The genesis of the scandal began when a paediatrician Dr Marietta Higgs attended a medical conference in Leeds in 1986 to learn about what was then being trumpeted as a useful medical technique to identify sexual abuse in children. This technique, known as Reflex Anal Dilation (RAD) was being promoted at the conference by two paediatricians Dr Chris Hobbs and Dr Jane Wynne. Unreported in the national media at the time, these two doctors were placing great strains on Leeds social services by their increasing referrals of children, identified through the RAD technique, as having been sexually abused.
RAD had its origins in the United States and for many years had been used to identify homosexuals. Since, during this period, homosexuals were a persecuted minority with no voice, there was no forum or platform available that was sufficiently influential to question whether or not the RAD technique was an effective method of detecting anal penetration. The assumption made by the advocates at the Leeds conference was that this supposedly tried and tested, medically accepted technique could be reliability transferred from identifying homosexuals, a practice that was now no longer socially acceptable, to identifying child sexual abuse, a subject that was beginning to arouse concern in medical and social services circles. The issue had gained some national prominence with the establishment of the Childline telephone service by TV presenter Esther Rantzen.
Dr Higgs returned from the Leeds conference full of enthusiasm for the RAD technique, armed with what turned out to be a dangerous zeal for putting the test into practice. Shortly afterwards in January 1987 she was appointed as a consultant paediatrician to Middlesbrough General Hospital to form a partnership with the hospital's existing paediatrician Dr Geoffrey Wyatt, who had been working there since 1983 without controversy. Dr Higgs quickly converted Dr Wyatt to the effectiveness of the RAD test and the need for it to be put into practice.
The pair set to work with vigour and during a five month period in the spring and summer of 1987 they identified 121 children from 57 families who, according to the evidence of the RAD test, had been victims of sexual abuse. These children were all removed from their homes and subjected to repeated invasive and intimate examinations by medical staff. They were also subjected to intensive interrogation by social workers led by Cleveland's child protection officer Sue Richardson, a committed supporter of the diagnostic test of the two paediatricians.
As might be expected the large number of children taken into care over a relatively short period caused enormous problems for the hospital, social services and the courts. The parents of the children taken into care began to fight back, setting up a support group and, with the backing of the local newspaper, mounted a campaign with the slogan 'Give us back our children'. A major player then entered the fray, the local MP Stuart Bell, whose lobbying in Parliament and to ministers in support of the parents brought the controversy to the attention of the national media. He became a vocal supporter of the rights of the parents against the paediatricians and social services whom he considered to be fanatics with a vendetta against the institution of the family.
Although the social services and the courts were happy to do the bidding of the two paediatricians, the local police surgeon was becoming concerned about the huge rise in child abuse cases that he was being asked to investigate. As a result of his increasing scepticism of the validity of the RAD test, relations between the Council's social services and the police reached breaking point. Because of this impasse, and the extensive media coverage, the government agreed to the request of Stuart Bell to set up a public inquiry to investigate the whole affair, headed by Judge Elizabeth Butler-Sloss. Drs Higgs and Wyatt were then barred by the health authority from carrying out any further RAD tests. The main conclusions in the report of Judge Butler-Sloss were that the parents criticisms of social workers were justified and that the interviews they carried out did not meet professional standards. During video-recorded sessions, social workers were seen to threaten and attempt to bribe children in order to confirm the social worker's views that they had been abused. Leading questions were asked of the children which would not have been permitted in court. Both the doctors and social workers were criticised for being too ready to accept that abuse had taken place, and for the belief that lack of disclosure by the children was evidence of denial. Nearly 100 of the children were returned to their parents but over 20 remained in local authority care. The media coverage of the scandal was mostly hostile to the paediatricians and social services staff. Most reports concluded that the RAD test was likely to be unreliable, that the paediatricians and social workers uncritically accepted the test as a sure sign of sexual abuse, that the scale of child sexual abuse among the Cleveland families was likely to be very limited in scale, that the vast majority of families were treated harshly and unsympathetically by Cleveland social services and that most of the children were wrongly taken from their homes.
With the benefit of hindsight the Cleveland scandal probably prevented a much greater injustice being perpetrated against British families. Drs Higgs and Wyatt initially only applied the RAD test to children who had already come to the attention of social services. However, carried away by their zeal to track down child abusers by this supposedly foolproof method, they started to extend the test to children brought into the hospital for unrelated ailments. This resulted in a huge spike in referrals to social services and, because of the numbers, allowed innocent parents an opportunity to group together to mount a campaign, which quickly created positive publicity through the local media and the efforts of the MP.
If the two paediatricians had been a little more restrained in their zeal the number of families affected would have been a lot smaller. Thus it is unlikely that a campaign to challenge the diagnoses of the paediatricians would have become established. Given that the courts and social services in Cleveland, and in the earlier Leeds case, all accepted the RAD test as reliable, it would only be a matter of time before the technique would gradually have been implemented throughout the country. In such a scenario, it would take a lot longer before the validity of the RAD test started to be questioned, by which time tens of thousands of children might have wrongly been taken from their families. In such a situation parents would soon become afraid to seek medical treatment for their children if they feared that they might be snatched from them by the authorities. In the Cleveland case the vigilantes made the mistake of targeting families as a source of child abuse. At that time the paedophile hysteria had not yet achieved lift off and the press sympathised with the plight of parents rather than express concern about the risk to children. Dr Higgs continues to believe in the reliability of the RAD technique and has stated that she would act no differently today. Although not known at the time surveys have shown that only a tiny number of paedophiles engage in anal penetration of their victims, preferring alternative methods of molestation. Moreover, two surveys in 2002 and 2011 by the NSPCC revealed that only 0.1% of the children under 18 who participated had been subject to sexual abuse by parents or step-parents. So the RAD test was not only unreliable but also useless in detecting most forms of child molestation.
Children's charities played no part in the Cleveland scandal, but in time they would soon discover that fanning the flames of child abuse paranoia would create a nice little earner for them which could continue indefinitely. The lesson they learned from Cleveland was to tread carefully before implicating families, and instead pursue a strategy of instilling fear in the general populace over the threat from the ever present paedophile lurking behind every corner.
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