Ombudsman rejects father’s claim that council failed to consider his concerns that child was victim of Fabricated or Induced Illness (FII) by Proxy

The Local Government and Social Care Ombudsman has concluded that Lincolnshire County Council consulted medical professionals and considered a father’s concerns in line with relevant policies “without fault”, after he complained the council failed to consider his concerns that his child is a victim of Fabricated or Induced Illness (FII) by Proxy.

Fabricated or Induced Illness (FII) is a clinical situation where a child is, or is very likely to be, harmed due to parents'/carers' behaviour and action, carried out in order to convince doctors that the child's state of physical and/or mental health or neurodevelopment is impaired.

Mr X complained the council failed to consider his concerns that his child is a victim of FII by Proxy, and prevented them from being assessed for it despite providing “supporting evidence”.

The case concerned a child, Y. Y’s mother (Mrs Z) commissioned a private assessment which concluded Y has a neurodevelopmental condition.

However, Mr X was of the view this was a “deliberate misdiagnosis”, and that Mrs Z’s actions matched the description of FII by proxy.

The Ombudsman said: “Records show [Mr X] raised concerns with the GP in mid-2022 and advised he thought Mrs Z was fabricating illness. The GP raised this with the council who told the GP to look at its FII policy. It explained the first step was for a paediatrician to assess Y. If the paediatrician has evidence of possible FII then the relevant health professional should make a referral to the council.”

Mr X contacted the council again a few months later. He said following advice the council had given the GP, Y had an appointment booked with a paediatrician. However, the paediatrician cancelled the appointment as they were of the view this was a “welfare issue” and told Mr X to go back to the council.

The GP requested a consultation with the council in early 2023. The council advised the GP to discuss the concerns and relevant information with other health professionals as so far, it was only Mr X raising the concerns.

Mr X contacted the council again in 2023 reporting he remained concerned Y was a victim of FII by proxy. He said he followed up with the clinician who completed the private assessment. The clinician confirmed Y has had no formal diagnosis but it was their “professional opinion” that Y has a neurodevelopment condition.

The council explained to Mr X that whilst Mrs Z had told others Y has a neurodevelopmental condition with no formal diagnosis, this “did not evidence” she was fabricating an illness, given the professional opinion of the clinician.

The council advised it would be concerned if Mrs Z was medicating Y without a medical reason but there was no evidence to suggest this was the case.

Mr X complained to the council saying despite providing evidence of Y being a victim of FII, a health professional had still not assessed Y for this.

The following month, the council issued a complaint response saying it had directed the GP to its FII policy after Mr X raised concerns. It explained the policy includes a referral to paediatrics to undertake further assessment or observation of Y. Should the paediatrician have concerns for Fabricated and Induced Illness then the relevant professional should make a safeguarding referral.

The council said no paediatric or GP referral had ever been made to the council identifying concerns for FII for Y.

After Mr X took his complaint to the Ombudsman, the Ombudsman concluded: “The council has advised Mr X that it has never received a safeguarding referral from the GP, paediatrician or any other professional despite the council explaining and sharing its policy twice. The records show the GP has shared Mr X’s concerns with the council on his behalf but the GP has not advised it is of the same view.

“The council has considered the concerns in line with its FII policy, recorded it’s decision-making and advised Mr X it has no evidence Y is a victim of FII by proxy or that Mrs Z is medicating Y without medical reason to do so.”

The Ombudsman added: “Whilst I appreciate Mr X disagrees with the council on the matter, there is no fault in how the council reached its decision to take no further action.”
Heather Sandy, Executive Director for Children’s Services at Lincolnshire County Council said: “We do not comment on the details of individual cases, but recognise that the Ombudsman has concluded that the council took the appropriate action and found no fault in how we reached our decision.”

Lottie Winson