Multimedia: Trial by video
Authors: Annabel Ferriman
Journal: BMJ (1999)

Someone to Watch Over Me, ITV, 12 January

  Few people attract as much sympathy as parents “wrongly” accused of child abuse. Some members of the public believe that doctors and social workers accuse parents of abuse at the drop of a hat and on the flimsiest of evidence. So it was salutary to see hard evidence of abuse during a television programme last week, even though it made grim watching.

Yorkshire Television’s documentary Someone to Watch Over Me, which tackled the controversial subject of covert video surveillance of parents suspected of Munchausen syndrome by proxy, produced footage showing apparently normal parents inflicting various forms of abuse in a cool, calm, and collected way. Viewers saw men and women trying to smother their babies by covering their children’s mouths and noses with their hands or bodies. The babies squirmed and kicked as they tried to wrest their faces away from the obstruction.

You might imagine that health workers would welcome the showing of such evidence, because it should increase the public’s understanding of the issue and strengthen the hands of the professionals in dealing with doubters. Not a bit of it. The programme was condemned by the Community Practitioners’ and Health Visitors’ Association and by a reader in social work at Leeds Metropolitan University. The association claimed that the programme was a breach of patient confidentiality and human rights: “Filming of mothers in hospital is of dubious value in long term treatment and using these pictures for entertainment on prime time television is tasteless and flouts medical ethics. These parents are mentally ill and to hold them up for public viewing is warped and serves no useful purpose, other than to titillate the audience. We will be making a formal complaint to the Network.”

The attack by Terry Thomas, reader in social work at Leeds Metropolitan University, was more of a rant against the ethics of covert video surveillance than an attack on the programme itself. Writing in the Guardian last week, he claimed that putting parents in a special hospital cubicle with hidden cameras “encouraged” them to commit crimes. He also claimed that, because in the case of North Staffordshire Hospital the video filming of 39 parents over eight years had resulted in 38 child protection orders, the doctors were only filming parents whom they already knew were guilty of child abuse and against whom they could have got child protection orders anyway. But this claim was strongly denied by Professor David Southall, consultant paediatrician at North Staffordshire Hospital, Stoke on Trent, who pioneered the use of covert surveillance. He maintained that he and his team went ahead with surveillance only when they “did not have enough evidence to go to court to protect a child.”

Professor Southall, who has been pilloried in a previous television programme for favouring covert surveillance, was also accused by the Sunday Express of providing the video footage for Yorkshire Television’s documentary. In fact, although Southall gave an interview to the film makers, he refused to provide video material on the grounds that such footage was part of his patients’ medical records and, as such, was confidential. The programme’s producer, Glyn Middleton, explained in an article in the Guardian that he was able to obtain the British footage from the United States, where it was being used to train professionals in how to identify this kind of abuse. Middleton also used a great deal of video material from doctors and prosecutors on the other side of the Atlantic, where they did not object to releasing it.

Having obtained the footage, were the film makers justified in showing it or were the health visitors right in claiming that it merely provided audience titillation? Personally, I don’t think that they could have made a useful film without it. To discuss the issue of covert video surveillance without showing the abuse that it uncovered would have been a sterile exercise. People are disinclined to believe that atrocities occur unless they see the evidence with their own eyes. 

None of the parents in the film was identifiable, with the exception of three mothers in the United States who had been found guilty by the courts. Moreover, in each case, it was the baby who was the patient, not the parent, so you could say that the doctors did not owe these adults a duty of confidentiality. Finally, any producer making such a documentary could legitimately plead the cause of “public interest.” As members of the public, we are expected to participate in the long running debate on child abuse and could be asked to serve on a jury trying an accused parent. Surely it is better if we understand something about the subject rather than flounder about in ignorance?

The 39 babies who underwent covert surveillance at North Staffordshire Hospital had a total of 41 siblings, 12 of whom had previously died suddenly and unexpectedly. After covert surveillance, four of the parents admitted suffocating eight siblings. When the Community Practitioners’ and Health Visitors’ Association says that “filming of mothers in hospital is of dubious value in long term treatment” it may be right, since treating these disturbed individuals is difficult. With good video evidence, however, doctors might be able to protect the parents’ other children from further harm and, with a well informed public behind them, might be able to make progress in combating abuse.