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Archived Transcript for 22 November 2001:
Pages 101 to 150
101
1 MISS ARTHURWORREY: That is correct.
2 MR GARNHAM: Had it not been suggested to you by your
3 managers that that would be a sensible thing to do in
4 this sort of case?
5 MISS ARTHURWORREY: No, it was not.
6 MR GARNHAM: From the time you received these papers
7 Miss Arthurworrey you were taking part, were you not, in
8 a Section 47 investigation?
9 MISS ARTHURWORREY: Yes, that is correct, yes.
10 MR GARNHAM: Because child protection concerns were
11 immediate concerns from day one?
12 MISS ARTHURWORREY: That is correct, yes.
13 MR GARNHAM: So it is for you, is it not, from that moment
14 to make inquiry so as to ensure that Victoria is safe?
15 MISS ARTHURWORREY: Those inquiries should be made as soon
16 as the referral is received on the Duty Team.
17 MR GARNHAM: Which would have been before that?
18 MISS ARTHURWORREY: Which was the week before that, yes.
19 MR GARNHAM: Did you check that they had been made?
20 MISS ARTHURWORREY: It would have appeared from Victoria's
21 file that checks to the GP, checks regarding her
22 schooling had been made.
23 MR GARNHAM: But that is not the only things that are
24 necessary to ensure she is safe. I mean she is in
25 hospital, you know that.
102
1 MISS ARTHURWORREY: That is correct.
2 MR GARNHAM: So that while she is there she would appear to
3 be safe.
4 MISS ARTHURWORREY: That is right.
5 MR GARNHAM: But nothing in place for example to stop her
6 carer discharging Victoria, no police protection having
7 been taken out.
8 MISS ARTHURWORREY: There was no police protection.
9 MR GARNHAM: So what did you do to ensure from the first
10 time you saw this that Victoria was going to be safe?
11 MISS ARTHURWORREY: Could I have a look at the strategy
12 meeting recommendation?
13 MR GARNHAM: Yes, they are at 6/091.
14 MISS ARTHURWORREY: On page 096 at number 10: "Protection,
15 other information", point 10: "Who is protecting the
16 child?" and Rose Kozinos has said "The hospital".
17 MR GARNHAM: That plainly was the position as things then
18 stood but there was always the risk that she might be
19 discharged, was there not? Did that thought go through
20 your mind, did you think about that, that if she was
21 being abused the abuser might discharge her?
22 MISS ARTHURWORREY: I knew that the hospital had been asked
23 to contact the department had Kouao -- they had been
24 asked to contact the department if Kouao attempted to
25 discharge Victoria.
103
1 MR GARNHAM: Thank you very much. You then set out in your
2 notes the eight tasks which you thought you had to
3 complete. This is about 67 and 66.
4 MISS ARTHURWORREY: Yes.
5 MR GARNHAM: Those included obtaining a medical report from
6 Dr Forlee I think.
7 MISS ARTHURWORREY: Yes.
8 MR GARNHAM: What had prompted that? Did you know or had
9 you just taken it verbatim from the strategy meeting
10 minutes?
11 MISS ARTHURWORREY: I had taken it from the strategy meeting
12 minutes but I also knew from those minutes that, and
13 from the initial referral, that the hospital had
14 concerns regarding old markings on Victoria's body.
15 MR GARNHAM: So that is what prompted this task of getting
16 a report from Dr Simone Forlee?
17 MISS ARTHURWORREY: That was my understanding at the time,
18 yes.
19 MR GARNHAM: You also had to obtain a report from the
20 hospital social worker in relation to neglect.
21 MISS ARTHURWORREY: That is correct, yes.
22 MR GARNHAM: Did you understand that to mean that the
23 hospital social worker herself would provide the report
24 or that she would obtain a report on those issues from
25 the hospital?
104
1 MISS ARTHURWORREY: I believed in Karen Johns' fax to me she
2 had invited me to contact the hospital ward for those
3 concerns.
4 MR GARNHAM: So you did not understand that it was going to
5 be Karen Johns who was going to be providing that
6 report, you understood that was going to come from the
7 hospital?
8 MISS ARTHURWORREY: I understood that, yes.
9 MR GARNHAM: Then once the medical reports plural had been
10 obtained, a joint home visit was to be arranged?
11 MISS ARTHURWORREY: That is correct, yes.
12 MR GARNHAM: Why did you need to have the medical reports
13 before you did that?
14 MISS ARTHURWORREY: Because basically social services rely
15 on evidence from a hospital into the causes of a child's
16 injuries.
17 MR GARNHAM: And you need that before you visit the child?
18 MISS ARTHURWORREY: Absolutely, yes.
19 MR GARNHAM: Because?
20 MISS ARTHURWORREY: So that we know what we are dealing
21 with.
22 MR GARNHAM: I see. Last question before I suggest to the
23 Chairman that we break. One of the tasks you had or one
24 of the tasks that is listed is checking with
25 International Social Services.
105
1 MISS ARTHURWORREY: That is correct.
2 MR GARNHAM: What was done about that?
3 MISS ARTHURWORREY: At that point I had overlooked that
4 particular recommendation and I did not do anything.
5 MR GARNHAM: Is it right to say that nothing was done about
6 that until November?
7 MISS ARTHURWORREY: That is correct.
8 MR GARNHAM: Thank you. Sir would that be a convenient
9 moment?
10 THE CHAIRMAN: Thank you. I will not go through it again
11 Miss Arthurworrey. I think you know that you are not
12 allowed to discuss your evidence with anyone during this
13 break. Ladies and gentlemen, we will reconvene at five
14 to 2.
15 (1.05 pm)
16 (The short adjournment)
17 (1.55 pm)
18 MR GARNHAM: Please come back to the seat.
19 Miss Arthurworrey, there were two matters arising out of
20 this morning's evidence I want to ask you about before
21 we continue. First of all, you talked about or rather
22 you adopted an expression of mine about a matriarchal
23 hierarchy at Haringey and I think you likened it to
24 being in a school. Where did Carole Baptiste fit into
25 that hierarchy, which side of the divider is she on?
106
1 MISS ARTHURWORREY: Carole Baptiste was a child.
2 MR GARNHAM: Thank you. Secondly, you remember I could not
3 find a reference to a point about inconsistent
4 instructions. Can I take you to that and ask you about
5 it now. Volume 45A, please.
6 Page 150.684. This, you will recall, was in
7 relation to the statement of John Myrie, given to the
8 Monaghan Inquiry.
9 MISS ARTHURWORREY: Yes.
10 MR GARNHAM: On page 684, in the second paragraph it reads
11 as follows:
12 "Carole Baptiste was a constant topic of
13 conversation. Priscilla ..."
14 Who is that?
15 MISS ARTHURWORREY: Priscilla Bannis was a social worker in
16 the B Team.
17 MR GARNHAM: "... Barry Almedia ..."?
18 MISS ARTHURWORREY: He was a senior practitioner in the
19 B Team.
20 MR GARNHAM: "... and myself [that is Mr Myrie] had been
21 around, so there was a counterbalance for
22 Lisa Arthurworrey. Carole Baptiste would say to
23 Lisa Arthurworrey do one thing and Priscilla and I would
24 say do not."
25 Now is it right that you were getting that sort of
107
1 conflicting advice or instructions?
2 MISS ARTHURWORREY: I do not remember that happening.
3 MR GARNHAM: Thank you. Can we go back to the notes we were
4 looking at before the break. Volume 6, page 67, please.
5 Do you remember I asked you about checking with
6 International Social Services and you said that is not
7 something you did until November?
8 MISS ARTHURWORREY: That is correct, yes.
9 MR GARNHAM: Can I ask you about another entry on that page
10 with regard to schooling? There are two entries in the
11 second and third box down in the middle: "No info on GP
12 or scald", "No record of GP or scald". Do you see that?
13 MISS ARTHURWORREY: I see that.
14 MR GARNHAM: It says:
15 "No records coming up on this child but since N17
16 [presumably a reference to the postal address] falls in
17 the catchment area of Tottenham PS, try Devonshire
18 Primary School for any info."
19 I do not know what Tottenham PS is, if it is "P".
20 MISS ARTHURWORREY: I do not know what that is either.
21 MR GARNHAM: There is a reference there to Devonshire
22 Primary School --
23 THE CHAIRMAN: Excuse me Mr Garnham. I must say, members of
24 the public, you are not allowed to wander around and
25 have discussions with anybody else whilst you are in
108
1 this hearing room. If that happens again I will take
2 a firm line on it.
3 MR GARNHAM: Thank you, sir.
4 Can we go back to that page, please. Reference
5 there to Devonshire Hill Primary School and a suggestion
6 that somebody tries them for information. Do you see
7 that?
8 MISS ARTHURWORREY: I see that.
9 MR GARNHAM: Did you make any inquiries with Devonshire Hill
10 Primary School?
11 MISS ARTHURWORREY: No, I did not.
12 MR GARNHAM: Why not? Did you not understand that to be
13 your job?
14 MISS ARTHURWORREY: I did not understand that to be my job.
15 MR GARNHAM: You agreed with me this morning that one of
16 your functions was to coordinate the investigation into
17 Anna's case, Victoria's case.
18 MISS ARTHURWORREY: That is correct, yes.
19 MR GARNHAM: Here is a suggestion that as part of that
20 investigation inquiries should be made at Devonshire
21 Primary School. Do you know whether anybody made those
22 inquiries?
23 MISS ARTHURWORREY: I do not know whether anybody made those
24 inquiries.
25 MR GARNHAM: You should have ensured that somebody, if not
109
1 you, did.
2 MISS ARTHURWORREY: Yes, I accept that.
3 MR GARNHAM: You knew that the strategy meeting which had
4 taken place four days before you were first involved had
5 not taken place at the hospital where Victoria was
6 a patient.
7 MISS ARTHURWORREY: Yes.
8 MR GARNHAM: You knew that no medical staff had attended
9 that strategy meeting.
10 MISS ARTHURWORREY: I knew that Karen Johns, the hospital
11 social worker, had attended but no medical staff had
12 attended.
13 MR GARNHAM: Did you see it as being important that there
14 was made available to you good quality medical evidence
15 relating to Victoria?
16 MISS ARTHURWORREY: Absolutely, yes.
17 MR GARNHAM: Did it bother you then that the strategy
18 meeting had been held at a place away from the hospital
19 and without doctors or nurses being there?
20 MISS ARTHURWORREY: I do not remember --
21 MR GARNHAM: It was not something that stuck in your mind as
22 "I must make sure I get decent medical reports in this
23 case" because there was not even a nurse at the strategy
24 meeting.
25 MISS ARTHURWORREY: I knew I had to get decent medical
110
1 reports.
2 MR GARNHAM: You tell us that you discussed this case after
3 you read those initial files with Carole Baptiste,
4 paragraph 80 of your statement if you want to look at
5 it. Yes?
6 MISS ARTHURWORREY: Yes.
7 MR GARNHAM: Was Miss Baptiste's response helpful?
8 MISS ARTHURWORREY: Miss Baptiste just told me that this was
9 a case about a child who was in hospital with scabies.
10 No, it was not helpful.
11 MR GARNHAM: She did not tell you what to do, or when it
12 should be done by, or anything of that sort?
13 MISS ARTHURWORREY: She just told me to implement the
14 strategy meeting recommendations and that was it.
15 MR GARNHAM: Did she set a date for review of the strategy
16 meeting?
17 MISS ARTHURWORREY: No, she did not.
18 MR GARNHAM: Did anybody?
19 MISS ARTHURWORREY: No, they did not.
20 MR GARNHAM: Did you?
21 MISS ARTHURWORREY: No, I did not.
22 MR GARNHAM: That would be the normal procedure, would it
23 not, to ensure that a review date is established?
24 MISS ARTHURWORREY: I think that was a deficiency in the
25 system, identified after Victoria's death. I remember
111
1 Carol Wilson discussing the fact that no review strategy
2 meetings were taking place in North Tottenham and after
3 Victoria's death that was then implemented.
4 MR GARNHAM: I see. This is a general problem, is it, that
5 reviews strategy meetings simply did not take place in
6 North Tottenham?
7 MISS ARTHURWORREY: That is correct, yes.
8 MR GARNHAM: So it is a matter of chance whether anybody
9 found out whether the tasks set at strategy meetings had
10 been done or not?
11 MISS ARTHURWORREY: That is correct, yes.
12 MR GARNHAM: That gives the impression that nobody has
13 a handle on what is being achieved in this office at
14 this time?
15 MISS ARTHURWORREY: Absolutely, yes.
16 MR GARNHAM: In your discussion, that first discussion you
17 had with Carole Baptiste, was there any talk about the
18 documentation from the NMH? Did you discuss so much the
19 documentation that you had by then obtained?
20 MISS ARTHURWORREY: I did have a discussion with
21 Carole Baptiste about the documentation that I had
22 obtained.
23 MR GARNHAM: Did you ever, after that first day, have
24 a discussion with Carole Baptiste about the NMH
25 documentation?
112
1 MISS ARTHURWORREY: I made reference to the North Middlesex
2 documentation after Constable Jones and myself had
3 interviewed Victoria on the 6th August.
4 MR GARNHAM: Thank you. What about the CMH documentation
5 which subsequently was to come into your possession?
6 Was that discussed with Carole Baptiste?
7 MISS ARTHURWORREY: I remember clearly receiving the
8 documentation from the Central Middlesex Hospital.
9 I remember --
10 MR GARNHAM: Date please.
11 MISS ARTHURWORREY: The 12th of August. I remember running
12 to Carole Baptiste with this documentation because
13 I felt it was a crucial link in Victoria's case and
14 I felt that it was a documentation that should have been
15 present at the first strategy meeting.
16 MR GARNHAM: I am going to come back to that meeting on
17 12th August. Can I make sure I understand for the
18 moment, you are confident you discussed the CMH
19 documentation with Miss Baptiste on 12th August?
20 MISS ARTHURWORREY: I showed her the documentation. She
21 looked through it and just said, "That is good. The
22 decision to discharge Victoria had obviously been the
23 right decision".
24 MR GARNHAM: Because I think it is right, as you probably
25 know, that subsequently Miss Baptiste denies that you
113
1 showed her that. Were you aware of that?
2 MISS ARTHURWORREY: Not really, no.
3 MR GARNHAM: All right. Even with the degree of input you
4 had from Miss Baptiste on that first occasion, the
5 beginning of August, it was pretty obvious, was it not,
6 that this was an important and difficult case?
7 MISS ARTHURWORREY: I knew it was an important case. I knew
8 it was child protection, therefore I knew an urgent
9 response was needed. I did not realise that it was
10 a difficult case, no.
11 MR GARNHAM: It was believed to involve an injury to
12 a child, first point.
13 MISS ARTHURWORREY: That is correct.
14 MR GARNHAM: The referral was from a hospital, second point.
15 MISS ARTHURWORREY: Yes.
16 MR GARNHAM: A strategy meeting had already taken place.
17 MISS ARTHURWORREY: Yes.
18 MR GARNHAM: Your work plan had been identified and 18 tasks
19 had been drawn up, not all for you but there were
20 18 tasks.
21 MISS ARTHURWORREY: Yes.
22 MR GARNHAM: It was already obvious, was it not, that a good
23 deal of work needed to be done on this case and that you
24 were needing to coordinate that?
25 MISS ARTHURWORREY: Yes.
114
1 MR GARNHAM: There was nothing to stop you from reconvening
2 the strategy meeting, was there?
3 MISS ARTHURWORREY: The decision to reconvene strategy
4 meetings had to come from either a manager or the chair
5 of the strategy meeting.
6 MR GARNHAM: But you could suggest it if you felt it
7 important in this case?
8 MISS ARTHURWORREY: With the benefit of hindsight I could
9 have suggested it but at the time I did not even realise
10 that Haringey should have had review strategy meetings.
11 MR GARNHAM: I am suggesting to you that it should have been
12 obvious to you it was important, because firstly as we
13 have discussed there was no medics at the original
14 strategy meeting and, secondly, there had at that
15 meeting not been fixed a date for review. Both things
16 would have pointed, would they not, to somebody taking
17 the initiative and saying, "We need a reviewing strategy
18 meeting in this case"?
19 MISS ARTHURWORREY: Yes.
20 MR GARNHAM: Back to your notes. The next entry is for
21 3rd August, that is when you received the fax from the
22 NMH saying that Victoria was now fit for discharge.
23 MISS ARTHURWORREY: That is right, yes.
24 MR GARNHAM: The fax is at 275 in volume 6.
25 The first paragraph deals with discharge plans, the
115
1 second with medical photographs. This is a memo to you
2 from Karen Johns, 3rd August. She has been informed by
3 Rainbow Ward that Anna is now ready for discharge. What
4 do did you understand by that expression "ready for
5 discharge"?
6 MISS ARTHURWORREY: That Victoria was ready to leave the
7 hospital.
8 MR GARNHAM: Did you understand that that was an assertion
9 of her medical fitness, or the good sense of the
10 discharge generally?
11 MISS ARTHURWORREY: The good sense of the discharge
12 generally.
13 MR GARNHAM: You did not read that as simply saying she is
14 now medically fit enough to leave hospital?
15 MISS ARTHURWORREY: No, I did not.
16 MR GARNHAM: "... and the ward would like this to happen as
17 soon as possible".
18 MISS ARTHURWORREY: Yes.
19 MR GARNHAM: So presumably in the light of your previous
20 answers you took the view that you needed now, quickly,
21 to take the steps necessary to facilitate Victoria's
22 discharge?
23 MISS ARTHURWORREY: That is correct, yes.
24 MR GARNHAM: Did you discuss what "ready for discharge" was
25 intended to convey with anybody else?
116
1 MISS ARTHURWORREY: Regrettably, I did not.
2 MR GARNHAM: You can see now, can you, it might have meant
3 one of two things: either medically fit or everything is
4 fine to go?
5 MISS ARTHURWORREY: I can see that now, yes.
6 MR GARNHAM: Was this memo seen by your manager, by
7 Carole Baptiste?
8 MISS ARTHURWORREY: I really cannot recollect.
9 MR GARNHAM: You were aware, were you, from that memo, that
10 by that date the scabies which had been mentioned
11 previously in the material you had seen had been
12 successfully treated?
13 MISS ARTHURWORREY: That is correct, yes.
14 MR GARNHAM: The second fax you receive is on the next page,
15 I think. We have it there in a form that has an
16 amendment on it. Do you have 276?
17 MISS ARTHURWORREY: Yes I do.
18 MR GARNHAM: I am sorry, I should have asked you before we
19 left the previous one -- sorry. The second paragraph on
20 275 deals with medical photographs. What did do you as
21 a result of receiving that?
22 MISS ARTHURWORREY: I remember discussing -- showing both
23 these faxes to Constable Karen Jones when we met on
24 5th August before interviewing Kouao.
25 MR GARNHAM: This implies that Jones will know about the
117
1 procedures to obtain these photographs.
2 MISS ARTHURWORREY: That is correct, yes.
3 MR GARNHAM: Did you discuss that with Jones?
4 MISS ARTHURWORREY: We did have a discussion.
5 MR GARNHAM: Did you understand her to understand how to get
6 the photographs?
7 MISS ARTHURWORREY: At the time, yes.
8 MR GARNHAM: You thought she knew what to do?
9 MISS ARTHURWORREY: I did, yes.
10 MR GARNHAM: The photographs never materialised, or did not
11 materialise at this stage, did they?
12 MISS ARTHURWORREY: They did not, no.
13 MR GARNHAM: Did you ever chase up with Jones, saying, "Why
14 did you not do what Karen Johns had said"?
15 MISS ARTHURWORREY: No, I did not.
16 MR GARNHAM: Why? Were you not interested to see the
17 photographs?
18 MISS ARTHURWORREY: I think once we had received the
19 reports, the medical reports from the North Middlesex
20 Hospital, and they did not state that there was
21 non-accidental injury --
22 MR GARNHAM: This seemed less important to you.
23 MISS ARTHURWORREY: That is correct, yes.
24 MR GARNHAM: Sorry, I interrupted because we were looking at
25 276. Would you go back to that, please. This is the
118
1 second fax of that, I think the second fax you saw,
2 although it is earlier in time because it is 29th July.
3 You saw this fax?
4 MISS ARTHURWORREY: Yes, I did.
5 MR GARNHAM: When you saw it, did it already have the
6 endorsement on at the bottom?
7 MISS ARTHURWORREY: Yes, it did. Yes.
8 MR GARNHAM: Thank you. Back to your notes again, please.
9 You say you responded to the fax from Karen Johns --
10 MISS ARTHURWORREY: Could I just have the page number of my
11 contact sheet please?
12 MR GARNHAM: Yes you can. 267 and the pages that follow
13 that are earlier in the bundle --
14 THE CHAIRMAN: 067.
15 MR GARNHAM: I am sorry, Miss Arthurworrey. Can we look
16 first at 066, the bottom of that page. It says:
17 "Telephone call to North Middlesex. Purpose: to
18 respond to the fax received."
19 Which fax?
20 MISS ARTHURWORREY: That was the fax from Karen Johns.
21 MR GARNHAM: We have just looked at two. Which one are you
22 referring to?
23 MISS ARTHURWORREY: I am referring to the one where she is
24 telling me that Victoria is ready for discharge.
25 MR GARNHAM: Thank you. That is the one on page 275. I do
119
1 not think you need to trouble to look it up. So you are
2 responding to that, yes?
3 MISS ARTHURWORREY: I was, yes.
4 MR GARNHAM: And the outcome was that you spoke with
5 Isobel Quinn, yes.
6 MISS ARTHURWORREY: Yes.
7 MR GARNHAM: Why did you speak to her?
8 MISS ARTHURWORREY: Because Karen had invited me to speak to
9 the nurse in charge at North Middlesex on the Rainbow
10 Ward that day, who was Isobel Quinn.
11 MR GARNHAM: Thank you. You then set out what you were told
12 by Nurse Quinn at the bottom of page 66 and then down
13 page 65, is that right?
14 MISS ARTHURWORREY: Yes.
15 MR GARNHAM: That includes the assertion, halfway down on
16 65, that the hospital is satisfied with the explanation
17 given by Anna's mother re her burns.
18 MISS ARTHURWORREY: Yes.
19 MR GARNHAM: I suspect you will already know
20 Miss Arthurworrey that the Inquiry asked Nurse Quinn
21 about that note. Sir, for your note Day 18, page 170,
22 line 25. Nurse Quinn denied that she said that to you.
23 In fact, she said that she was telling you precisely the
24 opposite, that there were remaining concerns about the
25 burns. What do you say about that?
120
1 MISS ARTHURWORREY: I say about that that my recollection of
2 that conversation has been noted and I took great care
3 and attention because I knew that this was important
4 information.
5 MR GARNHAM: You see, if it is the case -- if it is the
6 case -- that the hospital were not in fact satisfied
7 about the burns being caused by way of an accident or by
8 Victoria, it would be very odd if Nurse Quinn had said
9 what she did, would it not? If.
10 MISS ARTHURWORREY: It would be, yes.
11 MR GARNHAM: If that is right there are two possibilities,
12 are there not? Either Nurse Quinn is wrong in saying
13 that the hospital had concerns about the burns on
14 3rd August, or else your note of the conversation is
15 wrong.
16 MISS ARTHURWORREY: Yes, I accept that.
17 MR GARNHAM: But you are confident that the note of the
18 conversation is correct?
19 MISS ARTHURWORREY: I am confident that the note of that
20 conversation was correct.
21 MR GARNHAM: And the implication we should draw from that is
22 that Nurse Quinn is not correct when she says that the
23 hospital did have concerns about the burns?
24 MISS ARTHURWORREY: Nurse Quinn was not correct when she
25 said that.
121
1 MR GARNHAM: In any event, Miss Arthurworrey, you say in
2 paragraph 84 of your statement that Quinn agreed to send
3 you a note of the hospital's concerns and the medical
4 information.
5 MISS ARTHURWORREY: That is because I had asked her for
6 that.
7 MR GARNHAM: Yes. Am I right to read paragraph 86 to mean
8 that she did what you expected her to do?
9 MISS ARTHURWORREY: Yes.
10 MR GARNHAM: And the result was that you got an 11-page fax
11 from Nurse Quinn?
12 MISS ARTHURWORREY: I cannot actually remember how many
13 pages Nurse Quinn sent me. At the time I wrote this
14 statement my legal team asked me to count the pages in
15 the report section of Victoria's file, which is what we
16 did, and that is how we arrived at the figure 11.
17 MR GARNHAM: That count is based on documents that we have
18 in two different parts of our bundles and I just want to
19 identify them with you. Could you please have volume 6
20 in front of you. You probably have that. Page 245,
21 first of all.
22 245 is the first of some body maps, yes? Did you
23 have those?
24 MISS ARTHURWORREY: I really do not remember but I do
25 remember looking at some body maps.
122
1 MR GARNHAM: 248, paediatric assessment forms. Did you have
2 that?
3 MISS ARTHURWORREY: Yes, I did have that.
4 MR GARNHAM: The child protection forms at 250, did you have
5 that?
6 MISS ARTHURWORREY: Yes, I had that.
7 MR GARNHAM: Go to 252. Is that the form in which you
8 received that? I think you know that there is another
9 version of that and the other version of that has an
10 endorsement from Dr Rossiter on it with an arrow. We
11 have in our bundles two copies, one with the endorsement
12 and one without. Do you recall which version you got?
13 MISS ARTHURWORREY: I do not recall which version I got.
14 MR GARNHAM: So it could be you had the version with
15 Dr Rossiter's annotation on it?
16 MISS ARTHURWORREY: It could be, yes.
17 MR GARNHAM: You then had CP5 at page 253.
18 MISS ARTHURWORREY: Yes.
19 MR GARNHAM: And you had the A&E Department sheet at 254.
20 MISS ARTHURWORREY: Yes, I did.
21 MR GARNHAM: Did you also have the other section which would
22 make up the 11 pages at 281? Did you have that letter
23 first of all?
24 MISS ARTHURWORREY: I did receive that letter, yes.
25 MR GARNHAM: This is a memo to you on 3rd August from
123
1 Isobel Quinn.
2 MISS ARTHURWORREY: That is correct, yes.
3 MR GARNHAM: The document that followed, 283? No, I do not
4 think you could have had that. The last document is the
5 two I have taken you to.
6 MISS ARTHURWORREY: Yes.
7 MR GARNHAM: Can I ask you now with that in mind to look
8 back to your note at page 64. What did you understand
9 was going to be faxed to you by way of medical reports?
10 MISS ARTHURWORREY: I understood that Dr Forlee's medical
11 reports would be faxed to me because that was one of the
12 recommendations of the strategy meeting.
13 MR GARNHAM: And Dr Rossiter? Did you understand you were
14 going to be getting a report from Dr Rossiter?
15 MISS ARTHURWORREY: There had been no mention of Dr Rossiter
16 in that first strategy meeting, so, no.
17 MR GARNHAM: What then do you mean in your notes by the
18 observation halfway down the page at 64:
19 "Isobel agreed to fax reports by Dr Rossiter and
20 Dr Forlee"?
21 MISS ARTHURWORREY: During my conversation with Isobel Quinn
22 I had been told that Dr Rossiter had carried out a ward
23 round, I think it was on the 1st August, and had noticed
24 signs of emotional abuse. Isobel Quinn gave me
25 examples. She mentioned for example the master/servant
124
1 relationship and that was -- I asked her to fax me those
2 concerns.
3 MR GARNHAM: Yes, I am sure it is me being slow but the note
4 on page 64, "Isobel agreed to fax reports by Rossiter
5 and Forlee", is that an accurate statement as to what
6 happened in that telephone conversation?
7 MISS ARTHURWORREY: It is not entirely accurate, no.
8 MR GARNHAM: How should we read it as amended then?
9 MISS ARTHURWORREY: "Isobel agreed to fax Victoria's medical
10 reports".
11 MR GARNHAM: Did you know that there was a Rossiter medical
12 report at that stage?
13 MISS ARTHURWORREY: No, I did not.
14 MR GARNHAM: So that part of that note is simply wrong?
15 MISS ARTHURWORREY: It is wrong, yes.
16 MR GARNHAM: In paragraph 84 of your statement you say, at
17 the last line of 84:
18 "As a result of our discussions Nurse Quinn agreed
19 to send me a note of the hospital's concerns, together
20 with a copy of Victoria's medical information."
21 Is that more accurate?
22 MISS ARTHURWORREY: That is more accurate.
23 MR GARNHAM: That is interesting because of course the notes
24 on page 64 are much more contemporaneous than this
25 statement but nevertheless you think the notes are
125
1 wrong?
2 MISS ARTHURWORREY: Isobel Quinn did not specifically say
3 that she was going to fax a report from Dr Rossiter, so
4 it is wrong, yes.
5 MR GARNHAM: The original list of jobs that you had as you
6 record them at page 67 requires you to obtain a report
7 from Dr Forlee, does it not?
8 MISS ARTHURWORREY: It does, yes.
9 MR GARNHAM: Was that ever obtained? Did you ever have
10 a report signed by Dr Forlee?
11 MISS ARTHURWORREY: I thought I did at the time, yes.
12 MR GARNHAM: Which was?
13 MISS ARTHURWORREY: The CP1.
14 MR GARNHAM: The form completed at the time of Victoria's
15 first admission to the NMH?
16 MISS ARTHURWORREY: Yes.
17 MR GARNHAM: The report from the hospital social worker that
18 you refer to in your list of jobs is a report that
19 intended to cover concerns about neglect, is it not?
20 MISS ARTHURWORREY: Yes.
21 MR GARNHAM: Did it occur to you that the memorandum from
22 Nurse Quinn at 281 that we looked at a moment ago --
23 turn it up, please -- might be the report setting out
24 concerns about neglect?
25 MISS ARTHURWORREY: I had asked Isobel Quinn for that
126
1 report, yes.
2 MR GARNHAM: So this was the answer for the task: get
3 a report on neglect?
4 MISS ARTHURWORREY: At the time that was my understanding,
5 yes.
6 MR GARNHAM: So there is no question in your mind that you
7 saw Quinn's report as doing anything more than listing
8 the neglect issues?
9 MISS ARTHURWORREY: Yes.
10 MR GARNHAM: You did not see it as being a comprehensive
11 report listing all of the hospital's concerns?
12 MISS ARTHURWORREY: Well I had asked Isobel Quinn to send me
13 all of their concerns.
14 MR GARNHAM: That is where I am having difficulty because
15 I thought you told me a few moments ago that you saw
16 this fax on page 281 as being the response to the
17 request for a report dealing with emotional concerns.
18 MISS ARTHURWORREY: Could I just have a look at the strategy
19 meeting recommendations, please?
20 MR GARNHAM: Yes, of course. Page 91 and you will need to
21 look at page 94.
22 You see, there appear to be two separate things
23 required here. Point number 1 is Dr Forlee, examining
24 paediatrician, expressing " ...concerns with previous
25 NAI shaped like a belt buckle. Obtain medical report re
127
1 their concerns".
2 MISS ARTHURWORREY: Yes.
3 MR GARNHAM: "Also need to state how old injuries are",
4 I think it is. Then further down that same page,
5 item 4:
6 "Obtain report from hospital social worker re
7 concerns of neglect."
8 MISS ARTHURWORREY: Yes.
9 MR GARNHAM: What I am suggesting to you is that you had,
10 from Quinn, the answer to item 4.
11 MISS ARTHURWORREY: Yes.
12 MR GARNHAM: But that you had nothing more than the CP forms
13 from Forlee relating to other issues.
14 MISS ARTHURWORREY: That is correct, yes.
15 MR GARNHAM: They had the CP forms at the time of the
16 strategy meeting.
17 MISS ARTHURWORREY: Well, I did not attend the strategy
18 meeting, so I do not know.
19 MR GARNHAM: You knew they were available because you told
20 us you had them in your hand prior to your conversation
21 with Nurse Quinn, yes?
22 MISS ARTHURWORREY: Did I say that? I do not remember. The
23 first time I received any medical information on
24 Victoria was after I had requested it from Isobel Quinn.
25 MR GARNHAM: Sorry, that may be my mistake. You thought,
128
1 did you, that the CP forms answered issue 1 here?
2 MISS ARTHURWORREY: At the time I did, yes.
3 MR GARNHAM: You thought they amounted to a report prepared
4 as a result of a request in that strategy meeting?
5 MISS ARTHURWORREY: I did, yes.
6 MR GARNHAM: I still do not quite understand how that can be
7 the case, because Dr Forlee's CP form is completed on
8 24th July.
9 MISS ARTHURWORREY: I had not noticed the date at the time.
10 MR GARNHAM: Let us look, in any event, at what material had
11 reached you by 3rd August insofar as it related to
12 physical abuse. You had the original referral sheet
13 from Caroline Rogers.
14 MISS ARTHURWORREY: That is correct, yes.
15 MR GARNHAM: You had the strategy minute meetings.
16 MISS ARTHURWORREY: Yes.
17 MR GARNHAM: You had the CP form, obtained that day, you
18 remind me.
19 MISS ARTHURWORREY: Yes.
20 MR GARNHAM: You had the body maps.
21 MISS ARTHURWORREY: Yes.
22 MR GARNHAM: You had Dr Forlee's concerns noted at least, as
23 we see them on page 65; yes?
24 MISS ARTHURWORREY: Yes.
25 MR GARNHAM: Six lines or so from the bottom:
129
1 "When she was examined Paediatrician Forlee noticed
2 old injuries which appeared to be non-accidental."
3 MISS ARTHURWORREY: Yes.
4 MR GARNHAM: And you had, you tell us in paragraph 85 of
5 your statement, Nurse Quinn's observations about old
6 injuries being NAI.
7 MISS ARTHURWORREY: Yes.
8 MR GARNHAM: So there is a build-up of material there, all
9 of which suggests that the North Middlesex Hospital had
10 concerns about non-accidental injuries.
11 MISS ARTHURWORREY: Not specifically, no. I knew that North
12 Middlesex Hospital were concerned with old markings
13 which had been found on Victoria's body but nobody made
14 specific reference to these marks being as a result of
15 non-accidental injury.
16 MR GARNHAM: Look at page 41 in volume 6. This is the
17 original referral sheet I think from Caroline Rogers.
18 MISS ARTHURWORREY: Yes.
19 MR GARNHAM: Halfway down that piece of text:
20 "The next day on Rainbow Ward the nurse bathed Anna
21 and saw old marks on child's body. Up until then the
22 staff did not suspect physical abuse but since
23 witnessing the marks they feel sure they are
24 non-accidental. Dr Forlee suggests that the marks look
25 like they were done by belt buckles."
130
1 MISS ARTHURWORREY: Yes.
2 MR GARNHAM: So you had that much from the North Middlesex?
3 MISS ARTHURWORREY: In the initial referral, yes.
4 MR GARNHAM: Paragraph 89 of your statement you say, first
5 sentence:
6 "Whilst possible emotional abuse was specifically
7 mentioned neither Nurse Quinn's notes nor the NMH
8 medical information referred to physical abuse."
9 You see, what I am suggesting to you is you would
10 not expect Nurse Quinn's note to refer to physical abuse
11 because she was writing with respect to a request
12 relating to emotional abuse; do you agree with that?
13 MISS ARTHURWORREY: I agree with that.
14 MR GARNHAM: But the rest of the NMH material did on
15 a number of occasions refer to physical abuse including
16 the referral sheet which I have already taken you to, so
17 how can you write "nor did the NMH medical information
18 refer to physical abuse"?
19 MISS ARTHURWORREY: The North Middlesex Hospital's medical
20 reports that were sent to me did not make specific
21 reference to physical abuse.
22 MR GARNHAM: You go on:
23 "There was no reference to old marks, to a belt
24 buckle mark or to loop wire marks or to non-accidental
25 injury ..."
131
1 But there was, at least in the first two of those
2 there certainly was in Caroline Roger's referral taken
3 from the North Middlesex, was there not?
4 MISS ARTHURWORREY: Yes.
5 MR GARNHAM: Given that against that background the hospital
6 were contemplating discharging Victoria, as you then
7 knew, were you not concerned about what might happen to
8 her?
9 MISS ARTHURWORREY: I was concerned.
10 MR GARNHAM: Not only were there still unresolved questions
11 about non-accidental injury, but there was now the
12 up-to-date observations of Nurse Quinn about emotional
13 abuse?
14 MISS ARTHURWORREY: Yes.
15 MR GARNHAM: Did that taken in the round not lead you then
16 and there to start a full assessment of Victoria?
17 MISS ARTHURWORREY: In order to begin a full assessment of
18 Victoria I needed a medical report which gave clear
19 diagnosis of non-accidental injury.
20 MR GARNHAM: Did you? Because you were concerned, were you
21 not, about the emotional abuse as well? You do not only
22 do assessments where there is physical abuse?
23 MISS ARTHURWORREY: No.
24 MR GARNHAM: You would also do one where there is emotional
25 abuse?
132
1 MISS ARTHURWORREY: Yes.
2 MR GARNHAM: And you had clear statement from the hospital
3 that there were concerns about emotional abuse?
4 MISS ARTHURWORREY: Yes.
5 MR GARNHAM: So why then not start a full assessment then
6 and there?
7 MISS ARTHURWORREY: Because it is important to gather all
8 the relevant information before initial assessment can
9 be made, can be started.
10 MR GARNHAM: You need to gain all the information before you
11 can start the initial assessment, is that right?
12 MISS ARTHURWORREY: In preparation for the initial
13 assessment, yes.
14 MR GARNHAM: Could you have done an assessment of that sort
15 without a home visit? If you have concerns about
16 emotional abuse do you need a home visit?
17 MISS ARTHURWORREY: Yes, I believe we do.
18 MR GARNHAM: So the things that were essential at that stage
19 for you to obtain were a proper set of medical reports
20 and to conduct a home visit?
21 MISS ARTHURWORREY: Yes.
22 MR GARNHAM: That would have been part of or preparatory to
23 your assessment --
24 MISS ARTHURWORREY: Yes.
25 MR GARNHAM: -- of Victoria's needs.
133
1 MISS ARTHURWORREY: Yes.
2 MR GARNHAM: You tell us that some of the medical material
3 you had to read was difficult to read.
4 MISS ARTHURWORREY: I remember receiving Dr Forlee's medical
5 report and I remember struggling to understand North
6 Middlesex's concerns around non-accidental injury.
7 MR GARNHAM: Will you go to 252, please, in volume 6.
8 This is the unamended version of CP3 and I am
9 wondering whether this is the passage you had difficulty
10 reading?
11 MISS ARTHURWORREY: It is, yes.
12 MR GARNHAM: Is it the first two words under the word
13 "height" that you could not read or is it something
14 else?
15 MISS ARTHURWORREY: Basically, from the CP3 I was not able
16 to ascertain what the North Middlesex concerns were
17 around non-accidental injury.
18 MR GARNHAM: Sorry, I thought you were saying in your
19 statement that there were passages in this form that you
20 could not read.
21 MISS ARTHURWORREY: And there are also parts of this form
22 I could not read.
23 MR GARNHAM: Let us deal with the latter part first then.
24 What is it that you could not read?
25 MISS ARTHURWORREY: As you have mentioned --
134
1 MR GARNHAM: Those two words which I think is "cervical
2 adenopathy"?
3 MISS ARTHURWORREY: Right.
4 MR GARNHAM: You could not read that. You were trying to
5 make an assessment of what that report said about child
6 abuse risks?
7 MISS ARTHURWORREY: That is correct, yes.
8 MR GARNHAM: What did you do about your non-understanding of
9 those words? Did you phone up the doctor?
10 MISS ARTHURWORREY: I phoned Dr Rossiter on 3rd August.
11 MR GARNHAM: And asked her what those words were?
12 MISS ARTHURWORREY: The purpose of the telephone call to
13 Dr Rossiter was for her to clarify the concerns that
14 I had received in this medical information.
15 MR GARNHAM: I understand that but that was not my question,
16 was it? Did you ask her what those words meant?
17 MISS ARTHURWORREY: No, I did not.
18 MR GARNHAM: Why not?
19 MISS ARTHURWORREY: I did not think to ask at the time. It
20 is something that I just did not do.
21 MR GARNHAM: While we are dealing with that page CP3, could
22 I ask you to look at the other version of CP3 which we
23 have at 286. Do you have that?
24 MISS ARTHURWORREY: I have.
25 MR GARNHAM: That is the same document with the endorsement
135
1 by Mary Rossiter.
2 MISS ARTHURWORREY: Yes.
3 MR GARNHAM: It has a fax header sheet running across the
4 top line which appears to suggest that it was sent at
5 12.20 on 3rd August, from John Gilpin Ward at the NMH to
6 a number 0181 887 2449. I have to confess I do not know
7 whether that is the receiving number or the sending
8 number.
9 MISS ARTHURWORREY: I do not know.
10 MR GARNHAM: That would have been about the time, would it
11 not, that you received the CP forms?
12 MISS ARTHURWORREY: Yes.
13 MR GARNHAM: So that there is a fair chance that you
14 received it in this form, including the endorsement?
15 MISS ARTHURWORREY: Yes.
16 MR GARNHAM: What did you understand the endorsement by
17 Dr Rossiter to mean?
18 MISS ARTHURWORREY: I do not even remember noticing that
19 endorsement. The first time I became aware that an
20 endorsement had been made was when I was preparing my
21 statement.
22 MR GARNHAM: Looking at that now, how do you interpret it?
23 MISS ARTHURWORREY: I still struggle to understand what it
24 means.
25 MR GARNHAM: It is above an arrow which runs from the
136
1 conclusion "I wish to await further information
2 before committing myself" to the box "I consider the
3 incident is likely to be non-accidental" and beside it
4 someone has written -- we think it is Dr Rossiter:
5 "What is uncertain is the category."
6 Does that mean anything to you now?
7 MISS ARTHURWORREY: Not really, no.
8 MR GARNHAM: If you had seen this and been conscious of this
9 amendment and not known what it means, what would you
10 have done?
11 MISS ARTHURWORREY: I would have spoken to Dr Rossiter and
12 asked her to explain what that meant.
13 MR GARNHAM: In your conversation which would have been
14 later that day with Dr Rossiter you did not do that?
15 MISS ARTHURWORREY: I did not do that, no.
16 MR GARNHAM: Because you were not conscious of having seen
17 this endorsement?
18 MISS ARTHURWORREY: That is correct, yes.
19 MR GARNHAM: Did your manager see this document?
20 MISS ARTHURWORREY: I really cannot remember if
21 Carole Baptiste did see this document.
22 MR GARNHAM: All right. You knew, did you not, on 3rd
23 August, that Victoria had been seen at the Central
24 Middlesex Hospital as well?
25 MISS ARTHURWORREY: I did.
137
1 MR GARNHAM: When did you first contact the Central
2 Middlesex Hospital?
3 MISS ARTHURWORREY: I did not contact the Central Middlesex
4 Hospital.
5 MR GARNHAM: Why not?
6 MISS ARTHURWORREY: Because it was something that I had not
7 done prior to interviewing Kouao and Victoria because
8 I knew that Caroline Rogers had put in a request for the
9 Central Middlesex Hospital to send their notes.
10 MR GARNHAM: How did you know that?
11 MISS ARTHURWORREY: Because there was a note on the file.
12 Could we go back to Dr Schwartz?
13 MR GARNHAM: The fax reference of Dr Schwartz?
14 MISS ARTHURWORREY: Yes.
15 MR GARNHAM: Yes.
16 MISS ARTHURWORREY: It was actually Caroline Rogers' request
17 to the Medical Library for records.
18 MR GARNHAM: That is at 277 I think in this bundle. That is
19 the fax to Caroline Rogers from Dr Schwartz. The next
20 page is to Medical Reports Library.
21 MISS ARTHURWORREY: Yes.
22 MR GARNHAM: 278. Do you have that?
23 MISS ARTHURWORREY: Yes.
24 MR GARNHAM: "We are currently undertaking a Section 47
25 child protection investigation re the above child.
138
1 "We understand you have been involved in the family.
2 "Could you send any information ... "
3 So that is the inquiry you knew had begun?
4 MISS ARTHURWORREY: That is right.
5 MR GARNHAM: Did you chase up to see whether there was
6 a response to that coming?
7 MISS ARTHURWORREY: No, I did not.
8 MR GARNHAM: Why not? Is that not part of the material you
9 need to gather if you are going to carry out this
10 assessment?
11 MISS ARTHURWORREY: After interviewing Kouao on 5th August
12 in my notes of that interview I did write that checks
13 needed to be made with the Central Middlesex Hospital
14 and that was a recommendation in the strategy meeting.
15 MR GARNHAM: When did you eventually get the CMH material?
16 MISS ARTHURWORREY: It came on the 12th.
17 MR GARNHAM: Can I ask you about your conversation with
18 Dr Rossiter on the 3rd? You knew that she had grave
19 concerns, would you agree?
20 MISS ARTHURWORREY: Could I have a look at my note, please?
21 MR GARNHAM: Your original notes?
22 MISS ARTHURWORREY: Yes.
23 MR GARNHAM: Yes. Volume 6, page 62 and thereafter.
24 MISS ARTHURWORREY: My recollection of my telephone call
25 with Dr Rossiter is as is written here. The purpose of
139
1 that telephone call is to clarify her concerns in the
2 medical report and the outcome of that telephone
3 conversation was that:
4 "Dr Rossiter feels Anna may be subject to emotional
5 abuse, believes she is displaying evidence of anxious
6 attachments. Anna appears to seek attention and praise
7 from all the nursing staff but when mother arrives
8 rushes to her side as if she has been called to
9 attention. Dr Rossiter described that as
10 a master/servant relationship."
11 MR GARNHAM: Did you understand Dr Rossiter to have grave
12 concerns about Victoria?
13 MISS ARTHURWORREY: I understood Dr Rossiter felt that
14 Victoria was at risk of emotional abuse. I did not know
15 she had grave concerns, no.
16 MR GARNHAM: Could I ask you to look at volume 50 please,
17 page 19. This is the transcript of your evidence at the
18 Old Bailey, Miss Arthurworrey. You were asked
19 a question at the bottom of page 19:
20 "And we have heard from Dr Rossiter, and it is right
21 that she had very serious reservations about this case.
22 Is that not so?"
23 You answer over the page:
24 "Dr Rossiter said that she had grave concerns about
25 the case."
140
1 MISS ARTHURWORREY: On 3rd August I did not know that
2 Dr Rossiter had grave concerns. On 1st October I was
3 visited by Petra Kitchman, the child protection advisor
4 who had informed me Dr Rossiter had concerns.
5 MR GARNHAM: So you say that this answer you gave at the
6 Old Bailey relates to a much later time, do you?
7 MISS ARTHURWORREY: I believe so.
8 MR GARNHAM: Just look at the context it is in, this line of
9 questioning. It does read, does it not, as if this is
10 a reference to the conversation you had with Dr Rossiter
11 at the beginning. You see, your answer goes on:
12 "Dr Rossiter said that she had grave concerns about
13 the case. One of the recommendations from the strategy
14 meeting was that I obtain reports from Dr Rossiter.
15 I did that, on 3rd August."
16 MISS ARTHURWORREY: All I can say to that response is
17 looking back at it that was not an accurate reflection
18 of what I had understood was going on at the time.
19 MR GARNHAM: Your summary of the conversation you had with
20 Dr Rossiter is the one you have just read from, page 63
21 in volume 6. Yes?
22 MISS ARTHURWORREY: Yes.
23 MR GARNHAM: How is it you are able to have a sensible
24 conversation about this case with Dr Rossiter without
25 having seen Victoria? Do you feel confident you could
141
1 understand what she was on about and pursue with her the
2 things that were concerning you when you had not met
3 Victoria?
4 MISS ARTHURWORREY: I would have needed to have had an
5 understanding of the hospital's concerns before I met
6 with Victoria.
7 MR GARNHAM: Nobody had seen Victoria, nobody from social
8 services or the police had seen Victoria by that time,
9 had they?
10 MISS ARTHURWORREY: No they had not.
11 MR GARNHAM: Had you spoken to any of the nurses who were
12 caring for Victoria by that time? You had not, had you,
13 apart from Quinn?
14 MISS ARTHURWORREY: I remember speaking to a nurse regarding
15 Kouao's visiting Victoria.
16 MR GARNHAM: You see, the difficulty I have with what you
17 are saying so far is that you obviously place
18 considerable weight on the conversation you had with
19 Dr Rossiter and yet it appears to have been happening in
20 something of a vacuum. You have what you regard as
21 partial medical evidence, you have had no direct contact
22 with Victoria and you are then seeking to understand
23 from Dr Rossiter all her concerns about this child. Is
24 that right?
25 MISS ARTHURWORREY: At the time, yes.
142
1 MR GARNHAM: Dr Rossiter mentioned to you anxious
2 attachment, amongst other things. You have just read
3 that to us.
4 MISS ARTHURWORREY: She did.
5 MR GARNHAM: Did you know what that meant at the time?
6 MISS ARTHURWORREY: Dr Rossiter -- I believe Dr Rossiter
7 gave an example of anxious attachment. Dr Rossiter said
8 that Victoria seeks attention and praise from the
9 nursing staff. That was the example she gave me
10 I believe of anxious attachment.
11 MR GARNHAM: She also told you things that would have been
12 of concern, of interest to you: fear of being undressed.
13 MISS ARTHURWORREY: Yes.
14 MR GARNHAM: Frightened of mother's partner.
15 MISS ARTHURWORREY: Yes.
16 MR GARNHAM: Unexplained marks.
17 MISS ARTHURWORREY: "Dr Rossiter said there were a number of
18 marks on Anna's body. However Dr Rossiter is unclear as
19 to whether these were caused by Anna scratching herself
20 or infection from the scratching. Two old thumb marks
21 were also observed on her body."
22 MR GARNHAM: Unexplained marks.
23 MISS ARTHURWORREY: Unexplained marks.
24 MR GARNHAM: That is enough, is it not, for you to begin
25 a full investigation into this child's well-being?
143
1 MISS ARTHURWORREY: Yes it was.
2 MR GARNHAM: You do not need to have conclusive evidence
3 about non-accidental injury from a doctor before you
4 begin that process?
5 MISS ARTHURWORREY: No, we do not.
6 MR GARNHAM: It is enough if there are concerns and there
7 was enough in this case for you to be concerned about
8 Victoria, was there not?
9 MISS ARTHURWORREY: Yes, there was.
10 MR GARNHAM: You say that Dr Rossiter did not suggest any of
11 the marks on Victoria were indicative of physical abuse
12 in your statement.
13 MISS ARTHURWORREY: That is correct, yes.
14 MR GARNHAM: She has said to us that she told you there was
15 certainly neglect, probably emotional abuse, and
16 possibly physical abuse. What do you say?
17 MISS ARTHURWORREY: The recollection that I have of
18 a conversation with Dr Rossiter is as I have written it
19 in my notes on 3rd August.
20 MR GARNHAM: When she mentioned to you about old thumb
21 marks, did you ask her what they might indicate?
22 MISS ARTHURWORREY: No, I did not.
23 MR GARNHAM: What did you think they might indicate?
24 MISS ARTHURWORREY: I really did not know. I thought
25 that -- I assumed that if Dr Rossiter felt that these
144
1 marks had been caused by physical abuse then she would
2 have mentioned that to me.
3 MR GARNHAM: Were you going to say something else?
4 MISS ARTHURWORREY: I was just going to say that my
5 conversation with Dr Rossiter was not really
6 a discussion, it was a very factual conversation. It
7 was one-way. Dr Rossiter gave me all of this
8 information and I wrote it down at the time and then
9 I agreed to, at the end of that conversation I agreed to
10 update her following the home visit.
11 MR GARNHAM: She says she was not in her office at the time,
12 she was I think doing a ward round or a clinic at the
13 time, so she did not have any of the material in front
14 of her and that she was responding to your queries as
15 best she could without the papers in front of her. Is
16 that the impression you got?
17 MISS ARTHURWORREY: Dr Rossiter did not tell me that she did
18 not have the papers in front of her. When I introduced
19 myself as Lisa Arthurworrey and as Victoria's social
20 worker, Dr Rossiter knew which child I was talking about
21 and just went into this factual resume of her concerns.
22 MR GARNHAM: It makes it sound, Miss Arthurworrey, as if you
23 are simply the passive recipient of information, that
24 you saw yourself as a collecting bowl into which people
25 could pour their observations about Victoria rather than
145
1 somebody going out on an investigation; is that fair?
2 MISS ARTHURWORREY: I knew that before I carried out the
3 investigation into Victoria I knew that I needed to have
4 all the relevant information.
5 MR GARNHAM: Did you ask Dr Rossiter: "Is there any evidence
6 of physical abuse here"?
7 MISS ARTHURWORREY: I did not ask her, no.
8 MR GARNHAM: If you are conducting an investigation, why
9 not? It at least had been at the very least hinted at
10 in the previous hospital papers, so why not ask her?
11 MISS ARTHURWORREY: I considered that I was speaking to
12 a senior consultant paediatrician who had seen Victoria
13 and therefore if there was any concerns regarding
14 physical injury, they would have been communicated to
15 me.
16 MR GARNHAM: But you are just being passive then, waiting to
17 see what people tell you?
18 MISS ARTHURWORREY: But Dr Rossiter was the senior
19 consultant who had seen Victoria, so yes.
20 MR GARNHAM: But you did not ask her --
21 MISS ARTHURWORREY: I did not ask her.
22 MR GARNHAM: -- how she thought the scaldings had been
23 caused, did you?
24 MISS ARTHURWORREY: From my telephone conversation with
25 Nurse Quinn I had already established that the hospital
146
1 were happy with that explanation. When I spoke to
2 Dr Rossiter thereafter, Dr Rossiter also made mention of
3 the scalding injury but did not specifically specify
4 that she thought that this was a non-accidental injury.
5 MR GARNHAM: Did you ask her about the belt buckle mark?
6 MISS ARTHURWORREY: No, I did not.
7 MR GARNHAM: Were you not at least inquisitive as to whether
8 the previous notes of a belt buckle mark had led to
9 a conclusion by the doctors?
10 MISS ARTHURWORREY: Certainly in the medical information
11 that I had received on the 3rd of August there was no
12 reference to a belt buckle mark. There was also no
13 reference -- Isobel Quinn had not made any reference to
14 a belt buckle mark but I knew from the referral that the
15 hospital's concerns had been old markings and there was
16 a mark that looked like a belt buckle mark, but they
17 were not sure.
18 MR GARNHAM: What do you understand to be the meaning of the
19 word "old" when the hospital says "this is an old mark"?
20 MISS ARTHURWORREY: I understood it to be an old mark, as
21 opposed to fresh mark.
22 MR GARNHAM: So it could have been a week or two old?
23 MISS ARTHURWORREY: Yes.
24 MR GARNHAM: So why not ask the doctor when you get on the
25 phone for her views about the belt buckle mark, which
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1 had been described previously?
2 MISS ARTHURWORREY: It is just something that I did not do.
3 I considered I was speaking to a senior consultant
4 paediatrician.
5 MR GARNHAM: And she would tell you everything you needed to
6 know?
7 MISS ARTHURWORREY: And she would tell me everything
8 I needed to know.
9 MR GARNHAM: You discuss the fax you had got from Quinn with
10 PC Jones, I think.
11 MISS ARTHURWORREY: I cannot remember when I discussed that
12 fax but I can say certainly before the visit with Kouao
13 on 5th August PC Jones sat at my desk and we went
14 through the medical information that I had received.
15 MR GARNHAM: Look at page 62 in your notes. About halfway
16 down the page it says:
17 "Discussion with Karen Johns, PCPT."
18 Am I right to see that as a mistake? You do not
19 mean Karen Johns, you mean Karen Jones?
20 MISS ARTHURWORREY: That was a mistake, yes.
21 MR GARNHAM: That should be Karen Jones?
22 MISS ARTHURWORREY: It should be Karen Jones.
23 MR GARNHAM: So you did on that occasion discuss with
24 Karen Jones what you had learned from the hospital?
25 MISS ARTHURWORREY: Yes, although I do not remember what was
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1 actually discussed.
2 MR GARNHAM: PC Jones says in her witness statement that you
3 told her that you had a statement in which a doctor
4 described a belt buckle mark. Do you remember that?
5 MISS ARTHURWORREY: No I do not.
6 MR GARNHAM: PC Jones says that she asked you to fax it to
7 her. Do you remember that request?
8 MISS ARTHURWORREY: I think I do remember that request.
9 MR GARNHAM: And what you faxed in response was Quinn's
10 statement?
11 MISS ARTHURWORREY: I really do not remember.
12 MR GARNHAM: That statement from Quinn does not contain any
13 reference to a belt buckle mark.
14 MISS ARTHURWORREY: It does not, no.
15 MR GARNHAM: Were you confused where the reference to a belt
16 buckle mark had come from, do you think?
17 MISS ARTHURWORREY: I knew the reference to a belt buckle
18 mark had been raised in the initial referral and had
19 also been raised in the strategy meeting.
20 MR GARNHAM: You also discussed the Quinn fax with Baptiste.
21 MISS ARTHURWORREY: Yes, I did.
22 MR GARNHAM: She told you to arrange a home visit before the
23 discharge.
24 MISS ARTHURWORREY: That is correct, yes.
25 MR GARNHAM: Did she tell to you see Victoria?
149
1 MISS ARTHURWORREY: No, she did not.
2 MR GARNHAM: Did she tell you to talk to all those involved?
3 MISS ARTHURWORREY: No, she did not.
4 MR GARNHAM: Did she tell you to contact CMH?
5 MISS ARTHURWORREY: No, she did not.
6 MR GARNHAM: What did she tell you should be the police'
7 role? Did she talk about the police and what they
8 should do?
9 MISS ARTHURWORREY: She did not, no.
10 MR GARNHAM: After that conversation with Baptiste where you
11 looked at the position then, was it the evidence about
12 physical abuse, such as it was, that concerned you or
13 was it the evidence about emotional abuse and neglect?
14 What sort of case did you think you were dealing with
15 then?
16 MISS ARTHURWORREY: Emotional and neglect.
17 MR GARNHAM: You say in paragraph 98 that the hospital's
18 "ambivalence", that is your word, about the marks on
19 Victoria's body left you with no option but to pursue
20 this as an investigation into social issues case; yes?
21 MISS ARTHURWORREY: Yes.
22 MR GARNHAM: Why is it that ambivalence on the part of
23 a hospital about the cause of injuries leaves you with
24 no choice but to treat it as a social issues case?
25 MISS ARTHURWORREY: Basically during the initial assessment
150
1 process a local authority has to ask itself number one,
2 is this child a child in need; number two, is there
3 reason to suspect that this child is at risk of
4 significant harm?
5 MR GARNHAM: Absolutely, and what you had was ambivalence --
6 MISS ARTHURWORREY: That is correct.
7 MR GARNHAM: -- about physical marks on this child's body?
8 MISS ARTHURWORREY: That is correct, yes.
9 MR GARNHAM: What did you do to resolve that ambivalence?
10 MISS ARTHURWORREY: I raised the markings on Victoria's body
11 with Kouao during the office interview on 5th August.
12 MR GARNHAM: But she is at least potentially the abuser or
13 one of the abusers, is she not? She might be, she is
14 the person who has had the care of the child, so if
15 there is physical abuse she might be the one?
16 MISS ARTHURWORREY: She might be the one.
17 MR GARNHAM: So how is raising with her the physical marks
18 going to help you resolve the hospital's ambivalence?
19 MISS ARTHURWORREY: It would not have resolved the
20 hospital's ambivalence.
21 MR GARNHAM: So how were you going to resolve that
22 ambivalence?
23 MISS ARTHURWORREY: Dr Rossiter had said to me that she did
24 not think the markings on Victoria's body had been
25 caused through accidental injury. Dr Rossiter clearly
|
