A STATEMENT
BY PROFESSOR JOHN WALKER-SMITH
I
deny the allegation that there was
systematic bias in the pattern of
referral for the children in the 1998
Lancet paper. No children were
invited to participate in the study.
Upon
review of the Centre for Paediatric
Gastroenterology, Royal Free
Hospital, work book entitled
“Biopsies VI 4/9/95 to
21/7/97”, we confirm that the
children who were reported in the
Lancet paper of 1998 were the
first 12 children consecutively
referred to the university department
of paediatric gastroenterology with
autism and related disorders, who had
gastrointestinal symptoms requiring
ileo-colonoscopy to exclude chronic
bowel inflammation. These children
were referred to me at the university
department of paediatric
gastroenterology at the Royal Free
Hospital from July 25, 1996, to
February 24, 1997—one being
referred from the island of Jersey
and one from the USA. By the time the
paper was accepted for publication,
as mentioned in an appendix to the Lancet
paper, up to January 28, 1998, a
further 40 children had been so
investigated, 39 with the syndrome
reported in the paper. The children
were all investigated specifically
and exclusively by clinical need to
determine whether bowel inflammation
was present that could then be
appropriately treated.
These
children were referred to the Royal
Free by their general practitioner
(ten cases) or consultant
paediatrician (two cases). Some
parents had heard of Dr
Wakefield’s previous work on
inflammatory bowel disease and
specifically requested referral, but
the channel of referral was always as
described above. However, the pattern
of referral was often that the
parents of the children approached Dr
Wakefield directly knowing of his
work, frequently by telephone. In the
case of one patient, in whom it has
been alleged that I contacted a
consultant in order for a referral to
be made, he had been asked by the
parents of this child to contact me
to explain what investigations were
available at the Royal Free for
children with autism and bowel
problems. To the best of my
recollection, I did not invite any
children to participate in our study.
None
of the children at the time of the
referral was known by the team of
paediatric gastroenterologists who
cared for and investigated these
children to be involved in a pilot
project commissioned by the Legal Aid
Board. At the time of consultation, I
was aware that some parents were
engaged in legal proceedings. Review
of the clinical notes of the 12
children in the 1998 Lancet
paper indicate that we had become
aware at the time of publication that
one child was involved in litigation
proceedings against the vaccine
manufacturers.
Professor
John Walker-Smith
Emeritus Professor of
Paediatric Gastroenterology