Too Insignificant For The Law

Distressing. Harrowing. Fucking Shameful. There aren’t any words powerful enough to describe the experience of following George Julian’s brilliant live tweeting of the GMC hearing into Dr Valerie Murphy, the responsible clinician in charge of Connor Sparrowhawk’s care at STATT. (Responsible and Care being totally inappropriate to the evidence unfolding in Manchester). The hearing is scheduled for two weeks and I strongly suggest anyone interested in learning disability care, take a look at George’s forensic reporting @JusticeforLBGMC.

On Tuesday, Sara was called to give evidence for no other reason than for Dr M’s brief to attack her. Her evidence wasn’t needed. Her presence was an opportunity to prolong Sara’s pain. Sara has written about the day in the most moving and important blog post for many a long time.

There is so much that could be written about the hearing. To be honest, the tweets are so relentlessly shocking, I’ve long since lost the ability to differentiate.

We’ve heard about Death by Indifference. We know that learning disabled people are seen as not quite human. But seeing it revealed in rolling black and white is deeply distressing. It’s not unusual for patients NOT to be clerked in on admission. It’s not common for families to be included in anything – history gathering; best interests; concerns. All this came from the horses mouth.

One thing that has repeatedly made my blood boil and the tears flow has been the total contempt for the law. Every now and then, Dr Murphy has been questioned about the Mental Capacity Act and her responses consistently show that she didn’t give a hoot for a piece of legislation that was introduced to protect the most vulnerable people. If she had followed the law, Connor may not have died.

There were lots of disjointed discussions about the Mental Capacity assessment. Dr Murphy’s evidence is such a shambles, I feel confident in saying that she probably didn’t carry out a capacity assessment. From the start, she assumed, even if it occurred to her at all, that Connor lacked capacity. For everything. Capacity to consent to medication? Capacity to agree to admission? A blanket decision based on contempt for her patients.

Let’s remind ourselves that the first principle of the five principles of the Mental Capacity Act states: “A person must be assumed to have capacity unless it is established otherwise”. Dr Murphy wouldn’t give her patients that respect, that legal right. From that dismissive starting position, Dr M blocked the next two principles, namely, the person must be supported in making a decision, and that people must be allowed to make unwise decisions. When your patient’s rights are so irrelevant, principles two and three don’t even appear on the radar.

The fourth principle is almost laughable to Dr M. This is the one about best interests and in the egocentric world of Dr M, only she has the expertise to make a best interests decision. Sod the collaborative process. Sod the lifelong experience of the patient’s family. But the evidence of the hearing reveals something even worse. It doesn’t look as if Dr M made a best interests decision. Or, she put the cart before the horse, and made a best interests decision and then contrived/ignored a capacity assessment to justify it.

I would stick my neck out and say that the evidence revealed today shows that she broke the law as far as the Mental Capacity Act goes. On several counts.

This doesn’t surprise me too much. A couple of years ago I did a public speaking gig at a mental health conference. My brief was to describe how in 2010, the MCA had been abused in Steven’s case but ultimately saved him. The conference room had 6 large round tables on one side of the room and the same number on the other side, with a walkway through the middle. As the room filled up, all the Psychiatrists and senior clinicians assembled on the left bank and the AMHPs, the BIAs and the ward staff sat on the right. It was the worst, scariest gig I’ve ever done. Some of the psychiatrists sat with their backs to me for the whole hour I spoke. They talked loudly amongst themselves. As I was describing Steven’s mental capacity assessment, two of them got up and went to the tea urn at the back of the room. At the break, nobody spoke to me. My spirit was around my ankles. I went out for a fag and one of the AMHPs joined me. He apologized and said their response had been quite common. There was no interest in the Mental Capacity Act at all because it’s fundamental principles were so far removed from the psychiatrists belief system.

All this shone like a rancid turd during Dr M’s evidence. At one point, she even came out with the old chestnut – the Mental Health Act trump’s the Mental Capacity Act. That is code for, “bollocks to the law. I know best”.

It’s called the Mental Capacity Act 2005. It’s now 2017. Yet you still hear deluded, self important professionals say, “we’re still bedding it in”. It’s scandalous. For the Dr Murphy’s of this world, there is no intention of bedding it in. Their patients don’t deserve that right.

One final piece of phlegm from the hearing. Shortly after Connor’s death, Dr Murphy returned to Ireland. She has her own practice and does some lecturing at UCC. In April this year, Dr Murphy delivered a presentation on the Mental Capacity Act for the students.

Click on the sixth link for the slides Dr M used –

The second slide states: “Preserve the dignity of the patient”.

Connor died.


9 thoughts on “Too Insignificant For The Law”

  1. Thank you for writing this – reading the live tweets is harrowing. But at least I can read them in my own space when I feel I can. Hearing Sara’s evidence fells like twisted entertainment.

  2. This is a most sad reality, and whilst not all psychiatrists fit this bill, I am on total agreement that psychiatry needs a total revamping or to be extinguished as a profession.

    1. Appraisal of skills needs to happen, and testing wrt general health care knowledge.
      Our previous psychiatrist, who is a ‘lead’ spokesperson in the field of autism (not), couldn’t even take blood pressure readings.

      I’m still with the good psychiatrists that you also mention – the ones who take the Hippocratic oath seriously.

  3. Mark have you thought of passing this on to Sir James Munby he can be contacted direct through Joan Goulborn

  4. Distressing, Harrowing and Fucking Shameful.

    Could well be the title of a book describing the world of health and social care – for people with autism and learning disability – over the last decade.

    Arrogant and powerfully dangerous clinicians have prescribed dangerous drugs in the dark. Then justified their incompetence by scarifying brave grieving parents.

    Public and Private Organisations and their leaders have walked – still walk – away free with loads of cash in hand, from permitting neglect and cruelty and the avoidable and far too early deaths, of our sons and daughters.

    Academics seek justice for our sons and daughters – till the PhD is filed, and job tenure secured.

    Social work professionals hired by Public paymasters willing to bend the laws Mental Health and Capacity. Have

    * committed quick and dirty assessments – to shoot other peoples Human Rights with holes.

    * for a salary, removed all safe support from very vulnerable sons and daughters, with a pen.
    * been paid to, sans advocate remove support within minutes. And then, sans conscience moved
    on to the next – leaving only misery and danger as a care plan..

    * brokered,sold our sons and daughters over and over – like cattle – to the highest bidder.

    * when challenged, Public employees and their paymasters,without fear of penalty have
    first ignored then attacked and stripped exhausted families bare, of their health and hope.

    While charity made rich on our sons and daughters label – and the Government agencies rewarded so handsomely to prevent, and challengeto stop these atrocities and injustices,




  5. Sadly the social workers and AMHPs often have a similar mindset, particularly as they’re being drawn further in to shore up the fissures in a crumbling mental health system that had serious flaws at it’s best and perhaps was never meant to ‘work’ in the way that people imagine..

    The suggestion that these individuals are arrogant and vindictive is one that would get most of us diagnosed with a PD along with some drivel about transference and how we are projecting our own flaws onto them.

    Assuming they actually had a sufficient level of engagement to be aware of that. Probably their own conversation or the tea urn won out. Which might be a small mercy.

    1. Marie, that’s so true, as are many blogs I’m reading.. I’m fairly sure all working in the system know there’s little ‘service’ done the way all the great initiatives wanted. I’ve met enough of them now to know the few good ones aren’t the norm.
      It’s an ‘I’m getting paid anyway’ attitude as my dead friend (a dedicated mother who was my friend) used to say.
      Even parents of people with autism who aren’t incarcerated, join the bandwagon, so it’s not even a black and white them and us.
      And it’s not even only the highest up in the chain, as the care workers are often in it to do the least work.
      It’s all lack of ethics.
      Easy work if you ‘leave them to rot’ as my friend used to say.
      Getting the least skilled to care for the most complex wouldn’t happen anywhere else in the NHS. Except mental health, as they can’t answer back either.
      The carrot and stick approach with ethics has relied on the carrot for too long.

  6. I find all this so incredibly difficult to read and digest as we face very similar challenges ahead as Sara and her family have had to endure and so many others too. The blanket systematic neglect and wholesale disregard of the MCA and other regulations and laws, including basic human rights, set up to protect vulnerable human beings is damning. It’s simply unbearable. This tribunal should wake sleeping giants. This is happening right now in what most believe is a civilised nation and horrific deaths by indifference continue because the perpetrators appear to be protected.

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