FAMILY DIVISION
LEEDS DISTRICT REGISTRY
Coverdale House 13-15 East Parade Leeds LS1 2BH |
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B e f o r e :
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In the matter of: | ||
Re: K & ORS (Children) |
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Apple Transcription Limited
Suite 104, Kingfisher Business Centre, Burnley Road, Rawtenstall, Lancashire BB4 8ES
Telephone: 0845 604 5642 – Fax: 01706 870838
Counsel for the Mother: MR HAYDEN QC and MS MURDEN
Counsel for the Father: MS COVER and MR PRIESTLEY
Counsel for the Children: MR HAYES
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Crown Copyright ©
"Alec has clearly very significant and complex disabilities. These can be summarised and listed as: (1) global developmental delay; (2) generalised hypertonia; (3) visual impairment due to cortical blindness; (4) epilepsy. I think it reasonable to describe the motor disorder as cerebral palsy, although the further classification of this would be difficult. It is clear that despite very extensive investigations, the underlying cause of Alec's disabilities has not been found. Alec is clearly totally dependent for his needs."
"Alice has severe and complex disabilities. Alice has difficulties with motor skills and it would be appropriate to term this cerebral palsy. Alice also has microcephaly and she has shown evidence of learning difficulties. Alice has a past medical history of epilepsy, although this is currently well controlled. Alice has a degree of visual impairment, although this is not severe."
"Zac has severe and complex disabilities. It is reasonable to describe his motor disability as cerebral palsy. It may be reasonable to describe this as dyskinetic cerebral palsy. Zac has severe global developmental delay. He has visual impairment. He shows plagiocephaly."
"Alec, Alice and Zac have severe and complex neuro-disabilities. Although there are differences in their presentation, they are essentially similar and presented in a very similar fashion. It seems very likely therefore that the causation of these three children's disabilities are the same. It is very likely indeed, given the fact that the three children are from the same parents, that the underlying cause is genetic. However, despite very intensive and extensive investigation, this cause has not been uncovered. However, it is quite likely that at some stage the underlying genetic cause will be uncovered and it is very important that the children continue to see a consultant paediatric neurologist and also clinical geneticist who can make sure that the underlying diagnosis is considered at intervals. I cannot find any evidence that any of the children's difficulties are related to any past history of abuse or neglect."
"I assume this applies to Alec, Alice and Zac K. Clearly without a definite diagnosis of the underlying causation, it would be very difficult indeed to give a prognosis for these children. However, at present it is possible to say that none of the children appear to have life threatening disorders. It is known that children who have cerebral palsy, even relatively severe cerebral palsy, may not have a significantly shortened life-span. This is dependent upon various factors which include any evidence of recurrent chest infections which may become more severe and eventually can become life threatening. So far there is no evidence of this occurring in any of the three children. This may also be dependent upon severe epilepsy which itself can, again, be life threatening. Again, there is no evidence of this in any of the three children. It is important to recognise that whatever the similarities between these three children are, all five children are distinct and different human beings and may each have different potentials and different needs and therefore, in relation to three of them, different care needs."
"Like Dr Morrell, the reporting consultant paediatrician, I do think the burden and practical effects of caring for her disabled children in her particular social and family situation have clearly been cumulative and it is noticeable that it is only over recent years as that burden of care has increased with Alice and then Zac's arrival in the family, that she has developed increasing symptoms of both mental and physical ill health. I see her increasing symptoms of depression and anxiety over recent years as being largely secondary to her situation, and I see her physical symptoms of widespread pain and reduced mobility, fibromyalgia, as being psychosomatic in aetiology and another way in which the level of her stress has been presented. It is relatively common for individuals from their background cultures to present with psychological symptoms of stress, depression and distress through physical symptoms of pain and disability that are not fully medically explained, such as fibromyalgia."
"I consider she is a woman who through various factors, including her estrangement from her locally living siblings, the increasing burden since 2000 of caring for her three disabled children as they have been born, and her relatively poor command of English, has become socially isolated and progressively overwhelmed with the responsibilities of caring for her three seriously disabled children without respite. That progressive overwhelming of her coping abilities has become evident over recent years with her developing symptoms of depression, anxiety and panic, alongside increasing physical symptoms of chronic pain and reduced mobility that are psychosomatically mediated. I see her combination of psychological and physical symptoms as being secondary to her situation."
"I see the psychological mechanisms and aetiology of his physical symptoms of fibromyalgia and irritable bowel syndrome as being similar to his wife as these are psychosomatic or somatoform conditions which I consider as secondary to the increasing stress and burdens of care that he and his wife have been subject to over recent years."
"There is likely to be a significant improvement in his condition if it is possible to engage with him and his wife to address the issues that concern them."
"A court may only make a care order or supervision order if it is satisfied (a) that the child concerned is suffering or is likely to suffer significant harm and (b) that the harm or likelihood of harm is attributable to (1) the care given to the child or likely to be given to him if the order were not made not being what it would be reasonable to expect a parent to give to him, or (2) the child's being beyond parental control."
"A person who (a) does not have parental responsibility for a particular child but (b) has care of the child may, subject to the provisions of this Act, do what is reasonable in all the circumstances of the case for the purpose of safeguarding or promoting the child's welfare."
That is, as it were, the statutory foundation of the agreement that has been made in this case.