registration time on many occasions, discuss her own health issues and the children's health issues at the top of her voice, in front of her children, other children and other parents.  She had extensive knowledge of medical issues and shared it willingly.  Although the mother denied this, I accept the evidence of Ms C and Ms L on this point.  Ms L told me that when mother discussed ailments in public X would become disruptive and Y would become upset.  The more public, the more negative the impact was on the children.

 

181         When cH enged in cross-examination, Ms L confirmed to me that the mother definitely told her about her HIV.  She also told her that she had cancer - a terminal illness - in front of children.  She also told her that she was paralysed from the waist down on one occasion because she fell in hospital and broke her pelvis and had to have emergency surgery.  At that stage she was in a wheelchair.  When she was asked about the callipers at the back of the wheelchair she changed her version and said that it was only one leg which was paralysed.  Ms L saw her getting out of her wheelchair in the car park, putting the wheelchair in the boot and driving off.  When it was suggested to Ms L that the mother did not say she was paraplegic, Ms L said that she definitely did. 

 

182         It had become gradually clear that a lot of the information the mother was imparting to the teachers was incorrect. This was information about both her, and the children.  So concerned were the professionals when X and Y were at H nursery, they convened a professional's meeting on 16th June 2011.  Y was two and a half, X was three months short of four.  The meeting was convened specifically because of concerns about the mother presenting the children with wide ranging, often conflicting medical needs, presenting them to various professional agencies, and giving different professionals different information.

 

183         Present at this meeting were Dr J, a GP Registrar, Ms Z, Pre-School Teaching Team, Ms F, Key Worker, Ms M, Interim Manager, Ms V, a Children's Centre Teacher, Ms H, a Children's Centre Teacher, NM, a Social Worker, Ms L, new SENCO and inclusion officer, Ms McC, Community Nurse, Ms M, Health visitor and Dr F, Consultant Paediatrician, Ms A, Physiotherapist and Ms B, SENCO from F School.  In my judgment, the size of the meeting reflected the size of the concerns.

 

184         All who were present and spoke reported that the mother gives exaggerated and inconsistent information. For example, she said to Ms B that she had a terminal illness. She said to Ms C than Y needed surgery on her eye which would keep her in hospital for three weeks, needed to have her ankles broken and re-set, and X needed to have his big toenails removed under general anaesthetic. None of this proved true.  The information was given in front of the children.  When confronted with inconsistencies, the mother changed her version.

 

185         The meeting was told that the mother was describing X as having serious behavioural issues (mother was concerned about ADHD, although CAMHS said he did not have it, and also, possibly, that X was on the Autistic Spectrum. There was absolutely no substance for that.)  X was presented to doctors and to nursery teachers as having severe asthma, a number of allergies and violent tantrums, none of which were observed at the nursery.  Those connected with the nursery described him as very focused, had very good language, was calm, co-ordinated, good at sharing, a child who would come to his teacher to ask questions.  He was not clumsy; he was very "normal" in all ways.  In respect of Y, Dr F said that when reviewing Y in 2011 that Y was delayed, but nothing specifically alarming, and she was actually less delayed at the examination than she appeared when she first entered the room.

 

186         The actions decided by the meeting included the social worker discussing concerns with mother, giving her feedback from the meeting, and coordinating all information about her.  The doctors would review issues of X's asthma and sleep problems (Y has apparently been prescribed melatonin since she was 18 months old, but X had no medication), and pass information back to social worker. Also, a query was raised as to whether father has PR and to try and develop a relationship with him.

 

187         I am satisfied that nobody confronted the mother at this stage and, indeed, not until October 2014, about these concerns.  The reasons for this are numerous ("Not my job", said the social worker, “Health should do it".  "Nonsense", said Health, "Don't antagonise the mother, she may act out and cause even greater harm to the children" are but a few). The failure to deal with the concerns appropriately is outside the scope of this judgment.  What is important is that the mother did not know the extent of the concerns about her, and the father was not approached by anybody who would share the concerns with him. Records indicate that the mother said that the father did not wish to be involved, did not want to attend meetings. In evidence, the mother denied that she said this.

 

188         The evidence of Ms L and Ms B, both written and oral, emphasised the concerns about the mother and the inaction in respect of the same. So concerned was Ms L, the Inclusion and SENCO officer, about the children and the inaction, she made a MASH (Multi-Agency Safeguarding Hub) inquiry on 7th July 2014.  She told me she has never done one before in 35 years of teaching.  As a result a professional's meeting was convened on the 19th September 2014.  The outcome was that a s.47 strategy meeting would be convened at the school to include Police, Health, GP and school.  It was the responsibility of the social worker to convene; as far as I am aware, this did not happen.

 

189         Ms L also told me that the mother repeatedly expressed a view that both children are in need of a Special Educational Needs Statement.  In Ms. L's view neither did; neither received one although the mother applied once for X and twice for Y. 

 

190         Concerns were expressed about Y's self-esteem. She told me that mother kept saying in front of Y that she was clumsy, cannot see and she was constantly told that there was something wrong with her.  Y's self-esteem was affected. The following comment was overheard by a student teacher: "Go on, Y, bloody get on the toilet before you piss yourself".  I deal with Y's enuresis separately.

 

191         In 2013/2014  the mother asked Ms L to write a report on both children's needs to a disability charity (Family Fund) to obtain funding.  Ms L refused.

 

192         Ms B told me that her concerns about the mother's conduct matched those of Ms L. 

 

193         I turn to deal with the evidence of Ms E.  She filed one statement.  Her account of the children at the play scheme appears in an email she wrote to the social worker, to be found at F62.  By agreement with the children's social worker she produced a scrapbook, which proves that a picture is worth a thousand words.

 

194         She told me that both children arrived at the Centre as children with special needs. Both were there for six days.  They were brought daily by the mother, both in wheelchairs.  Both children waited for the mother to go away, jumped out of their wheelchairs and spent time playing, going on the slide, playing football (X), dressing up, dancing and twirling (Y).

 

195         X was in leg braces, in addition to his wheelchair.  These restricted his movement, but he nonetheless tried to get involved with everything. The photographs speak for themselves.

 

196         Mrs. E told me that the mother explained that Y could not stand for long.  Y was five and a half; her mother told Mrs. E that she had the mental age of a two and a half year old and a physical age of a three and a half year old.  Mrs. E said she and the other play supervisors found Y to be a bright, articulate, friendly little girl, with great imagination in her role play.  Y, when twirling, said: "Look at me, I can be myself again".  Y wet herself once in the course of the six days she spent at the scheme.  She had no problem with asking to go to the toilet.

 

197         Although the mother said she did not remember saying any of this, I accept the evidence of Mrs. E.  It is contained, as I said, in an email sent to the social worker of 7th August, just after the children started at the scheme.  The mother denied telling Mrs. E that Y needed a brain scan to ascertain whether she can fly (to Disney World) despite her seizures.  On this, too, I prefer the evidence of Mrs. E.  I also accept that the mother said that X was diagnosed with muscular dystrophy.  Mrs. E was not the only person to whom the mother said this.

 

198         Of note, in my judgment, is that both children went up the climbing frame, but just before coming down the slide both looked over to the car park and asked if mum was there; when told she was not, they both came down the slide but checked every time that their mum was not around.

 

199         On National Play Day, both children ended up going on public transport.  The mother said that Y's physiotherapist said she was not allowed to use her leg and that it had to be kept straight as she was not allowed to bend her knee even though she was sitting in the wheelchair with her legs crossed.  I could not find a note in the medical/physiotherapy files to this effect.

 

200         Having seen the photographs and heard Mrs. E's evidence, I am entirely satisfied that the immobilisation of both children was promoted by their mother. It is clear that Y did not need to be in a wheelchair.  X clearly wanted to be mobile. There is no evidence that the mother, at that stage, promoted any attempt to mobilise him.

 

201         I turn to deal with the evidence of Mrs. M and the question of actual harm being caused by the mother to X.

 

202         Mrs. M was X's class teacher in Year 2 between September 2014 and 1st May 2015 when the children left the school.  She filed one statement, dated 22nd October 2015.  I have seen notes she wrote after the conversations with X; all notes are dated.  She told me that they were written immediately after each conversation.

 

203         I make it clear at the outset that I accept Mrs. M's evidence. I find that she accurately reported what X has told her.  I find that her notes were recorded immediately after the events they describe.  I also find that she has not prompted X, nor has she put to him leading questions, being aware of safeguarding guidelines.

 

204         I do not accept that any shortcomings in Mrs. M's statement for this hearing, dated 22nd October 2015, undermine the veracity or accuracy of the totality of her evidence.  I have regard to her oral evidence as well as the notes she made or, indeed, the notes typed on her behalf by Ms L. 

 

205         I accept the criticism made on behalf of the mother of the quality of the police enquiry, including a lack of an ABE interview, (which deals not only with words but with demeanour), and the absence of the first half of the mother’s interview.

 

206         I put the events of the last week of April in context. I am satisfied that on the 20th April (a Monday) the mother wrote to Mrs. M to say that X was placed back in plaster during an Easter holiday due to a fall while walking the dog in the heavy winds.

 

207         In the same letter the mother explained that on Wednesday night (15th April) he was admitted to hospital after an x-ray showed a dislocation of the same knee whilst in plaster.

 

208         In the same letter, which is cut in places and therefore difficult to read in its entirety, the mother says that he was due to return to Orthopaedics in a week's time to see if he is going to require surgery to try and stop the various dislocations. No such suggestion is evident from any of the medical notes at the Royal Free Hospital.

 

209         On 28th April the mother notified the F School that the children would be moving to QIS after the Bank Holiday. That was the first the school were told, and the first the children were told.  This left the children at F SCHOOL on the 29th and 30th April.

 

210         On the 29th April Ms F (an Admin/Welfare Officer at F School) was informed by mother that X's right wrist "was pinging out last night".  The mother informed her that the new school could accommodate X better as there were no slopes and two wheelchair users and another child with cerebral palsy like Y attended it.

 

211         She also said that Y was very sore below from wetting regularly but not coming to see her.  She knows this because the puppy bites Y's bottom when she is or has been wet.  I mention this since in the mother's submissions (presumably on instructions) this was raised as one of the improbabilities in X's account.

 

212         I turn to the narrative of the events from the 23rd April 2015.  Mrs. M told me that she was aware of the child protection concerns in respect of X and Y.  I accept the submission made on behalf of the mother that there was a heightened atmosphere of suspicion in respect of her.

 

213         I accept that 23rd April 2015 was not the first day after the Easter holiday that X was in a wheelchair.  X has been in a wheelchair four times over a period of seven months, and had wrist injuries on three occasions.  I do not think this undermines the timing of the conversation with Mrs. M.  I am satisfied that X was upset and frustrated as a result of not being able to be out during playtime.

 

214         Mrs. M told me that she enquired of X about his dislocated leg and the wheelchair.  He said this:

 

"I went to hospital, the Doctor said he wouldn't keep putting me in a cast when I don't need it, mum got cross.  She wouldn't leave until he signed to say that he would. He said he had a long line of people and if she wouldn't go he had no choice.  So he did. He also said I would have an operation on my knee if she kept saying something was wrong, to make my mum stop it. But she wants me to have an operation. I don't know why".

 

215         Mrs. M told me that X cried and said he was confused. He said: "She gets me to lie. You shout if I lie".

 

216         In evidence, she said she could see X's frustration from his body language, the way he was waving his arms, and from the way he cried.  The cry appeared to her to be genuine. She said X was really upset.

 

217         There is no evidence as to what Mrs. M did with this information.  Surprisingly, perhaps, she was not asked about it.

 

218         The next entry is on 29th April.  Mrs. M told me that on 29th April X remained in the class during afternoon play and Mrs. M asked him how he was.  He then told her that what really happened to his leg was that he went to the park with his mother and sister and when he got to the bottom of the slide his mother had leaned forward and popped his knee out.  He said he screamed and was very angry.  He said his mother knew how to pop his knee out because the doctors showed her how to pop it in.  He said he told the hospital about what his mother had done to him and they said he should not tell his mother that he had spoken to the hospital about this.  He then said he told his mother about telling the hospital and she was very cross and said that she would take his new Lego away if he caused her any trouble at the school.

 

219         He also said that he was not going to talk anymore because his mother wore a big black boot and she hit him and his sister with it.  When Mrs. M asked him if he spoke to his dad about it he said that she hits his dad as well.  X said that his mother pulls his sister's pants down in the park and shows everybody her bottom.

 

220         On the same day, the 29th April X came in with a wrist brace.  He told Mrs. M that there was nothing wrong with his wrist and that his mum told him to lie, he did not know why.  He said that he never popped it in bed, and that there was nothing wrong with it.

 

221         He explained that he went to the doctor's because he hurt it (his leg) in the park. He said that he hurt "it" in the park.

 

222         Mrs. M asked him whether he was sure and he said: "My mum made me say it, she gets me to lie, I don't know why, I just say nothing. There's nothing wrong with my leg either."

 

223         Mrs. M asked X if he ever asks his mother why she makes him lie, and he said he did not say anything, he just did it.

 

224         She told him that it was important to tell the truth, and that she was sorry he did not know what to do.  X then cried and repeated "she makes me lie".

 

225         On 30th April he told Mrs. M that he was playing with Lego in his room and that his mother entered the room and twisted his wrist out.  He screamed in pain; at first she said nothing but later said she was sorry.

 

226         In her statement Mrs. M added that X told her that at times he locks himself in the garden because there is a gate there and he can tie a rope around it. This account included that his mother hits both him and his sister, that his sister tried to help him by throwing soaps at his mother on the window when she tried to get him out of the garden, and said that his mother smacks him for nothing and his father was upset about it and went to sit in his van in the drive because he was scared of his mother who hit him too.

 

227         Mrs. M asked him why he had not told her this before.  He said that it was because he was moving to a new school on that day and no one would know that he told her.  She told him he was very brave and that she would need to tell somebody else who could help him.  He said that she would not be able to help him unless she had a really strong metal bar and a padlock for his bedroom door so that his mum could not get him anymore.  He would only give his dad and his sister the code to get in.

 

228         Y was brought downstairs to speak to the police.  X told Y to tell the policeman the truth because they did not have to lie anymore. Y has not supported any of X’s information. There is not proper record of the questions she was asked or the answers she gave.

 

229         The mother, in evidence, denied doing anything of the sort described by X.

 

230         She said that on the 23^rd   X came home very upset and told her that he had been asked a lot of questions by Mrs M, especially about his health. He told her that she, Mrs M, could not understand why his leg was in plaster because her husband has hypermobility too and when he dislocated his knee he had a splint and not a plaster. He told his mother that when he told Mrs M that he fell over his puppy in the heavy winds she told him he was lying.

 

231         I pause to say that having seen Mrs M give evidence, I do not believe she told X he was lying.

 

232         The mother said that on the 24^th X was upset again and told her that he lied to Mrs M because she kept pressing him and he had told her he fell over 3 rocks.  He was upset because he was forced to lie.

 

233         I am afraid I do not accept as true the mother's evidence of what X is alleged to have told her at home on the 23rd and 24th April. I believe he said something to her to alert her to the fact that there was a discussion between him and Mrs. M.  It is likely, in my judgment, that the events of the 23rd and 24th April precipitated the children's unexpected removal from F School to QIS.  I do not believe the mother when she says that she went to seek Mrs. M on two or three separate occasions. Mrs M told me that she was unaware that the mother was trying to seek her out. Nor do I believe her that the two letters have been taken to the school, one by X, another one by herself.  I am entirely satisfied that if this mother wanted to see a teacher/head teacher, she would have found a way of doing so.  There was no reason for a letter which was delivered to the school office not to have been kept and filed together with the dozens of other papers appertaining to this family.

 

234         The mother, in her statement, provides a long list of complaints against F School. I do not enumerate them. They have not been recorded anywhere in conversations between her and teachers or SENCOs. The teachers were not cross-examined about them. It seems to me that these were an afterthought, after X made his allegations and she decided to move the children.

 

235         The father has not, at any stage during the week, gone to the school to discuss matters with any of the school personnel.

 

236         In submissions on the mother’s behalf I was invited to consider X's allegations as being inconsistent, fantastical and outlandish.

 

237         The following was put:

 

(a)     the assertion that doctors conspired to conceal the allegations made to them and/or failed to relay them to child protection officers within or outside the hospital was untenable.

 

(b)     the assertion that the mother successfully pressurised a doctor into treating X in a way which was contrary to his interests or medical needs was highly unlikely.

 

(c)      the inconsistency between the claim on 23rd April 2015 that there was no reason to go to the hospital in relation to his knee and his claim to have been injured by the mother on 29th April 2015.

 

(d)     the unlikelihood the mother hitting all of the family, including the father, with a black and then a purple boot.

 

(e)      the unlikelihood of the allegation that mother exposed Y's bottom in public.

 

(f)      the unlikelihood of the allegation that the family dog bit Y's bottom.

 

(g)     the unlikelihood the allegation that Y threw soap at the mother.

 

(h)     the unlikelihood of the allegations involving X's retreat to the garden shed, etc.

 

(i)      the unlikelihood of the allegations about X being smacked 20 times by the maternal grandmother.

 

(j)      the unlikelihood of the claim made, as X laughed, that father had been assaulted so that his bottom was red.

 

238         I have considered the submissions carefully.  I remind myself that X was only seven and a half in April 2015.  He was a child who had spent his conscious years attending medical appointments, he knew he had asthma and allergies and ADHD, and that he was a child who was highly medicalised.  His physical restrictions due to plaster and the use of a wheelchair have been going on for a year.

 

239         Although I have not heard first hand evidence from X, I accept Mrs. M’s evidence that his distress was genuine.

 

240         I am satisfied that there is room for some confusion in X's account, and that he may well have conflated a number of visits to the hospital into one event.

 

241         On 1st April 2015 he was admitted to the Royal Free Hospital.  It was a self-referral.  On this occasion the account was that he fell in the wind four days earlier.  A brace was applied.  The mother felt that a brace was insufficient and he should be in full plaster again. The mother said that she relocated his knee twice on the Sunday, presumably 29th March. The mother further said he fell in the wind four days earlier.  X's leg was x-rayed; the patella was sitting in place.

 

242         He was brought back to A&E on 3rd April when the back slab was described as loose, and plaster of Paris was then re-applied.

 

243         X had two more visits in respect of his leg, one to his GP and another one to A&E, on 15th April.  On 16th April he was admitted overnight.  His behaviour was described as odd when his cast was replaced. He was agitated and frightened.  He said to his mother:  "You are lying to me, mum when you said my hypermobility was severe".

 

244         On a ward round on 17th April, the mother reported that his right knee had dislocated more than 50 times.

 

245         On 21st April X apparently suffered a fall from his wheelchair in the Finchley Golf Club.  The wheelchair went over a bump, X fell back and the wheelchair fell on him.  He was described, on admission, as claustrophobic, ADHD,  prone to panic attacks and, query, with autoimmune disorder. 

 

246         Mum thought that he had re-dislocated his right knee which was in the cast, and also dislocated his left knee when he fell from his wheelchair.  There were no clinical signs for either. The x-ray of both legs was normal, and there was mild swelling of the left knee only.

 

247         To say that X had an eventful three weeks would be an understatement. I find it surprising that when he gave Mrs. M his account he did not mention a fall from a wheelchair; I would have thought it a memorable event.

 

248         I examine his allegations vis-à-vis the mother’s modus operandi in years past.

 

249         The mother was able to persuade Mr. A, Orthopaedic Surgeon, to extend the plaster on Y's leg in July 2014 on the basis of a lie about a previous dislocation. I am satisfied that the mother was unhappy about X’s back slab applied on 1st April and wanted plaster cast.  I would not put it beyond her to be insistent about it.

 

250         Lying to doctors is very much part and parcel of the mother's behaviour.  She said on 17th April that X had 50 dislocations by then.

 

251         It was clear to me that the mother discussed surgery at some stage (see note of 20th April) although there is no mention of it in the notes of that time.  It is equally likely that X could have been fearful of having yet another medical procedure.

 

252         I accept that it is unlikely that any doctor would have told X not to tell the mother that he had told the doctor what she did to him.

 

253         Paragraphs (d) to (j) in para 32 above depend, of course, on the veracity of the mother (and later of the father). The dog clearly bit Y's bottom.  It is quite possible that the mother exposed Y's bottom in the park when she got her to squat to urinate.

 

254         I have found the following persuasive:

 

(i)      X’s evident fear when discussing with Mrs. M about him locking himself away and not giving anybody other that his father and Y a code to get into the room.

 

(ii)     X's distress as described by Mrs. M.  She believed him and considered his crying genuine.

 

(iii)    The timing of the account: on the last day of him being in the school, remembering that mother said to him if he caused her trouble at school, she would take his Lego away.

 

(iv)    It is possible that X was trying to protect himself from the mother by locking himself in the garden. 

 

(v)     It is possible that Y threw soaps from the window, although I accept that she said nothing when spoken to (and not properly interviewed).  It is sufficiently bizarre to be true.

         

255         I am invited not to ask myself why X would have made these allegations if they were untrue.

 

256         I have considered the evidence very carefully.  In my judgment, X's account is extremely worrying.

 

257         This was not the first time that X alleged that his mother has hurt him.  I have referred before to him giving account of his mouth being stuffed with potatoes, his finger being shut in the door to make it bleed. He also said that (I believe once) when he sat on the naughty step his mother slapped his face.

 

258         Having taken into account all the submissions on behalf of the mother I, nevertheless, find that during the week of the 23rd to 30th April the mother hurt X.  X's fear, as observed by Mrs. M was, in my judgment, real.  I accept that he was laughing when he spoke to the police officer, and accept he said he wished to go home.  In my judgment, it is just possible that he thought that now he has told he would be safe.  Indeed, he said to Y that she did not have to lie anymore.

 

259         X returned to the police station with his mother and maternal grandmother on the 7th May.  The mother has been back at home after 1st May.  X's retraction and account of events, which he gave on 7th May, does not cause me to change my finding.  It is clear that he had been at home with his mother and father and may well have been influenced to retract his allegations and make up allegations about Mrs. M.

 

260         I have asked myself whether I can find, to the requisite standard of proof, that the mother deliberately popped X's knee and twisted his wrist.  If the knee is less clear (she said she did pop it back on Sunday 29th March twice) the description of what she did to his wrist is striking.  It has the detail of location, time (X was playing with his Lego), sensation (extreme pain) and reaction (scream). I cannot possibly accept an explanation that X made this up because Mrs. M put pressure on him.

 

261         I therefore find that the mother has deliberately twisted X's wrist. I do not find that she deliberately popped his knee out although I do find that she hurt it.  I find, additionally, that the mother has told X to lie.  It was very much what she did, a lot of the time and, in my judgment, she would have shown no compunction in telling him to do the same. In my judgment, for a child of X's age to make up that his mother told him to lie, in the circumstances of this case, would be highly unlikely. 

 

262         Finally, it is notable that X said that the mother has hit him for nothing or something, and that if his dad was around he would go and sit in his removal van in the driveway because he was scared of his mum using her boots on him too.  I found this description persuasive.  X clearly trusted his father, since he was one of the two with the code to the safe room. The fact that the mother's home does not have a driveway does not cause me to doubt the authenticity of X's description.  The father denied that the mother ever hitting the children with or without boots, and told the Officer in the Case that the mother was the best mother in the world.  I have issues with the father's credibility, with which I deal below.

 

263         Finally, it this section, I turn to deal with the evidence of Ms B . She filed one statement, signed on the 26th January, the morning when she gave her evidence. She gave evidence from her recollection. I found her an honest witness.

 

264         During 2011-2012 she was inclusion officer and SENCO for F School. She first became involved with X in 2011, with Y in 2012.

 

265         She attended the professional’s meeting at H nursery on the 6^th June 2011. I am satisfied that she was well aware of the concerns about the mother.

 

266         She next met the family at F School for a pre-admission visit. The mother told her that she was terminally ill, but she was not going to tell the children until they were 12 years old. She did not name the illness though she did say she was in the last stages. For obvious reason, Ms. B found this odd; the children were two and not yet four. I find it exacerbated her concerns about the mother.

 

267         She next saw the family on the 18.6.11, at the school fair. She did not think they recognised her, or indeed saw her.

 

268         She told me about an incident she watched on the 18.6.11, when the family came to the school fair. She said X and the father went off to see some stalls. The mother and Y remained standing in front of her, with their backs to her. Y was standing quietly. She saw the mother pick up Y's left wrist, put her thumb and fingers around it and squeeze very hard. She realized the mother was doing this since she actually saw the fingers tighten around the wrist. Y started crying. The father and X then returned, and the mother said to the father "take her, she's playing up".

 

269         Ms. B told me that she was totally shocked, but said nothing to them at the time. She did not want to damage her relationship with the family. She did record this in the school records and reiterated it at meetings. When she gave evidence about it, she said that the image was as live in her memory today as it was on the 18.6.11. She had absolutely no doubt about what she saw.

 

270         The mother denies any such incident. Indeed, she (and the father) do not remember the pre-admission meeting with Ms. B, or any contact with her.

 

271         In submissions on behalf of the mother I am invited to treat this evidence with caution. I am invited to consider the physical evidence - namely how Ms. B could have seen the tightening of the grip. I do not have a difficulty with this description. What I found puzzling was that Y did not try to pull her hand away or cry out in immediate pain when the mother tightened her grip.

 

272         I found the explanation for not intervening acceptable. I believe Ms. B when she says she was so shocked she did not know what to do. She has regretted it many times since.

 

273         I make a limited finding about this incident. I am satisfied that Ms. B reported that which she believed she saw, and did not inflate an account. On the other hand, I am satisfied that Ms. B was ready to  give what she believed she saw a negative interpretation.

 

274         I find that the mother did pick up Y's wrist and squeezed it, without Ms. B being able to see or perhaps hear whether anything was said between mother and daughter before the squeezing of the wrist. I accept it hurt Y.

 

275         I accept that the mother said to the father to take Y since she was playing up, although Ms. B did not see Y doing anything untoward.

 

276         However, since Ms. B did not see the front of mother and Y, neither she and consequently nor I have the full picture. I therefore find that although the mother hurt Y’s wrist, I cannot find that she did it maliciously, with gratuitous intention to hurt her.

 

The Mother.

 

277         The mother filed four statements. She also filed a response to threshold.  She gave oral evidence. In the middle of her evidence she suffered an asthma attack, as a result of which she lost her voice.  The remainder of her evidence was given through Miss King as an intermediary.  The mother would whisper her answer and Miss King articulated it for the court.  I am very grateful to the mother's team for the resourcefulness in introducing this system.

 

278         I have read the eloquent submissions prepared on the mother's behalf, indeed, I read them more than once, to ensure that I have not missed anything in considering both the detail and the wider canvas in this case.

 

279         The mother is aged 39.  As I have said, her own medical history is complex, and will require some scrutiny in the second part of these proceedings. She told me, for example, that her HIV virus was contracted when she was 14, when she was  raped on a family holiday in Turkey by a local man. There are references, in her medical notes, to further rapes by a Turkish man (or men), in this country. She said these notes were erroneous. This was not examined in evidence.

 

280         I have dealt with her involvement in the historical fraud.  I do not propose to deal with the evidence, such as it is, about her nephew, D, since I do not think the information is sufficient for me to make a finding.  I do not need to make findings about D to find that the mother is capable of lying, manipulating and persisting with her lies.  

 

281         Some examples of her dishonesty appeared in her statements. In her first statement, she mentioned in passing that she did not make any false applications for housing benefits.  She said that there was some misunderstanding in respect of housing benefit and she is repaying the money now.  This, of course, was a lie.  What she is repaying now is money obtained by fraud in respect of A, housing benefit and income support on the basis of being a single person (whilst claiming she did not realise her husband was working full-time because he worked nights).  RD's  report became available in September 2015.  The mother, then, had to deal with the truth of the events, as she did in her third statement. The fraud, incidentally, appears to have been in the region of some £50,000.

 

282         Another example of the mother's dishonesty is, in my judgment, the reason she gave for removing the children from F School.  She said that both children were unhappy there, that X was insufficiently stimulated and that Y was being bullied.  Nowhere in the extensive records of F School is there any record of Y being bullied (nor was it put to any of the teachers), nor is there a record of the mother demanding additional work for X.  There is a clear record that Y was sad to leave the school.

 

283         I read the assessment of the maternal grandmother, conducted for purposes of possible special guardianship.  It describes a troubled and disturbing childhood of both the mother and her siblings. It has not been examined in the course of this hearing. The mother said that she was unaware of some of the information.  It may be relevant to the second part of this hearing.

 

284         The mother had excellent representation before me. I am, of course, aware that she has to prove nothing.  It has, nevertheless, not escaped my attention that, despite her very recent evidence that since 2009 she has not spent any night on her own and that the burden of staying with her was divided between members of her family and the father, no member of her family came to testify about the children's problems, especially such problems which were not observed by anybody except the mother.  Having regard to her representation, I did not think it an accidental omission.

 

285         Furthermore, the mother has made many references to her own mother, who was, apparently, a SENCO, and advised the mother about, inter alia, X's ADHD and Y's special needs.  The maternal grandmother lives in close proximity and is closely involved with the children.

 

286         I have not put any significant weight on the absence of witnesses on behalf of the mother. I mention this as an observation.

 

287         I have dealt with substantial parts of the mother's evidence in other parts of this judgment.  I have made clear that I do not regard her as a reliable witness and that when her evidence conflicts with others, I prefer their evidence to hers.  I do not accept the submission that the mother acted as an over anxious parent, who herself experienced allergies and asthma, and therefore may have overreacted at times.  As   Dr Ward opined, and cross-examination of the mother proved, there was systematic exaggeration and fabrication of symptoms at least in respect of X’s allergies, Y's epilepsy and her asthma. I do not think it a co-incidence that X’s symptoms in respect of asthma and ADHD abated when his dislocations and subluxations started.  In my judgment, the mother had a new cause to use to satisfy her apparent need to present him as a disabled child.  Y's asthma and epilepsy abated after December 2014, when she achieved the highest rate of DLA for both components.

 

288         The explanation for the mother's "inaccuracies" in the DLA applications are worth a mention.  It is submitted on her behalf that in oral evidence the mother gave quite a detailed account of her own difficulties over the years, and the impact that these have had not only on her ability to cope with the challenges which X's and Y's health have posed for her, but also upon her perception of their difficulties, with a tendency to see things in a bleaker light than with hindsight they merited.  The mother told me that, overall, she did not believe she had been untruthful in relation to, in particular, the second DLA claim for Y as she (the mother) had tried to set out what she genuinely felt Y's difficulties to be. 

 

289         In my judgment, the mother's approach to the DLA applications needs looking at for two reasons.  First, to fully understand the extent of the mother's lies and, secondly, because it is her evidence that the father read over her applications and checked them, and also checked her letter of 1st June 2014.

 

290         Mother's applications for DLA, Special Educational Need provisions, registration of both children as disabled, and application for charity money on the strength of their disabilities, is the clearest, most direct, demonstration of her fabrication and exaggeration of the children's conditions.  She is unable to deny it and say that somebody else mis-recorded what she said.  I deal separately with the mother's evidence about the father's participation in this process.

 

291         It is not possible, nor, in my judgment, is it necessary for the purposes of this judgment to go through all the applications the mother made.  The chronology is at appendix 6. It is important to look at the dates of the applications and set them against things happening to the children on the ground around the same time.

 

292         I am satisfied that throughout the early applications for the children the mother must have exaggerated symptoms and diagnoses. The first application in respect of Y was submitted, as far as I am aware, on 20th May 2010, when Y was about 14 months old.  I am not sure when she first applied for DLA for X, but it is clear that by 16th March 2011 she sought to appeal the award he was granted.

 

293         Although no evidence was given about this, I take judicial notice of the structure of DLA for children. The two components are care and mobility.  Under the care component the rate the child gets depends on the level of looking after they need, for example, the lowest rate would be help for some of the day or night, the middle rate would be frequent help or constant supervision during the day, supervision at night or someone to help while they are on dialysis.  The highest rate would be help or supervision both through day and night, or that they are terminally ill.

 

294         In the mobility component, the rate the child gets depends on the level of help they need getting about, for example, the lowest rate would be: can they can walk but need help and or supervision when outdoors?  The highest rate is when they cannot walk, or are virtually unable to walk, can only walk a short distance without severe discomfort, could become very ill if they tried to walk or they are blind, or severely sight impaired.

 

295         The mother's aim was throughout to get the highest rate for both children, for both their care and mobility elements.  To achieve this, she had to present both children as seriously disabled. This, in my judgment, she did throughout their lives.

 

296         I take the view that it is sufficient for my purposes to deal with applications from 2013 to 2015.

 

297         I start with the application for Y in August 2013. Y was four and a half years old.

 

298         Before I deal with the application, I remind myself of the review before Dr F on 8th March 2013.  The main concerns were motor disorder attributable to premature birth, severe squint and associated perceptual difficulties, asthma and eczema.  Medication was Ventolin and Becotide inhalers for asthma and melatonin for Y's sleep.

 

299         Dr  F reported Y as being shy at first, but engaged beautifully during the session.  She was seen operating her mother's telephone to play a game.  She was walking well (in tights without shoes), and keen to demonstrate her skill at jumping and rolling on the mat. She still needs some prompting to sit up on her chair.  She was chatty and using good sentences, for example:  "I am making something else - it’s a surprise".  She counted to 20, named nine out of ten colours, and had other linguistic age appropriate skills. Her eye/hand co-ordination showed immaturity in holding her crayon, and she struggled in the direction of her stroke.  She worked at a two-and-a-half-year-old level at this task. She managed, however, to perform reasonably well on the Griffith Developmental Assessment Scales.

 

300         Dr F's assessment of her was that, overall, she seemed to be making excellent developmental progress. She did show some immaturity in attention control.  Her eye/hand skills are less advanced than her language. Importantly, there has been no mention of visual or auditory impairment, nor of seizures or epilepsy, although I am, of course, aware that the mother continued to persist that Y was tested for all three.

 

301         I turn to the mother's application, some five months after the review by Dr F.  Under "Statement of someone who knows the child" (a standard part of the form), the child minder wrote that Y has visual impairment, dyspraxia, learning disabilities, asthma and epilepsy. I do not think that the child minder came to these conclusions without the mother's assistance.

 

302         I do not intend to go through all the information on the form.  I am satisfied that the mother described Y as a disabled child, suffering from syndromes and conditions with which she was never diagnosed.  I give a few examples: Y, apparently, had dyspraxia. She would talk to strangers and tell them everything about herself.  Later in the same form, but under a different heading, the mother said that Y cannot communicate with somebody she does not know. She cannot speak clearly in sentences, but could put together simple words. She can walk but finds it hard to co-ordinate all her muscles at one go and she is visually impaired.  She needs to go up and down one step at a time, and needs help to go upstairs, go downstairs, move around safely, and get in and out of a chair.  She needs a large print book and can follow the television only if it has very big pictures (contrast this with Y playing happily on her mother's telephone).  The mother maintained that she needs to check whether Y was ever certified blind or partially sighted.  She said Y cannot recognise faces across a room, or across a street.

 

303         The pièce de résistance on this form is the mother's description of Y's seizures. She wrote that Y was being checked for epileptic fits and absences, knowing only too well that Dr R has said throughout that whatever Y may have (something which only the mother reported) it is not epilepsy.  She goes on to say that the fits have no warning, that Y had a serious injury in the past six months as a result of a fit (concussion) and had blackouts, fits and seizures. According to this form, Y had 120 fits a month.  She loses consciousness, comes out screaming and wets herself.

 

304         The information about the fits is a lie. Y has never been diagnosed with dyspraxia. The physical limitations are greatly exaggerated.  Remarkably, the mother does not mention Y's asthma in this application.

 

305         On 16th October 2013 Y was refused DLA mobility component.  She was already receiving care component at the highest rate.  Although the mother appealed the original decision, this was not reversed. Y was not classified as unable, or virtually unable, to walk. The mother was notified of this on 14th December 2013.

 

306         In my judgment, the mother started working on increasing Y's mobility component from that time until her final successful application on the 3rd December 2014.

 

307         In February 2014 Y saw Dr F at her annual child development review.  The mother reported that Y has been admitted to hospital on three occasions - Dr F could identify one only - for concerns about abdominal pain and constipation, which resolved without significant intervention.

 

308         Dr F made it clear that there is not strong evidence of any seizure disorder and any anti-epileptic medication is not indicated.

 

309         Dr F reported that Y was friendly and fairly cheeky. She co-operated well, enjoying adult attention, and quite demanding of it.  She was easily distracted and quite impatient.  She had made excellent progress in the last year. Her use of language is satisfactory for her age.  Her eye-hand skills have shown considerable catch-up, although they were still immature for her age, and she may have some persisting perceptual difficulties.  Her immature attention control is also a factor.

 

310         I remind myself of the evidence about Y's mobility from the summer scheme of 2014.

 

311         In June 2014, the mother wrote a letter to appeal Y's previous mobility allowance. The following lies appear therein:

 

                                                  (a)            Y was deprived of oxygen for 4 minutes at birth.

 

(b)    She was delivered at 29 weeks.

 

(c)    She had to return to hospital for two weeks after having been discharged home.

 

(d)    At the age of six months Y was diagnosed with a motor neuron disorder.

 

(e)    She was referred to Finchley Memorial Hospital as it was discovered that she would need a specialist buggy to be getting around due to dyspraxia and pains in her muscles. It was later decided that a small wheelchair was suitable. Y has outgrown her wheelchair and needs a larger one.

 

(f)     Y was investigated in respect of hearing loss.

 

(g)    Y had seizures.

 

(h)    Y was visually impaired, she wears glasses and had very marginal residual difficulty because of her squint.

 

 

312         The mother concludes the letter at TR194, saying that Y was a five and a half year old little girl who suffers with cerebral palsy, motor neuron disorder and dyspraxia.  The dyspraxia affects Y's joints which means she is dependent on her wheelchair when these episodes (painful joints) occur.  These are at least four times a week.

 

313         Despite the mother’s fabrications, the mobility component was not varied.

 

314         The mother then applied for an oral hearing.

 

315         On the 3rd December 2014, both parents attended an oral hearing of the appeal of Y's mobility allowance.  The mother reported that by her fifth birthday she could walk only if she could hold on to a hand and had to wear special knee high boots to straighten her feet, but this did not solve the problem.  She said that Barnet Wheelchair Services had a special wheelchair made for her; it was easier to wheel her than in a buggy.  She said it took two hours to walk to the corner shop.  She complains of joints hurting and pain all the time. She has to be carried. The school call the mother frequently to bring Y's wheelchair in. I pause to say that this was the first time Y’s painful joints were mentioned as a persistent factor. I have not come across it in the medical records.

 

316         The mother further claimed that Y was now diagnosed with mild cerebral palsy.  She had somebody constantly watching her in the playground. She dislocated her knee in 2013 when she went over.

 

317         The mother said that the London Borough of Barnet have arranged an individual education and health care plan for a neurologist. Numerous “chasers” have been provided for a brain scan. She had poor short term memory.  Instructions had to be constantly repeated and kept simple, and there was a 1: 1 teaching assistant with her at all times.  She said that the pain in the joints is three to four days a week in summer, and on at least four out of seven days she wakes up with paints in her joints in winter.  When it is very cold her joints are stiff and the pain increases. Even when she wears socks, tights, gloves Y is still cold.

 

318         The father added that her walking was affected by her brain damage.  She apparently starts and then falls after two seconds.

 

319         The written record and record of the oral evidence indicate that there has not been a significant improvement in Y's walking ability since 2012.  She remained virtually unable to walk. The decision of the Tribunal was that Y was eligible for the mobility component at the highest rate.

 

320         Whilst pursuing her application for the top DLA, in January 2014 the mother registered both children as disabled.

 

321         On 10th March 2014 the mother applied for Y to be statemented.  She claimed that Y suffered from cerebral palsy, visual impairment, dyspraxia, global developmental delay, neurological problems and asthma.

 

322         The school did not support the application.  They informed that they can provide what Y needs on site.

 

323         The mother requested a statutory assessment for Y.  Y was consequently seen by an educational psychologist. He concluded that what provisions were needed could be provided by the school.

 

324         I have already mentioned that the mother applied for financial support from a charity called Family Fund, which assists disabled children.  Ms L refused to write the letter supporting the application on the basis that the children were not disabled.

 

325         In her oral evidence, Ms S described Y as lovely, confident, extrovert, positive girl who enjoys learning and is fully mobile. She is not a girl who needs the highest rate of DLA for both care and mobility.

 

326         I turn to applications in respect of X. The mother applied for DLA for X sometime in 2010/11.  The papers are not in the bundle, but there is an appeal dated 16th March 2011.

 

327         Before I deal with the mother's application on 17th June 2015, I need to deal with a letter she wrote on 1st June 2015.  I remind myself that by then the father was living at her home on a full-time basis.  Although the letter is long, the easiest way to deal with the mother's lies is to reproduce it in its totality. I note, incidentally, that although her spelling and grammar on forms and notes reflect the mother’s dyslexia, this letter, and many others she is alleged to have written, do not. She denied that the father wrote any of the letters, as did he. I cannot, and do not, take this evidence any further. 

 

328         It is difficult to know where to stop in marking the lies in this letter.  As Dr Ward said: this is not the child she has read about in the documents she surveyed:

 

"1st June 2015

 

New Claim for X.

 

Please find below details of X's issues. 

 

Walking:  X takes a long time to walk a short distance due to his asthma, e.g. from a car park to a play session 5 metres (in evidence the mother explained that she did not know how long a meter was).  He will complain that his chest hurts and then he has medication to control this.  X's asthma has become worse and his medication has been increased.  He could have either an anaphylactic shock due to his allergies at any time, which means he needs to be transported quickly to the hospital. This is a complete lie.  By October 2014 the mother attended a meeting where it was made clear that X no longer needs EpiPen and his asthma, insofar as it exists, is controlled.

 

My son, X, also has a health condition, hypermobility syndrome, which makes his bones brittle and susceptible to easy fractures.

 

His health condition got worse in April 2014 and he had numerous bone dislocations, mainly his knee and hips requiring him to be put in plaster of Paris (“POP”) and, in May 2014, ended up with both legs in full plaster casts due to dislocation in both legs.  He was kept in plaster until July 2014.  He was also issued a wheelchair since May 2014 due to his immobility before and after the POP.  From July 2014 onwards, X has been placed into twin knee support splints to help aid recovery of his mobility. 

 

                 X has had several episodes of dislocating his knees since September 2014 and has again been put in POP since March 2015.  X is constantly in pain and requires regular doses of pain killers.  X has permanently been in a wheelchair since March. 2015.

 

X has been issued a 1:1 support teacher at school due to his lack of mobility.

 

Care:  X needs support from his parents when he needs to use the toilet at night, and when he is pain with his joints, and he often calls out for pain relief and medication during the night."

 

          The next line is smudged but it seems that X needs help when he is getting dressed. 

 

"This has impacted greatly on his independence.

 

Eating and drinking:  X has been finding it very difficult with food since he was young.  I believe this is partly related to his allergies and partly to fears of food.

 

Medication:  X does need an inhaler and pain relief at school and at home.  This is given to him regularly.   I have given X his inhaler on regular occasions day and night.

 

Vision:  X now requires glasses to help with his eyesight.  X has been prescribed with glasses at the opticians. 

 

Communication skills:   X needs support with communication at school.  He gets very nervous in group activities at school.  He will not talk much at school but he is quite happy to write his ideas on paper rather than talking when others can hear him.  X used to have a tongue tie, which was operated on last year (it was operated on in 2013).  This made him to have a speech impediment (never documented anywhere).  X gets anxious if his routine gets changed.

 

Sleep:   X does not sleep well at night.  This is partly due to his asthma and partly due to the fact that my kids seem to have some sort of sleep problem.  X's sleeping problems are also due to his joint problems as stated above.

 

Supervision:  X needs more help than a child of the same age as he could easily eat food he does not realise he is allergic to, or pick on warning signs (e.g. lips changing colour).  He would not understand the severity of this and needs constant supervision to pick up on this.  He needs watching at night sometimes for the following reasons, e.g. pain.  X can also be woken up by a sudden bout of diarrhoea and a dirty bed as a result of an allergy attack from something he has eaten in the day time.  As a result of this he has a poor sense of danger, e.g. he will try to touch plug sockets (X was nearly eight years old!!!) or get outside without an adult, we live near a main road.  He therefore needs a greater level of supervision.  He also wakes up frequently at night time, and wakes the whole family.  I have to wake up and supervise X to ensure that he does not touch things, e.g. plug sockets or hot tubs, when everybody else is asleep.  He seems to need less sleep than a child of his age.  I feel it might be in my son's best interest to have an independent medical if this would be possible; it is very difficult to show his needs in words.

 

I await your response."

         

 

329         In the application form itself, the mother enumerated the following: X needs help with all tasks, e.g. personal care when getting around.  He has been out of plaster only for a few days.  He will not stop before crossing a road.  He cannot turn in bed because of his joints.  He gets a lot of pain in his joints.  He cannot wipe himself in the toilet because of his joints. He cannot climb stairs because of his dislocation.  He has problems with his vision, he will not recognise people across the street and needs large print in a book.  He cannot communicate with somebody he does not know, and is anxious talking in a group.  He cannot recognise common dangers, cope with planned changes and cannot cope with unplanned changes of daily routine.  He feels regularly anxious and panicky, does not like things to change, and is impulsive and has tantrums.  He needs help to follow instructions, to play with others, join in play with others and understand other people's behaviour.  He will regularly throw items out of his bed, e.g. a juice bottle, he may try and touch plug sockets, he cries out at night that he has wet himself.  He wets himself day and night.  He feels people are staring at him. He soils his bed regularly.

 

330         From 31st July 2015 X received DLA for help with getting around until 30th July 2017.  He also received the higher rate of disability personal care from 31st July 2015 to 30th July 2017.

 

331         In November 2015 the mother wrote that he can walk short distances but is diagnosed with EDS.

 

332         The mother sent in a new application with Professor G's letter, this was in November 2015.  X, as a result of this, became entitled to a higher rate for help with personal care, because he needs help with bodily functions several times a day at short intervals right through the day and he also needs help with bodily functions more than once at night or once for a prolonged period.  He also needs help with getting around.  He got the lower rate because he needs someone to guide and supervise him when he is walking on routes which are unfamiliar.  This is not the boy described by Ms S, the head of QIS, who described him in her oral evidence as able, bright, working well, jumped out of his wheelchair as soon as he could on his first visit to the school on the 28th April.  He had no difficulty getting around on crutches in June 2015, and no reported difficulties with toileting. 

 

333         In her oral evidence, the mother either denied saying things, or not remembering having said them, or making mistakes, or being over anxious about herself.  I am afraid that I do not believe any of this.  I go as far as finding that on any occasion her evidence conflicts with anybody else's, and on most occasions her evidence conflicts with an existing record, I prefer the other person's evidence, as well as the other record, to hers.  The one exception to this is her evidence about the father.

 

334         In the past, especially around 2011/2012, the mother is recorded to have made statements to people about the father not being involved with the children.  There are references where she is supposed to have said that the father is just a taxi driver, and that Y barely knows him. 

 

335         At the professionals' meeting at H nursery on 6th June 2011 one of the decisions was to check whether the father has PR and try to develop a relationship with him.

 

336         On the 17th June, the day after, Ms M, the Health Visitor, made an appointment to speak to the father, on the 21st June.

 

337         The following day the mother, apparently, in conversation, was adamant that the father did not need a meeting and that he was not interested in the children and did not have PR.  As far as I am aware, the meeting with the father never took place.

 

338         On the 22nd June 2011 the father collected the children.  He had a conversation with Ms V.  He said he was happy with both children's progress in the nursery,  and told  her  what  they  do with  the children at home.  She recorded that it was a brief and positive meeting.  As far as I am aware, there are no records of other meetings between the father and any of the teachers until May 2015.

 

339         At a strategy discussion on 8th March 2012 the social worker said that the father did not want to be involved in social care.  At the same meeting it was noted that the mother became defensive at the thought that the children's centre would build a relationship with the father.  She insisted that she was on her own and was very adamant about this.

 

340         She was cross-examined by Mr Cassidy, on behalf of, the father about her unwillingness to involve him in the children's schooling. I thought that her answers came as a surprise to him. 

 

341         She said she did not remember saying that the father did not want to be involved, and that he did not have PR.  She also said that she did not remember that she said he was but a taxi driver and that Y did not know him. 

 

342         She denied having ticked the box where it said that no correspondence should be sent to the other parent.  Interestingly, on the same document (HCC160) she ticked a box saying that she was not a lone parent.  I am not sure what to make of this, although I am satisfied that the father received at least some correspondence, for example his permission was sought for X to go on a trip on 10th August 2010.  It is clearly his signature on the document giving permission. It may have been given to him by the mother.

 

343         Further, the mother assured me that the father would check the DLA forms she filled in.  He would check if anything was missing, and check the spelling, for example in 2015 on X's form he reminded her to put in the nut allergy; she admitted that she should have told him then (although apparently she told him two to three years earlier) that X no longer had a nut allergy, but she did not, and wrote it in. I believe this part of her evidence.  When cross-examining Ms M, it was put to her that it was the father who wrote “nuts” on the DLA form. The mother corrected this in her evidence in chief, accepting that it was she who wrote it.  She confused herself between who wrote it and who said it.  There was no reason for her to lie about this to me.

 

344         Similarly, she was adamant that the father checked the letter at TR193.  This is the letter which deals with Y's brief health history, which accompanied the 2014 June appeal in respect of Y's mobility element.  Despite the father denying this, the mother was certain that he did.  The letter contains some very clear lies, about Y suffering from motor neurone disorder, dyspraxia and seizures.  She said that he checked some other letters too, and that some other letters were checked by other members of the family.  It depended who was around.

 

345         Overall, she described the father in positive terms. In my judgment, there was no reason for her to lie to me about his involvement in the DLA applications.

 

346         Finally, the mother told me that the father went with her to the Tribunal on 3rd December 2014, not as a driver, as he sought to suggest, but with the intention of being "a 50:50 parent".  Again, the father denied this.  I formed the impression that the mother was becoming somewhat vexed at having all the blame about the fabrications and exaggerations in the DLA claims at her door. I accept her evidence that the father came to the hearing intending to fully participate, although I accept that it was an exception to his usual attendance at events dealing with medical issues.

 

 

 

The Father.

 

347         The father filed five statements and a very short response to the threshold document. The first three dealt with anecdotal issues, and the fourth with aspects of Dr Ward’s report.  I therefore asked him on 26th January (some six days into the hearing) to file a further statement, which he finally did on 29th January (some ten days into the hearing).   By then the mother had given some of her evidence.   His fifth statement is dated 29th January. It is still rather vague. It deals, briefly, with the history of his relationship with the mother. He says that he has stayed sometimes at the mother’s property prior to April 2015. This has happened either when he had come to see the children and it has been more convenient to see the children overnight, or when the mother was admitted to hospital. There is no mention of the fact that he stayed twice a week (which he mentioned in a previous statement) because the mother needed an adult to stay there every night.

 

348         The father is 52.  As I understand it, his marriage to the mother is his first and only one.  He described the birth of his two children in Africa as being a result of two visits in the course of which he got their mother pregnant.  One child is 19, the other 22.  He told me he sends over money and groceries, and visits occasionally.  These children have never been to the United Kingdom; they have never met their half-siblings, Y and X, face to face. 

 

349         The father told me that he was born in Brighton and moved to live in London when he was 13.  He went to business school and is a member of the Association of Business Executives specialising in marketing.  Between 1983 and 1999 he did odd jobs.  He told me he had management jobs since about a year 2000, and from 2005 to 2015 he worked for the witness service at the Magistrates' Court.  In 2015 he started his own removal business.  This has been a difficult for him because he now has to be effectively a full-time carer.

 

350         I dealt with the historical fraud earlier in this judgment.   It is possible that information about the father claiming benefits for three years whilst in full employment is true too.  This was not examined in detail in the course of this hearing and I do not make a finding about it.  Should this be considered important or relevant to the outcome of this case more enquiries can be made in due course.

 

351         I also dealt with the relationship of the parents elsewhere in this judgment.  I accept that it is an opaque subject.   I do not know the truth about how often the father stayed at the family home, but I have no reason to doubt his account in paragraph 10 of his statement. Significantly, there are no medical appointments for the children around the dates he gives. In any event, the situation has now changed and, for the past 10 months, the parents have lived together, occasionally sharing a bedroom. This has not caused either any difficulty.  In my judgment it is an indication of their closeness before 30th April 2015.

 

352         It is, therefore, even more surprising that the father has never raised queries about his children's health.  The father told me that he may have attended three to four medical appointments out of, possibly, 150 over the years.   He told me that the mother reported to him after hospital and GP appointments, showed him letters and that he simply believed her.  He was asked whether he ever had any suspicions about the mother's truthfulness, having regard to her dishonesty in the past, in respect of, for example, her HIV, or A; in so far as historical lies were concerned, he thought that the past was the past and that they had moved on.  Matters such as a phantom pregnancy, the occasional lie about her own health (I am satisfied that she told him she broke her pelvis etc. since he reported it to the school) have never raised in his mind concerns about the mother's mental health.

 

353         In his fourth statement, and having read Dr Ward's report, he conceded that the mother may have exaggerated and fabricated some symptoms of the children's conditions. 

 

354         His demeanour when giving evidence matched, in my judgment, the low key tenor of his written evidence.  Indeed, I considered that in his oral evidence he was less concerned, or at least appeared to be less concerned, than appeared to be the case in his fourth statement.  In my judgment, in his oral evidence he failed to understand the impact on his children of being treated, and especially presented, as disabled.  He also considered that the mother was a loving and, perhaps, over caring mother and minimised the fact that, for years, the children may have received medication they did not need, and were pushed around in wheelchairs when it was not necessary.

 

355         My impression of the father was that he is an intelligent man.  The discrepancy between his apparent apathy to the medical condition of his children and his intelligence puzzled me.  Despite realising that throughout the times the children were with him (25% of their time!) there was never any need to take them to hospital or to a GP, or to a Walk-In Centre (except once to a GP in he thought), he did not consider that the frequency of their medical treatment and the alleged seriousness of their conditions required a more thorough involvement on his part.   The father said that the family would spend a two weeks’ holiday abroad every summer, and holidays in this country too.  Other than a dropped wrist last summer and the Somerset incident in 2012, the children have not manifested in his presence the majority of the symptoms they were manifesting in their mother's care almost week in and week out.    

 

356         Despite the father's denials I accept the mother's evidence about the extent to which he was involved with the DLA applications.  He said that he corrected spelling.  I have not noticed any corrections, but noticed many spelling errors.  I am not sure how good the father's spelling is, but he did not do a very good job on the mother's forms.  I believe the mother that he read at least the letter of 1st June 2014. I also find that his participation in the Tribunal in December 2014 was much more active than he wanted me to believe.  In fact, the evidence about his participation in the Tribunal and, indeed, the transcript of the evidence, came in at the very last minute, almost by accident.  The father, in my judgment, was visibly agitated about it, said he did not intend to go into the room, that he sat there and did not listen, and denied saying that Y falls down every two seconds.  I do not believe him.

 

357         In my judgment, his attitude to the DLA applications is not dissimilar to his approach (or, should I say, modus operandi?) to the historical fraud.  There, too, the mother was the front person, filled in all the forms made all the claims in respect of A, and presented two children as children of the father.   But for records that the father was there at interviews where the mother clearly lied, and did not correct her lies, his involvement would be more difficult to prove. 

 

358         In my judgment, there is sufficient evidence for me to find that the father was aware of the mother's untrue and exaggerated claims in the DLA forms.  In those he colluded with her.  His participation in the Tribunal and his attempts to lie about it caused me serious concern about his credibility. 

 

359         The fact that the father lied about the DLA application does not, of course, mean that he lied about everything else. 

 

360         Having reviewed the evidence, I have come to the conclusion that the father has deliberately kept himself in the shadows, so to speak, in respect of accessing anybody involved with the children.  I have already dealt with his attendance - or lack of it - at medical appointments.  In respect of the school, I cannot say where the truth lies about the mother's alleged comments about him in the years of 2011 and 2012.  However, I do find that in later years, when there have clearly been some issues with the children's schools, he has not made any effort to go to the school and discuss matters with the teachers.  Indeed, when invited he said that he could only attend after 7 pm or on the weekend, knowing very well that that was not a realistic proposition.  Even at the time when Mrs. M was alleged to have put pressure on X on 23rd April 2014, the father did nothing.  The mother told me that she asked him to go to the school but that he did nothing about it. His explanation is that he worked, and therefore did not go. There is no record that he ever attended parents’ evenings, although no specific evidence was heard about this. In my judgment, had he attended, this would have been raised on his behalf.

 

361         There has been minimal cross-examination about this in the course of the hearing.  Sometimes, the wider canvass becomes apparent only in the course of the evidence being assembled.  I, therefore, cannot make a finding that the father has deliberately kept himself away from the front line, where the children were concerned.  I do find, however, that is non-attendance at parents' events (except the fair at F School and parent’s breakfast at Y’s school,  both in 2011) or virtually never speaking to teachers, even though he was a parent who regularly conveyed the children to the school, puzzling.  I remind myself that I am talking about a period of about five years.

 

362         That said, there is evidence, which I accept, that the father has a seemingly close and warm relationship with the children.  I am satisfied that since he moved into the family home, there has been a significant reduction in the children's attendances for medical attention.  The wheelchairs are in the shed (that of the mother's too, apparently), the crutches are in the loft.  X's physiotherapist, Mrs. S, is satisfied with his progress, and I accept the father's evidence that he tries to contain X at times of possible subluxation before he takes him to hospital.  What I cannot assess is what part these proceedings play in the sea change of attitudes in the household. 

 

363         I am concerned about the father's conduct, once the proceedings have commenced, when dealing with medical professionals.  It is my view that, from May of last year, the father understood the concerns the local authority, albeit he may not have had the full picture of the mother's behaviour.  He knew that he should notify the social worker, AMcN, about all medical appointments for the children.   I am satisfied that the disguise of the medical appointment with Professor G was a deliberate lie on the part of both parents.  I do not accept the father's evidence that it was an oversight or an omission. I also find that his account of what happened at the meeting conflicts with Professor G’s account. I do not understand why the father has not informed the social worker in advance of the two attendances at the Royal Free Hospital in October 2015, especially as they were not emergency attendances, or of the forthcoming appointment with Dr R in November. If he can text the social worker after, he can text her before. Not producing Dr L's letter at A&E is a matter of further concern.  I would have thought that, in view of X's history of attendances in hospital in 2014/15, the father would be prepared for all eventualities and carry this letter with him at all times.  I have found his explanation about it unsatisfactory.  This causes me concern about the father's co-operation with the local authority in future.

 

364         Other than not informing the social worker, I do not find that the father's conduct in respect of the appointments in October 2015 to be subject to criticism.  I accept that he may have delayed X's attendance at hospital by trying to deal with his pain at home.   The proximity to the visit to Dr G is no more than a suspicion. 

 

X.

 

365         I deal with two issues relating to findings I need to make about X. These are his hypermobility, and his behavioural difficulties.

 

Hypermobility.

 

366         Dr Hasson is a Consultant Paediatrician and paediatric rheumatologist. His qualifications and experience appear at the beginning of his 2 reports. He is a fellow of the Royal College of Paediatrics and Child Health. He has been a consultant since 1994.His evidence was clear, consistent and without ambiguities. I accept his evidence about X's condition.

 

367         He explained that X's hypermobility is a normal variant in today's society. It is not a syndrome. Whether it is referred to as EDS3 or not, there is no known or mapped gene, unlike EDS 1, 2 or 4. It should not be qualified as mild or severe. Some 30% populations exhibit symptoms associated with hypermobility.

 

368         The correct treatment is physiotherapy and strengthening of core muscles. Immobilisation is the worst possible solution to dislocations and subluxations.

 

369         His very clear view was that none of the presentations of X between May

2014 to October of 2015 could be regarded as unnecessary. They all had symptoms that he would expect to see on presentation by an anxious parent of a child in pain.  He considered that medical professionals have conducted their own examinations rather than relying solely on what has been reported.

 

370         Even when it has become clear to him that some evidence about X's other condition may be have been exaggerated or fabricated, he did not change his opinion. He did not think that the mother has referred to or specified symptoms to medical professionals that were fabricated or induced, although he qualified it by saying that he only saw "filtered" medical information from records.

 

371         He did not think that there is evidence to suggest that X somatised symptoms. I note that the Local Authority, rightly in my judgment, no longer pursue this limb of their original findings sought.

 

372         He explained that orthopaedic surgeons approach dislocations and subluxations in a totally different manner to rheumatologists. With a child presenting in pain, with a history of dislocation or subluxation of a knee, A&E doctors, as well as orthopaedic consultant surgeons, would immobilise the leg. Some of this would, of course, depend on the history given. Dr Hasson agreed that there is no evidence of X having pulled elbows as a child, even though the mother reported this to him and to Professor G. Nor is it recorded that he had hip problems as a child.

 

373         That said, Dr Hasson did not find it odd that problems with X's joints did not start occurring until X was six years old. That too is, according to him, a normal variant.

 

374         As a result of Dr Hasson's evidence, it seems to me that although there are a number of suspicions in respect X’s presentation between April 2014 and July 2015, the local Authority cannot prove at the requisite standard of proof that the mother fabricated X’s dislocation/subluxations, as was suggested in the opening statement.

 

375         I accept that the frequency of his dislocations/subluxations between 1^st May 2014 and 5^th July 2015 is suspicious; I have counted 15, 16 if the dropped wrist in Florida is included. The description of him being allowed on a trampoline and then left unsupervised, with two legs in plaster cast, is suspicious and alarming.  The history given to some of the orthopaedic surgeons is untrue, and indicates that the mother exaggerated past symptoms. The proximity of the attendances at A&E in October 2015 to the unauthorised appointment with Professor G is suspicious. And all problems (other the 2^nd October 2015 shoulder dislocations/subluxations) abating since July of last year, when these proceedings were commenced, is also suspicious.

 

376         Suspicion is insufficient for findings in the binary system. I cannot make findings about fabrication and exaggeration connected with X’s hypermobility. I also cannot make a finding that X was exposed to x-rays unnecessarily; Dr Hasson said that when presenting with symptoms like X’s, an A&E doctor would not take risks and will x-ray, although a dislocation, let alone a subluxation, very rarely show on x-rays.

 

377         I need to deal, however, with the issue of X’s immobilisation in a wheelchair and whether that was necessary, or inflicted upon him unnecessarily by his mother.

 

378         X was in plaster for two months in 2014 of which six weeks were with both legs in plaster casts. Following that he was restricted in cricket pad splints from 25^th July 2014 against medical advice and placed in a wheelchair again against medical advice [RNOH53-54] until at least early September 2014.  It should be noted that X arrived back at school in September 2014 unexpectedly in a wheelchair with both legs strapped up. Within 2 days of his being in school, the school reported that X was toileting independently, in and out of his chair, playing football with other children at lunchtime FMS285.  This mirrors the description of X by Ms E of the summer play scheme both children attended in August 2014, and Ms S’s description of April 2015.

 

379         Mother was clearly told by the physiotherapist and nursing staff in the RNOH X should not use his cricket pad splints nor his wheelchair save for very long distances.

 

380         However it is clear from the photographs that he is still in the splints at the play scheme in August 2014, and his legs were still strapped up on the 8^th September 2014, on his return to school. Father in his evidence confirmed that X used them whilst on holiday as well as using his wheelchair.

 

381         I accept that the records suggest that X understood that he ought not be in splints, telling his mother on two occasions that he should not wear them.

 

382         The mother's evidence was that it was not she who put them on, but that X, having expressed to her that he should not wear them, did in fact put them on himself. I do not accept her evidence. This young boy has been immobilised for weeks; much as he tried to do with his splints on when given the opportunity, he was nevertheless unable to enjoy the freedom his friends did. In any event, X reported to the nursing staff that his mother put them on. 

 

383         I find that mother deliberately replaced X’s cricket pad splints against medical advice and kept X in a wheelchair when he did not require it. She did little to mobilise her son. I accept the submission that it is likely that there is a connection between the immobilisation and presenting X as disabled for the purposes of the DLA application.

 

384         It seems to me that the physiotherapy regime, which I accept is not easy to maintain with an eight-year-old boy, did not start properly until the father started attending Mrs S. It is clear that the immobilisation weakened X's core muscles. I also accept that to have kept him in a wheelchair for so long must have caused him upset and emotional harm. I do, however, accept that X does not now dwell on the time he was immobilised.  I take this from the Guardian’s last conversation with him, in January of this year.

 

ADHD.

 

385         The mother now accepts that X does not, and never did have ADHD. I find that she reported it systematically, for years, to medical staff and his teachers. At times, she is recorded as reporting that he was received medication for this.

 

386         The mother now accepts that X's behavioural issues, noticed by her but not others when X was at nursery, were to do with her parenting rather than with an inherent problem with X.

 

387         Whereas the mother reported X as being aggressive and physically violent to Y and to her, H nursery did not notice such behaviour.

 

388         I accept that it is likely that X was affected by his mother's absences, both at the time of Y's birth, and those due to her own medical issues. I accept the evidence from the schools that the mother freely discussed her health issues, true and untrue, in front of X, but I cannot decide how this affected X as opposed to his upset for his mother’s absences.

 

389         CAMHS records from the relevant period (2009-2011) suggest that the mother needed help with her parenting, but did not always make herself available for meetings. There are a number of letters indication missed appointments. They made it clear in 2011 that X was too young for an ADHD assessment, not least since medical intervention (Ritalin) would be contra-indicated at this age.

 

390         In March 2009, there was a positive report about the mother’s engagement with the service, about her being able to utilise advice and about X improving, his aggressive behaviour reducing and his sleep and feeding improving.

 

391         By April of 2012, when Dr L referred the mother to the Tavistock, it has become apparent both the worker at the Tavistock and Dr L that there were discrepancies between the mother’s reports and observations at the children’s schools.

 

392         The Tavistock, after some investigation and very limited work, discontinued their involvement with the family.

 

393         Other than finding that the mother fabricated a diagnosis of ADHD, I do not propose to make findings about the reasons for X's difficulties. I know that the Mother had sessions with KM in 2012, but the evidence has not been examined in sufficient detail since  Ms M was not available to attend court.

 

Y.

 

394         I deal with three issues relating to findings I need to make about Y. They are, in turn, epilepsy, immobilisation and enuresis.

 

Epilepsy.

 

395         I am satisfied that the mother has fabricated evidence about Y’s epilepsy, as a result of which Y had unnecessary EEGs, hospital attendances and unnecessary anti-epileptic medication.

 

396         The account of the evolution of Y's alleged diagnosis for epilepsy is yet another example of her ability to lie, manipulate and expose her child to unnecessary medical intervention.

 

397         The mother claimed that Y had epilepsy on, inter alia, the applications for DLA, on the application for registering her as disabled, and on many admissions to hospital.  The truth is Y has never been diagnosed with epilepsy; the only people who have seen her to have "absences" were her father (on three occasions in the past nine months) and her mother, who has seen seizures, fits, jerking movements, all lasting up to five minutes.  There is a vague account in Dr R’s last report of a technician who observed Y at her last MRI; it is far from clear that the 5 second episodes are real absences. Despite being ask to video a seizure, and despite the seizures lasting for up to three or five minutes, this was never done.

 

398         The first time there was any mention of absences was in July 2010, although the mention of seizures is missing from the mother's first DLA application made on 20th May 2010.  The description given to Dr F was that Y stares and is unresponsive; these last two to three minutes, after which she looks puzzled and screams.  Dr F said that she thought Y needed more investigation especially in relation to her "unresponsive" episodes, which could be seizures.  I am satisfied that Dr F relied on the mother's description.

 

399         As a result of Dr F's concerns, Y had an MRI scan under sedation and an EEG.

 

400         By 11^th March 2011, Dr R, a Neurologist from GOSH, who is involved with Y to date, wrote to Dr F, explaining the difficulties Y may have associated with the injury to the white matter of her brain.  He explained that there may be cerebral palsy.  There may also be associated delay in speech and learning.  He mentioned reported occasional blank episodes with shivering movements.  However, following the MRI, he has not arranged a routine follow-up, and suggested that he would see Y if there were new concerns.

 

401         In cross-examination, Miss Markham concentrated on the new concerns reported by the mother. From that time, the Mother was presenting Y as a child with seizures.  She agreed in cross-examination that she was never told by any doctor that Y had epilepsy; she said she presumed she did.

 

402         When the mother went to see Dr F at Y's child development clinic on 6th January 2012, she did not mention any concerns about vacant staring.

 

403         Two months later the mother wanted Y to be re-referred to Dr R, who had said in March 2011 that this will not be necessary unless there were new concerns.  The mother reported to Dr H that Y was having absences occurring more frequently (not having mentioned any two months earlier to Dr F), lasting about five minutes and that Y shakes occasionally with it. She has had, apparently, eight episodes since January.

 

404         On 28th May 2012, Y was seen at Barnet Hospital by Dr A, a Specialist Paediatric Registrar.  The mother told her that Y had been investigated for a possible seizure disorder at GOSH but, because the family moved, letters of appointment were lost, and GOSH discharged the mother for non-attendance. That was untrue.

 

405         She indicated to Dr A (GP155) that the GP monitored the absences, which "can occur 3 to 4 times a day, although for periods of weeks sometimes there aren't any".  They last three seconds (I wondered whether this is mis-recorded and should be minutes) and have persisted since early age.  There were no noticeable triggers, but were followed by an episode of screaming.

 

406         She said that last year (2011) there were episodes of breath holding; this year, last couple of months, progression of absences were more prolonged and now associated with jolting arms, legs and head.

 

407         I pause to say that Y has been attending H nursery since September 2011. Nobody at H nursery observed anything like this.  Indeed, nobody anywhere, not H nursery, not F School, and not QIS, not at any after school clubs or summer schemes, has ever seen anything the mother described.

 

408         The mother told Dr A on the same occasion that there have been two recent occasions when Y suffered these episodes.  The first occurred when the family were on holiday in Somerset.  The episode lasted five minutes during which Y was vacant, had jolting movements of her arms, legs and head and was unresponsive.  The family (father was there) called two first aiders over and they called 999, which arranged for an ambulance to arrive.  The ambulance, apparently, arrived "before it stopped".  Y was taken to A&E, observed for a couple of hours and discharged.  

 

409         The second episode occurred a couple of days later, when Y was in bed seemingly asleep.  The mother says she went to check on her and described the same as in Somerset, exactly the same but lasted three minutes; both episodes being followed by a screaming fit.  Y was disorientated, not initially responsive to her name and the situation resolved after 15-20 minutes.

 

410         The Consultant Paediatrician Dr A, who had not seen the mother before, perhaps not surprisingly considered with the mother a seizure disorder; the mother apparently was not surprised to hear the news.  The Consultant re-referred her to Dr R at GOSH.  The mother, in my judgment, achieved her aim.

 

411         On 22nd August 2012, Dr R refused to arrange a routine follow up.  He said that since the episodes did not seem to be very frequent, he would not recommend further investigations at the moment.  The mother claims not to have seen this letter.  I do not believe her.

 

412         In September 2012, the mother was seen by Dr H, her GP.  The mother was very worried about seizures - three in last month.  She felt that she has not been listened to by the Specialists at Barnet.  It was put to her in cross-examination that she was pressing for a re-referral to GOSH; although she denied it, I accept it.

 

413         Dr H  was sufficiently concerned at the mother's description and given history, that she did re-refer her to Dr R.  So the mother went to see Dr R again on the 14th March 2013.  By then Y was four years and two months old, described by Dr R as: 'very bright, alert and talkative'.  She walked independently.  She spoke in full sentences.  She demonstrated good hand function and co-ordination and did some very good colouring.

 

414         Dr R said that the nature of the episodes was unclear, but some could be seizures. Again, he relied fully on the mother's description.  He proposed to repeat EEG with melatonin (Y had already had an EEG in 2010).  He did not recommend any medication, but mentioned that if episodes become more frequent he would consider trial medication with sodium valproate.  He would be happy to discuss medication with the mother.

 

415         By the end of March Y had a further EEG, put to sleep under melatonin.

 

416         In her application for enhanced DLA, in August 2013, the mother wrote that Y was being checked for epileptic fits and absences.  She mentioned that the epileptic fits and absences have no warning, that Y had a serious injury in past six months due to a fit (concussion), displayed dangerous behaviour after a fit, a blackout or a seizure and had these episodes 15 days every month, four fits a day and three fits a night over 20 nights a month.  That, in my calculation, is some 120 seizures/absences a month. Though there had been 60 episodes during the day, no one except the mother, including at the breakfast club, F School, afterschool club or her father, had seen any of this.

 

417         When cross-examined she said that blanking and fits means the same to her. She was reminded that she described 'blanking' as staring, and 'fits' as accompanied by jerking movements and stiffening body. She did not seem to remember this or recognise the difference.

 

418         On 25th September 2013 the mother took Y to A&E at the Royal Free Hospital.  The history taken on admission records was that the mother said Y had a fever and four seizures a day in the past four days.  Today (the 25^th September) seizures were lasting longer; she is being investigated for seizures at GOSH.  Later, it is recorded that normally she has one fit a month but there has been an escalation to four fits today with one lasting as long as five minutes.  During the same admission, Y was seen at night at 00.15 on 26^th September 2013.  The mother reported that she had three seizures whilst in hospital. She reported that Y bit her lip - nobody had seen this, only the mother.  In evidence the mother said Y did bite her lip once, but she could not remember when. Biting of a lip is a classic symptom of epilepsy.

 

419         It appears from the discharge note and the discharge letter (GP197) that the Paediatric Registrar, Dr G, discussed the case with Dr R, who confirmed that no sodium valproate has been given because seizures were not confirmed.  Future management was to be an urgent appointment with Dr R at GOSH.  It seems also clear that in reliance on mother's history (although no seizures were observed on the ward overnight), when Dr G discharged Y he prescribed sodium valproate "as per GOSH plan from last clinic letter".  Although this appears somewhat cryptic, this may well refer to the discussion Dr G had with Dr R.  The prescription was for three to four days, and another one for when she had a fit.

 

420         On 28th October 2013 Y was re-admitted to the Royal Free  Hospital.  She was collected by ambulance, having had two alleged seizures at the swimming pool. Nobody from the swimming centre produced evidence for this hearing of Y having had a seizure.  The mother told the ambulance crew that Y was under epilepsy management and that she was seen at the Royal Free Hospital four weeks earlier.  She gave them history of one seizure in the pool and one later in the changing room. She said that Y vomited 4 times.

 

421    When collected by the LAS, the mother told them that Y was on sodium valproate (RF963).  When Y was admitted, the mother confirmed that Y was on sodium valproate (RF856).  When seen on the ward, she informed the medic who saw her that she has now ran out of sodium valproate.

 

422         At this admission, she is recorded to have said to a nurse at the Royal Free Hospital that Y had an EEG four months ago and an EEG one month ago, the second of which was at Barnet which confirmed seizures.  She did not have 2 EEG’s within the past 4 months; none of her EEGs confirmed seizures.

 

423         The admission note records the mother's history as Y having three to four minute tonic-clonic seizures, about one minute apart, unconscious in between, incontinent and vomiting past fit.  The clinician’s comments are that Y is a known epileptic, awaiting information from GOSH. 

 

424         At GP208 the record of her stay at the Royal Free Hospital states that she has clearly been well throughout her admission, afebrile, without any paroxysmal events since admission. Mother was strongly advised to video any further paroxysmal episodes.

 

425         It is worth perhaps mentioning that when giving her medical history on admission, the mother reported cerebral palsy, epilepsy, asthma, eczema, dyspraxia, visual impairment, platelet problems and learning difficulties.  In cross-examination the mother admitted in that dyspraxia and epilepsy were untrue.  Platelet problems have never been mentioned anywhere else as far as I am aware; she did not remember mentioning them.

 

426         Mother denied that she ever administered sodium valproate to Y; I do not believe her.  In my judgment, the above train of events which includes references from a number of sources, including that mother has run out of the drug, proves, at least to the requisite standard of proof, that based on the mother's modus operandi  and history giving, sodium valproate was prescribed and given. This was against the express advice of Dr R.

 

427         On 21st November 2013 the mother attended Dr R's clinic again, having been referred there after the alleged seizures at the swimming pool.

 

428         The EEG, which Dr R examined, referred to some changes but they were not clearly epileptiform and there was no direct evidence of seizure activity.

 

429         Mother reported to him that Y had blank episodes lasting up to 10 minutes, typically one or two per day.  At that time, Y would not respond to anything and then scream.

 

430         She also reported limb jerking episodes two to three times per week, but said that since 28th October there was only one, when Y fell downstairs and landed on mother's ankle which was now sprained.

 

431         There was no strong evidence that the phenomena were epileptic. Dr R reported that he would not recommend starting anti-epileptic medication.

 

432         The mother never informed the DLA that there was no longer a diagnosis of epilepsy and, indeed, that in October 2014, there was no longer a diagnosis of asthma.

 

433         At the review in 2014, the mother reported a much reduced occurrence of seizures, but still absences and once or twice per week, lasting up to 4-5 minutes. There were still no photographs or videos of limb jerking. The mother said she never took videos since she was too concerned to look after Y. Nobody else, of all those who stayed with her night in night out, took a video either.

 

434         The parents took Y to see Dr R again on 3^rd December 2015. In his letter to the Local Authority solicitor, dated 26^th January 2016, he explained the reasons why he continues his annual reviews. Vacant episodes continue to be reported by the parents. Due to her longstanding abnormalities as discovered on her MRI brain scan in 2011, she may be at a slightly increased risk of seizures.  In the past, she was returned to his clinic because of reports of unresponsive episodes with shaking limbs. He clarified that there was never a diagnosis of epilepsy, and that all things remaining equal, he will discharge Y from his clinic at the next review.

 

Wheelchair.

 

435         By way of pre-amble in respect of Y, I remind myself that Dr F saw her for a review on 6th January 2012; Y was just 3.  Dr F's report summarises Y's locomotor skills as:

 

          "…has been advised to wear supportive footwear.  Her feet have, nevertheless, a tendency to turn in, especially the left.  She still cannot manage to walk long distances, but she can run a little, and can manage the stairs although she needs supervision and prompting."

 

436         On 21st February 2012 the mother arrived at school with Y in a wheelchair. In evidence, she told me that she wanted a new buggy for Y, but was told that a buggy for a three-year old was cumbersome and was offered a wheelchair in lieu. I do not believe her.  She was asked in cross-examination, on behalf of the guardian, why, with all the money she was receiving from DLA she did not buy Y a buggy if the NHS buggy was too cumbersome.   She had no answer to that.

 

437         She told staff at the school that Y was referred for a wheelchair by the physiotherapist and the occupational therapist.  Both denied this. On the 8th March the mother told the school that Y will need a big hip operation.  This is not mentioned in any of the medical notes.

 

438         The mother told me in oral evidence that she used the wheelchair for Y on and off, when they were out.  I formed the impression that she used it as she would a buggy.  She said she stopped in January 2013, but had to use it again in July 2013.

 

439         It is of note that, even having been advised time and time again that Y did not require a wheelchair, that the letter from Dr R, a Consultant Orthopaedic  Surgeon, recorded that Y uses a wheelchair most months on and off.

 

440         On 7th July 2014 Y presented at Barnet General Hospital with her mother who gave a history of "dislocated left patella medially this am, swinging off a chair and chair collapsed at school mother relocated patella", with a relevant history of cerebral palsy, hypermobility and epilepsy.

 

441         A note taken at the school by M says this:

 

"I was pushing X (in a wheelchair) on the way to school, Y fell, went to weekend school, they called me to say that her knee was swollen.  I took her to Barnet, she was x-rayed and it's her Cerebral Palsy kicked in.   She has got a broken knee, they put it in a cast, her other knee is swollen.  Stanmore (hospital) phoned they are going to see her today to look at her bones for her CP. This may mean now that she may always be in a wheelchair. X is having an operation on his leg next week."

 

There is no record of Y in the notes of Stanmore Orthopaedic Hospital.

 

442         The record from Barnet Hospital states that Y may well have had a fall at Sunday school, but there was no dislocation and Y had no need for a plaster cast. Further when being seen on 14 July in clinic mother lied to Mr. A in order to prolong an application of the plaster cast:

 

"Mum very keen that she goes back into a back slab for another week or so as this was similar to an episode three months ago when she was taken out of the back slab and into a tubigrip and dislocated straightaway."

 

There is no record of an episode like this three month ago or, indeed, at any time before 7th July.

 

443         Further in September 2014, when in clinic with Dr R, mother suggested that there had been further dislocations since July: "This may have happened twice since" when there is no evidence of this at all.

 

444         Further, and somewhat remarkably, the mother and father allowed the DLA tribunal to be misled into thinking that Y had been treated in a plaster cast for a dislocation in December 2013, with the mother being recorded as telling the Panel that around Christmas/December 2013 Y went over and dislocated her knee. The record says “the plaster bone was very weak, had to go into wheelchair”. This probably means that the plaster bone was applied for a week and she had to go into a wheelchair.  She should have someone constantly watching her in the playground, she was trying not to use wheelchair so can exercise and strengthen her bones/muscles.

 

445         I find that Y never needed to use a wheelchair. I have dealt with the events of the summer scheme below. I am satisfied that the mother immobilised Y and placed her in a wheelchair to achieve her own aims.

 

Enuresis.

 

446         The issue of Y’s enuresis is puzzling and troubling. I have not been able to find that there was, or is, a deliberate attempt to sabotage Y’s attempt to become dry. Having regard to recent evidence, it seems to me that Y’s enuresis is not just a physical issue.  The father has been involved with issues of her wetting since he moved into the family home, and more closely since December 2015, when the mother was forbidden to come into the school.

 

447         There is a long history to the attempts to help Y to get to the toilet on time. I am satisfied that both F School and QIS have employed techniques and introduced system to help Y.

 

448         I am also satisfied that there have been periods when Y’s day enuresis has been less problematic than in 2015. I was told by the parents, who also told the Guardian in January, that the problem is abating and that Y has some days without accidents.

 

449         Dr Ward said that as Y is a little girl with developmental delay and a history of cerebral palsy, she may not be as reliable about continence as other children. Although she added that wetting at times of leaving school is not an unusual pattern for a child, this was contingent on a child feeling constrained from going to the toilet at school. This is not a case at QIS.

 

450         As I say, I am aware that attempts have been made at F School to introduce charts and stickers systems. It seems to me that the problem as reported by the parents escalated in 2015, contrary to evidence from the school.

 

451         I am satisfied that there was a time when a much younger Y was very worried when she wet herself.  Ms C told me that Y was wetting constantly (this is at nursery at H nursery, when Y was three). She kept asking Ms C whether she was cross with her and asked her constantly not to tell her mother. I can only surmise that her mother’s reaction was worrying for Y.

 

452         Dr H  and Dr F both have tried to deal with Y’s enuresis. The mother wondered whether some medical intervention would be appropriate. Y was referred to an enuresis clinic.

 

453         It is not clear what history the mother gave then; as to her propensity to exaggerate on this issue too, I have evidence by way of a statement from Dr T, Y's current GP.  He said that the mother told him in 8th October 2015 that at school Y wets herself 4-6 times a day. The mother disputed saying this and maintained that she said 4-6 times a week. Dr T  specifically signed a statement to deal with the numbers and I am satisfied that the mother said 4-6 times a day. It was on that basis that Dr T  contacted Ms M who assured him that these numbers were exaggerated.

 

454         I am satisfied that in April 2014 pads have been introduced. The concern was for Y's self-esteem; the pads came, I assume, to limit change of clothes during the day and other children observing that Y's clothes, or the carpet, were wet.

 

455         The pads have long been discontinued, albeit reintroduced by the parents in December 2015, without advice from Mr H, the nocturnal enuresis nurse to whom Y was referred. Although I am satisfied that the pads the father brought to school were not pads for a little girls’ incontinence, I cannot find that either these pads were actually given to Y or that they were given to her to make her life difficult. The history of the pads, just like so many other in this case, is not straightforward but I do not need to deal with it.

 

456         On the 22nd July 2015 the Guardian visited the children for the first time. Y told her that her mother said she should talk to her about her wetting. When the Guardian sought to reassure her that the wetting will stop, Y said it would not. She emphasised that it never would.

 

457         There are two aspects of Y's enuresis I do deal with. Ms S, head teacher of QIS signed a statement and gave oral evidence before me. She told me that on the 28th April 2015, the day the family came to see the school, the mother did most of the talking, and was particularly vocal when discussing the children’s health needs and the support she felt they needed in the school.

 

458         Ms S went with the family to visit the children’s prospective classes. Whilst talking to Y's teacher, the mother spoke of Y's difficulties in Y’s presence. She said Y could not read or write and needed all her work enlarged to A3 size. (She later found that neither was correct). She also informed the teacher, within the earshot of the other children, that Y wets herself and that she requires a card system in order to help her use the toilet. Ms S considered this conversation highly inappropriate, since it was conducted so publicly in front of Y.

 

459         The mother denied discussing Y's wetting as described. I prefer Ms S’s evidence to hers. This description is totally in keeping with everything else I heard about the mother’s behaviour at the children’s schools.

 

460         On June the 11th 2015, the children were due to go on a trip to the Tower of London. The mother raised serious concerns about Y running away, and also wetting herself. So concerned was Ms. S that she asked the deputy head to provide 1:1 support for Y. There were no issues with her behaviour, nor did she wet herself.  I remind myself that in the course of the Summer play scheme, Y wet herself once in the course of six days.

 

461         Ms. S told me that since the mother has not been allowed in the school (since the first week in December), the conversations with the staff about Y’s wetting have decreased significantly.

 

462         Ms H is a child and support family worker at QIS. She is experienced and possesses the correct qualifications. She signed one statement and presented a log from the school record dealing with Y's toileting between 5^th October 2015  to 9^th December 2015.

 

463         She told me that at school Y wet herself very rarely. Indeed, in the summer term of 2015, she wet herself once. However, since the autumn term of 2015, wetting became a major problem for the parents.  Ms. M told me that there was a considerable and significant discrepancy between the parents' claims and the school's observations.

 

464         As a result of the parents claiming that Y was coming home wet at the end of the day, she began to monitor the situation closely.

 

465         She devised a system whereby Y goes to the toilet every hour. She also has a system of Y giving her a sign (thumbs up) so that she can see there is a problem without her classmates noticing. A sticker reward system was introduced, then stopped and then reintroduced.

 

466         She told me that Y becomes very frustrated with being reminded constantly to go to the toilet. On the 8^th December 2015, Y's class teacher recorded that when asked to go to the toilet Y said: "Why does my mum want me to do this?" When the teacher tried to explain that her mother wanted to be sure she did not wet herself, Y insisted that she never wets herself.

 

467         Another note, of the 5th January of this year, recorded the father collecting Y, who told him she had a good day. Her father said: "Great".  She said: "I didn't wet myself". He replied: "That's because your teachers are helping you". To this Y apparently replied "No…I did it. I asked…"

 

 

468         The school found the discrepancy between the parent’s reporting and what they have observed at school very frustrating.

 

469         I am satisfied that Y’s enuresis goes beyond issues of just bladder control. This is a matter which may have to monitored during the continuation of this case. At this stage, it cannot, in my judgment, form a part of the Local Authority’s threshold.

 

Discussion. 

 

470         Despite the hundreds of pages I have read in this case, despite hearing oral evidence for nearly 3 weeks, and despite the eloquent and detailed submissions on behalf of all the parties, I consider that I am far from having the true picture of this family.

 

471         To be told, after closing submissions, that for the past 5 years the mother has always had another adult sleeping in her home, without this being mentioned once by either parent, neither in the nine statements (between them) nor in oral evidence, makes me wonder what else could be discovered if the right questions were asked. There have been many opportunities for one or other parent to mention it. Considering that one of the strongest arguments in support of the local authority’s case is that the exaggerated and fabricated symptoms only happen at night, on weekends, and/or during school holidays, I would have expected to know that others, apart from the father, are able to support her account.

 

472         Hedley J. said, in 2007, that there is absolutely nothing wrong with unconventional set-ups in families; It follows inexorably from that, that society must be willing to tolerate very diverse standards of parenting, including the eccentric, the barely adequate and the inconsistent. It follows too that children will inevitably have both very different experiences of parenting and very unequal consequences flowing from it. It means that some children will experience disadvantage and harm, while others flourish in atmospheres of loving security and emotional stability. These are the consequences of our fallible humanity and it is not the provenance of the state to spare children all the consequences of defective parenting. In any event, it simply could not be done.

 

473         The unconventional set up of this family does not, in itself, cause me concern. I also accept, and indeed find, that parents who defraud the benefit system do not, without other evidence, cause their children significant harm. They may be breaking the law, but this is not the criminal court.

 

474         I find that both these children have suffered significant physical and emotional harm due to the conduct of their mother. I have dealt with details in the body of the judgment.

 

475         I find that the father, at least, failed to protect them from the harm she has inflicted upon them by exposing them to unnecessary appointments, unnecessary medication, by giving them and others (perhaps including him) the impression that they are significantly more disabled than they are. His view in April 2015 was that the mother was the best mother children could have. Despite her history of untruthfulness, he never questioned her about what would appear to a normal parent bizarre.

 

476         In respect of her, the case can be summarised thus: a rash became an allergy capable of causing anaphylactic shock, an upper tract respiratory infection (a cold) became an asthma attack necessitating ambulance conveyance to A&E, clumsiness became dyspraxia, naughtiness ADHD, tummy ache IBS, a possible short absence epileptic fit and every mention of possibility a confirmed diagnosis. EpiPen, analgesics, sodium valproate, inhalers -  all were administered irrespective of whether they were needed or not. Paramedics and doctors were regularly misled about medical histories, to achieve medical intervention greater than necessary.

 

477         I have re-read the letter from Mr T, of LAS safeguarding, at the beginning of bundle E. The reported 20 ambulance attendances, with the histories the mother gave to the paramedics summarise the concerns in this case in some 5 pages.

 

478         I am satisfied that other than glancing through the mother’s medical notes, I know little about her true state of physical and mental health. I find that she continues to pose a risk to both children; she pursued lies in respect of X as late as November 2015, well into these proceedings.

 

479         The Guardian invited me to deal with the Royal College of Paediatrics and Child Health guidelines. I do not. I believe that a diagnosis of the mother belongs to an adult psychiatrist specializing in FII. In my judgment, one certain element in the mother’s conduct is obtaining financial benefits by lying about the children's disabilities. It is unlikely, as Dr Ward said in her evidence, that this was the only motive in presenting her children as significantly more disabled than they were. Any mother who is prepared to do to her children that which this mother did to hers over a period of many years is unlikely to have done it just for money. It is likely that there are other issues, which need to be teased out, examined, and most importantly, assessed as to whether they are capable of change.

 

480         In my judgment, the situation in respect of the father is more complicated.

 

481         It was only when I came to write this judgment that I realised how little I actually know about him. Whereas there are volumes and volumes of records dealing with the mother, it was not until he gave evidence in chief, that I got some background information about him.

 

482         Although this case is not about money, it could not have escaped anybody’s attention that the mother received DLA and child credit of a minimum of about £1500 a month, tax free, which grossed up would amount to over £20,000 a year; This would not be far from the last salary quoted to me by the father. For the father to say that the parents did not talk about money whilst they were having two holidays a year, one of them foreign, is simply unbelievable. In my judgment, the father’s financial affairs need to be examined more closely, in order to understand what part, if any, the exaggerated and untruthful DLA applications played in him distancing himself from the children’s true medical picture. I regret that these questions have not been raised earlier. This absolutely no criticism of anybody. The importance of this, in my judgment, became apparent only as an afterthought.

 

483         I do accept the following submissions on behalf of the father:

 

i.       H nursery on 17.6.11 described a brief and positive meeting where he was happy with the children’s progress.

 

ii.     F School describe no difficulties at all with father when he brought children to and from school and he was noted to step in while mother was at hospital.

 

iii.  KM on 10.7.12 reported father to be "calm and placid in character and engaged with the children".

 

iv.  The previous social worker noted father to be co-operative and expressed no concerns about him at all. On 26.2.15 she noted good interaction between the father and the children and that Y was very close to her father turning to him for support. The father was noted to say ‘thank you for everything you have done for the family’ and Y followed his lead.

 

v.     Ms. M said of the father and discussions of wetting in her oral evidence ‘The father was always so grateful for the support we have put in. He said you are doing everything you can.  Both Ms. M and the head teacher noted the amount of discussions about Y’s wetting to have decreased markedly since the father alone had been bringing the children to school.

 

vi.  Ms. M also reported in her oral evidence that the father agreed with her in the discussions about Y's homework: 'He agreed with me that it was just children getting used to their routines.'

 

484         I have dealt with other positives in the section about the father.

 

485         I remind myself of X's conversation with Mrs M, where he made it clear that he felt safe with his father (as opposed to his mother) by giving him the code to the room where he would shut himself away.

 

486         I am also satisfied that there is no evidence that the father ever exaggerated symptoms to anybody, although the discovery that he gave X an EpiPen injection on 10^th December 2014 is of concern.

 

487         It is therefore so much more of an enigma as to why this father turned a blind eye to the behaviour of the mother over at least the past 5 years.

 

488         I accept the important (in my view) fact that astounding as it may be, nobody, either from the health sector, or from the school, or from social services, has ever raised with the father the ongoing concerns about the mother. The first time this was discussed with him was after the events of the last week in April 2015. I say astounding, since despite the apparent reticence the mother demonstrated about contact with him, he was easily accessible at the school and through the social worker. I accept that in February 2015, the social worker thought that the case could be closed. I do not think this explains his conduct in the previous 4-5 years.

 

489         I take the view that it is virtually inconceivable that the father did not notice, over a period of years, that all the problems which the mother described to him in respect to visits at hospitals, journeys by ambulance, asthma attacks and anaphylactic shocks, all happened either in the five evenings in the week that he was not staying in the family home, or on those weekends the family did not stay together, which, if I understand the evidence correctly, there weren’t many.

 

490         It is, of course, possible that the father did not notice anything untoward. In that case, I have to ask myself whether he is the right person to care for these children.

 

491         If, on the other hand, he realised that the mother was exaggerating the children's symptoms and reporting to others non-existent facts, and did not stop her, either because he colluded with her about the DLA fraud or because he was reckless about the children’s welfare, then the risk of him caring for the children has to be approached from a different angle.

 

492         Having given this a lot of thought, I cannot actually come to a conclusion about the reasons for the father's failure to protect his children from the harm the mother was causing them. I find he took quite some time, in the witness box, to grasp the harm to Y being wheeled around, completely unnecessarily, in a wheel chair, saying "I can now be myself" when her mother left the area. But even if he did not understand the concept of emotional harm, his total failure to attend any medical appointments with the mother, considering that he did not see seizures, asthma attacks which necessitated ambulance rides to A&E, anaphylactic attacks which necessitated EpiPen injections (the description of the one injection he apparently gave X did not describe a situation where X had serious breathing difficulties), is, in my judgment simply incomprehensible, and very concerning. I find that the father at least failed to protect his children, and I am not convinced that he will be able to protect them in the future, not unless some significant changes take place.

 

493         I will deal with the question of interim orders and interim placement for the children on the 29th February.

 

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