17/04/2013 by socialistfight
Submission To Appeal Of G J Downing:
The Relevant Expert Psychiatric Advice:
Advance in psychiatric treatment.
Mental health of children with learning disabilities By Pru Allington-Smith
1. Pru Allington-Smith is a consultant psychiatrist dually accredited in child and in learning disability psychiatry and employed by North Warwickshire National Health Service Primary Care Trust. She works in a child learning disability team in Coventry and at Brooklands Hospital (Brian Oliver Centre, Brooklands, Coleshill Road, Birmingham B37 7HL, UK. Tel. 0121 329 4930; e-mail: email@example.com), which has an in-patient service for adolescents who have learning disabilities in addition to severe psychiatric, behavioural or emotional problems.
Many children with learning disabilities have communication problems and some have no speech at all. Additional sensory disabilities, particularly hearing impairment, may further reduce the child’s ability to interact with others and to communicate. Consequently, these children may find it hard to understand what is asked of them and even to communicate their basic needs. If you cannot tell your parent that you are wet, cold, thirsty, hungry or in pain, what do you do? You may cry, hit out or hurt yourself. The last two actions work particularly well in attracting the attention of carers, who then have to work out what the problem is.
Poor Coping Mechanisms
A lack of coping strategies can lead to reliance on aberrant behaviours when things go wrong. If a child learns that shouting, screaming or becoming aggressive when unable to think of a solution to a problem brings an adult to deal with it or remove them from the situation, such challenging behaviour can become an automatic response to any situation where the child feels uncertain or threatened.”
This is the passages from the Operation Support Manager, Darren Hill’s notes of the disciplinary hearing on 12 March that related the situation best:
GD: All the way to Finsbury Park when he was screaming I did think what was going on here? I thought does he know the child? But again I thought that the child was in need of urgent medical assistance and that he must be taking him somewhere to get that.
DH: Why did you believe that he needed urgent medical attention?
GD: Based on the continuous screaming, it was obvious that he was having some sort of fit and in distress.
DH: But you said that they can from the Whittington Hospital (Archway)?
GD: Yes from in front of the Whittington hospital, he ran from across the road!
DH: Did you not think it odd that he would leave a general hospital if he needed assistance?
GD: Yes I did think it odd!
DH: Why did you not ask if he needed assistance?
GD: I thought that he might have some intention of getting assistance. I thought that was what he was doing, so I didn’t ask.
DH: Why when you concern was so great?
GD: I had to look at the balance that if I stopped the bus and asked for the Police or an ambulance it (he) would (be) continuously in distress for a much longer time.
DH: But you stated that he needed urgent medical assistance, surely that would have been the best course of action!
GD: But it would have taken such a long time for an ambulance to arrive that it would be the responsible adult who would have asked for an ambulance or ask for some assistance!
DH: But if your concern was so great and growing! Why didn’t you ask if he was ok?
GD: But he is the responsible adult and I must assume that he is taking him I somewhere that he can get assistance!
DH: Did you feel he was in control of the situation?
GD: On the balance of probability, I assumed he knows what he is doing and that he was taking the child somewhere to get help and that was what was going on; but doubts remained!
DH: So your concern was not so great to feel you had to intervene?
GD: No, I made a judgement that he was in control.
The significance of the screaming child
Manager Darren Hill states in his dismissal summary: “You then state that your concern was that the child was screaming and what was going on? But yet you quickly established that they child was disabled and that the man was either related to him or was his carer. You then state that the child’s continuous screaming whilst on route to Finsbury Park caused you to have great concern for his wellbeing and that he clearly need urgent medical assistance. Yet when asked if your concern was so great why you didn’t call for assistance, you state that it would have taken too long. Clearly your concern was not that great and you then seem to have further justified this by saying that you believed the man was a responsible adult and was in control of the situation. On further questioning you justified the need for assistance due to the child’s screaming, but you contradict yourself by stating that you could see from the start that the child had a disability and that the screaming was an indicator of that disability, so therefore why would he need assistance!”
The bolded piece at the end of this extract shows a complete lack of understanding of the situation of a child with mental disabilities: This attitude is completely contradicted by Ms Pru Allington-Smith above. Her analysis clearly explains the reasons for a mentally disabled child’s screaming:
“If a child learns that shouting, screaming or becoming aggressive when unable to think of a solution to a problem brings an adult to deal with it or remove them from the situation, such challenging behaviour can become an automatic response to any situation where the child feels uncertain or threatened”
The attitude of Mr Hill, as recorded, is to reject the suggestion that there was a problem and to suggest this was simply a normal occurrence from a mentally disabled child. Take the following passage of questioning:
DH: You stated on page 3 of the fact finding that the child was clearly disabled. Can you tell me when you first established that the child was disabled?
GD: As soon as they got on! It was undeniably obvious when they boarded the bus at Archway. I would like to add that I have two autistic nephews, one of whom is severely autistic!
DH: What made you believe that the child was disabled?
GD: Because I am familiar with how autistic children behave and not just the facial expressions, they have a vacant look that you can tell, like my nephews. Although I have not encountered that type of screaming, but I would say that the way he was screaming indicated that.
DH: You mean the way he was screaming indicated he was disabled?
GD: I would like to say regarding the trip to Finsbury Park, my overall concern was to the safety of the child and where he could get medical assistance as soon as possible.
DH: You keep stating that the child needs urgent medical assistance as soon as possible! Where was this assistance to come from in your judgement?
GD: I didn’t know where he was to get this assistance, but I had to be assured that the man knew where he was to get the assistance and that he was taking him there!
DH: Based on how the child was acting?
DH: But why did you believe he needed assistance, when you have stated that you had established that the child was clearly disabled; a belief that was reinforced by the way that the child was screaming from your experience!
GD: Even disabled children do not engage in screaming fits, screaming is a cry for help!
DH: Not necessarily in a disabled child, it is not uncommon for people with certain types of disabilities to be prone to uncontrollable outbursts or screams!
GD: I have not encountered that type of screaming in my autistic nephews!
DH: Autism has a very wide spectrum and you are also making the assumption that the disability is autism!
In the bolded sentences above it is clear that Mr Hill, in his anxiety to prove that I had no justifiable reason to be concerned about the child, dismissed the screaming. Mr Hill seems to think that once we have established that the child is mentally disabled then he is just “crazy” and anything he does is just beyond comprehension and there is no need to try to understand it and we should not be concerned by it.
Again in the following passage, particularly in the bolded passages, Mr Hill has a bizarre and totally dismissal attitude to the child’s suffering:
GD: What possible reason would you have for taking him in a bus from Archway to Finsbury Park and back again? If you are saying that I didn’t do it in the best possible manner then it’s possible, but I was worried about the stress of driving under these conditions.
DH: What if we imagine for a second that I am the father of the child who we assume is autistic and I say to you that my child loves riding on back and forth on buses!
GD: I would say that it was a peculiar thing to do as he was screaming and he couldn’t tell you anything and do it was causing him distress.
DH: What for someone with autism to have an obsession or fixation about buses, not really they are called schemas!
GD: It is not right they shouldn’t be on the bus screaming!
DH: Where should they be?
GD: In a hospital being treated!
DH: I’m afraid Gerry we don’t institutionalise disabled children simply because they scream anymore.
The last remark by Mr Hill suggesting that seeking medical assistance for a mentally disabled child in distress is the same as asking for them to be instrutionalised. This is very wrong and is insulting to me personally and quite unwarranted. I pride myself on being open and aware of people with disabilities, this implied charge is backed up by nothing I have said or done and more than anything else offends me. Furthermore Mr Hill is making assumptions that suggests that he had his mind up about my case from the start as at no point have I indicated that I had such a negative attitude to disability, yet he seeks to characterise me as a bigot.
As Sean McGovern – Unite the union Executive Council Disabled Members Representative who has viewed the cases on my behalf observed: “Gerry Downing’s actions and his concern for the child’s wellbeing are laudable – whether or not he read the situation correctly he attempted to do the right thing. Travelling on public transport with children can be a fraught experience in itself. I suspect travelling with a child who has, possibly, severe mental health issues on a London bus must be difficult for all concerned.”
His suggestion that I have a reactionary attitude to disabled people is ludicurous, his own attitude as displayed here is obviously the reactionary one.
And the judgemental part of the document from Mr Hill:
“Having considered all of these facts it is my believe that the child’s wellbeing was not your concern and that your issue was not with the need for assistance but that the child’s actions and screaming was a distraction and irritating you. This is why, when they boarded again your conduct was completely disproportional to the situation as seen by the other passengers’ reactions and intervention. In my judgement your conduct was grossly disproportional and did nothing more than embarrass and humiliate the man who was trying desperately to calm his disabled son and not draw attention to him. My other concern is despite all of this you still fail to see that you have done anything wrong which worries me and suggests that you are a risk to the business. Therefore l believe that this does constitute an act of gross misconduct and my decision is summary dismissal.”
“Having considered all of these facts it is my belief that the child’s wellbeing was not your concern” judges Mr Hill, in contradiction to all the evidence that I have given. The evidence of Mr Hussein Abdullah likewise backs up my concerns. He says that he picked up the pair from the same stop I dropped them off – he was the bus behind me and this was possibly on the same day. After a few bus stops he stopped the bus and said “the child is sick, we should call an ambulance” – The man said he was just upset and got off the bus. Mr Abdullah says the man seemed to be attacking the child by pulling him close with the blanket.
My Hill then dismisses my concerns for the health and safety of the passengers and the possibility that this distraction might cause an accident: “your issue was not with the need for assistance but that the child’s actions and screaming was a distraction and irritating you.” There are very real health and safety aspects of driving under such distracting conditions and had I not been so concerned for the child’s welfare and under such stress from my personal domestic situation I would have refused to proceed from Archway under those conditions.
I had continued driving from Archway to Finsbury Park, some 20 minutes under the stress of the continual screaming out of concern that the child should get assistance as quickly as possible. When the man re-boarded the bus at Finsbury Park with the child it was clear that he was not seeking assistance for the child and he was incapable of dealing with the situation himself. I was about to be subjected to this stress again, “maybe all the way the Brent Cross” as I say my Submission – a journey of some 50 minutes. Here the immense stress of the situation is reduced to mere culpable “irritation” such as one might get at a baby crying on the bus, a common occurrence which I have put out with without reacting on many occasions in my bus driving career of more than 20 years. This situation was far more stressful than that and one I had never encountered before. The prospect of having to endure it for another 50 minutes did fill me with dread; I was prepared to put up with the “irritation” (extreme stress in fact) out of concern for the child. I have explained my own personal circumstances yet Mr Hill does not bother to mention these in his judgement as if stress was not a factor in the case. It clearly was, the CCTV evidence of my body language shows that I am suffering severely from stress at this point.
Mr Hill concludes.
“Your conduct was completely disproportional to the situation as seen by the other passengers’ reactions and intervention” The controversial incident as shown on CCTV is recorded in Mr Hills notes here:
12:52:16, Man boards the bus with child and sits back into the same seats
12:52:34, Driver seen exiting cab
12:52:36, Man can be seen with his hand over child’s mouth.
12:52:43, Driver seen putting his hands up to his ears.
MD – What does this gesture mean?
GD – 1 thought that the child should be in an ambulance not on public transport.
MD – Did you offer medical assistance?
GD -I only got to talk to him briefly and I asked him what he was doing, the whole affair made no sense to me l didn’t know what was going on.
Camera 5, 12:52:46, Right hand, thumb in air.
MD – Can you explain what this hand gesture is?
GD – I’m saying to the man you have come from Archway now your (you are) going back again.
Camera 5, 12:52:59, Man seen making hand gesture with flat hand.
MD – Do you recall what the man was saying?
GD – As far as I remember he said something that I didn’t understand but he didn’t tell me that he was seeking medical help for the child.
12:53 :13, Driver walks towards the back of the bus towards passengers.
GD stated that at this point I was trying to explain to them that he had travelled from Archway and he was going back again.
MD – What did the passengers say to you at this point?
GD – They were saying leave him alone, I was trying to explain my concerns but nobody would listen.
MD – Why would they be saying to you to leave them alone?
GD – Because they didn’t know about the previous occurrences
MD – Regarding the previous occurrences, can you please explain these again?
GD – That he ran across the road holding the child with one hand over his shoulder and the other between his legs, the child was screaming all the way to Finsbury Park, now as far as I could see he was taking the child back to Archway, these events made no sense to me were as for the passengers it seemed to them that he was taking his child from Finsbury Park to the Whittington Hospital. 12:53:28, Driver goes into the cab and drives away from the stand.
My explanation as to why the passenger reacted to my confronting the passengers is shown here:
DH: So is Ms Ahmed’s statement correct about you saying to him “you came all the way from Archway and know (now) you’re going back with him”?
DH: What was his response to that question?
GD: He didn’t respond, because at that stage a few passengers intervened, one in particular.
DH: Who was that?
GD: I think it may have been Ms Solebo who I identified from the CCTV.
DH: What did she say to you?
GD: I spoke loudly, if you look at the CCTV I had my hands up to my ears and I need to be heard over the screaming. I don’t remember what Ms Solebo said to me but it was along the lines of “leave him alone and shame on you” it was along those lines.
DH: Why would she say that to you’?
GD: Because in my view she would have no knowledge of what precisely occurred and that there was no indication that the man was seeking to bring the child to somewhere to get assistance; they would not have know of the previous odd behaviour of the man!
DH: What odd behaviour?
GD: What I described to you the bring of the child from Archway and back again.
DH: Why would that be relevant in the way you were addressing the man?
GD: If you look at Ms Solebo report she says I tried to justify to the passengers why I was having a go and that ‘we would not hear of it’!
DH: But why would that knowledge of the previous events make any difference to how you were dealing with the man and his son to the passengers?
GD: They would have known what had happened and they would have known that he was not bringing the child to seek assistance as soon as possible.
DH: You don’t seem to understand my point of what difference would that have made to how you were addressing (speaking too) the man and the child?
GD: Because in my view if it was that he was getting on the bus it was to get assistance, but by getting back on the bus again he wasn’t doing that in a logical way!
DH: But that is not what you said earlier you stated that getting back on the bus was logical
GD: No it was illogical, how would it be logical to get back on the bus again, that is not what I meant.
DH: You can’t explain how the passengers having prior knowledge of what happened before would make any difference in how you spoke to the man and child?
GD: They would have known that I had a right to know what was going on, but they wouldn’t hear of it!
DH: Did any of the other passengers raise any concerns at the time?
GD: Not in any individual way that I can remember it was a general voicing that I didn’t want a screaming disabled child on the bus.
DH: Looking back why would they have that opinion?
GD: Because if they had known what had gone on prior they would have know that my actions were not inappropriate and would have made a balanced decision on what was going on!
DH: Forget the history of the situation for a moment, why do you think this group of independent people who have know (no) prior knowledge of the man, the child or you, should watch this situation evolve in front of them and believe that your actions were totally unacceptable. So much so that they have submitted 2 separate complaints, which the CCTV validates.
GD: I can’t forget the history, they may have thought that they were right to intervene and because they didn’t have the full story at that time and had a different perspective of them. In many situations in life people come to conclusions when they don’t have the full story!
DH: What different perspective would they have had?
GD: They could observe them directly, where as I couldn’t.
DH: So after this altercation what was the interaction between the man and the child that satisfied your concern’?
GD: I just thought that he was comforting the child in the way he was holding him and trying to calm him.
This is the crucial passage which explains why the passengers had a different attitude to the situation than I had. They just did not know what had previously occurred. This is a big obstacle for Mr Hill so he tries to get around it by pretending it just did not happen as seen in the bolded passage above: DH: Forget the history of the situation for a moment, GD: I can’t forget the history.
As I said in my Submission to the GDE: “Bus driving is a very stressful job at the best of times. The 15th February was less than a week before my partner was facing a major operation to remove her voice box for throat cancer on the 21st. It was due to take a whole day we were told and her chances of survival were only 30%. It became almost impossible to continue driving with that level of screaming. It might cause me to have an accident, and I had no knowledge of how long it might go on, all the way to Brent Cross maybe? I could not have continued driving for much longer under that pressure but then the child needed urgent assistance and I confronted the man because he clearly was not seeking medical assistance for the child as quickly as possible.”
These mitigating circumstances are not just ignored in the Summary but implicitly are taken to show why I was “irritated” culpably and my actions were unreasonable to the extent that it constituted Gross Misconduct for which I had to be summarily dismissed to protect the good name of the company.
For Mr. Hill to suggest it is normal practice to bring screaming autistic children on buses “back and forth” is quite ludicrous. To expect the bus driver to continuing driving the bus in these circumstances is totally unreasonable. To neglect both the child’s well being and the passengers’ safety is incredible. In fact I am still the only person in this entire sorry affair to express any concern whatsoever for the well being of the child. The passengers intervention were to save the man from embarrassment and Mr Hill’s judgement likewise is motivated by concern at the ‘embarrassment and humiliation’ suffered by the man and still shows no concern whatsoever for the well being of the child. He says my actions “did nothing more than embarrass and humiliate the man who was trying desperately to calm his disabled son and not draw attention to him”.
Bus drivers have a duty of care for their passengers. My assertion in the questioning that the screaming by the child was a cry for help is borne out by the assessment of an acknowledged top expert in mental disability, the consultant psychiatrist Ms Pru Allington-Smith. From her assessment it is clear that this carer is totally incompetent, he should not be in charge of such a child. He is seen continually holding the child close to him with a blanket, obviously to prevent him hitting out and attempting to stop the child screaming by putting his hand over his mouth as seen in the CCTV evidence.
Clearly social services should be informed of this situation which rightly concerned me. If I acted angrily it was out of concern for the child and the stress the situation and my own personal domestic situation put me in. Metroline has no policy on assessing such situations and do not supply any specialised training to drivers, or managers, in the proper way to deal with such an unusual situation which I had never encountered before and am unlikely to encounter again
Sean McGovern – Unite Executive Council Disabled Members Representative observed recently on my case: “Gerry Downing’s actions and his concern for the child’s wellbeing are laudable – whether or not he read the situation correctly he attempted to do the right thing. Travelling on public transport with children can be a fraught experience in itself. I suspect travelling with a child who has, possibly, severe mental health issues on a London bus must be difficult for all concerned”.
Actions of carers of disabled people can be misconstrued. What we see as heavy handedness could indeed be the best way of dealing with a situation. Then again, it could be that the carer is using too much force. These are difficult judgements to make at the best of times.”