Wakefield  Kumar  MMR/MR

The GMC and the MMR case: 162-95 is the key

By John Stone

In order to convict all three doctors in the GMC  hearing the panel  had to dissemble in front of the press and public, maintaining that  the generic ethical permission granted to Andrew Wakefield’s colleague Prof John Walker-Smith to take retain biopsy samples for scientific use (given the reference by the Royal Free ethics committee of 162-95) was a “project”. Their ruling read out to the assembled media on 28 January stated:

“The Panel has heard that ethical approval had been sought and granted for other trials and it has been specifically suggested that Project 172-96 was never undertaken and that in fact, the Lancet 12 children’s investigations were clinically indicated and the research parts of those clinically justified investigations were covered by Project 162- 95. In the light of all the available evidence, the Panel rejected this proposition.”

Calling 162-95 a “project”  enabled the panel to avoid explaining before the public that Walker-Smith was acting inside his ethical remit as the most senior clinician in the field, or to avoid having to give any reasoning behind their decision that this ethical permission did not pertain in this instance. The GMC panel were required to come to a view on the basis of the highest standard of proof in English law (“beyond reasonable doubt”) and yet their decision effectively changed the rules on the basis of which Prof Walker-Smith and his colleague Prof Simon Murch had made their clinical decisions  13 or 14 years after the event.

 The chairman of the GMC panel, Surendra Kumar, which has also branded Andrew Wakefield as “dishonest” failed to disclose on his own behalf, that he owned shares in MMR manufacturer GlaxoSmithKline or that he sat on two medicine licensing authority committees  (HERE). Kumar was appointed in succession to Prof Denis McDevitt who was forced to withdraw following press enquiries regarding his presence on a government committee  in 1988 which had passed the controversial mumps ‘Urabe strain’ MMR vaccine, Pluserix, as safe in 1988 (HERE). Kumar also presently sits on the British Medical Association ethics committee (HERE )

This is just the culmination of a 6 year long prejudicial exercise. Writing in 2004, the Lancet’s editor Richard Horton, recalled a meeting he had with a senior GMC officer following the weekend in which he and journalist Brian Deer made their original allegations against Wakefield, in which they discussed how to bring about a prosecution (HERE):

"Indeed, the GMC seemed non-plussed by Reid's [John Reid, the Health Secretary] intervention. The best their spokeswoman could say was: 'We are concerned by these allegations and will be looking at what action, if any, may be necessary.' In truth, they  (the GMC)  had not a clue where to begin. At a dinner I attended on 23 February (2004), one medical regulator and I discussed the Wakefield case. He seemed unsure of how the Council could play a useful part in resolving the confusion. As we talked over coffee while the other dinner guests were departing, he scribbled down some possible lines of investigation, and passed me his card, suggesting that I contact him directly if anything sprang to mind. He seemed keen to pursue Wakefield, especially given ministerial interest.

Here was professionally led regulation of doctors in action - notes exchanged over liqueurs in a beautifully panelled room of one of medicine's most venerable institutions.”

This parody of legal process did not stop the GMC also putting Horton on the stand three years later to testify against Wakefield.