- LOOK SPECIAL: THE CLEVELAND INQUIRY
ON September 17 last year, it was the turn of two of the Cleveland children to peer nervously round the great wooden doors of the Middlesbrough town hall council chamber and then proceed with small, cautious paces out across the floor. Here at last they were at the centre of the greatest assembly of civil power apart from parliament itself.
But at the time of their appearance, the public inquiry into child abuse had broken up for lunch. Acting with the full judicial authority of a High Court, Lord Justice Butler-Sloss, the assessors who sat beside her, the 11 teams of barristers and solicitors, the witnesses, the press, the parents and the nosy onlookers, had vacated their seats for 90 minutes, and now the ornate Victorian debating room was merely an empty shell.
As the children - two boys aged 11 and 12 - picked their way among the lawyers' benches and the hundredweights of paper, however, both of them suddenly laughed. What a joke, they thought, that all these important people were spending so much of their daytimes taking about them. Fear gave way to excitement, and they ran around the room to try out peoples' chairs.
"It was the one time when there was any physical presence of a child in the chamber," says David Venables, official solicitor to the Supreme Court and the man in charge of presenting the children's' case. "They approached us themselves and said that they would like to see where the inquiry was going on, so they were taken in by my staff."
For the boys, the visit was a welcome relief from the troubles they had been through. Throughout the morning, they had been in an office elsewhere in the Middlesbrough municipal buildings recounting their tale to lawyers. They had spoken of the abuse that they had been experiencing at school, and had recalled their dealings with Dr Geoffrey Wyatt.
"To tell a child about the proceedings is one thing, but for them to see what was happening is something else," says a member of Venables's staff, who was present when the boys went in. "They felt a lot better about it all afterwards and they were certainly less frightened. With the older boy it led to further disclosures about the abuse that was going on."
Whether they would have liked to have taken part in an inquiry session was not a matter that could be raised. At the outset of the hearings, in August last year, Butler-Sloss and her colleagues ruled that it was "unthinkable" for even the older ones to be heard in public- and, with Venables's agreement, they thought even an appearance in private "was an unacceptable additional stress".
With the benefit of hindsight, many observers believe that this was a mistake and that some means should have been found by the inquiry to have involved the children more. Some pointed to the precedent last year when a sexually abused child gave evidence at the Old Bailey, protected from her abusers by a specially-arranged wooden screen.
"If that was the only time a child was allowed into the room, then it's a real sign of what sort of society we are," says Michele Elliott, director of the Kidscape project and a home office adviser on abuse. "If the child is old enough to understand what is happening, is it not possible that it would have been a healing experience for some of them to hear what was going on?"
It was not, after all, Lord Justice Butler-Sloss and the assembled ranks around her who were being sexually abused. Nor were they the victims of Dr Marrietta Higgs's and Dr Wyatt's approach. They had not been taken from their mothers by social workers at a time of their greatest need of support. And they were not imprisoned and then besieged in a hospital ward by the world's television and press.
In an attempt to redress this imbalance, Venables's team was ordered to seek detailed interviews with as many of the children as they could. Of the 165 examined by the paediatricians at Middlesbrough General Hospital between January and July last year, 51 were over the age of eight, and 32 of these took this small chance to have their say in the affair.
"The remaining 19 were thought likely to be badly affected by further discussions, or their parents did not want them to be troubled further, or they proved in some way difficult to trace," Butler-Sloss noted. "The official solicitor reported to the inquiry that the children's stories reflected variously 'misunderstanding, mistrust, discomfort, anger, fear, praise, gratitude and sheer relief'."
Horror stories are plentiful in what the children said. Although Butler-Sloss and her team didn't feel able to determine how many of the children diagnosed by Higgs and Wyatt last year were actually abused, there is considerable evidence of suffering. Most worrying were cases where children experienced what the inquiry report dubbed "the plight of the double victim".
The double victims of Cleveland were the most abused of all. In harrowing accounts, recorded in private by the official solicitor's staff and submitted to Butler-Sloss, these children told how, having already been sexually assaulted, they were subjected to further distressing treatment by the doctors and social workers.
One case, recorded in the ponderous language of lawyers, involved a family with five children who were referred to Higgs. The second-oldest daughter, who was then aged 13, had volunteered to her mother that she had been abused by her father and, as a result of this disclosure, the children were taken into care and the man prosecuted for indecent assault.
The abuses in the family were of the most serious kind. A 12-year-old girl told of how the father was having full sexual intercourse with her and had threatened her with a knife. Three more of the children spoke of similar experiences and, probably as a result of the home situation, the oldest of the children had become disturbed.
After the daughter's disclosure, the children were then on the receiving end of ill-treatment of a different kind. "Dr Higgs did not introduce herself, nor her colleagues," the official solicitor's staff noted from two of the girls. "She told them to strip - she inserted a stick and cotton wool into their 'privates' and it hurt a little. They were rolled over for their bottoms to be examined and this did not hurt.
"The doctor did not call them by name. They were told to dress and tell the next one to go in. They returned to the community home but were not spoken to or told what was going on. They did not see their mother for 28 days while the Place of Safety order was in force and had recently seen their younger brother and sister for the first time in five weeks."
Not surprisingly, the bewildered children were not happy with the events they had set in train. The oldest daughter, aged 15, had begged her mother not to tell social workers about the abuse, but had been assured that she would not be taken into care. Instead, when the authorities were told, she was brought in to see Higgs and, in tears, was taken away. "She felt very bitter towards the social workers who deceived her before the medical examination," the lawyers' report continues.
There are cases, too, of children experiencing this kind of treatment when they had not already been abused. One girl, aged nine, was seen by Wyatt after her seven-year-old brother had told him that the children used to sleep in their "uncle's" bed. They had not been hurt and there was no evidence of wrongdoing, but they were made to suffer nevertheless.
"According to the girl, Dr Wyatt had turned her over and wanted to 'go into her front'," the lawyers recorded after interviewing the child. "She said Dr Wyatt was 'talking not very nice'. He was shouting, she was afraid. Dr Higgs, she said, had a 'nasty face', but she did not say anything nasty. It was Dr Wyatt who was speaking nastily."
The children were examined by Wyatt several times and said that his approach was different from that of police surgeons who were later brought in. "Those doctors did not shout or force them, and their examination did not hurt," the girl was recorded as saying. "Looking back, the girl thought it all disgusting."
Whether young children should be treated like this is not a matter for serious debate. Some of the bad management of the cases occurred as Higgs, Wyatt and social workers were being overwhelmed by the logic of their own commitments. Children were being processed so quickly that there was little time for kindness.
"In many cases, the result of her diagnosis caused unnecessary distress to children and their families," Butler-Sloss said about Higgs in her report. "This leads us to the reflection that some of the children suffered harm after they were removed from home whatever may have happened to them previously."
A report from an expert committee on how to diagnose abuse, issued by the government at the same time as the inquiry findings last week, went further on this point. It said that medical aspects are only one part of the diagnostic process, that the emergency removal of a child "is in the majority of cases not necessary," and that extreme caution must be used.
"Hurried intervention may cause more harm to the child and the family," the report states. "There is rarely a need for immediate detailed clinical examination. In the majority of cases this can be organised with deliberation so that the emotional trauma to the child is minimal... Repeated examinations at this initial stage should be avoided."
Dr Stephen Wolkind, a consultant child psychiatrist who was a member of the team which prepared the report, is one of many experts who believes that the discovery and handling of abuse cases can in some cases actually do emotional harm to a child when the sexual contact has not. He believes that usually no action should be taken by doctors and social workers until the whole family has been evaluated.
"You have got to see how a child is functioning and its relationship with its parents," Wolkind says. "If it is getting on well at school, isn't depressed, isn't suffering from problems, you have to be very careful about rushing in with investigations. You can do as much damage in the inquiries as the abuse did in the first place."
In the opinion of Higgs and Wyatt, however, abuse cases were rarely like this. Using their controversial reflex anal dilatation test, they came to the conclusion that enormous numbers of children were not only being sexually abused, but that it involved the most extreme acts - buggery - and was going on within the home.
But many experts believe that the Higgs/Wyatt assessment of anal penetration is worthless - and research in the United States suggests that more than half of unabused children will show "positive" in this test. The conclusion - borne out by the courts and the parents campaign in Cleveland - is that there were many cases where children were taken into care who had never been abused at all.
Just as worrying is that most cases of genuine sexual abuse would not be detected by the test. The real damage of incest and other sexual relationships between adults and children is usually in the emotional confusion it causes, the loss of trust within the family and the effect it can have on the abused person's long-term ability to form relationships.
"A lot of the process of growing up is being able to name, contain and use feelings," says David Pithers, a therapist working with the National Children's' Home. "Children who are abused are overwhelmed by the intensity of the feelings that they encounter and they have no conceptual framework within which they can place them."
Often, a sexually abusive relationship is highly coercive, even when physical force or violence is not used. As a result, psychiatrists and therapists such as Pithers who are studying the problem are increasingly finding patients - both as adults and children - whose feelings of affection, fear, love, violence and intimacy have become hopelessly confused.
To uncover these problems requires professionals to listen carefully to children, rather than make quick medical diagnoses. But, far from showing Higgs's and Wyatt's estimate of the incidence of abuse to be exaggerated, many of their critics believe that this listening approach would lead current estimates of one in 10 to be upwardly revised.
At the same time, hearing and respecting the views of children would inevitably lead to a different response when abuse has occurred. Professionals working with children all report the consistent finding that many children love the person who is abusing them and would prefer it to continue rather than to lose the relationship.
"The real problem about listening to children is that we then have to do something about what they say," says Michele Elliott of the Kidscape project. "It means not only recognising the scale of the problem, but also giving children choices about things like whether they go into a foster home or whether they stay with their mum or their dad, under supervision."
Such new thinking about child abuse is now increasingly being voiced by experts. Another is Jean La Fontaine, professor emeritus at the London School of Economics, who specialises in the study of sexual abuse. She believes that many people, and especially men, find it too difficult and painful to even accept that child abuse is happening.
She fears that, as a result, the backlash against Higgs's and Wyatt's naive crusade could leave children worse off than before. The campaign by Cleveland parents against false accusations of abuse and the public humiliation of the doctors could lead to a renewed denial that children are being abused and that many are being harmed.
"Whenever we come to consider this issue the children seem to get lost in the system," says Professor La Fontaine. "In the public inquiry, and before it, we heard a lot about parents' rights. Perhaps it's one of the tragedies of Cleveland that the children's voices have not been heard."