Expert witnesses should deliver services through the NHS

Proposals for far reaching changes to the way expert witnesses provide their services to the family courts in England and Wales were outlined this week in a long awaited report from Liam Donaldson, the chief medical officer for England.

Professor Donaldson recommends that rather than contracting individually with solicitors, experts should deliver their services through the NHS as a core part of its child protection work.

He was asked by ministers in 2004 to come up with ideas to tackle the shortage of medical experts, particularly paediatricians, willing to give evidence in cases in which parents face the possibility of having their children taken into care.

The recommendations are also aimed at ensuring the quality of expert witnesses and at building public confidence in their expertise after a series of high profile cases in which mothers accused of killing their babies have been acquitted or cleared on appeal.

Under the proposals NHS trusts with substantial paediatric, psychology, and psychiatry services would form teams of clinicians in the same specialty or on a multidisciplinary basis, possibly including other specialties such as paediatric radiology or ophthalmology. Teams could also include clinicians who have retired in the past two years.

Instead of individual solicitors choosing and instructing an expert, a public sector organisation would be appointed to contract with NHS teams to provide the service. Professor Donaldson says this could be done, for example, by the Children and Family Court Advisory and Support Service, or the Legal Services Commission, the body responsible for legal aid.

A team leader would allocate the lead role on each piece of expert witness work, and members of the team could discuss their current cases. Mentoring, training, and support would be provided and expert witnesses' work would become part of mainstream clinical activity, subject to clinical governance, appraisal, and peer review.

Professor Donaldson points out that a few teams of expert witnesses already exist in the NHS—for example, in child psychiatry at Great Ormond Street Hospital for children in London. The work would be built into employment contracts and job plans, and teams in adjoining areas could form local networks to share resources and training. Parties to a case would still be able to ask for an expert outside the area or one working as a private individual.

Paediatricians have shunned expert witness work in the wake of media vilification of paediatricians who have appeared as expert witnesses in court cases.