How on earth was he being paid to find a link? The legal aid stuff do you mean? Well his statement is here:
A STATEMENT BY DR ANDREW WAKEFIELD
Allegation 4 completely misrepresents the facts. These were two quite
distinct issues; the first a clinical report of 12 cases and the second, a
hypothesis-testing
laboratory study to examine for the presence or absence of measles virus in
autistic
children when compared with appropriate controls.
A minority of the children described in the 1998 Lancet report were part of
the second study that was funded in part by the Legal Aid Board (later to
become the Legal Services Commission). The relationship of these two
distinct studies to the legal status of the relevant children is set out
below. Professor Walker-Smith has already described the basis for the
referral of these children according to clinical need.
At the time that the children reported in the 1998 Lancet paper were
referred to Professor Walker-Smith for investigation of their
gastrointestinal symptoms-the time material to their sequential
investigation and subsequent inclusion in the report-none of the 12
reported children was in fact legally aided, ie, in receipt of legal aid
certificates and therefore legal aid funding.
Whether parents perceived an association with MMR vaccine or not, whether
parents had approached lawyers with the intent to seek legal redress, or
whether children were in receipt of legal aid funding or not, had no
bearing whatsoever on their selection for clinical investigation or
inclusion in the Lancet report. Since these allegations were made I have
returned to parents (and where appropriate their current awyers) to
determine these facts. At the time the children underwent ileo-colonoscopy
(ie, the time at which their pathology, as reported in The Lancet in 1998,
was detected and reported by endoscopists and histopathologists), one child
had been granted a legal aid certificate. The authors had no knowledge of
this fact until now.
In support of this and in view of these allegations, parents of children in
the 1998 Lancet report have provided a written signed statement that (i)
they contacted me for help given their child's gastrointestinal symptoms,
(ii) their referral to the department of paediatric gastroenterology at the
Royal Free was through their child's doctor, (iii) that at no time did I
encourage them to seek
legal redress through the courts in the MMR class action, and (iv) that
their child formed part of the initial study of 12 children reported in The
Lancet in 1998.
Independently, I was commissioned through a solicitor, Richard Barr, to
undertake quite separate virological studies on ten children. This is
entirely in line with other university-based studies that have been
similarly funded by the Legal Services Commission, and reported, for
example, in the BMJ.1 The list of children provided to me by Richard Barr
was based on his knowledge of an overlap
between patients referred to the Royal Free and those whose parents had
made contact with Richard Barr. I could not have constructed such a list
since I had no knowledge of the litigation cohort or the legal status of
children within this cohort. I was
specifically concerned with addressing the scientific question in relation
to measles virus-a perfectly legitimate question in view of the nature of
the intestinal disease and the sequence of events in the children. Measles
virus infection of the intestine is a specific interest of mine.
Once again, it is important to emphasise that I had no specific knowledge
of the legal status of the ten children on the list other than as described
above.
Investigations, in light of the current allegations, indicate that four of
these children (exact number to be confirmed by Richard Barr) were among
those reported in the 1998 Lancet paper. The virological studies on these
children have been submitted for publication. If and when these studies are
finally published, due acknowledgement will be made of all sources of
funding, including that
from the Legal Services Commission.
Allegation 5 is an inaccurate misrepresentation of the facts. The results
eventually reported in the 1998 Lancet paper were in the public domain long
before their publication in February, 1998, having been presented at
several national and international scientific meetings. They were readily
available for interested parties to scrutinise and interpret as they saw
fit. The findings were not actively made available to the media until after
publication but, other than this, there was no attempt to conceal these data.
Such was the level of concern from the clinical and scientific team at the
indings in this group of children with a similar history and an apparently
novel bowel pathology, that I and Professor Walker-Smith reported them to a
meeting in October, 1997, convened by the Hon Tessa Jowell MP, then
Minister of Health, attended by the Chief Medical Officer Sir Kenneth
Calman and other officials from the Department of Health in the presence of
Richard Barr of Dawbarns solicitors, and representatives of interested
parent groups. Barr, for his part, was in attendance as a lawyer,
responsibly concerned by the sheer numbers of parents reporting, to him,
developmental regression and gastrointestinal symptoms in their children
following MMR vaccination.
It is important to emphasise that the only aspect of the 1998 Lancet paper
that could have been used to justify a multi-party action, as in the
foregoing accusation, is the parents' perception of a temporal relationship
between MMR vaccine exposure and onset of symptoms. This perception was
well known to the lawyers long before we were even aware of the role of the
lawyers, or
the proposed multi-party action, and certainly long before our publication
in The Lancet in 1998. This publication alone added nothing further to the
issue of causation than that which was already well known to the lawyers.
The accusation is therefore specious. My own report to the Legal Services
Commission on this matter was served in 1999.
With respect to allegation 6, as has been indicated above, these were two
separate matters. One, a report of clinical investigations, and the other,
a study commissioned quite independently through Richard Barr. The latter
study was designed in order to explore the issue of possible causation.
These studies were concerned with viral detection in the diseased
intestinal tissues of ten potentially affected children. This approach is
entirely in line with other university-based studies that have been
similarly funded by the Legal Services Commission, and reported in the BMJ.1
Funds received from the Legal Aid Board were paid into, and properly
administered hrough, a research account with the special trustees of the
Royal Free Hampstead NHS Trust.
I have stated above that the origin of the list of children was provided to
me by Richard Barr. My involvement was limited to the legitimate concern:
was measles virus present in the intestinal tissue of these children?
As outlined above, I can confirm that publication of the relevant
virological studies is still awaited. An interim submission of a report of
this study (rejected) contained an explicit acknowledgment of the Legal Aid
funding; this will be made available as necessary.
If and when the relevant virological studies are finally published, due
acknowledgement will be made of all sources of funding, including that from
the Legal Services Commission.
For none of these or any subsequent children has legal status influenced
the need for investigation or the interpretation of the findings. Where it
is known that children are in receipt of legal aid certificates or where
studies receive funding from the Legal Services Commission, this will be
included in any relevant publication.
The clinical and pathological findings in these children stand as reported.
They have now been confirmed independently by reputable physicians and
pathologists. On the basis of the molecular detection of measles virus in
the diseased intestine of these children this issue, too, merits further
study.
I regret the difficulties that this issue has caused my colleagues over the
last week and I am grateful to them for their advice and support. I am
enormously grateful for the timely manner in which Richard Horton has dealt
with this issue and for his clarification of the issues surrounding
perception and reality where conflict of interest may be concerned.
My colleagues and I have acted at all times in the best medical interests
of these children and will continue to do so.
Dr Andrew Wakefield