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Verdict on MMR doctor

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Thursday, January 28, 2010
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This is Bath

The doctor at the centre of the MMR controversy faces being struck off after the General Medical Council today ruled he 'failed in his duties as a responsible consultant',  and went against the interests of children in his care.

Dr Andrew Wakefield, who grew up in Bath, also acted dishonestly and was misleading and irresponsible in the way he described research which was later published in The Lancet medical journal, the GMC said.

The council said he had acted with "callous disregard for the distress and pain the children might suffer."

In the late 1990s, Dr Wakefield - who was educated at King Edward's School and whose parents still live in Bath - and two other doctors said they believed they had uncovered a link between the jab and bowel disease and autism.

Today's ruling will be a setback to campaigners who back Dr Wakefield's claims and will fuel fears that the controversial doctor has been the victim of a sustained witch-hunt.

But it will also be hailed by mainstream medical world which has been alarmed at a fall-off in the take-up of the MMR vaccine.

Dr Wakefield was absent from today's hearing but parents who believe their children were damaged by the MMR jab heckled the GMC panel of experts as they delivered their findings.

The hearing - which was the longest and most complex case ever held by the GMC - has sat for 148 days over a two-and-a-half-year period.

Thirty-six witnesses gave evidence at the hearing, which has reportedly cost more than £1 million.

It centred around Dr Wakefield's study, which sparked a massive drop in the number of children given the triple jab for measles, mumps and rubella.

During the mid 1990s, uptake of the MMR vaccination had stood at 92 per cent, but five years after The Lancet paper, the vaccination level had fallen below 70 per cent in some places. Measles cases in Britain rose from 56 in 1998 to 1,370 in 2008.

The latest Health Protection Agency figures show that uptake of MMR is now 85 per cent, which is still insufficient to ensure immunity in the community.

Many blamed Dr Wakefield for needlessly panicking the public, but his supporters said that his only ‘crime’ was to voice concerns about MMR which embarrassed the Department of Health.

As head of the research team, Dr Wakefield said he believed the combination of three virus strains for measles, mumps and rubella may overload the body's immune system. This could enable a bowel disorder - linked to autism - to develop, he said.

Dr Wakefield said tonight: "I am extremely disappointed by the outcome of today's proceedings. The allegations against me and against my colleagues are both unfounded and unjust - I repeated unfounded and unjust - and I invite anyone to examine the contents of these proceedings and come to their own conclusion."

He said on a personal note he was "dismayed" that two of his colleagues had been "dragged through this process". He went on: "It remains for me to thank the parents whose commitment and loyalty has been extraordinary. I want to reassure them that science will continue in earnest."

He also thanked his family, supporters and legal team for their "enormous help".

Speaking to the Mail on Sunday at the weekend, Dr Wakefield had said he feared the GMC's decision today would be politically-motivated.

'If there's any justice, we should be cleared,' he said. 'However, there's the political backlash to consider. I fear the GMC will want to make an example of us.

'The issue was not about me, but about how to crush dissent. I scare the establishment because I care and I am diligent.

'I think they're terrified because they've not done adequate safety studies. I've been treated in the standard way in which people who raise these kinds of questions are treated.

'It's extremely challenging, but if I fail to stand up to the bullies, the price to be paid is enormous.'

Verdicts on the facts of the case were delivered today at the disciplinary hearing in central London which has so far cost at least £1 million.

The GMC heard allegations that all three doctors involved in the research failed in their duty to act in the best interests of children in their care.

The accusations related to investigations for the study based on 12 youngsters with bowel disorders carried out between 1996 and 1998.

At the time, all three doctors were employed at the Royal Free Hospital's medical school in London, with honorary clinical contracts at the Royal Free Hospital.

The children in the study, aged three to 10, all had a history of normal development followed by the loss of acquired skills such as language.

All the children were found to have intestinal disorders including diarrhoea and constipation, and nine of them were diagnosed as having autism.

MMR is the combined vaccine against measles, mumps and rubella and helps to reduce the risk of epidemics. The jab contains weakened versions of the live disease viruses.

Measles kills about a million children each year around the world and cases are at their highest level in the UK for 20 years. Mumps can cause deafness, while rubella can cause terrible birth defects if caught during pregnancy.

The vaccine is injected into the muscle of the thigh or upper arm.

It is given to children at around 13 months of age after the immunity the baby got from their mother fades.

It is given again when children are aged between three and five to increase the chance that those  who didn't acquire immunity from the first jab are protected.

Over 500 million doses of MMR have been used in over 90 countries around the world since the early 1970s. The World Health Organization states that MMR is a highly effective vaccine with an outstanding safety record (WHO, 2001).

The Government says single vaccines (rather than the combined MMR) put children and their families at risk because it increases the chances of them catching the diseases while they are waiting for full immunisation cover. Ministers say the use of the combined MMR is not an issue of cost.

In eight cases the parents or the child's GP noticed that the symptoms emerged soon after the child received the MMR jab.

Subsequent research into a further 48 children revealed that 46 followed the same pattern, according to the research team.

But the GMC heard that the study subjected 'vulnerable children to 'inappropriate and invasive' tests by the doctors, who were in breach of 'some of the most fundamental rules in medicine'.

Dr Wakefield did not have paediatric qualifications and had not worked as a clinical doctor for several years when he ordered the tests, the panel was told.

One of the key claims was that the married father-of-four accepted more than £50,000 from the Legal Aid Board for research to support a group of parents' attempts to fight for compensation.

It was alleged Dr Wakefield applied for money so that five children and their families could stay in hospital during tests, and for MRI scans for each child.

The money was paid into an account at the Royal Free for Dr Wakefield's research, but, the GMC alleges, the cost of scans and hospital stays would have been met by the NHS.

Dr Wakefield was also accused of paying children £5 for blood samples at his son's birthday party, then joking about it afterwards.

In 2004, the Chief Medical Officer Professor Sir Liam Donaldson launched a stinging criticism of Dr Wakefield.

He accused him of 'mixing spin and science' and blamed his paper for a loss of confidence in a vaccine that had saved millions of children's lives.

The Lancet's editor Dr Richard Horton waded into the argument, saying he would not have published Dr Wakefield's research if he had known about this 'fatal conflict of interest'.

In another blow to the doctor in March, ten of the authors of the original paper spoke out against him by issuing a partial retraction of the study's findings.

While the doctors said their 1998 paper made it clear that no causal link was established between the triple jab and autism, the possibility of such a link had been raised.

In a statement in The Lancet, the authors said they now wanted to formally retract the interpretation placed on the study's findings.

In June 2006, the GMC announced that Dr Wakefield was under investigation for alleged misconduct.

In an interview with The Observer newspaper the following July, Dr Wakefield said he planned to defend himself vigorously against the allegations.

Dr Wakefield has spent many years in isolation from the mainstream scientific establishment and now works mainly in the USA, having relocated to Texas in 2001.

All three doctors denied the allegations against them.

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