A context note for the determination of facts #JusticeforLB

Late last night the MPTS tribunal met to deliver their determination of facts in the case of Dr Valerie Murphy, the consultant psychiatrist who was the responsible clinician for LB during his time at the STATT unit, run by Southern Health NHSFT. I’d like to share a few thoughts, a sort of context note for the determination, its based on flashbacks I’ve been having over the last two weeks.

I’d like to share a little about my past. As a young child I remember viscerally feeling ill, fragile and wooey, whenever it became clear to me that all was not right in the world, that an injustice was being done; that someone was being mean in the playground; that the kids from the partial hearing unit weren’t allowed to play british bulldog; that Maria or Samantha always got picked for the lead role in the school play and I was always narrator which meant no costume, just school uniform (the joys of being a bookish child). I learned fairly quickly that pointing out these injustices led to you being labelled a snitch, that it was best to stay silent and internalise it all. Luckily life at home was a bit different, my parents (mostly) tolerated me banging on about my rights (before I was in double digits – can you imagine what a nightmare I was); they encouraged me to develop a sense of right and wrong and while I’m sure they didn’t always welcome it, they did accept that I’d ‘refuse to play happy families’ when we went out in public if all was not well (I should point out my childhood was fairly idyllic – I’m in no way playing a tragedy card here, just putting on record the experience of knowing something is not right, and having to just get on with it).

Fast forward 20 something years and I was a young 23 year old PhD student – naive, eager to please, desperate to do well and over in Ireland to conduct my first Irish fieldwork, visiting classrooms, unit and residential schools for profoundly disabled children. I was floored when I walked into my first unit, on my first day. I had already done fieldwork in England and Wales and expected to find things more or less comparable, but my brain rattled around in my skull as I tried to compute what I saw. There were only five children, of varying ages, and let me be clear that without a doubt people were doing their best, but their best was woefully below what I’d come to expect. One child was strapped into his chair by a leather belt (to stop him getting up and moving around), another girl’s hands were swaddled and she was being cuddled by a nun on a rug on the floor, another young lad (probably in his early teens) was alternatively smashing his head off the heel of his hand or the classroom wall (before two middle aged women attempted to restrain him and take him to a safe room), a girl sat in her wheelchair silently, banging her flat hands of her tray table and then poking her finger into the corner of her eye (which was explained to me as to get the stars you might get when you bang your head – essentially for some sort of stimulation) and the fifth child sat drawing at a table. This was special education for profoundly disabled children in the Irish capital in the year 2000.

I went back to my host department in complete shock; I was shaking, confused and furious (and in no way convinced I was cut out to do this PhD). The head of the department (one of the wisest, kindest and most wonderful men I’ve ever had the privilege of meeting, never mind working with) sat and listened to me rant and rave. He in no way attempted to defend what I told him, but he wasn’t shocked. There were few lesson plans or structures; even simple communication aids (like Big Mac switches used to enable a person to indicate yes or no) were a novelty; hardly anyone I met seemed to understand that behaviour (such as banging your head or poking your eye) could be interpreted as communication, or indeed that it could be as a result of sheer boredom. It was woeful.

Over the next year I saw worse than that and was slowly exposed to the Irish way of thinking. Disabled children were a ‘gift from god’, they were cared for in the best way that people knew, by mostly unqualified staff, often from religious orders. If they were lucky they got someone early enough in their career to be enthusiastic and intent on doing things differently, or they might get an experienced teacher who’d moved to Ireland but wasn’t allowed to teach in mainstream without a competency in the Irish language. I met very few people who considered profoundly disabled people had much to contribute to life, beyond perhaps being objects ‘sent’ to develop people’s devotion and piety. On the whole disabled children were infantalised and kept very much out of sight, as were disabled adults.

I think it’s fair to say that Irish society was entirely different to what I’d experienced before, and that the provision for disabled children (and disabled people) was years behind what happened in England and Wales. Literally about 30 years behind at that time. The Education (Handicapped Children) Act of 1970 established what Kathy Sinnott would achieve in Ireland the following year, after successfully arguing her autistic son had the right to an education.

What has all of this got to do with Dr Valerie Murphy I hear you ask?

Well about this time Dr M was studying medicine at the National University of Ireland in Cork, before moving to Oxford to develop her ‘specialism’ in psychiatry and learning disability. A few of the comments on the MPTS tribunal judgement have indicated that Dr Murphy did not see LB as fully human, she did not engage with him, did not consider he had capacity (for any decisions) and did not afford him, or his family, the human rights he was entitled to.

My context is not to excuse Valerie Murphy, far from it, she had seemingly spent ten years practising in the UK by the time LB died. The context is to suggest that Murphy’s not viewing learning disabled people as fully human is entrenched deeper than just LB. It is to suggest that she is not fit to practice in the UK or Ireland. It is to suggest she has not moved with the times.

It is deeply worrying to me that she will return to work on Monday, treating patients in Cork. That she is still unaware of her own inadequacies, her lack of knowledge about mental capacity or epilepsy, still struggling to admit that she was wrong and that the consequences of how poor her performance cost a young man his life. The judgement states:

‘It noted that in your oral evidence you eventually accepted that you did have a duty to conduct some risk assessments and you had admitted your failure to comment on risk assessments conducted by the nursing staff’ [my emphasis].

Dr Valerie Murphy showed no remorse to Sara, LB’s mother, and the Barrister acting on her behalf (presumably under her instruction) subjected Sara to a cross examination that I was embarrassed to witness and shocked that the tribunal did not call to a halt.

My flashbacks of the last fortnight, my anger at the injustice of this process, my fear for the learning disabled people of Ireland has never been greater.

Up until now JusticeforLB has focused largely on trying to get accountability for LB’s (entirely preventable) death; on shining a light on the inhumane struggle that families face trying to ascertain what happened to their loved ones; on ensuring that learning disabled people are seen as fully human. This has been largely focused on the UK, with a little Spanish camino action and some satellite JusticeforLB actions across the globe during #107days and other occasions.

I think it’s time that we spread our message in LB’s beloved Emerald Isle.

4 comments on “A context note for the determination of facts #JusticeforLB”

Helen Rutter says:

I am ashamed to admit I have not heard of this case. Please could you provide some background. I live and teach special needs in Ireland and agree – we are 30 years behind – but improving. One of the things that drives me nuts is that we have just completed the 2nd level education cycle for 4 young people with autism – not profoundly disabled – but none the less SEN & there is no proper adult provision for them!

george says:

Hi Helen, when I wrote this I hoped to be inundated by people telling me how much better things were now, I’ve had the opposite. Sounds like there’s still a long way to go until all people are treated as fully human and have the opportunities and rights that affords them. A potted overview is here https://twitter.com/JusticeforLB/status/899330192107343873 (hopefully you should be able to read the thread even if you don’t have a twitter account). There’s more information here http://justiceforlb.org/. Hope things continue to improve, not much point a country being fiercely pro-life and then not providing the life bit, for all its citizens. Thanks, George

Helen says:

George – did this death happen here or in the UK? I’m thinking it was in the UK, and maybe that is why it somehow passed me by. This is dreadful, and by giving up her licence to practise in the UK does it not apply in the Republic as well? Ireland is not pro-life – it is anti abortion – rather different, I fear! There is no equality of opportunity here, although much lip service is given. It has improved, we are about circa 1970 London at this point. I shall be following this and trying to raise the issue thanks for your response

george says:

Hello again Helen, sorry, yeh I should have made that clear. LB died in Oxford, in an NHS hospital. As yet we’ve not had any coverage in Ireland, but are hoping that the involvement of the Irish psychiatrist might change that. Outrageously, the way the rules currently are is that relinquishing a licence, and indeed being struck off the medical register in the UK (if it comes to that) has no impact on the ability to practice in Ireland. My understanding is that the GMC will let the Irish Medical Council know if Dr Valerie Murphy is struck off, but then it’s up to the IMC to do their own investigation. Meanwhile she is doing the guest lecture circuit/opportunities in Ireland as an expert in mental capacity and epilepsy, no shame…. and presumably to attempt to raise her standing/reputation. I’ve had one email response to this post suggesting I’m out of touch and things are much better in Ireland than I suggest – I very much hope so, and if they aren’t, that they improve quickly. Thanks for your interest, George

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