Selecting a Paediatric Expert for Criminal Proceedings

Selecting a paediatric expert for criminal proceedings requires a different approach than in civil litigation. The primary distinction lies in the governing procedural rules and the legal purpose for which the expert evidence is sought. In criminal cases within England and Wales, the expert’s role and the conduct of their evidence are governed by the Criminal Procedure Rules (CrimPR) Part 19. Understanding these procedural boundaries is the first step in ensuring that the expert instruction is focused on the relevant issues of fact.

The Scope of Duty Under CrimPR Part 19

In criminal proceedings, an expert’s overriding duty is to the court, as stipulated in CrimPR 19.2. This duty prevails over any obligation to the party instructing them. Unlike civil proceedings, where the court may direct the appointment of a single joint expert under CPR 35.7, criminal litigation typically involves experts instructed by the prosecution and the defence separately. While the court may direct experts to narrow the issues in dispute, the fundamental expectation remains that the expert provides objective, impartial assistance to the court on matters within their professional expertise.

When instructing a paediatric consultant, neurologist, or radiologist, counsel should ensure the expert is briefed on their role in the context of the trial. The expert must maintain a clear distinction between their clinical findings—the objective data obtained from examination or imaging—and the ultimate determination of culpability, which is a matter exclusively for the court.

Selecting the Appropriate Specialist

Criminal allegations involving children often require a multi-disciplinary approach. Selecting the correct specialist depends on the nature of the alleged incident and the clinical evidence available. Common areas of instruction include:

• Paediatric Radiology: Where skeletal surveys are central, an expert must be experienced in differentiating between developmental variants, metabolic bone disease, and potential trauma. Experts should be cautious when discussing the timing of injuries, as bone healing and radiological appearances are subject to biological variation.
• Neurology and Abusive Head Trauma (AHT): Where there are allegations of inflicted brain injury, an expert must be capable of presenting a robust differential diagnosis. This requires a comprehensive review of the clinical history, including the presence of medical conditions that might mimic trauma.
• Paediatric Cardiology and Metabolic Medicine: In cases involving sudden or unexpected death, the remit may need to expand beyond general paediatrics to ensure that underlying, undiagnosed conditions have been appropriately evaluated as part of the clinical narrative.

By providing independent witness assessment services, experts assist the court in evaluating complex clinical scenarios. Counsel should frame instructions to allow for analytical independence, avoiding questions that seek to force a definitive finding where the medical data is inconclusive.

Reviewing the Evidential Record

Before instruction, solicitors must ensure that the expert has a complete set of relevant records, typically including the full medical history, contemporary imaging, and records of the child’s development. The expert should be provided with a neutral chronology drafted by the instructing solicitor, which identifies key events without being overly interpretive. The expert’s ability to articulate inconsistencies between the oral history and objective clinical findings—without straying into character evidence—is vital to their testimony.

Procedural Directions

If an expert requires further information or clarification, they should be aware of the mechanism for requesting directions from the court. CrimPR 19.3 sets out the requirements for expert reports, which must be clearly structured, referenced, and include a statement that the expert understands their duty to the court. If experts from opposing sides are directed to hold discussions, the resulting statement should focus solely on the areas of clinical agreement and disagreement. This process must be conducted with transparency to preserve the expert’s professional independence.

When preparing your instruction, consider whether the expert possesses the specific sub-specialist expertise required for the clinical findings, whether sufficient time has been allocated for the review of complex data, and whether the questions posed allow for a balanced consideration of alternative clinical interpretations.