Videos expose child abuse in hospitals

15.54: Mother puts hand over child's mouth, then slaps her hard on the face.

15.54: Mother puts hand over child's mouth, then slaps her hard on the face.

16.41: Mother changes nappy, takes pillow and forces it over child's head. After eight seconds mother removes pillow, replaces it for three seconds. A nurse enters, alerted by the observers.

"Unbelievable." And yet this abuse is happening, according to the Royal College of Paediatrics and Child Health, in hospitals the length and breadth of Britain.

As a United Nations conference in Oslo discusses the problem of child labour and exploitation, this extract from four days of covert video surveillance at the North Staffordshire Hospital in Stokeon-Trent exposed an abusive mother who was later convicted of attempting to smother her one-year-old daughter.

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The abuse did not end there. From 39 children observed in the hospital, where paediatricians suspected abuse by a parent or parents, 33 adults were prosecuted. The video cameras were installed at the North Staffordshire Hospital under the instruction of Prof David Southall, and at the Royal Brompton Hospital, in London, when he began working as a paediatrician in 1992.

But the abuser has many faces. In most of the cases Prof Southall stresses the ability of the abusers to deceive doctors into believing they are loving, caring parents, who, when doctors' backs are turned, revert to the systematic abuse of their children. His report on child abuse makes for disturbing reading. "A proportion of serious child abuse is inflicted by severely disturbed, deceitful but plausible parents. This abuse may be difficult to recognise, life-threatening and associated with extreme degrees of physical and mental harm that are difficult to imagine. Covert surveillance has revealed that many such parents appeared caring and kind in the presence of professionals, yet within seconds of being alone with the child became cruel and sadistic."

These parents, some of whom knew they were being filmed, descended into abuse of unthinkable cruelty. Four of the parents later admitted that the deaths of eight other children in their families were not the result of cot death - or sudden infant death syndrome - but that they had been suffocated. Another death of a sibling, from gastro-enteritis, was in fact found to have been a direct result of poisoning.

So far the professor and his team of observers have faced little criticism for their work, although cot-death associations have warned that, while some cases may be attributed to abuse, covert surveillance should not "tar" all parents "with the brush of child abuse."

More significant is the criticism of Colin Morley, a consultant paediatrician at Addenbrookes Hospital in Cambridge. Warning against the dangers of using poor quality videotapes and the interpretations of "already suspicious" doctors, Mr Morley says another Cleveland or Orkney child abuse case could be on the cards. For many years social workers in Cleveland applied a particular diagnostic technique to detect child abuse, on the instructions of two paediatricians. After 121 children were removed from their families, however, they were all returned when an inquiry found the test was redundant. While the wish to protect children cannot be ignored, the case did little to endear over-eager social workers to new mothers and fathers. But one of the sad realities is that a similar kind of child abuse to that covered up at the Kincora Boys' Home outside Belfast in the 1970s still appears to be happening in children's homes in North Wales.

Social workers, policemen, sponsors of the Tory party under Margaret Thatcher - all have had allegations of child abuse, including buggery, rape and indecent assault, levelled at them in secret behind the closed doors of an inquiry into child care in Gwynedd. That a "twilight world" of "sexual, physical and emotional abuse" has, allegedly, been allowed to continue seems beyond belief, when the primary purpose of social workers and their colleagues is to provide stability.

Uncomfortable though it may be, the videotapes exist. How can they be ignored even if civil rights groups point out the potential flaws of covert video surveillance? How can the abuse of children and the subsequent confessions of their parents be ignored when such apparently definitive evidence exists?

It seems likely that Prof Southall's method of gathering evidence will be wound down in favour of a new approach to identifying child abuse by the Department of Health and child protection agencies. While Prof Southall calls for social workers to be "much more highly trained" in identifying abuse, he may risk promoting a strategy which runs ahead of current thinking within the care services. Prof Southall's shock strategy has its critics, but in the darkened room of a hospital children must feel safe, not only in the treatment they receive from doctors, but at the hands of their own parents.