Management flaws found in treatment of McColgan case

 

Both the North Western Health Board and a family doctor are criticised in a report on the McColgan physical and sexual abuse case expected to be published today. The report finds that a legal remedy would have been available at the time if all the information had been in the hands of the board's legal adviser.

The report has been compiled by a review group which started its investigation following the criminal case in 1995, when Joe McColgan was sentenced to 12 years in prison for physically and sexually abusing his children over almost two decades. The group is composed of Mr Michael Bruton, a management consultant and qualified social worker, Dr Sheila Ryan, chief executive of the Western Health Board, and the Eastern Health Board's director of community care, Mr Paul Harrison.

The investigation was suspended last December, when a civil case against the health board and the doctor, Dr Desmond Moran, by one of the children, Ms Sophia McColgan, opened in the High Court. She alleged they did not protect her and her siblings from the abuse. The case ended in January with a six-figure settlement for her, two of her brothers and a sister. The review group then resumed its work, and completed the report over the summer.

While stating that the father must accept the primary responsibility for abusing the children, the report also finds that the abuse was allowed to continue due to managerial failures and a lack of an integrated approach between different bodies in the health board.

There was an operational practice within the social work department focused on a "non-legal interventionist approach towards child protection". There was a stronger emphasis on the role of parents and the family as a unit, rather than the child-centred approach now in place under the 1991 Child Care Act.

Although child-protection legislation has developed greatly since the abuse came to the board's attention in 1981 and 1983, the review group concludes that "a legal remedy would have been feasible" at the time had all the information been discussed with the board's legal adviser.

However, it praises the field social work staff, the school, whose vice-principal worked out of hours to secure the safety of the eldest boy, and another GP who referred the two eldest children to hospital.

"One of the managerial weaknesses in the case lies in the failure to convene, either by the Director of Community Care and Medical Officer of Health or senior social workers at key times, a case conference," it says. This was not done either in 1981 when the eldest boy had a serious fracture, or in 1983 when sexual abuse was disclosed, it says.

This was particularly critical in 1984, when a "a forceful, insightful report" by the field social worker was never presented to a case conference because none was called. The board's solicitor was inadequately briefed by the senior social worker at the time, and the review group also found a "stark contrast" between the report of the field social worker and a letter from the then senior social worker to the father, effectively closing the case until 1993.

The totality of information held by all the professional staff was never collated, according to the report, nor was there any correlation of episodes of hospital contact arising out of incidents of physical abuse.

"The health care professional most involved with the family was the GP," it says. "When G disclosed sexual abuse, it caused shock, horror and disbelief especially to the general practitioner and social worker . . . [His] response was to perform a physical examination and to feel relief when no signs were detected."

It also criticises him for turning to a chaplain for advice on the matter, rather than to other professionals or experts in the field, and singles out for comment his explanation to the review group: "I was trying to get him [the eldest boy] to get on with his father and mother, and trying to keep the family together."

The report says that today there is much greater awareness within the health board of the danger of child abuse. The board is now making "strenuous and consistent efforts" to manage its child-care responsibilities, and it praises many of its current practices, including a review of case conference decisions. There is also a statutory framework for the protection and promotion of the welfare of children.

The McColgan family gave up their right to anonymity in order to pursue their case, so, although the report does not identify the family or the doctor involved, their names have already entered the public domain through the court case.