The death of a 10-year-old boy over 26 years ago is once again being investigated, amid claims of a cover-up by both the police and medical professionals. Robbie Powell from Ystradgynlais, Powys died a preventable death in 1990. Originally, an investigation by the Crown Prosecution Service (CPS) said that numerous individuals could be charged. But they never were. So now, his grieving father is once again fighting for justice.
Note: All evidence cited in this article has been seen by The Canary.
A treatable illness
William Powell has secured another investigation by the CPS into events leading up to, and following, his son Robbie’s death on 17 April 1990. Those events have been described, in one investigation seen by The Canary, as a “complicated scenario that clearly demonstrates suspicious conduct” – including alleged manslaughter.
Robbie was suffering from Addison’s disease, a serious but treatable condition. It causes the adrenal glands above the kidneys to fail, resulting in weight loss, fatigue and muscle failure – among other problems. It is identifiable with a simple blood test, and treatable with hormone-replacement medication. But in Robbie’s case, numerous chances to diagnose and then save his life were missed. After two weeks of illness, he died in Morriston Hospital, Swansea. Addison’s disease didn’t kill him; the severe dehydration that it causes resulted in a massive drop in Robbie’s blood pressure, causing two heart attacks. The second one was fatal.
An inquest jury in 2004 returned a verdict of death by natural causes, aggravated by neglect. But Mr Powell was disappointed with the verdict, saying at the time it should have been one of unlawful killing. So far, no one has ever been prosecuted. But as a mass of evidence shows, there were numerous failings and missed chances to save his life.
A grave hospital error?
On 5 December 1989, Robbie was admitted to Morriston Hospital. He was seriously ill with vomiting, abdominal pain and was critically dehydrated, with excessive weight loss. He was an inpatient for four days and was treated for critical dehydration, vomiting and fever.
Although his parents weren’t told this, Robbie was suspected of having Addison’s disease, and an ACTH test (which measures the functioning of the adrenal glands) was ordered. But there were other tests for Addison’s that could have been carried out. They weren’t. Four days later, Robbie was discharged. His parents were told he had gastroenteritis.
But the hospital told Ystradgynlais Health Centre, a practice of seven GPs, a different story. They said that:
- Robbie had a hormonal imbalance.
- Addison’s had been suspected.
- The ACTH test had been ordered.
- The parents had been informed of the ACTH test.
- There would be an outpatient appointment arranged for January 1990.
At the outpatient appointment on the 18 January 1990, Mrs Powell was told again that Robbie had gastroenteritis, and they believed that all was well. But following that, the consultant, William Forbes, wrote to the GPs asking them to monitor Robbie for Addison’s disease. He also said they must send Robbie straight back to hospital if he became unwell. But Robbie’s parents were told none of this. Forbes was deemed grossly negligent on two occasions for not acting on his suspicions, by a police-appointed independent medical expert.
Robbie did fall ill again. In April 1990 his condition began to seriously worsen, in the same way it had in 1989. He was repeatedly seen by various GPs, right up until his death. Altogether, there were nine opportunities to save Robbie’s life, and all of them were missed.
In the final 15 days before Robbie died, he was seen by five different doctors, seven times, four of whom were found by a medical expert to have been grossly negligent:
- Dr Paul Boladz saw Robbie two days before his death. He refused to visit Robbie at home, and diagnosed glandular fever when he examined him at the local hospital. He prescribed Amoxicillin (which should not be given to suspected glandular fever patients), and booked blood tests for Robbie for two days later. Dr Boladz was deemed grossly negligent.
- Dr Keith Hughes saw Robbie the day before he died. He failed to spot the symptoms of Addison’s disease, postponed a vital blood test, was unable to carry out a crucial blood sugar test, due to out-of-date equipment, and initially refused Robbie a hospital admission. Dr Hughes was deemed grossly negligent.
But it was two doctors in particular whose actions were criticised most heavily by the CPS, regarding a possible cover-up: Dr Nicola Flower and Dr Michael Williams.
Dr Williams saw Robbie six days before his death, when he was lethargic, dehydrated, vomiting and had obvious weight loss. All of these are characteristic symptoms of Addison’s disease. Dr Williams was aware of the suspected and potentially life-threatening condition. But instead, he informed the Powells that he would make a hospital referral and sent the family home with a prescription for medication to treat the dehydration and vomiting. Dr Williams later informed the police that he had suspected leukaemia. But he didn’t action the referral until after Robbie had died.
The CPS accused Dr Williams of forgery of medical records and perverting the course of justice. They said the hospital referral:
was clearly presented in form designed to mislead anyone reading it into thinking it had been written contemporaneously… [and] to avert any criticism of his management of Robbie’s case.
On the day of Robbie’s death, Dr Flower saw the young boy twice at his house. In the first instance, after he had collapsed and lost consciousness at home, she refused a hospital admission and stated that the suspected glandular fever had moved to Robbie’s chest. But after the young boy’s condition got even worse, Dr Flower was called out again, at around 5.30pm. Mr Powell says her attitude was “appalling”:
In the presence of Diane and my sister, I asked Dr Flower if she had ordered an ambulance. She threw the referral letter, which she had just written, across our breakfast bar and said, “No, take him by car”. Dr Flower then stormed out the house without a thought or a care for Robbie or us. Her attitude towards us on that day was absolutely appalling.
Robbie died in hospital at 9.45pm that evening. It was discovered that 56 days after his death, Dr Flower had rewritten Robbie’s medical records saying he was well when she saw him on the day of his death. A medical expert deemed her grossly negligent, and the CPS found her consultation notes to be forgeries and deemed she had perverted the course of justice. They said:
There is clear evidence to suggest that the risk of Robbie dying would have been obvious to any reasonably competent GP… The obvious conclusion is that the notes were written up after the event, and were designed to mislead any investigation into her clinical competence.
Although Forbes was found “medically grossly negligent” in 1996, it was the judgement of the CPS that he could not be charged for gross negligence manslaughter, due to the intervention of the GPs, in the last 15 days of Robbie’s life. Furthermore, the police and the CPS did not instruct a GP medical expert to consider the care provided by Robbie’s GPs.
In 1996, the former West Glamorgan Health Authority admitted liability for Robbie’s death after Mr Powell sued them. But although £80,000 was paid into court, the Powell family never received the money as it was eaten up in legal costs at the Court of Appeal.
In March 1994, Mr Powell went to Dyfed Powys police to ask them to investigate Robbie’s death. After two investigations, and the CPS claiming the police had left “no stone unturned”, they found no crimes had been committed. But after repeated lobbying by Mr Powell, Dyfed Powys police called on a West Midlands police officer to conduct an independent investigation.
Called “Operation Radiance” it was led by the late Detective Chief Inspector, Bob Poole. It uncovered:
- Gross negligence.
- Perverting the course of justice.
- Possible conspiracy issues with the GPs.
- That 35 criminal charges could be brought in the case, including involuntary manslaughter and corporate manslaughter.
The CPS agreed with the first three, but would not act on the “conspiracy” issue – even though the related forged referral letter involved two people. Furthermore, evidence shows a “secret meeting” took place between Forbes (Robbie’s consultant) and the five GPs involved in the boy’s care. It is alleged that the letter from Forbes to the GPs, detailing Robbie’s suspected Addison’s disease, was removed from his records after this.
Operation Radiance also found countless failings in Dyfed Powys’ police investigations:
- They failed to take any sworn witness statements from the Powells and other relevant witnesses, under section 9 of the Criminal Justice Act, meaning a prosecution could never have been brought.
- They failed to collect any evidence from experts regarding the GPs.
- They failed to do a forensic investigation into Robbie’s medical records.
- They failed to speak to any staff at Morriston Hospital.
An investigation by Avon and Somerset police into Dyfed Powys force in 2003 found them “institutionally incompetent” regarding their investigations into Robbie’s death. It said they “failed to investigate professionally, efficiently and effectively the circumstances surrounding and subsequent to the death of Robert Powell”.
Dyfed Powys were accused of being “institutionally incompetent”. But the investigation by Avon and Somerset police was also problematic. The evidence of Dyfed Powys abject failings was clear, yet Avon and Somerset never looked into whether it was mere ineptness or a deliberate cover-up. And the evidence suggests it could have been either:
- The GPs also worked for Dyfed Powys police as surgeons.
- The head of CID and a superintendent were issued with disciplinary notices regarding their alleged misconduct, but were then allowed to retire. And therefore, did not participate in the investigation.
- Witnesses say some of GPs could have allegedly been friends with senior police officers.
- Dr Hughes, deemed grossly negligent by the CPS, had personal links to Dyfed Powys police.
But Avon and Somerset police also had links to Dyfed Powys. The Chief Constable of the latter, Terry Grange, had spent years working for the former as Deputy Chief Constable. In short, his former colleagues were investigating his current staff.
Over the past quarter of a century, politicians have also come and gone. Wales’s former First Minister, Labour’s Rhodri Morgan, said in 1995 Robbie’s death was:
one of the worst cases of maladministration or deliberate cover-up that may have stained the record of the Welsh Office in its 30-years-plus history.
But as First Minister he didn’t do anything, handing the matter over to his successor in 2009. In July 2012, new First Minister Carwyn Jones apologised to the family. He said there had been many errors and launched an inquiry to look at the lessons the NHS could learn. A report was published in July 2012, but Jones had made 18 redactions. And despite calls from other members of the Welsh Assembly, Jones would not launch a public inquiry.
About a boy
In November 2014, the CPS agreed to look again at why no charges were brought over Robbie’s death. But, 20 months later, little progress has been made. In emails seen by The Canary, the CPS:
- Appears not to have been given all the evidence by police.
- Has unnecessarily compiled its own index of police documents, rather than use Operation Radiance’s index.
- Has not given Mr Powell the chance to provide a formal statement, nor will the Director of Public Prosecutions meet with him.
Mr Powell says that the CPS is making things “unnecessarily complicated”, and treating him like an “adversary”, not a secondary victim of crime.
Writing in The Guardian in 2006, Nick Davies said Mr Powell had repeatedly turned for help:
to the coroner and the local health authority… to the local police, the CPS and finally to an outside police force… They all let him down – guilty variously of indolence, indifference, cynicism, favouritism and sheer incompetence. Now the state that failed him is denying him the public inquiry that might expose the depths of its weakness.
The state is sadly still letting the Powell family down. The CPS just last week failed to respond to emails from Mr Powell, with its director, Alison Saunders, repeatedly not replying.
But ultimately, this story is about the most basic of human emotions: the love of a father and mother for their child. Speaking to The Canary, Mr Powell said of Robbie:
Robbie was an outgoing and very happy child who had many friends of all ages. He was caring and loving, and his love for his family shone brighter than the North Star. Watching Robbie take his last breath, at Morriston Hospital, just 30 minutes after being refused an ambulance, will haunt us for the rest of our lives.
Mr Powell has been fighting for over a quarter of a century for justice for Robbie. He has had numerous barriers placed in his path by the state and those directly involved in the young boy’s death. But he is rock-solid in his belief that his son could, and should, have lived. And he will not rest until questions are answered, and those who may be in part responsible, brought to justice.
All evidence cited in this article has been seen by The Canary.
The Canary will be working with the Powell family on a further investigation into Robbie’s tragic death.
– Write to your MP, asking them to intervene in the case.
– Support the family on Facebook.
Featured image via the Powell family
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