South Tyneside Metropolitan Borough Council v K & Ors

In care proceedings, the civil standard remains the balance of probabilities. Where allegations are inherently improbable or particularly serious, the court should require cogent evidence before making adverse findings. Suspicion alone is insufficient.

Evidence from treating medical specialists requires careful scrutiny because their involvement may affect objectivity. Their evidence is not automatically suspect. The court may rely on it where the possible risks are recognised and the opinions are logically supported, particularly when supported by reliable contemporaneous nursing evidence and independent specialists.

The local authority sought a care order for a baby who had suffered bilateral subdural haematomas and episodes of serious deterioration. The father admitted shaking the child on one occasion, but denied causing earlier minor injuries or deliberately obstructing the child’s airway during later hospital admissions.

The court considered whether the minor injuries and ten hospital incidents were proved, and whether the evidence established the statutory threshold under Children Act 1989, section 31.

1. The admitted shaking incident caused significant harm and established the threshold criteria under section 31 of the Children Act 1989. The father’s late admission had also prolonged medical investigations and separated the child from his mother.
2. The alleged minor injuries were not proved. Although babies of that age do not ordinarily bruise themselves, the injuries could have been accidental, the explanations were not wholly implausible, and the evidence did not reach the required cogent standard. Suspicion was insufficient.
3. The court assessed each hospital episode separately and then considered the overall pattern. Relevant features included the abrupt and life-threatening collapses, rapid recovery, the father’s presence when he was alone with the child, the nursing evidence, and the medical opinions.
4. Only episodes 3 and 4 were proved to have resulted from deliberate airway obstruction by the father. The evidence concerning the other episodes remained insufficient, despite serious suspicion.
5. Evidence from treating specialists must be examined carefully because close involvement may create risks of undue influence or loss of objectivity. That did not make the evidence inadmissible or inherently unreliable. Having considered those risks, the court was entitled to rely on the opinions of Dr Cronin and Dr Ramesh, supported by Professor Sibert and Mr Punt. The approach was consistent with the logical-analysis principle in Bolitho (deceased) v City and Hackney Health Authority (1998) AC 232.
6. The caution in Re B (Sexual Abuse: Expert’s Report) (2001) 1 FLR 871 concerned different circumstances and did not prevent reliance on the treating specialists’ evidence in this case.
7. The threshold criteria were therefore proved by the admitted shaking and the two deliberate airway-obstruction incidents. The mother was not involved and had no knowledge of those incidents.