17. LA-A49, a 12-year-old with significant learning disabilities, received short-stay care at Monkton Street. In 1986, approximately six months after the allegation at Ivy House, his mother noticed a blood clot and redness on LA-A49’s bottom when bathing him. She told a doctor that LA-A49 had named LA-F26, a care worker at Monkton Street, and used words suggesting anal abuse. LA-A49 was examined first by a GP and then by a doctor from a hospital child sexual abuse team, neither of whom found any abnormality or indication of sexual abuse.^[1] It was, however, reported to the Metropolitan Police Service and the police surgeon who examined LA-A49 concluded that there was “overwhelming evidence of anal abuse consistent with buggery”.^[2]

18. As a result, the Metropolitan Police Service immediately sought to arrange a medical examination by a police doctor for all children at Monkton Street.^[3] Letters to parents referred to an incident of indecent assault that was being investigated and stated that it might be necessary for other children to be examined by a police doctor, although parents were also free to consult their own GP.^[4] The police surgeon examined eight children in July 1986 and reported evidence of sexual abuse in relation to five and possible abuse in a sixth child.^[5] One child, following a medical examination which required the child to be physically restrained, indicated to his mother that he had been locked in a bathroom and a man had hurt his bottom, although his mother was unable to discern any clear reference to a particular member of staff.^[6] No other children made any allegations of abuse. The Metropolitan Police Service arrested LA-F26 in July 1986 but did not subsequently press charges.

19. A management inquiry panel (assisted by independent advisers, including a consultant paediatrician, a child protection consultant and a team leader working within schools for children with disabilities) was established by Mr Osmond in July 1986.^[7] In contrast to the initial investigation into the Ivy House complaint, its terms of reference included all alleged incidents of child sexual abuse at Monkton Street. The parents of children who were the subject of any allegations were interviewed and invited to meet the inquiry panel.^[8] The management inquiry panel was unable to reconcile the contradictory medical opinions regarding whether or not LA-A49 had been sexually abused.^[9] In addition, having met with the independent consultant paediatrician, the police surgeon subsequently expressed the view that, while there was justifiable suspicion in six cases that the child had been sexually abused, there was also an acceptable alternative explanation for the medical findings in each of those cases. A consultant obstetrician conducted a second examination of one child at the request of her parents and concluded that it was “extremely unlikely” that the child had ever been subjected to vaginal or rectal intercourse.^[10] The management inquiry panel – in the first Monkton Street report (dated March 1987) – was critical of the police surgeon and the police investigation.

“In several cases the medical examination of children, by the Police Surgeon, involved the child being physically restrained. This may have had traumatic effects on the children concerned, and could have increased the chances of the child confusing the medical with any actual sexual abuse that may have occurred. We deplore the use of force: we think that the use of ‘disclosure interviewing’, in a safe and comfortable environment, linked to a medical examination afterwards, would have been a reasonable alternative … On the basis of the evidence given to us, several children were either frightened, upset or confused by the Police Surgeon’s medical examination. In some cases, physical force was used to restrain the child – we think this was wrong and in itself constituted a form of child abuse.”^[11]

The management inquiry panel made a number of recommendations to Mr Osmond. Similarly to the review panel, it proposed the production of a leaflet for parents and the public on identifying and responding to suspected child abuse, increased training for staff and a review of inter-agency collaboration with the police in cases of alleged child sexual abuse.^[12] There is no record, however, of its recommendations being implemented.

20. There was a second Monkton Street investigation in 1988, conducted by Heather Stephenson (social services manager) and Pauline Rowe (personnel officer). This considered whether an allegation of sexual abuse against a member of staff (LA-F2) – although referred to by the mother of LA-A49 in the first inquiry – had been fully investigated. On the basis of the original investigation and the further investigations made by the second panel, it was concluded that there were no grounds for disciplinary action against LA-F2.^[13]

21. On the recommendation of the panel, LA-F26 was reinstated but in view of the events and the feelings of parents “to a post elsewhere in the Directorate”.^[14]