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Archived Transcript for 15 November 2001: Pages
1 to 50
1
1 Thursday 15th November 2001
2 (10.00 am)
3 THE CHAIRMAN: Good morning everyone. Mr Garnham.
4 MR GARNHAM: Good morning sir. Before we begin the evidence
5 today there are a couple of procedural matters I would
6 like to draw to your attention. First of all the
7 timetable. This has, as we indicated we would on
8 Tuesday, now been recast. We will publish later today,
9 we hope by lunchtime, a daily timetable for the rest of
10 this week and for the next two weeks. We will also be
11 amending and updating the weekly schedule for the
12 remainder of Phase 1. That should be available by the
13 end of this week.
14 We still anticipate finishing the evidence by
15 Christmas but it seems more sensible now in the light of
16 the fact that our timetable has slipped over the last
17 week or so to put off final submissions until January
18 and our provisional view would be that the most sensible
19 time for you to hear those submissions would be towards
20 the end of the second week of January.
21 The second procedural matter, sir, relates to the
22 question of final submissions. Our procedural note that
23 was published when these public hearings began
24 anticipated time limited oral final submissions from
25 interested parties. We encouraged suggestions for
2
1 amendments to those procedures and one such suggestion
2 that seems to us to have merit is that witnesses who
3 have been subject to notice of criticism but who are not
4 recommended by interested parties ought also to have the
5 opportunity to make a final submission, both written if
6 they wish and oral. Accordingly, sir, with your
7 approval the Solicitor to the Inquiry will write to all
8 such witnesses indicating that you will consider any
9 written representations they wish to make, providing
10 a timetable for the submission of those written
11 submissions and indicating that they will be permitted
12 also to make a brief oral statement at the stage when
13 interested parties are to do the same thing.
14 THE CHAIRMAN: Thank you Mr Garnham. I am content with your
15 suggestions.
16 MR GARNHAM: Thank you sir. I will then call Karen Johns
17 please.
18 MISS LAWSON: While she is being called may I just say two
19 things in relation to the timetabling. The first is
20 obviously, and I am fairly confident I speak for the
21 representatives of other parties as well, that if there
22 is any assistance that we can give in relation to the
23 timetabling as opposed to simply the question of when
24 witnesses are available and what day they can come, I am
25 sure we would be very happy to do so.
3
1 The second point is an unsolicited and probably
2 unwelcome plea on behalf of Counsel to the Inquiry
3 because it is one which I fear he may be reluctant to
4 make himself while we are still in the middle of this
5 rescheduling exercise. I therefore make it because it
6 is not easy for those who have not done it always to
7 appreciate the physical and mental strain of
8 cross-examining or questioning witnesses all day, and
9 one of the joys of sitting close to Mr Garnham is that
10 I am probably better able to observe that strain on him
11 than those who are sitting further away. He is talented
12 but he is not Superman and he cannot sustain many more
13 days like we have had the first two of this week, and
14 pressing on it seems to me and trying to meet the
15 existing timetable, while a laudable objective, would
16 not assist the Inquiry's overall objective if Counsel to
17 the Inquiry collapses with exhaustion before we get very
18 much further.
19 THE CHAIRMAN: I am grateful for both of those comments.
20 Thank you very much indeed. As you will appreciate,
21 particularly in regard to the second one, I have
22 a considerable vested interest in keeping Mr Garnham
23 going and I take very seriously that point and I think
24 Mr Garnham knows the concern that I have for his
25 welfare.
4
1 MR GARNHAM: Thank you sir. I am not quite sure how I go on
2 now but I will do my best.
3 MS KAREN JOHNS (affirmed)
4 MR GARNHAM: Good morning Ms Johns, please have a seat.
5 MS JOHNS: Good morning.
6 MR GARNHAM: Would you give the Inquiry your full name.
7 MS JOHNS: My name is Karen Johns.
8 MR GARNHAM: And your professional address.
9 MS JOHNS: It is currently Civic Centre, Silver Street,
10 Enfield.
11 MR GARNHAM: You have made one statement for this Inquiry.
12 MS JOHNS: That is correct.
13 MR GARNHAM: A copy of it is now being put in front of you.
14 Sir, for your note it is volume 1 page 334.601.
15 I think it is also right you made a statement for
16 the CPS in relation to the criminal trial?
17 MS JOHNS: That is correct also.
18 MR GARNHAM: That is volume 46 page 102.501. Ms Johns, you
19 qualified as a social worker in 1986.
20 MS JOHNS: Yes, I did.
21 MR GARNHAM: And promptly thereafter began work as a generic
22 social worker with the London Borough of Enfield.
23 MS JOHNS: Yes.
24 MR GARNHAM: In October 1994 you were transferred to the
25 Social Work Team at the North Middlesex.
5
1 MS JOHNS: Yes, I was.
2 MR GARNHAM: By 1999 you were working primarily in the area
3 of antenatal, postnatal and general paediatric social
4 work.
5 MS JOHNS: That is correct.
6 MR GARNHAM: And your line manager at that time was
7 Cynthia Lipworth.
8 MS JOHNS: Yes, it was.
9 MR GARNHAM: You tell us your training included training in
10 child protection work.
11 MS JOHNS: Yes.
12 MR GARNHAM: Social work with black children.
13 MS JOHNS: Yes, that is correct.
14 MR GARNHAM: And joint interviewing.
15 MS JOHNS: Yes.
16 MR GARNHAM: You say, and this is paragraph 5 of your
17 statement, that your workload was high but not
18 overwhelming.
19 MS JOHNS: Yes, that is correct.
20 MR GARNHAM: You say that there were difficulties with
21 another full-time member of staff over sickness and
22 other matters.
23 MS JOHNS: Yes, I did make that statement.
24 MR GARNHAM: And that the impact of that was extremely
25 difficult for you.
6
1 MS JOHNS: Yes, it was.
2 MR GARNHAM: I do not need to enquire further into that,
3 subject only to this question. Did those matters have
4 any influence or any effect on your handling of
5 Victoria's case?
6 MS JOHNS: No, I sincerely believe they did not.
7 MR GARNHAM: Before turning to the facts of Victoria's case,
8 Ms Johns, there are six general matters I want to ask
9 you about and in case it assists you let me tell you
10 what they are in advance and they then I will come to
11 them. I want to ask you a little about policies and
12 procedures, about where strategy meetings should be
13 held, about attendance at meetings, about seeing the
14 child and "mother", about attendance at meetings and
15 a little more about your workload.
16 So the first of those general matters is policies
17 and procedures. You set out in paragraph 8 of your
18 statement the legislation and policies which you say you
19 followed. Do you have that?
20 MS JOHNS: Yes, I do.
21 MR GARNHAM: Those included Enfield child protection
22 procedures --
23 MS JOHNS: Yes.
24 MR GARNHAM: -- North Middlesex Hospital procedures and the
25 protocol agreed between Enfield and Haringey?
7
1 MS JOHNS: Yes.
2 MR GARNHAM: Did those various procedures ever conflict in
3 a way that caused you difficulties in the way you went
4 about your work?
5 MS JOHNS: Not that I remember.
6 MR GARNHAM: So there were not occasions for example in
7 Victoria's case where you found yourself receiving
8 guidance or direction that took you in different
9 directions?
10 MS JOHNS: No, but I should say that -- make it clear that
11 the London Borough of Enfield child protection
12 procedures dealt primarily with Enfield children, so
13 while I was mindful of them I followed the North
14 Middlesex Hospital procedures.
15 MR GARNHAM: Thank you. I will ask you a little more about
16 that later. Some of your work you tell us in your
17 statement involved Haringey children.
18 MS JOHNS: Yes, it did.
19 MR GARNHAM: In dealing with them did you make use of
20 Haringey's child protection procedures?
21 MS JOHNS: No, I did not follow them.
22 MR GARNHAM: Were those procedures, Haringey's, available to
23 you?
24 MS JOHNS: They were kept in the manager's office but mainly
25 for their involvement. I believe that they were
8
1 represented on Haringey's ACPC.
2 MR GARNHAM: But they were available to you?
3 MS JOHNS: They would have been had I wished to take them
4 and look at them.
5 MR GARNHAM: I may ask you a little more about that later as
6 well. Next, where strategy meetings should be held.
7 Following the various guidelines and procedures you have
8 referred to, where did you understand a strategy meeting
9 involving a Haringey child, who was an inpatient in your
10 hospital, ought to be held?
11 MS JOHNS: I understood that Haringey strategy meetings in
12 those circumstances should be held in the hospital.
13 MR GARNHAM: Should be held in the hospital?
14 MS JOHNS: Yes. If I can explain, the reason I understood
15 that is because I was at a multidisciplinary meeting,
16 I overheard Dr Rossiter saying in reference to
17 a particular case that she had understood herself to
18 have an agreement with Haringey and it made very good
19 sense when she said that why these meetings should be at
20 the hospital.
21 MR GARNHAM: Was that, were those remarks of Dr Rossiter's
22 made before or after Victoria's case?
23 MS JOHNS: A considerable time before.
24 MR GARNHAM: Let us see how that tallies with the policies
25 and procedures, may we? Could you have volume 24,
9
1 please. Will you go to page 1 in that volume. These
2 are Haringey's Child Protection Guidelines.
3 MS JOHNS: Yes.
4 MR GARNHAM: Go on to page 24 of that volume, 32 of the
5 guidelines.
6 MS JOHNS: Yes, I have that.
7 MR GARNHAM: That deals with strategy meetings.
8 MS JOHNS: Yes.
9 MR GARNHAM: And in paragraph 1 under "Steps to be Taken" we
10 see the following:
11 "Set up the strategy meeting on the same day of
12 receipt of referral. This is to include the Police
13 Child Protection Team, a specialist input for a child
14 with disabilities and a referrer when a professional.
15 A report from the examining doctor should be available
16 if they are unable to attend the meeting. In the event
17 of the child being in hospital the meeting must be held
18 at the hospital."
19 MS JOHNS: Yes I see that.
20 MR GARNHAM: Two questions arise. First of all, is it right
21 that that confirms your understanding that Haringey
22 children cases, where the child was an inpatient, ought
23 to be held in the hospital?
24 MS JOHNS: It certainly does, except I would say that what
25 I understood Dr Rossiter to say was more in terms of an
10
1 agreement. This actually suggests it is an instruction.
2 MR GARNHAM: Yes, it does, does it not?
3 MS JOHNS: Yes.
4 MR GARNHAM: The second question is whether you were aware
5 of that instruction at the time of Victoria's case.
6 MS JOHNS: I was not aware of it actually being part of the
7 Haringey procedures, although as I say I was aware that
8 Dr Rossiter had an agreement with Haringey ACPC that
9 this would happen and that it made very good sense for
10 that to happen.
11 MR GARNHAM: That was not followed in this case, was it?
12 MS JOHNS: I understand it was not, no. I am very aware it
13 was not.
14 MR GARNHAM: You were at the strategy meeting.
15 MS JOHNS: Yes, I was.
16 MR GARNHAM: And it was not in the hospital.
17 MS JOHNS: No, it was not in the hospital.
18 MR GARNHAM: So it is plain this instruction as you now see
19 it, agreement as you previously understood it to be was
20 not complied with.
21 MS JOHNS: That seems to be correct, absolutely correct.
22 MR GARNHAM: While we have that paragraph there, it suggests
23 the strategy meeting should be set up on the same day of
24 receipt -- to use their English -- of referral.
25 MS JOHNS: Yes.
11
1 MR GARNHAM: That did not happen, did it, not at least on
2 the same day as referral to you?
3 MS JOHNS: No, but I would think this refers to when
4 Haringey receives the referral which was not until quite
5 late on Tuesday the 27th.
6 MR GARNHAM: But even then the strategy meeting was set up
7 when?
8 MS JOHNS: It was set up for 2.30 on the 28th.
9 MR GARNHAM: "This is to include the Police Child Protection
10 Team".
11 Was there a Police Child Protection Team at the
12 meeting?
13 MS JOHNS: Yes, there was.
14 MR GARNHAM: Specialist input does not apply here and the
15 referrer when a professional. The referrer here was the
16 nurse or the doctor on Rainbow Ward?
17 MS JOHNS: Well I think I was actually seen as the referrer
18 at that stage.
19 MR GARNHAM: I see.
20 "A report from the examining doctor should be
21 available if they are unable to attend the meeting".
22 You tell us Dr Rossiter was unable to attend.
23 MS JOHNS: That is correct.
24 MR GARNHAM: Was there a report from her?
25 MS JOHNS: Well there was not a report from Dr Rossiter but
12
1 there were child protection forms which would normally
2 be something we would pass to Haringey.
3 MR GARNHAM: But there was not a report?
4 MS JOHNS: There was not a separate report, no.
5 MR GARNHAM: Who was responsible for setting up a strategy
6 meeting in a case like this?
7 MS JOHNS: This was a Haringey child and Haringey were the
8 responsible authority. It was clearly their
9 responsibility and there was no question about that
10 between us.
11 MR GARNHAM: Would you go to volume 26B, please, and to page
12 235. Do you have a 235 there?
13 MS JOHNS: I do have it in front of me.
14 MR GARNHAM: You are luckier than I am. My volume has not
15 been updated. May I have one moment? (Handed). Those
16 are the minutes of a meeting between social workers and
17 the consultant paediatricians of December 17th, 1997.
18 MS JOHNS: Yes.
19 MR GARNHAM: A meeting attended by you and your manager
20 Cynthia Lipworth?
21 MS JOHNS: That is correct.
22 MR GARNHAM: As well as a number of others who we can see
23 listed there.
24 MS JOHNS: Yes.
25 MR GARNHAM: Can you go to the agenda please at page 238.
13
1 Sorry, it begins at 237 but goes on to 238.
2 MS JOHNS: Yes, I have that.
3 MR GARNHAM: Six lines from the top of that page:
4 "For Haringey child protection strategy meetings or
5 case conferences in hospital the hospital social worker
6 will help to set them up ..."
7 MS JOHNS: Yes, I see that.
8 MR GARNHAM: You said that there was no question as between
9 you that the obligation to set up this strategy meeting
10 in Victoria's case lay with Haringey.
11 MS JOHNS: Yes, that is correct.
12 MR GARNHAM: It would seem from that paragraph, would it
13 not, that you were also to be involved in that you were
14 to help set them up?
15 MS JOHNS: I understood that to be by negotiation, if
16 Haringey had wished me to help in any way that could
17 have been negotiated and I probably would have accepted.
18 They may have asked me to invite somebody in particular,
19 it may have been easier for me to do that and I would
20 have certainly assisted in any way I could.
21 MR GARNHAM: It says:
22 "... e.g. write to other hospital staff to arrange
23 a venue but the Haringey staff will chair meetings and
24 write to other professionals in the community."
25 MS JOHNS: Yes.
14
1 MR GARNHAM: I read that as if you are to at least assist in
2 writing to hospital staff and arranging a venue at the
3 hospital.
4 MS JOHNS: Well only if requested.
5 MR GARNHAM: You say that is implicit, do you, in that note?
6 MS JOHNS: Well it is my understanding. And I think it had
7 been practice that if Haringey had wished us to assist
8 it would have been something that was negotiated and
9 worked out in that telephone discussion.
10 MR GARNHAM: So that this note here does not purport to set
11 out the circumstances in which you are to be involved,
12 you would say?
13 MS JOHNS: I think it does set out the circumstances, yes,
14 and I do see what you are saying, but my understanding
15 from this, and I am sorry if that is not clear, but it
16 is that I would help, I would assist, for example
17 writing to other hospital staff and arranging a venue.
18 MR GARNHAM: So we are clear, your evidence to the Inquiry
19 is that the obligation to manage the thing lay with
20 Haringey but that this note indicates that if you are
21 asked then you will assist?
22 MS JOHNS: Of course, that is my understanding and that is
23 how we practised.
24 MR GARNHAM: I see. Certainly it is implicit in this, is it
25 not, that strategy meetings in these sort of
15
1 circumstances are to take place in hospital?
2 MS JOHNS: Yes they should do because the child is in
3 hospital and the professionals caring for that child are
4 at the hospital.
5 MR GARNHAM: While we are on this document I wonder if you
6 could turn to page 235, please.
7 MS JOHNS: Yes, I have that.
8 MR GARNHAM: Go to the second paragraph or the second full
9 paragraph, which begins:
10 "Regarding Haringey clients there appeared to be
11 some confusion regarding the Enfield social worker's
12 role with these clients".
13 This is December 1997, so let me ask you about that
14 first. What was the confusion?
15 MS JOHNS: I think it was over roles and responsibilities.
16 MR GARNHAM: How was that confusion addressed?
17 MS JOHNS: Well, it was addressed by discussion with
18 Haringey, in particular with the Child Protection
19 Adviser Ann Graham. We had meetings.
20 MR GARNHAM: What was the outcome?
21 MS JOHNS: There was a particular meeting with Ann Graham
22 and with the social workers and managers at which we did
23 actually formulate some clearer working practices and
24 I believe that document has been set before you. It is
25 a document I am familiar with.
16
1 MR GARNHAM: You will have to help me with that. I do not
2 immediately remember recalling it. I am sure it is
3 here. Do you know where it is?
4 MS JOHNS: I am sorry?
5 MR GARNHAM: Do you know what it is?
6 MS JOHNS: Well it is the minutes of a meeting between
7 Haringey and Enfield.
8 MR GARNHAM: Doubtless during the course of the morning we
9 can find that and I will come back and show it to you.
10 In any event, you regarded, did you, the confusion as
11 having been cleared up?
12 MS JOHNS: I would not say that, no, I would not say it was
13 cleared up. I feel that efforts to address the
14 confusion were made and things were becoming clearer in
15 some areas. I think there was always some confusion.
16 MR GARNHAM: By the time we get to the summer of 1999, where
17 did confusion remain?
18 MS JOHNS: I am sorry, I am just thinking back to the summer
19 of 1999.
20 MR GARNHAM: Victoria's case?
21 MS JOHNS: Yes, of course. I think on that particular case
22 I did not have any confusion about my role and
23 Haringey's role. I think in that particular instance it
24 was clear to me and I felt at the time it seemed to be
25 clear to Haringey as well.
17
1 MR GARNHAM: I am being passed the minutes of a meeting that
2 I have seen before but this predates the one we have
3 just looked at and we perhaps ought to eliminate that
4 from our enquiries, to borrow an expression. Volume 26,
5 please. Page 20. These are the minutes of a meeting
6 attended by you and Ms Lipworth and also Ann Graham on
7 behalf of Haringey.
8 MS JOHNS: Yes, that is correct.
9 MR GARNHAM: That would not appear to be the meeting because
10 that predates the one we have looked at, but you tell me
11 whether that is right.
12 MS JOHNS: I am sorry, I am slightly confused because the
13 meeting we looked at just now was between social workers
14 and paediatricians.
15 MR GARNHAM: That is true but I understood we were looking
16 for a meeting between Ann Graham and you.
17 MS JOHNS: Yes, that is right.
18 MR GARNHAM: To deal with the confusion that appears to have
19 arisen. Now, I assume you were going to tell me that
20 this was not it because this postdates the meeting we
21 have looked at, but if I am wrong about that please
22 correct me. Is this the meeting you are talking about?
23 MS JOHNS: It was the meeting I was talking about.
24 MR GARNHAM: Ah, well that does predate the one we have
25 looked at.
18
1 MS JOHNS: Yes, it does.
2 MR GARNHAM: So that obviously was not the meeting at which
3 the confusion identified in the 1997 meeting was
4 addressed.
5 MS JOHNS: No, you are right, it could not have been.
6 MR GARNHAM: So --
7 MS JOHNS: Could I just say addressing confusion was an
8 ongoing process.
9 MR GARNHAM: That may be as troubling as the previous
10 position. How then, let me ask you again, how then was
11 the confusion identified in the December 1997 meeting
12 sorted out?
13 MS JOHNS: It probably was never fully sorted out, it just
14 remained I think.
15 MR GARNHAM: For more than eighteen months at least until
16 Victoria's case?
17 MS JOHNS: It would seem to be although at times it seemed
18 less of a problem than at others.
19 MR GARNHAM: That is extraordinary, is it not, that you and
20 Haringey identify a problem and it rumbles on for more
21 than eighteen months? It may be a question you cannot
22 answer.
23 MS JOHNS: I cannot really answer that, not really.
24 MR GARNHAM: That appears to be the position and we must
25 look for our answers elsewhere.
19
1 MS JOHNS: Yes.
2 MR GARNHAM: My next general point concerns attendance at
3 meetings. According to the procedures, who should
4 attend strategy meetings?
5 MS JOHNS: According to the Haringey procedures that we just
6 looked at?
7 MR GARNHAM: Whichever procedures you were following, who
8 did you understand should attend?
9 MS JOHNS: I was not actually setting up the meeting so
10 I would not have been following either Enfield or
11 Haringey procedures in that particular -- this is
12 probably indicative of the confusion that existed.
13 I understood from looking at Haringey's procedures now
14 that it would be the police, the referrer, which in that
15 case was myself, and the examining paediatrician or the
16 paediatrician with responsibility for the child, or
17 a report from that person.
18 MR GARNHAM: Can we look at volume 21, please. Page 1 of
19 that volume is the Enfield Guide to Interagency
20 Procedures and Practice issued by the ACPC for Enfield.
21 MS JOHNS: I have that.
22 MR GARNHAM: As a matter of interest is that the Enfield
23 child protection procedures you refer to in paragraph 8?
24 MS JOHNS: I am sorry, can I just check what I have said to
25 put it in context?
20
1 MR GARNHAM: Yes.
2 MS JOHNS: Yes, I am sorry, of course it is number 3, London
3 Borough of Enfield, yes.
4 MR GARNHAM: That is the same document?
5 MS JOHNS: Yes, it is.
6 MR GARNHAM: Go to page 28, please.
7 MS JOHNS: Yes, I have that.
8 MR GARNHAM: The last paragraph on that page sets out the
9 circumstances in which consideration should be given to
10 convening a strategy planning meeting, is that right?
11 MS JOHNS: Yes, that is correct.
12 MR GARNHAM: And over the page there is a list of the core
13 group members.
14 MS JOHNS: Yes.
15 MR GARNHAM: This includes the referring agency.
16 MS JOHNS: Yes.
17 MR GARNHAM: And who for these purposes do you say is the
18 referring agency?
19 MS JOHNS: In this particular case I at that point was the
20 referrer and the referring agency from my point of view
21 was the hospital, was the paediatric team.
22 MR GARNHAM: Did you understand that the essential people to
23 have at the strategy meeting included the doctors or did
24 not include the doctors?
25 MS JOHNS: Did definitely include the doctors and nurses,
21
1 and a nurse representative rather.
2 MR GARNHAM: The note underneath that list reads:
3 "In cases of physical abuse the core group members
4 should meet as a matter of urgency."
5 Is that right?
6 MS JOHNS: Yes.
7 MR GARNHAM: Was that your understanding of the way in which
8 things worked?
9 MS JOHNS: In cases of Enfield children, but I really do
10 need to stress this was -- this child was at all times
11 a Haringey child and Haringey was the responsible
12 authority. My primary responsibility was to pass
13 information to Haringey so they could execute that
14 responsibility.
15 MR GARNHAM: I understand that it was, that Victoria was
16 a Haringey child.
17 MS JOHNS: Yes.
18 MR GARNHAM: Did that affect the setting up of the strategy
19 meeting in substance as opposed to as matters of
20 procedure and form?
21 MS JOHNS: Well only in that Haringey would have set the
22 meeting up. It would not have been my role and it could
23 not have been my role to set up a strategy meeting for
24 a Haringey child. I had never --
25 MR GARNHAM: Did you detect any difference in the way
22
1 strategy meetings were set up in practice, regardless of
2 who was responsible for doing it between Haringey
3 children and Enfield children?
4 MS JOHNS: I must say I had very limited experience of being
5 involved in Haringey strategy meetings and the reason
6 for this is when we received a child protection referral
7 we passed that immediately to Haringey and they would
8 then take the case over with both hands from there and
9 it would be likely we had no further involvement. So it
10 would be very rare that I would even be aware of
11 strategy meetings, perhaps on a handful of occasions
12 throughout the six years I was there. There may have
13 been some differences and I am not absolutely certain
14 what those were.
15 MR GARNHAM: And you have explained that despite the note
16 I took you to a moment ago in 26B, 238, about your
17 helping to set up strategy meetings, you did not
18 consider that your role in Victoria's case?
19 MS JOHNS: It was my role if requested certainly and I would
20 have done what I could to assist.
21 MR GARNHAM: And you were not asked to assist even in the
22 invitations to those who should attend that?
23 MS JOHNS: No, I was not.
24 MR GARNHAM: Before we leave the 1997 meetings, and I think
25 you ought to have back the minutes of that again for the
23
1 purposes of this question, 26B, page 235, looking at
2 those present -- you will know them better than I do --
3 is there anyone there from Haringey?
4 MS JOHNS: No, there is no one from social services at that
5 meeting from Haringey.
6 MR GARNHAM: Anybody from any other part of Haringey
7 Council?
8 MS JOHNS: No.
9 MR GARNHAM: So it may be, may it not, that the confusion is
10 between you in Enfield and the paediatricians as opposed
11 to between Haringey and Enfield?
12 MS JOHNS: I am afraid I cannot comment on that really, I do
13 not know.
14 MR GARNHAM: Well, in practice you must know. Did you
15 understand that the confusion lay as between you and
16 Haringey or as between you and the hospital as to your
17 role?
18 MS JOHNS: I think there were two separate sets of
19 confusions really. I think that there were at times
20 some confusions between ourselves and Haringey on how we
21 managed cases and at what stage we passed cases on.
22 I think there were also confusions between the
23 paediatric team and ourselves about our roles and
24 responsibilities with Haringey clients.
25 MR GARNHAM: Is the confusion between you and Haringey set
24
1 out anywhere in a document, recorded in the minutes of
2 a meeting?
3 MS JOHNS: Well, yes, I think the meeting that I referred to
4 with Ann Graham, I think that was.
5 MR GARNHAM: Of a year earlier?
6 MS JOHNS: Yes.
7 MR GARNHAM: Your answers lead me to ask a similar question
8 as I put before. In the light of the state of confusion
9 that you say existed between three important players, do
10 you know why it was that nobody senior called together a
11 meeting and said, "Let us get this thing sorted out"?
12 MS JOHNS: I understand that subsequently, and it was after
13 this that did happen, a senior manager did liaise with
14 a counterpart in Haringey and try and once and for all
15 sort out our role with Haringey clients.
16 MR GARNHAM: You say "after this".
17 MS JOHNS: In terms of time.
18 MR GARNHAM: Yes, after Victoria's case?
19 MS JOHNS: No.
20 MR GARNHAM: After the 1997 meeting?
21 MS JOHNS: No, prior to Victoria's case.
22 MR GARNHAM: And after the 1997 meeting?
23 MS JOHNS: I believe it was after that, yes, it was in
24 between this time and Victoria's case.
25 MR GARNHAM: So there should be minutes of some meeting
25
1 where this is sorted out, should there?
2 MS JOHNS: I cannot say that it was actually sorted out
3 completely but I am sure there are minutes and letters
4 between senior managers of Enfield and Haringey in their
5 attempts to sort this out, in fact I know that process
6 was going on.
7 MR GARNHAM: So it may well be that amongst these documents
8 I have missed those, but if they are there could I call
9 on all of those involved to let us have sight of those
10 or to point me to where I should find them at some time.
11 Did Haringey ever hold strategy meetings in respect
12 of Haringey children inside the hospital?
13 MS JOHNS: Yes, I can remember strategy meetings being held
14 at the hospital, though I never attended any.
15 MR GARNHAM: Do you know what the criteria was that
16 determined whether they would be inside or outside?
17 MS JOHNS: I am afraid I do not know that. I know that
18 there are also Haringey strategy meetings held in
19 Haringey and I know that I had attended one there some
20 years before and a doctor had been with me at the time.
21 MR GARNHAM: Do you know who invited Dr Rossiter to the
22 strategy meeting in Victoria's case?
23 MS JOHNS: No, I do not.
24 MR GARNHAM: The next of my general points concerns seeing
25 the child. You say at the beginning of paragraph 6 of
26
1 your statement that you want to make it clear that at no
2 time did you speak to Victoria or her mother as you
3 understood the woman to be.
4 MS JOHNS: Yes, that is correct.
5 MR GARNHAM: You emphasise, and you have repeated the point
6 this morning, that you simply acted as a conduit.
7 MS JOHNS: Yes, that is correct.
8 MR GARNHAM: You tell us that you followed the protocol that
9 there was in existence between Enfield and Haringey.
10 MS JOHNS: I believe I did.
11 MR GARNHAM: Could we have a look at that, volume 26. Would
12 you go to page 20, please.
13 MS JOHNS: I do apologise. I am having trouble.
14 MR GARNHAM: Perhaps you could be helped.
15 MS JOHNS: Thank you.
16 MR GARNHAM: These are the minutes of meeting we looked at
17 before. Was this the protocol?
18 MS JOHNS: Yes, it was.
19 MR GARNHAM: Go to paragraph 2 of that protocol, please.
20 MS JOHNS: Yes, I have it.
21 MR GARNHAM: "Where child protection needs are not clear but
22 are suspected," the provisions in that situation are
23 then dealt with:
24 "If case not known to Haringey, the hospital social
25 worker will do an initial assessment in consultation
27
1 with ..." I think the duty team manager.
2 MS JOHNS: That is correct.
3 MR GARNHAM: "... i.e. getting any background information.
4 This assessment will then be discussed with the duty
5 team and if agreed to be clearly CP district team to
6 continue the work."
7 So you were required by that to do the initial
8 assessment. Yes or no?
9 MS JOHNS: I think the problem for me at the time was after
10 receiving a referral in respect of Victoria that not
11 only were the child protection needs not clear but the
12 referral itself was not clear and my aim at that point,
13 and I think probably could come under the umbrella of
14 initial assessment, was to clarify that referral, to see
15 exactly what I had and what I was dealing with.
16 MR GARNHAM: Can I make sure first of all that we have
17 established the general before we turn to the
18 particular?
19 MS JOHNS: Yes.
20 MR GARNHAM: As a matter of the general provisions of this
21 protocol, where child protection needs are not clear but
22 are suspected and the case is not known to Haringey,
23 you, the hospital social worker, should do an initial
24 assessment in consultation with the duty team manager.
25 MS JOHNS: That is what it says here, yes.
28
1 MR GARNHAM: What is involved in an initial assessment, as
2 far as you are concerned?
3 MS JOHNS: At the time I think it was very unclear. I mean
4 I think since we have had the framework for assessment
5 it is clearer, but at the time initial assessment could
6 just simply mean gathering the information that was
7 available and clarifying from that what kind of referral
8 there was or was not, or perhaps even interviewing
9 a parent.
10 MR GARNHAM: I am interested in the first of those two
11 alternatives. You say that an assessment, an initial
12 assessment could consist simply of gathering the
13 information together?
14 MS JOHNS: Yes, drawing the information together.
15 MR GARNHAM: In what possible sense is that an assessment,
16 initial or otherwise?
17 MS JOHNS: It comes under the umbrella of initial
18 assessment. I mean, it might be.
19 MR GARNHAM: What are you assessing in that?
20 MS JOHNS: You might actually be assessing what kind of case
21 this is, because if child protection needs are not
22 clear, that does need to be clarified at some point.
23 Before the case can be passed to Haringey properly and
24 appropriately, that does need to be clear and that would
25 and was certainly in this case my main aim.
29
1 MR GARNHAM: That might be right but that is not
2 inconsistent, is it, with your doing an initial
3 assessment that goes further than that?
4 MS JOHNS: It is not inconsistent but I would certainly do
5 an initial assessment in consultation with the duty team
6 manager.
7 MR GARNHAM: May an initial assessment at least sometimes
8 involve speaking with the child?
9 MS JOHNS: It could do, it depends very much -- probably not
10 in a clear child protection case.
11 MR GARNHAM: Would you have a look at volume 2, page 166.
12 MS JOHNS: Yes, I have that.
13 MR GARNHAM: That is the fifth page of an inquiry into
14 Victoria's case conducted by Enfield. You are doubtless
15 familiar with it?
16 MS JOHNS: Yes, I am.
17 MR GARNHAM: The first sentence reads:
18 "An initial assessment is defined as a brief
19 assessment which may include involvement of other
20 agencies in gathering information and interviews with
21 child and family members as appropriate."
22 MS JOHNS: Yes.
23 MR GARNHAM: Where is it so defined, do you know?
24 MS JOHNS: I am afraid I do not know that and I do not know
25 at the time in 1999 where it might have been defined.
30
1 MR GARNHAM: It asserts that a brief assessment, an initial
2 assessment may include interviews with child and family
3 members as appropriate.
4 MS JOHNS: Yes.
5 MR GARNHAM: Do you not regard the position as being that an
6 initial assessment should always include those steps?
7 MS JOHNS: No, I do not think it necessarily would and as it
8 says here, it may include.
9 MR GARNHAM: Can I ask you to look at Enfield's ACPC
10 guidance please, volume 21. That guidance starts at
11 page 1 in that bundle. We have identified that before.
12 MS JOHNS: Yes.
13 MR GARNHAM: If you go to page 26.
14 MS JOHNS: Yes, I have that page.
15 MR GARNHAM: That is the second page of the procedure for
16 child abuse referrals we see from the previous page.
17 MS JOHNS: Yes.
18 MR GARNHAM: And the last paragraph on that page reads:
19 "The child needs to be seen by the social workers as
20 a matter of urgency as well as any other children of the
21 family."
22 So in a case where an Enfield social worker was
23 responsible for an Enfield child, then would you agree
24 that the child had to be seen as a matter of urgency?
25 MS JOHNS: I would agree. When child protection concerns
31
1 are made clear and there is therefore purpose in seeing
2 the child, yes. That may not necessarily mean that
3 a social worker by themselves would see the child. It
4 may mean at that point a decision has been made to
5 undertake a joint investigation with the police. It may
6 even mean that the police actually would see the child
7 with someone who the child felt comfortable with and
8 that may not be the social worker. That could be
9 someone in the child's family or another professional.
10 MR GARNHAM: Where do we find that set out here? Is it the
11 next sentence that you are referring to? It does not
12 seem to be quite the same thing.
13 MS JOHNS: Well, I mean I am obviously referring here to
14 Enfield children. I can only do that because at this
15 stage I would not be involved with a Haringey child,
16 once we are talking about the child being interviewed.
17 MR GARNHAM: That is precisely the reason why I am asking
18 you the point because I am wondering whether there is
19 a difference in treatment of Enfield and Haringey
20 children because it appears to be the position that
21 whereas in the case of an Enfield child you see your
22 role as little more than an information gathering role
23 and passing role --
24 MS JOHNS: With a Haringey child.
25 MR GARNHAM: I am sorry, with a Haringey child.
32
1 MS JOHNS: Yes.
2 MR GARNHAM: Whereas with an Enfield child your own
3 procedures require you urgently to see the child.
4 MS JOHNS: That is correct.
5 MR GARNHAM: So the consequence will be that a Haringey
6 child is not seen urgently whereas an Enfield child is?
7 MS JOHNS: I do not necessarily think that is the case.
8 I think with a Haringey child the urgency would take
9 place because I would hopefully have passed a clear
10 child protection referral to Haringey and in my
11 experience Haringey would respond promptly to that and
12 always have. I cannot actually think of an instance
13 when they received a clear child protection referral
14 from myself that they did not respond promptly.
15 MR GARNHAM: What about Victoria's?
16 MS JOHNS: They responded promptly.
17 MR GARNHAM: Are you saying Haringey saw the child promptly?
18 MS JOHNS: They had a strategy meeting.
19 MR GARNHAM: My question is very straightforward: are you
20 saying Haringey saw the child promptly?
21 MS JOHNS: Clearly they did not see the child promptly but
22 I am not aware that that was poor practice, I think that
23 was because planning was required in what was
24 potentially a serious child protection situation. There
25 were clear marks on this child. The police may have
33
1 wanted to talk to the parents first, a memorandum
2 interview to be arranged. We try not to operate as
3 a fire service and rush in. We think very carefully
4 about how we would interview a child, where, the
5 circumstances, the purpose.
6 MR GARNHAM: Look at the preceding words on page 26:
7 "The investigation should not be held up on the
8 grounds that the police or another agency is not
9 available to undertake joint working. The welfare of
10 the child is of paramount importance."
11 Bread and butter to social workers.
12 MS JOHNS: Yes, of course.
13 MR GARNHAM: So the fact that others are to be involved is
14 no ground according to Enfield's procedures for
15 a slowdown in the investigation and in fact the next
16 sentence makes it clear that the child should be seen as
17 a matter of urgency.
18 MS JOHNS: Yes, I mean, perhaps I am misunderstanding
19 slightly what you are saying but I do not think in this
20 case it was held up on the grounds that the police or
21 other agency were not available. I mean, as soon as
22 I passed the referral to Haringey on the 27th in the
23 afternoon my understanding from the duty officer was
24 that she was going to discuss both with a senior and
25 with her own Police Child Protection Team.
34
1 MR GARNHAM: Let me make the position that I am suggesting
2 to you clear, and that is that you should have seen
3 Victoria on the day you received the referral from the
4 ward.
5 MS JOHNS: I would not agree with that. I do not think
6 I had grounds to see this child.
7 MR GARNHAM: Would you have seen this child if she had been
8 an Enfield child that day?
9 MS JOHNS: No, I do not believe I would. I would have
10 spoken with the Police Child Protection Team when I had
11 a clear referral and I certainly did receive a clear
12 referral the following morning from Dr Forlee verbally.
13 MR GARNHAM: What do you see as the reason for not seeing
14 a child in the position of Victoria immediately upon
15 receipt of the referral?
16 MS JOHNS: Can I first clarify with you whether you mean the
17 initial and rather unclear referral that the Social Work
18 Department received on the 26th in the afternoon or the
19 clear verbal referral we received late morning on the
20 27th?
21 MR GARNHAM: Let us do both. 26th first.
22 MS JOHNS: 26th I do not feel we had grounds to see the
23 child.
24 MR GARNHAM: Did you suspect child abuse at that stage?
25 MS JOHNS: I did not have a clear suspicion, no.
35
1 MR GARNHAM: Is not the nature of suspicion that it is often
2 not clear?
3 MS JOHNS: Yes, of course it is.
4 MR GARNHAM: The essence of my question was if you
5 suspect -- which by definition means you will not be
6 clear --
7 MS JOHNS: Yes.
8 MR GARNHAM: -- should you not then see the child
9 immediately?
10 MS JOHNS: No, not in all cases.
11 MR GARNHAM: Why not?
12 MS JOHNS: I would not have a purpose to seeing the child.
13 There has to be a purpose for a child to be seen.
14 MR GARNHAM: How about asking the child, "How did you come
15 by these injuries?"
16 MS JOHNS: In the first instance, when a child is in
17 hospital with what we realised the following day seemed
18 to be serious injuries, i.e. a belt buckle mark, it is
19 not the place for the social worker in that first
20 instance to do that investigation. That is a medical
21 judgment has to be made at that point.
22 MR GARNHAM: Why?
23 MS JOHNS: Because there may be a perfectly plausible reason
24 for some of the injuries that children have.
25 MR GARNHAM: Why is a doctor any better able to make that
36
1 judgment than you are once you know that there is a mark
2 resembling a belt buckle mark?
3 MS JOHNS: Ah, after the 27th, I think you were starting me
4 off on the previous referral.
5 MR GARNHAM: You are quite right to correct me. Let us keep
6 to the 26th. I will come on to the 27th. On the 26th
7 what is there then that puts doctors in any better
8 position to make a judgment than you?
9 MS JOHNS: Because the marks that were reported to be on
10 Victoria's body could have been marks for any number of
11 reasons.
12 MR GARNHAM: But you had your doubts about whether they were
13 accidental, did you not, right from that first time?
14 MS JOHNS: The reason I had doubts is because the examining
15 paediatrician had actually begun to fill in child
16 protection forms but that happens on a number of
17 occasions. We quite often have child protection forms
18 completed or partially completed when actually nothing
19 comes of them. I think my understanding was that
20 because the presenting injury was burns, scalds, they
21 always have to be seen initially in a suspicious manner.
22 They have to be explored so that the initial thought of
23 the doctor would be quite understandably that these
24 could have been caused non-accidentally.
25 MR GARNHAM: You shared that suspicion, did you not, at that
37
1 time on the 26th?
2 MS JOHNS: Well, I had -- I accepted that the doctor had
3 felt some suspicion. I had nothing more than that but
4 my previous experience had suggested that sometimes even
5 though initially child protection forms were completed,
6 that did not always mean ultimately that the concerns
7 were founded.
8 MR GARNHAM: No, but you at least had suspicion on reading
9 what you got on the 26th from the ward.
10 MS JOHNS: I did not have sufficient suspicion to act on
11 that. My action was to clarify what the doctor's
12 suspicion was.
13 MR GARNHAM: Let me ask again, why is a doctor in any better
14 position to go from observing marks to suspicion about
15 their cause than you are?
16 MS JOHNS: Well, a doctor would be able to look at the
17 marks, to talk to the parent about those marks, to get
18 a history of how the marks came about and make
19 a judgment, a medical -- have a medical opinion on that
20 as to whether the explanation was consistent with the
21 injury that they are seeing. I could not do that.
22 MR GARNHAM: Okay, what about the 27th?
23 MS JOHNS: The 27th, I sought clarification by taking a memo
24 to the ward and a copy to the paediatrician with
25 clinical responsibility for Victoria, who was Dr Meates.
38
1 MR GARNHAM: I understand that, we will come on to that in
2 a moment, but once you had the information you did on
3 the 27th, would these procedures not have dictated you
4 then seeing Victoria?
5 MS JOHNS: No, because at that point I felt I did have
6 a clear verbal child protection referral which I would
7 then have to pass to Haringey after speaking with my
8 manager as soon as possible.
9 MR GARNHAM: The net result of this process that there was
10 in place in your area was that instead of you reacting
11 then as you would have done if this was an Enfield
12 child, the matter gets referred on to Haringey?
13 MS JOHNS: Yes, that is correct.
14 MR GARNHAM: If this had been an Enfield child you would
15 have gone and seen Victoria on the 27th, would you not?
16 MS JOHNS: I cannot say I definitely would have done.
17 I would have spoken with my manager and immediately
18 consulted with our Child Protection Team immediately
19 because there are marks to this child and a crime may
20 have been committed.
21 MR GARNHAM: Even if you do that, given your own procedures,
22 volume 26, page 26, volume 1, why delay? Why is there
23 even a question of delay in your going to see the child?
24 MS JOHNS: Because I would need to have a discussion with
25 the police first.
39
1 MR GARNHAM: Why? Look at page 26:
2 "The investigation should not be held up on the
3 grounds that the police are not available," so if they
4 were not available it should not be held up, and then:
5 "The child needs to be seen by the social worker" -- not
6 by the police or doctor, by a social worker -- "as a
7 matter of urgency."
8 How much more clear does it have to be?
9 MS JOHNS: The first part, "the investigation should not be
10 held up", obviously it should not but part of that
11 investigation or prior to the investigation starting
12 should be a strategy discussion, a discussion with the
13 police because the child has bruises, a crime could have
14 been committed. It would be inappropriate for a social
15 worker to go marching in -- you could not; you would
16 have to ask parents' permission to speak to a child
17 anyway. Talking to a child could prejudice, possibly
18 contaminate evidence that the police may want later for
19 criminal proceedings.
20 MR GARNHAM: I am interested in that. How would asking the
21 question, "How did you come by these injuries?"
22 prejudice criminal proceedings in your understanding?
23 MS JOHNS: Well, my understanding at that time was that if
24 a child then began to disclose I would be in quite
25 a difficult position. I would have wanted -- I would
40
1 have had to stop that child probably making too full
2 a disclosure. The child would then have to be
3 interviewed in a memorandum interview and have to repeat
4 all that again. It is far better for that all to be
5 joined together, child to be interviewed fully and
6 thoroughly once with the police there, with the police
7 leading that interview.
8 MR GARNHAM: Yes, I have to say to you that none of these
9 concerns appear to be reflected in the page of your own
10 procedures that we are looking at at the moment, do
11 they?
12 MS JOHNS: Not explicitly, no.
13 MR GARNHAM: Nor implicitly. On the contrary, explicitly
14 there is a requirement that you see the child as
15 a matter of urgency if it is an Enfield case.
16 MS JOHNS: It does depend on the circumstances. No two
17 cases are the same. I have many times gone to see
18 a family, seen a child but I have always I think
19 discussed this with the police. Often a brief
20 discussion, it is agreed in that discussion that we go
21 ahead, we see the parent, we possibly even see the
22 child. It does depend very much on the injuries.
23 MR GARNHAM: So the evidence you want this Inquiry to take
24 away from this stage of your questioning is that your
25 view was that were this an Enfield case you would have
41
1 an immediate discussion with the police child protection
2 teams, and then thereafter and in the light of that
3 discussion an interview with the child would be held?
4 MS JOHNS: Yes, yes. If the child is old enough.
5 MR GARNHAM: What is plain is that none of that happened to
6 Victoria. She got to the 6th August, the day of her
7 discharge, and she had not been seen by a social worker,
8 had she?
9 MS JOHNS: I realise that. I did not know that at the time.
10 MR GARNHAM: Whatever the explanation, that is entirely
11 unsatisfactory, is it not?
12 MS JOHNS: That is a matter that the responsible authority
13 will have to answer. I can only I am afraid answer for
14 the time that I had any responsibility and that was from
15 receiving the referral from Dr Forlee and passing that
16 on to Haringey in the most clear and coherent way that
17 I could.
18 MR GARNHAM: You are an experienced social worker with
19 considerable experience in child protection work. Do
20 you regard it as acceptable practice that thirteen days
21 should have passed between the child coming into
22 hospital and the child being seen on the ward
23 immediately prior to discharge without an interview of
24 the child?
25 MS JOHNS: Clearly you are asking me to comment on the
42
1 actions of another authority.
2 MR GARNHAM: I am.
3 MS JOHNS: I find it surprising but I am not aware of the
4 kind of information that Haringey received after my
5 involvement at the strategy meeting. I do not know on
6 what basis they made those decisions. It would be
7 unfair of me therefore to give you my view. I say I am
8 surprised, yes.
9 MR GARNHAM: This is all happening on your patch, is it not?
10 The child is in your hospital for which you are one of
11 the hospital social workers?
12 MS JOHNS: That is correct.
13 MR GARNHAM: Do you stand by if another authority ain't
14 doing its job on your patch?
15 MS JOHNS: That is a very difficult question. I would like
16 to say that I understood Haringey to be doing their job.
17 I attended the strategy meeting. I am fully aware of
18 all the tasks that came out of that strategy meeting.
19 It was quite clear to me that a full child protection
20 investigation was to be instituted.
21 MR GARNHAM: You were aware though, were you not, that
22 Victoria was not seen by any social worker before
23 6th August?
24 MS JOHNS: I was not aware. I was not aware until I was
25 contacted by the ward, I believe on Monday 2nd August,
43
1 and I suppose I was rather taken aback because I would
2 have assumed that Haringey had followed up prior to that
3 but it seemed at that point they had not.
4 MR GARNHAM: Did you chase that up?
5 MS JOHNS: I rang Haringey that day and I found out who the
6 allocated social worker was and I spoke to her.
7 MR GARNHAM: Did you ask her why she or anybody from
8 elsewhere in Haringey had not seen Victoria?
9 MS JOHNS: No, I did not ask her that question.
10 MR GARNHAM: You have mentioned about seeing Victoria's
11 mother. Can we again look at that page, page 26 from
12 your own guidelines?
13 MS JOHNS: Yes.
14 MR GARNHAM: Fourth paragraph on that page, the one that is
15 two above the one we looked at previously:
16 "Parents need to be involved from the start. They
17 must be informed what procedures are being invoked, who
18 makes the decisions, what statutory powers are held and
19 what are the roles and duties of the Social Services
20 Department and other agencies involved."
21 Do you agree that that is a requirement at least in
22 Enfield children cases?
23 MS JOHNS: Yes and it is good practice.
24 MR GARNHAM: Why did you not see Kouao?
25 MS JOHNS: I think, as I have touched on, prior to Kouao
44
1 being told by the doctors that a referral had been made
2 to social services I would not have had any reason to.
3 By that time the case had already been referred to
4 Haringey anyway. It would have been up to Haringey.
5 And I do remember that a recommendation came out of the
6 strategy meeting that the parent should be informed of
7 social services' involvement.
8 MR GARNHAM: I do not understand your last answer.
9 MS JOHNS: I realise probably it was --
10 MR GARNHAM: What you said was:
11 "... prior to Kouao being told by the doctors that
12 a referral had been made to social services I would not
13 have had any reason to."
14 MS JOHNS: No, I think I need to put that another way.
15 Kouao had not been told by the doctors that a referral
16 had been made to social services. That is essential
17 that parent know social services are going to be
18 involved. The next stage then is, yes, for parents to
19 be informed. We cannot go the other way around. Social
20 workers just cannot walk in and say, "I am involved".
21 Doctors do need to tell parents that they are making
22 this referral. They need to own that referral and take
23 responsibility for that. That should come about as part
24 of the questioning of injuries.
25 MR GARNHAM: I will ask you a little more about that when we
45
1 come to look at Victoria's case but that is you say your
2 understanding of the procedures, that there is an
3 obligation on doctors to do it and that you, the social
4 worker, cannot do it if they have not.
5 MS JOHNS: Well, that is correct. That is accepted
6 practice, not only in hospital but also in the
7 community. If I worked in the community, if a school
8 rang expressing concerns about bruising on a child,
9 anything, we would always say, "You must tell the
10 parent, you must share your concerns with the parents
11 and tell the parents and be honest with the parents that
12 you are concerned and are going to refer to social
13 services". That is absolutely courteous I think to do
14 that to parents, otherwise the trust is lost between the
15 profession and the parents and they wonder where we have
16 arrived from.
17 MR GARNHAM: I am going to suggest you are elevating
18 a courtesy to some sort of procedural pre-condition.
19 MS JOHNS: It is actually part of procedures, parents are
20 treated with courtesy.
21 MR GARNHAM: I will come back to that in a moment. The
22 fifth of my preliminary points was attendance at
23 meetings. I want to have your help on that if I may.
24 MS JOHNS: Yes.
25 MR GARNHAM: There were a number of interdisciplinary
46
1 meetings that could go on at and around this hospital,
2 is that right?
3 MS JOHNS: That is correct, yes.
4 MR GARNHAM: One of them was something called I think the
5 non-accidental injury forum.
6 MS JOHNS: Yes.
7 MR GARNHAM: Which was held on Tuesdays at the hospital.
8 MS JOHNS: I believe it was.
9 MR GARNHAM: Did you attend those?
10 MS JOHNS: No, I did not attend those meetings.
11 MR GARNHAM: There were also ward meetings held on Mondays.
12 MS JOHNS: The psychosocial meetings.
13 MR GARNHAM: That was my next question. Is the ward meeting
14 held on Mondays the same as the psychosocial meetings?
15 MS JOHNS: I understand they were the psychosocial meetings.
16 MR GARNHAM: Who attended the psychosocial ward meetings
17 from the hospital, do you know?
18 MS JOHNS: Well, can I first say that the psychosocial
19 meetings did not only take place on the paediatric ward,
20 on Rainbow Ward, but there were also psychosocial
21 meetings on a Wednesday and I think subsequently on
22 a Tuesday on the neonatal ward. I actually covered the
23 neonatal ward so I always attended psychosocial meetings
24 there until the point came when we were withdrawn from
25 all the meetings. I did not cover paediatrics until
47
1 after these meetings were suspended so I have never
2 attended one on the paediatric ward.
3 MR GARNHAM: You have never attended on the paediatric ward?
4 MS JOHNS: Never.
5 MR GARNHAM: When it was still happening, who did attend on
6 behalf of the social work team?
7 MS JOHNS: It would have been the social worker or social
8 workers covering paediatrics and they were my
9 colleagues. At different times they were different
10 colleagues.
11 MR GARNHAM: At Victoria's time, the time of Victoria's
12 admission, who had that, who was covering that ward?
13 MS JOHNS: I was one of the social workers covering that
14 ward. There were one and a half other association
15 workers also covering that ward. We at that time
16 actually pooled if you like and covered all the work
17 from all over the hospital which included antenatal,
18 postnatal, neonatal, termination of pregnancy, self
19 harm.
20 MR GARNHAM: Were you and your colleagues routinely
21 attending psychosocial meetings in the paediatric
22 department at the time of Victoria's admission?
23 MS JOHNS: No.
24 MR GARNHAM: Why not?
25 MS JOHNS: The meetings -- sorry, not the meetings; the
48
1 meetings had not been suspended, they continued, but the
2 social workers' attendance at the meeting had been
3 suspended by the time I became involved in paediatrics,
4 not obviously by the time Victoria was admitted to the
5 hospital.
6 MR GARNHAM: Why?
7 MS JOHNS: My understanding is that there were difficulties
8 experienced by the social workers attending the
9 paediatric meetings -- sorry, the psychosocial meetings
10 on the paediatric ward.
11 MR GARNHAM: Was it not part of your job to attend?
12 MS JOHNS: Do you mean was it in our job description?
13 MR GARNHAM: Yes.
14 MS JOHNS: Yes, it was an important part of our job to have
15 multidisciplinary liaison and that would include those
16 kind of meetings, yes.
17 MR GARNHAM: I can take you to it if you need it but you
18 probably will know this -- and for your note sir it is
19 29.006 -- your job description has as the second duty
20 participation in multidisciplinary discussions within
21 the various units and interdepartmental meetings in the
22 hospital, presenting the policy of social services and
23 the practice of social workers' work as they affect
24 individual clients.
25 MS JOHNS: Yes.
49
1 MR GARNHAM: Am I to understand your previous answers to be
2 to this effect, that despite the fact that that was in
3 your job description you had been instructed not to
4 attend psychosocial meetings?
5 MS JOHNS: Yes, that is correct.
6 MR GARNHAM: Who gave you that instruction?
7 MS JOHNS: Management.
8 MR GARNHAM: Who particularly?
9 MS JOHNS: At that time there were two managers.
10 MR GARNHAM: Who gave you this instruction?
11 MS JOHNS: The managers jointly.
12 MR GARNHAM: And they were?
13 MS JOHNS: Pat Dale and Cynthia Lipworth.
14 MR GARNHAM: Were you told the reason why you were being
15 given that instruction?
16 MS JOHNS: Yes, I knew the reasons by that time anyway.
17 MR GARNHAM: Which were?
18 MS JOHNS: That there were difficulties in the relationships
19 between social services and medical staff.
20 MR GARNHAM: You are being polite. We need to know what
21 they are, what were the difficulties.
22 MS JOHNS: The difficulties that the social workers
23 attending those meetings on Rainbow Ward reported were
24 that they felt they were not or their views were not
25 respected at the meetings and they were not given space
50
1 to give feedback, to give their view from a social work
2 perspective. They also felt I think that referrals were
3 just given to them in quite a haphazard way. That was
4 their perception, that they were perhaps given details
5 of a child without the name, without you know quite
6 important basic information being given and they did not
7 find that helpful in terms of following-up.
8 MR GARNHAM: 26B, please, 237. This is the meeting of the
9 meeting of 17th December between social workers and
10 consultants and first a general item concerning the
11 attendance of social workers at ward meetings on
12 Mondays. There are set out there four objections voiced
13 by social workers. Does that tally with your
14 understanding?
15 MS JOHNS: Yes, it does.
16 MR GARNHAM: You were at that meeting, were you not?
17 MS JOHNS: Yes, I was there.
18 MR GARNHAM: Eighteen months later social workers are still
19 not participating in psychosocial ward meetings.
20 MS JOHNS: No, they were not.
21 MR GARNHAM: I am struggling to understand how it can be
22 that a disagreement between you and the paediatricians
23 could result in your and your colleagues' continued
24 noncompliance with their job description and continuing
25 not to ensure there was a social work presence at these
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