The Local Authority v A & Ors

Introduction 1. This is a fact finding hearing in public law proceedings, remitted for rehearing by the Court of Appeal. I am concerned with two children, a girl aged 8 ½ and a boy aged 7 ½. 2. By way of general introduction I can do no better than quote Baker LJ in the Court of Appeal (Re F and B (Fact-Finding: Gonorrhoea) [2025] EWCA Civ 340) at para 1: “In June 2023, the girl, hereafter called "F", then aged 6, was diagnosed as suffering from gonorrhoea. The local authority started care proceedings in respect of F and her younger brother, "B", then aged 5. Interim care orders were granted but the children remained living with their maternal grandmother. In the proceedings, the local authority sought a range of findings on the basis of which it asserted that the threshold criteria for making care orders under s.31(2) of the Children Act 1989 were satisfied. The findings sought included sexual abuse, emotional harm, the poor mental health of the mother, parental drug and alcohol misuse, domestic violence, and criminality on the part of the children's father. All findings were substantially accepted by the parties to the proceedings, save for those relating to sexual abuse, which proceeded to a fact-finding hearing before HH Judge Greensmith over five days in September and October 2024. The local authority alleged that F had contracted gonorrhoea as a result of sexual abuse perpetrated by either the mother or the mother's brother, X. But in a reserved judgment delivered on 6 November 2024, the judge made findings that F had contracted the infection as result of fomite transmission, facilitated by X at a time when he knew he was carrying the infection and was contagious.” 3. The judge thereby acquitted either the mother or the mother’s brother (“the uncle”) of sexual abuse. The Court of Appeal concluded that the judge made a number of errors in his approach to the evidence and law, and remitted for rehearing to, as it turned out, me. At para 56, Baker LJ added: “I stress that I am not indicating any view as to the outcome of that rehearing which will be a matter for the next judge to determine on the totality of the evidence and submissions then put before the court, which may well include evidence and submissions on a range of matters not considered at the first hearing”. 4. This is my judgment on the rehearing. The threshold criteria 5. Other than in respect of the transmission of gonorrhoea, the findings sought by the local authority (“LA”) are accepted. They are, to alight upon the most significant aspects: i) Exposure to domestic violence perpetrated by the father against the mother. ii) Since May 2023, the mother has abandoned the children to the care of the maternal grandmother, only sporadically seeing them since. iii) The mother has poor mental health in the form of anxiety and depression, has had suicidal thoughts and has self-harmed. She is on anti-depressants. iv) The mother has a history of drug and alcohol misuse, including while caring for the children. She has tested positive for use of heroin, cocaine, ketamine, MDMA, cannabis and tramadol. v) The father has a history of criminal convictions for battery, criminal damage, drugs related matters and possession of weapons. On 3 November 2022 he threatened the maternal grandmother with a meat cleaver, for which he received a prison sentence. 6. On these accepted findings alone (without any reference to the sexual abuse allegations), the s31 threshold is crossed. The long term care plan of the LA is likely to be placement with the maternal grandmother and from everything I have seen and heard, there is little prospect of the children being returned to either parent. 7. The additional findings sought by the LA are that: i) F was infected with vaginal Gonorrhoea through transmission by contact between her vagina with the penis, vagina, mouth and/or anus of an infected person, such contact requiring intimate exposure of the respective mucus membranes. ii) F was infected with ocular Gonorrhoea through transmission by either: a. Contact between her eye and the discharge from the penis or vagina of an infected person; or b. Autoinfection due to F having already contracted vaginal Gonorrhoea. iii) By virtue of [the above], F has suffered significant sexual harm. iv) The perpetrator of that sexual harm was either M or the uncle. 11. At the time of F’s infection, she and B were living with the grandmother who was not an infected person and is ruled out as a perpetrator. Her partner also tested negative and is ruled out. The father is excluded from responsibility for the transmission of gonorrhoea because he was, at the relevant time, serving a custodial sentence. The LA submit that the mother and the uncle were both infected with gonorrhoea at or about the relevant time, and both were in contact with F; they are both, on the LA’s case, potential perpetrators. 12. The mother and uncle both deny infecting F by sexual means. They say that if F was infected (as to which they raise some doubt arising out of the testing process), the evidence does not establish that it was as a result of abuse by either of them. And, although it is not for them to give an explanation, any such infection is more likely to have been through a fomite/non-sexual means. 13. The Guardian in closing submissions invited the court to accept the expert evidence that the cause of F’s gonorrhoea was abusive sexual contact, that the only two people known to have had the ability and opportunity to infect F were the mother and the uncle, and that she cannot distinguish between the two in terms of responsibility. 14. I am very grateful to all the advocates who, fairly and thoroughly, explored before me all relevant evidence and submissions. Witnesses 15. I heard oral evidence from: i) Dr Rothburn. ii) The maternal grandmother. iii) Dr Ghaly. iv) The uncle. 16. The mother has filed witness statements but did not attend the hearing before me or give oral evidence. Similarly, she had not attended before HHJ Greensmith to give oral evidence although she did attend briefly on the day of closing submissions before leaving when she was told she might be expected to give her evidence. At the pretrial review, I recorded on the face of my order a warning that the court might draw adverse inferences should she not attend, and might make findings in her absence. I am told that she indicated to her lawyers an intention to attend this hearing. The day before the hearing, she attended at her solicitors’ offices, clearly under the influence of drugs. Her solicitors considered that she was in no fit state to give instructions. She was asked to stop using drugs and to attend court. In the event, she did not attend and therefore did not give oral evidence; she was not cross examined on a number of important matters. No application for an adjournment was made. I am told that she has not given instructions since 18 September 2023. As I will explain, in my judgment I should not draw adverse inferences against her from her non-attendance, but it does not follow that I should simply accept what she says in her written, and untested evidence. If her failure to give oral evidence leaves unanswered questions, that is itself part of the, albeit incomplete, evidential picture before me. Putting it another way, I do not conclude by reason of her non-attendance that she perpetrated sexual abuse on F, but nor do I simply accept, by reason of her written statements, that she did not. 17. The father did not attend. As no sexual abuse findings were sought against him, he was not expected to give evidence. He was represented throughout. His non-attendance did not affect this hearing. It does, however, reflect poorly on him that he did not come to court, and his counsel was without instructions throughout. He did not communicate with his legal team during the hearing. At earlier hearings I had been told that the father wanted to attend to observe matters directly relevant to his children. In the event, he has shown no such interest and it is hard, with hindsight, to justify the public funding expenditure on his behalf. 18. The uncle was diagnosed with ADHD at the age of 14. An intermediary report set out his poor listening and attention, impaired auditory memory, diminished ability to process and variable verbal expression. It recommended various participation measures. He was assisted by an intermediary throughout. Background 19. The mother, who is 25 years old, has a history of substance and alcohol abuse, and poor mental health. In 2014, she became involved with the father, now aged 31, who was involved with drugs, alcohol and crime. Their relationship was afflicted by incidents of serious domestic abuse. As a result of these matters, social services became involved and, following her birth in 2016, F was made subject to a child protection plan. In 2018, the mother gave birth to her second child, B. Social services remained involved with the family. In 2021, the parents' relationship came to an end. The mother's lifestyle remained chaotic and she continued to misuse drugs (including crack cocaine and heroin) which she funded by (I am satisfied) prostitution and theft. The father, who had been sentenced in August 2020 to six months imprisonment for battery, was sentenced in January 2023 to two years imprisonment for a Class A drug offence. 20. In May 2023, the mother (according to her untested written evidence) had unprotected sex with a man called G, and in June 2023 with a man called H. In May 2023, the uncle (who is now 24 years old) had unprotected sex with three women called J, K and L. 21. On 5 May 2023, the mother left the children in the care of the maternal grandmother, with whom the children had spent regular weekends until then. The mother was unable to continue to care for them because of her drug and alcohol use. The grandmother became the primary carer. 22. At that time, the uncle, then aged 21, was living at the grandmother's house. He has a history of mental health problems, and was a user of weed, ketamine, and magic (MMDA). 23. After leaving the children with the grandmother, the mother went to visit them once or twice per week at the grandmother’s home. During the oral evidence it transpired that she spent at least one night (the date was unclear but certainly before F’s gonorrhoea diagnosis) at the grandmother’s house, and slept on the floor of the children’s bedroom. 24. At some point in May 2023 (the oral evidence suggested on or about 23 May 2023), the uncle noticed green gunk discharging from his penis, and told the grandmother about it. Within a day or two he attended at a sexual health clinic and he received a text message from the clinic on 25 May 2023 confirming that he had tested positive for gonorrhoea and chlamydia; his recollection to me was that the texts confirmed what he had been told at the clinic was a likely outcome of the testing. Again, he told the grandmother. 25. The uncle told me that after the diagnosis, he did not have sex for a week or so, and thereafter he continued to have unprotected sex with partners. 26. In early June 2023, F’s right eye was observed by the grandmother to be swollen, red and itchy, and pus was oozing out. The grandmother thought it was conjunctivitis. As it turned out, these were symptoms of gonorrhoea and based on the expert evidence it is likely that she became infected at some point in the previous two weeks or so. 27. On 4 June 2023, the grandmother phoned the NHS helpline, and then took F to a walk in clinic. F was referred to hospital where eye swabs were taken during the night (strictly speaking, in the early hours of 5 June 2023) and she was given intravenous antibiotic treatment. She was discharged on 7 June 2025. The right eye swab tested positive for “gonorrhoea (scanty)” on 8 June 2025, as a result of which a referral was made to the LA. F (accompanied by the mother and grandmother) returned for a vulval swab, swabs on both eyes and urine test the next day, 9 June 2025, all of which took place despite some resistance from F. The eye tests were negative, the vulval swab “weakly positive” for gonorrhoea, and the urine test “equivocal” for gonorrhoea. 28. The uncle left the property at the grandmother’s insistence. The children remained living with the grandmother. 29. On 9 June 2023, throat and urine samples were taken from B which reported as negative. A perianal swab taken from him on 12 June 2023 was also negative. On the same day (12 June 2023) as part of the medical examination on B, an injury to his foreskin was found as to which there are no suggestions of abuse. 30. On 12 June 2023, a medical examination arranged for F had to be abandoned because she was crying and refused to be examined. It was therefore an incomplete assessment. In particular, physical anogenital examination could not be carried out. A re-attempt to do the physical examination on 13 July 2023 was again incomplete due to F’s distress. It was possible to examine part of her labia visually and there were no injuries. 31. On 14 June 2023, throat and vulva swabs taken from the mother tested positive for gonorrhoea. As she was (as far as we know) asymptomatic up to that point, it is not possible to know when she became infected. Tests of the grandmother and her partner were negative.On 3 August 2023, further testing established that the mother no longer had gonorrhoea. 32. On 23 June 2023, the local authority started care proceedings in respect of both children. Interim care orders were made on the basis of plans for the children to remain in the care of their grandmother, on condition that no person other than the grandmother and her partner lived in the property. The parents and the children (via their children's guardian) were joined as respondents, and the uncle was given leave to intervene. 33. The grandmother and children have moved home because the circumstances of potential sexual abuse became known in the local community and it was not safe for them to remain in the same property. 34. The mother’s chaotic lifestyle, characterised by drug and alcohol misuse, and association with inappropriate (often homeless) adults, has continued. On 27 May 2023, she reported to the police that the uncle had assaulted her, although no charges ensued. Hair strand testing has shown at different times high levels of cannabis, cocaine, heroin, ketamine, opiates and tramadol. She has been described to me by her counsel as a drug addict. 35. The uncle’s use of drugs continued. In a police interview on 23 March 2024, the uncle described himself as a user of “crack…Ket, cocaine, magic”. He has been involved in arguments, including physical altercations, with the mother. He has been charged with rape against a former partner which is alleged to have taken place on 23 March 2024, and the trial is due to start in October 2025. Charges against him have also been made for possession of drugs and theft alleged to have taken place on the same day and as part of the events surrounding the rape allegation. The expert evidence 36. I first heard from Dr Rothburn, a consultant medical microbiologist. I summarise his written and oral evidence as follows: i) Most strains of Neisseria Gonorrhoea (“NG”) have a similar antibiotic susceptibility/resistance profiles and are indistinguishable by comparing the antibiotic profiles. The strains would be therefore regarded as indistinguishable and in itself does not give an indication of the route/source of infection. ii) “… in many cases this is an asymptomatic genital infection. For this reason it is not possible to suggest the time sequence in which individuals became infected”. iii) Gonorrhoea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for gonorrhoea to be transmitted or acquired. iv) The gonorrhoea in the eye could be caused by touching the infected genital area and then touching the eye. The reverse is also possible in theory, although less likely. v) The possibility of fomite transfer (transfer via an inanimate object), is rare because NG is a fastidious organism which does not survive outside the human host in a dry environment. NG is strictly a human pathogen with no known animal or environmental reservoir. Survival of the NG bacterium on an inanimate surface depends on it being a moist environment. Survival of gonococci has been demonstrated for up to 24 hours on a towel periodically rinsed with warm, physiologic saline. NG does not reside on human skin but may be present transiently on the skin, for example the fingers, as a result of genital contamination and hence may be transferred to other body sites such as the eye(s). This is termed autoinoculation. The duration of survival of the bacteria on the hands in the absence of hand hygiene (washing) depends on the time for drying which would be minutes. vi) In answer to a written query about whether transmission could take place if a carrier of gonorrhoea contaminating a toilet seat which a child then touches : “In this scenario described above it is theoretically feasible that the NG bacterium would remain viable under moist conditions. So, if the hands were contaminated and were not washed and if there was touching of the vaginal or ocular (eye) mucosa there could then be transmission of NG with the development of an infection.” He gave similar answers about transmission via toilet rolls, clothing which is washed together, and use of the same towel. Overall, however, he said that these theories of non-sexual contact are rare and unlikely, albeit they cannot be completely eliminated. vii) There are no publications indicating the frequency of fomite transfer and infection. Research on the topic would be unethical and is limited. He was taken to some of the papers on the possibility of fomite transmission but said that these were usually individual case studies (e.g one about a girl in a much used thermal pool) with limited history, context and comparisons, or they were out of date (including from the 1890s). viii) In those infected by NG and Chlamydia trachomatis, the transmission of gonorrhoea but not chlamydia (or transmission of chlamydia but not gonorrhoea) is feasible as these are different species of bacteria. This is because the risk of infection from one individual to another would depend on various factors such as the relative viable bacterial load/inoculum for gonorrhoea and chlamydia at the time of the exposure as well as the host susceptibility to the development of infection for the individual bacteria, which are unknown and variable features. ix) There is no significance in the expression “weakly positive” to describe F’s vulva swab test, which was a reflection of the quantity of germ and was taken after she had received treatment for her eye. A positive result is a positive result. x) The samples taken from F on 9 June were subject to Nucleic Acid Amplification Test (“NAAT”). He agreed that it is necessary to apply the NAAT twice, using slightly different methodology, to strengthen the results. Although there was only one laboratory report (rather than two with the results of each separate test), he was confident that the testing would have been done twice as part of standard laboratory procedure, and he would not have expected two reports. He was confident that the tests were properly carried out. xi) He was asked about the process of taking the vulval swab on 9 June 2025. The medical notes show that because F was distressed and uncooperative, the swab was taken by the mother at the same time as she took urine, rather than by the two clinicians who were present. He agreed this was not gold standard but said that it was observed/supervised by clinicians and that any risk of contamination by the mother (who, a few days later, tested positive for gonorrhoea herself) was highly unlikely, indeed almost inconceivable. He added that a false negative was a much greater risk than a false positive. In short, he rejected the contention that these various matters placed the reliability of the testing in doubt. 37. Dr Ghaly, a consultant physician in genitourinary medicine, sexual offences examiner and forensic physician, told me in written and oral evidence: i) “Gonorrhoea is a sexually transmitted disease which is caused by contracting Gram negative intracellular diplococcus NG. The primary sites of infection are the mucous membranes of the urethra, endocervix, rectum, pharynx and conjunctiva.” ii) Transmission is by direct inoculation of infected secretions from one mucous membrane to another. The main route is “sexual contact with relevant anatomical sites, penile oral, penile anal and penile vagina…etc." The most likely mode of transmission in this case is through sexual contact. He explained that for a man to transmit the infection by sexual contact would require (a) penile contact (albeit not necessarily penetration) or (b) oral sex. For a woman, it would require (a) vulval contamination by frottage (which he considered anatomically less likely) or (b) oral sex. If the eye inoculation came first (i.e not as a result of autoinfection from the genital area), it would probably require discharging in the eye or oral sex. iii) "A positive culture for NG from any site in a child without prior peer sexual activity is strongly suggestive of sexual abuse. The question of whether gonococcal infection in children can be acquired through fomites still arises. To date there are no convincing data to support nonsexual mode of transmission in children.” And later “nonsexual contact is remote and has not been robustly substantiated in the literature”. iv) “Sexual abuse should be strongly considered when a gonorrhoea infection (i.e., genital, rectal, oral, or ophthalmologic) is diagnosed in a child after the newborn period and before the onset of puberty…..sexually transmitted disease may be the only physical evidence of sexual abuse in some cases." v) Vertical transmission (i.e from the mother to child during birth) is unlikely given the age of the child as well as no evidence that the mother had the infection during birth, nor any evidence of eye infection in the child shortly after delivery. vi) Gonorrhoea cannot survive outside the host for a significant length of time given the fragility of the organism and its susceptibility to dryness. Moisture is a main factor in its survival. The likelihood of transmission from an inanimate object (e.g. bathwater, a towel, toilet seat, bed linen) is uncommon and has not been widely supported in the literature but cannot be totally eliminated. vii) “It is worthwhile stating that the mere presence of the bacterium on a surface or object does not equate to transmission. In addition, if NG is easily transmitted via [a] nonsexual route, one would expect the other children to have been infected which was not the case.” viii) Although there have been studies which have shown the presence of live organism on inanimate objects, none have demonstrated that the organism can then be transmitted to humans. STIs have also been detected on clinic surfaces and hands of national health service staff using the NAAT but attempts to culture NG or Chlamydia Trachomatis from these specimens have failed, suggesting that this material is non-viable and the transmission via this route is extremely unlikely. The scientific evidence for non-sexual contact transfer (accidental/fomite/self-inoculation) is anecdotal, based on ad hoc individual cases and not researched. He considers it to be extremely unlikely although it cannot be completely ruled out. The thermal pool case (on which considerable reliance was placed in cross examination on behalf of the uncle) is a case report, with no context and no research based analysis. ix) The absence of genital injury does not rule out gonorrhoea through sexual contact. Indeed, “the majority of cases of child abuse have no injuries”. x) “It is plausible [for the child] to contract one infection and not the other”. This was in response to a specific question in the letter of instruction about the fact that the uncle contracted both chlamydia and gonorrhoea xi) The usual incubation period for gonorrhoea is three days to two weeks. An infected person usually becomes infectious and able to transmit the disease following the incubation period. The infection can be asymptomatic; a person can still be infectious and transmit the disease. Dr Ghaly told me that F was asymptomatic in her genital area, but may well have become symptomatic later had she not been treated. xii) Dr Ghaly explained the anatomical process of transmitting gonorrhoea non sexually to F’s genital area. It involves abducting the legs of the child and widening the labia to get into the vestibule area. The labia majora is not a mucous membrane, so infection would have to be inoculated into the labia minora (which is), or to a mucous membrane further inside the genital area. In a child of this age, the vulva is closed so the labia would need to be separated for the germ to be transmitted. This is a very sensitive part of the body, and it would be uncomfortable and painful. He agreed that children touch their genital areas, but externally and not inside the labia. xiii) Auto-inoculation is highly unlikely. Transmission to F’s finger either via an inanimate object (e.g. a towel or a toilet seat) or from her rubbing her eye, is very unlikely, if not impossible. The germ would then have had to be transmitted by F inserting a finger inside the labia which is very improbable. He was not aware of any case where an innocent mechanism of this nature has taken place. xiv) He said that the method of testing the vulval swab was for the laboratory to decide. From a clinical point of view, what matters is that the result was positive. He would not expect to see the report setting out all the details of the testing procedure, and he had no reason to doubt the two NAATs which were carried out. xv) He agreed that the process of taking the swab on 9 June (apparently done by the mother) was not ideal, but said there seemed to be no alternative because F was not cooperating. He did not accept (as suggested by leading counsel for the uncle) that there was a risk of a false positive; rather the risk would be a false negative. He could not see any means by which a vulval swab would show a positive result for gonorrhoea unless F was infected in the genital area. In particular, he did not consider it remotely realistic to contemplate that somehow the swab became contaminated by coming into contact with the mother’s infected genital area at the time. He was clear that the quality of the result was not undermined by how the swab was taken; any suggestion to the contrary was theoretical and very remote. He pointed out that the infection was also detected in the eye, about which there was no swabbing issue. xvi) He said that the word “equivocal” when describing the urine test is not a designation of a positive test, but he pointed out that she had been given antibiotics for the eye a few days before which would have had an impact on the infection. The words “weakly positive” when describing the vulval infection are not of great significance from a clinical perspective; what matters is the positive result. xvii) He said that autoinoculation from the vaginal area to the eye is possible, but the reverse is highly unlikely. The former could have taken place by F touching her infected area (not necessarily a mucous membrane) and then rubbing the eye. xviii) Dr Ghaly said (in answer to a question from me) that once inoculation of the infection to a mucous membrane in F’s genitalia had taken place, the infection would then have spread to other areas of the genitalia. xix) He particularly drew my attention to “Physical Signs of Child Sexual Abuse” (known as “The Purple Book”), 2024 edition para 10.1.3: “… accidental transmission, including fomite transfer and auto inoculation, non-sexual close physical contact have also been proposed. Although there have been studies which have shown the presence of live organism on inanimate objects none have demonstrated the organism can then be transmitted to humans. STIs or sexually transmitted infections have also been detected on clinic surfaces and hands of national health service staff using the NAAT test but attempts to culture Neisseria Gonorrhoea … from these specimens have failed, suggesting that this material is non-viable and the transmission via this route is extremely unlikely.” 38. Overall, the two experts were essentially in agreement that fomite or nonsexual transmission in this case is a theoretical possibility, but highly unlikely, and sexual contact is the most probable cause of F’s gonorrhoea infection. The mother 39. The mother in her written evidence denies abusing the children by direct transmission of gonorrhoea. She believes she herself contracted gonorrhoea from one of the men (G and H) with whom she had unprotected sex in May and June 2023. 40. From the time that the maternal grandmother started caring for the children in early 2023, until the issue of care proceedings on 23 June 2023, she saw the children twice in total. That evidence was contradicted by the grandmother who said that the mother came to her house once or twice a week and on one occasion stayed overnight in the children’s room. Because she did not attend to give evidence, she could not be cross examined on these or other matters such as sexual partners, symptoms, her movements in the relevant period, and how she handled the vulval swab on 9 June 2025. These are significant gaps in the totality of the evidence before me. The maternal grandmother 41. The grandmother said in her written and oral evidence: i) The children came to stay on 5 May 2023. They shared a room, the grandmother and her partner were in a room, and the uncle in a room. ii) The uncle would regularly go away and return for a few days at a time. There was always another adult around in the house. iii) The children had their own clean towels, as did the adults. The uncle, who is by nature messy, would leave his towel on the floor to be cleaned. There was one hand towel in the bathroom which everyone used. She cleaned all the towels every day. At bath time the children would use the same bath water (but not bath water used by adults). The bathroom would usually be hot and steamy, especially in June 2023. The bathroom door would normally be left open to ventilate it. The steam would clear in about five minutes. iv) From 5 May 2023, the mother came to the house once or twice a week for a few hours. There was always another adult in the house with her and the children. In answer to a question from me, she said that after 5 May 2023 the mother stayed overnight on one occasion (as well as visiting once or twice a week during the day). In answer to a follow up question from me, she said the mother slept on the floor of the children’s bedroom. That clearly came as a surprise to all the legal professionals as it had not appeared anywhere in the papers. I invited further questions on that topic. The mother’s leading counsel repeatedly pressed the grandmother on the accuracy of her recall. The grandmother repeatedly replied she was sure that it happened after 5 May and before 4 June, and the mother stayed overnight because she was sleeping rough on the streets at the time. At the end of this series of questions, she said she might have been confused, but I am confident that her initial, clear recollection that the mother stayed overnight was accurate. There is some support for the overnight stay in a social worker file note which records the grandmother saying that the mother “had stayed with them for a few days” which suggests more than one night. Of course, the mother did not enter the witness box to answer questions about this. v) The uncle told her in May about the green gunk coming from his penis. He told her when he was tested positive; she could not remember the exact date but she was confident it was before early June when F had her eye symptoms. vi) Neither of the children have ever made to her any disclosure of inappropriate contact with an adult. vii) She was present when the samples were taken on 9 June. Her recollection (unlike the record in the medical notes) is that the mother tried and failed to take a swab, but one of the clinicians succeeded. 42. Overall, she seemed to me to be honest and transparent in her evidence. The uncle 43. In his written evidence, the uncle said: i) That he was “sure” it was a Wednesday in June when he first noticed he had green gunk around his penis, symptoms of what turned out to be gonorrhoea. That would most likely be Wednesday 31 May. The next day he called to make an appointment for a walk in test at a clinic. He went to the clinic on Saturday (3 June) where he was told he had gonorrhoea and chlamydia. He said that the same day discharge and swelling was seen in F’s eye. Examination by the police of the uncle’s phone show that he received text messages from the clinic on and after 25 May 2023. Thus, the texts suggested that he attended the clinic a day or two before 25 May 2023, which is a week before the date which he described in his written statement. HHJ Greensmith found this unsatisfactory, but concluded that there was an innocent explanation for the discrepancy. The Court of Appeal stated that this discrepancy was capable of a malign explanation and allowed the appeal on this, as well as other grounds. Before me leading counsel for the LA expressly informed me that he did not intend to explore this discrepancy in cross examination, and I therefore do not take it into account. ii) He recalls that he had sex with a woman called J the week before he first noticed symptoms. J had a test and was found to be infected. A further week before that, he had sex with a woman called K; she tested negative. He believes he contracted gonorrhoea from J. He cannot explain how he contracted chlamydia. Orally, he told me he had unprotected sex after his diagnosis and could not give me any good explanation as to why he did so. iii) While living with the grandmother and the children in May/early June 2023, it was the grandmother who did all the caring, including bath and bedtimes. He was out a lot at work or with friends and had limited involvement with the children. At home, the adults and children had towels which were washed after each shower. He would take the towel down to the washing machine or leave it on a floor. The children always had clean towels. Orally, he added that he never saw F pick up or touch his towel. iv) When going to the toilet, he generally did not wash his hands. The discharge continued for one week. v) It is possible that F’s gonorrhoea was caused by the mother or one of the people she associated with. Orally, he told me that he was sure the mother did not cause it. 44. Overall, I found that he gave his oral evidence clearly, but I did not consider him entirely satisfactory about his continuation of unprotected sex after the diagnosis and his differing versions of the mother’s responsibility. Y (maternal grandmother’s partner) 45. Y did not give evidence but in written statements said that the uncle was at the house about 3-4 days per week during the relevant period. Law 46. The burden of proving the facts pleaded rests with the LA. The parents are under no obligation to disprove a case; that would amount to reversing the burden of proof. 47. The standard of proof is the simple balance of probabilities, neither more nor less: Re B (Care Proceedings: Standard of Proof) [2008] UKHL 35. 48. Findings of fact must be based on evidence, not on suspicion or speculation: per Munby LJ at paragraph 26 of Re A [2011] EWCA Civ 12. 49. The inherent probability or improbability of an event is a matter to be taken into account when deciding whether, on balance, the event occurred, but does not either lower or raise the standard of proof: Re B (supra) and Re BR (Proof of Facts) [2015] EWFC 41. 50. It does not follow that once all other possibilities are rejected, whatever remains must be the truth: Rhesa Shipping SA v Edmunds, The Popi M [1985] 1 WLR 948 per Lord Brandon at 955G. 51. The LA must prove not just the primary facts, but also the causal link between any facts found and the risks alleged: Re A [2016] 1 FLR 1 and Re L-W [2019] 2 FLR 278. 52. The decision on whether the facts in issue have been proved to the requisite standard must be based on all of the available evidence. The court looks at the broad canvas of the evidence before it in order to make findings on the balance of probabilities. Each piece of evidence should be considered in the context of all of the other evidence. As Dame Elizabeth Butler-Sloss P observed at para 33 of Re T [2004] 2 FLR 838: "Evidence cannot be evaluated and assessed in separate compartments. A judge in these difficult cases must have regard to the relevance of each piece of evidence to other evidence and to exercise an overview of the totality of the evidence in order to come to the conclusion whether the case put forward by the local authority has been made out to the appropriate standard of proof." 53. Appropriate attention must be paid to the opinion of medical experts, but those opinions need to be considered in the context of all the other evidence; A County Council v KD and L [2005] 1 FLR 851. The judge is the decision maker, the expert is not. The expert evidence is part of a wider picture. The judge can make findings which are contrary to the unanimity of medical evidence: Lancashire v D and E [2008] EWHC 832 (Fam). 54. The possibility of unknown cause must be borne in mind: Re R (Care Proceedings: Causation) [2011] EWHC 1715 (Fam). Today's medical certainty may be discarded by the next generation of experts or that scientific research will throw light into corners that are at present dark: Re U (Serious Injury: Standard of Proof): ReB [2004] 2 FLR 263 at paragraph 23. Scientific certainties of a past age are often proved conclusively wrong by later generations: per Mostyn J in A County Council v M and F [2012] 2 FLR 939 at paragraph 251. Today's orthodoxy may become tomorrow's outdated learning: R v Holdsworth [2008] EWCA Crim 971 at paragraph 57. 55. The evidence of the parents and carers (and in this case the uncle) is of utmost importance. The court should form a clear assessment of their credibility and reliability. The court is likely to place considerable reliability and weight on the evidence and impression it forms of them; Re W and another (Non-accidental injury) [2003] FCR 346. 56. A witness may say false things during an investigation and/or a hearing for many reasons, such as shame, misplaced loyalty, confusion, panic, fear, and distress: R v Lucas [1981] QB 720. 57. There may be many reasons for discrepancies. Peter Jackson J (as he was) said in Lancashire County Council v M and F [2014] EWHC 3 (Fam) at para 9 that: "To these matters I would only add that in cases where repeated accounts are given of events surrounding injury and death, the court must think carefully about the significance or otherwise of any reported discrepancies. They may arise for a number of reasons. One possibility is of course that they are lies designed to hide culpability. Another is that they are lies told for other reasons. Further possibilities include faulty recollection or confusion at times of stress or when the importance of accuracy is not fully appreciated, or there may be inaccuracy or mistake in the record keeping or recollection of the person hearing or relaying the account. The possible effects of delay and repeated questioning upon memory should also be considered, as should the effect on one person of hearing accounts given by others. As memory fades, a desire to iron out wrinkles may not be unnatural – a process that might inelegantly be described as "story-creep" may occur without any necessary inference of bad faith." 58. In respect of the pool of perpetrators jurisprudence, King LJ said this in Re A (Children) (Pool of Perpetrators) [2022] EWCA Civ 1348: “13. In Re B (Children: Uncertain Perpetrator) [2019] EWCA Civ 575, [2019] 2 FLR 211 ("Re B: 2019"), Peter Jackson LJ clarified the proper approach in respect of uncertain perpetrator cases and the concept of a pool of perpetrators. 14. At paragraph [46], he "state[s] the obvious" by highlighting that the concept does not arise either where the allegation can be proved to the civil standard against an individual in the normal way, or where only one person could possibly be responsible. 15. Peter Jackson LJ went on at paragraph [48] to emphasise that the concept of a pool of perpetrators does not alter the general rule as to the burden of proof and that it is for the local authority to show, in respect of any potential perpetrator, that there is a real possibility that that person had inflicted the relevant harm before they are placed in the pool. 16. Having emphasised these parameters, Peter Jackson LJ at paragraph [49] ("paragraph [49]") went on to set out the proper approach to be applied in every case: "[49]….The court should first consider whether there is a 'list' of people who had the opportunity to cause the injury. It should then consider whether it can identify the actual perpetrator on the balance of probability and should seek, but not strain, to do so: Re D (Children) [2009] EWCA Civ 472 at [12]. Only if it cannot identify the perpetrator to the civil standard of proof should it go on to ask in respect of those on the list: "Is there a likelihood or real possibility that A or B or C was the perpetrator or a perpetrator of the inflicted injuries?" Only if there is should A or B or C be placed into the 'pool'. (my italics)” And later: 33. “The evaluation of the facts which will enable a court to identify the perpetrator of an inflicted injury to a child will be determined on the simple balance of probabilities and nothing more. Having considered the matter afresh in the light of Elisabeth Laing LJ's observation, I am of the view that to go further and to add that the courts should not "strain" to make such a finding is an unnecessary and potentially unhelpful gloss which has outlived its usefulness and which was directed at a different issue as set out in paragraph [24] above. 34. I suggest, therefore, that in future cases judges should no longer direct themselves on the necessity of avoiding "straining to identify a perpetrator". The unvarnished test is clear: following a consideration of all the available evidence and applying the simple balance of probabilities, a judge either can, or cannot, identify a perpetrator. If he or she cannot do so, then, in accordance with Re B (2019), he or she should consider whether there is a real possibility that each individual on the list inflicted the injury in question.” 59. In Re C [2022] EWCA Civ 584 the Court of Appeal considered the issue of adverse inference from a party’s silence or failure to give evidence. The court was referred to the observations of Brooke LJ in Wiszniewski v Greater Manchester Health Authority [1988] PIQR 324 in summarising the correct approach to the drawing of inferences from a failure to attend or give evidence: “(1) In certain circumstances a court may be entitled to draw adverse inferences from the absence or silence of a witness who might be expected to have material evidence to give on an issue in an action. (2) If a court is willing to draw such inferences, they may go to strengthen the evidence adduced on that issue by the other party or to weaken the evidence, if any, adduced by the party who might reasonably have been expected to call the witness. (3) There must, however, have been some evidence, however weak, adduced by the former on the matter in question before the court is entitled to draw the desired inference: in other words, there must be a case to answer on that issue. (4) If the reason for the witness's absence or silence satisfies the court, then no such adverse inference may be drawn. If, on the other hand, there is some credible explanation given, even if it is not wholly satisfactory, the potentially detrimental effect of his/her absence or silence may be reduced or nullified.” 60. In the lead judgment in Re C Lord Justice Baker referred to the following at para 27: “I turn finally to the argument about adverse inference. The summary of the principles in Wiszniewski is consistent with observations in earlier authorities, including that of Lord Lowry in the House of Lords decision of R v IRC and another, ex p T.C Coombs and Co [1991] 2 AC 283 at page300 F to H: "In our legal system generally, the silence of one party in face of the other party's evidence may convert that evidence into proof in relation to matters which are, or are likely to be, within the knowledge of the silent party and about which that party could be expected to give evidence. Thus, depending on the circumstances, a prima facie case may become a strong or even an overwhelming case. But, if the silent party's failure to give evidence (or to give the necessary evidence) can be credibly explained, even if not entirely justified, the effect of his silence in favour of the other party may be either reduced or nullified." But as Holman J observed in Re U (Care Proceedings: Criminal Conviction: Refusal to Give Evidence) [2006] EWHC 372 (Fam), [2006] 2 FLR 690 at paragraph 30, in a passage approved by this Court recently in Re T and J (children); A mother v A Local Authority and others[2020] EWCA Civ 1344, Lord Lowry’s observation does "no more than describe and illustrate the very broad discretion of the court to draw adverse inferences, which must be exercised in a very fact-specific context." Analysis 61. The nature of a judgment is that it is usually set out in linear form, moving in chronological sequence, or from topic to topic. However, for the avoidance of doubt I have considered all the evidence in the round, taking account of how one piece of evidence interacts with all other pieces of evidence. I consider first the expert medical evidence, but my conclusions therefrom are firmly in the context of the other evidence in the case. 62. It was suggested on behalf of the uncle (and supported on behalf of the mother) for the first time in cross examination of Dr Rothburn that two aspects of the sample taking and testing of F on 9 June 2025 which led to the positive gonorrhoea result in the genital area were unreliable; the NAATs and the vulval swab. I do not in any way criticise counsel for either the mother and the uncle who came into the case at a fairly late stage, and in any event the Court of Appeal made it clear that this was a complete rehearing to include any new matters which might be relevant. However, as this had not been raised before, it was not practical to obtain further evidence, and no party suggested the case should be adjourned to do so. In respect of the specific points made, the experts (in particular Dr Rothburn) gave answers which I accept and which satisfy me, on the balance of probabilities, that the 9 June tests accurately record that F was infected with gonorrhoea. 63. I accept that the clinical report on the diagnosis of gonorrhoea would not have been expected to include a recitation of two NAATs, as this would have been a matter for internal laboratory protocol. There is no reason to doubt the diagnosis, particularly as a separate, earlier, test, was positive for gonorrhoea in the eye. 64. If and insofar as the mother assisted in obtaining the vulval swab on 9 June 2025, it was because F was resistant to the clinicians doing so, but it was overseen by two clinical professionals who, judging by the medical note, did all they could to secure samples. It is, as Dr Rothburn said, almost inconceivable that the mother somehow contaminated the sample by infecting it herself. Another suggestion (made in closing by counsel for the mother and not put to the experts) was that F might have been infected in the urethral region rather than the vaginal region at the time of the swab. Given that both the urethra and the vaginal opening are in the vulva, which was swabbed, I did not see any particular relevance in this. Further, even if this is correct, the mechanism for infection (opening the labia to inoculate a mucous membrane) is the same. The distinction between an infection in the urethra and an infection in another part of the genitalia seems to me to be largely academic; what matters is that any infection would have started with inoculation to a mucous membrane in the vulval area, from which it would have spread. Further, as the experts explained, the only possible issue arising from an unsatisfactory swab would have been a false negative, not a false positive. And it is of note that F had already tested positive for ocular gonorrhoea, which does not support any suggestion of a false positive. The experts did not accept that the vulval swab undermined their conclusions, and I agree. 65. The experts told me that the reference to “weakly” positive (which had been raised at the previous hearing) was of little import from a clinical point of view, and I accept that evidence. 66. Looking at all these points in the round, I am satisfied that the testing established that F was infected with gonorrhoea in the vulval area at the relevant time, and there is no cause to think it was unreliable. 67. In my judgment, the evidence overall establishes that F’s contraction of gonorrhoea was as a result of direct sexual contact and not a fomite transfer via, for example, a towel or a toilet seat or some other inanimate object. I accept the evidence of both experts that gonorrhoea in a child of this age is strongly suggestive of sexual abuse, which is the most likely explanation for the infection. Dr Ghaly in particular was clear that although in theory the NG bacterium might survive on an inanimate surface, particularly if conditions are hot and moist, there is no reliable evidence to demonstrate that it could then be cultured and transmitted from that surface to infect another person; touching is not enough, it has to be inoculated. 68. I agree with the experts that the research in respect of fomite transmission is not robust for reasons they gave. There is a dearth of sound research to provide a foundation for innocent, non-sexual transmission. At best it consists of ad hoc cases, with little or no context. There is a difference between a theory being proposed (e.g. fomite transfer via a towel) and it being established in science as a real possibility. The experts are not aware of any evidence that a child’s vulval area has been infected in this way. The passage quoted by Dr Ghaly from the Purple Book seems to me to summarise neatly the prevailing medical and scientific opinion on these matters. It was evident that both experts considered the theoretical possibility of fomite/non-sexual transfer to be extremely unlikely. They accepted it cannot be ruled out, but nor did their evidence, or any research material, rule it in. 69. Ordinarily, infection requires direct inoculation from a mucous membrane of the infected person to a mucous membrane of the uninfected person, either by touching or discharge. In the case of F, infection would have required inoculation on to her labia minora, the first mucous membrane inside the vulval area, or another mucous membrane further inside, such as the vestibule area or the vaginal opening. That would have involved her labia majora (which is not a mucous membrane) to be widened so as to enable the mucous membrane of the transmitter to infect the labia minora (which is a mucous membrane) or another mucous membrane further inside the vulval area. This is a very sensitive part of the body, and widening the labia majora to permit transmission in this way would have been highly uncomfortable and painful for F. Girls of F’s age, as Dr Ghaly told, me, explore the genital areas externally but not inside the labia. In short, he told me that it is highly unlikely this anatomical mechanism would have been conducted by F herself, and it would most likely have been done by a perpetrator. 70. The suggestion that the bacteria might have passed in a fomite/non-sexual way from, for example a towel used by the uncle to F’s genitalia is highly improbable, as is the suggestion that it might have passed via a toilet seat. Neither expert was aware of any such instance either in their own experience or in the literature. The germ would have had to transfer from an infected person to the towel, or toilet seat, and survive there for a period of time. It would then then have had to transfer on to, for example, F’s finger by her touching the towel/toilet seat. And finally, it would have to be inoculated soon afterwards from F’s finger to a mucous membrane in the vaginal area. All of this I consider to be improbable and did not happen for the following reasons: i) Towels were cleaned and changed daily and the children’s were kept separate from the uncle. The grandmother took charge of washing and drying them. I had the clear sense that although the uncle was not hygienic, the grandmother attempted to maintain a good standard of hygiene in the house. The uncle told me that he never saw F touch or pick up one of his towels. He also told me that he did not use towels to wipe discharge from his penis. It did not seem to me that F was regularly coming into contact with towels or toilet seats which had been used shortly before by the uncle. ii) The evidence of the experts is that the NG bacterium is unlikely to survive long on a towel or toilet seat, or other inanimate surface, or on a person’s finger. Moist conditions assist; it was June and the bathroom would steam up, but only for a few minutes. The possibility that (a) the NG bacterium would survive long enough to transfer from the towel/toilet seat to F’s finger and (b) thereafter sit on the finger long enough to be transmitted to her genital area is not to be excluded, but unlikely. iii) There is little evidence to suggest that the germ was capable of being cultured at these various stages. If summer warmth and moist conditions in the house (which are not particularly uncommon circumstances) are sufficiently propitious to allow the germ to survive on an inanimate surface, and then infect a third party, one might have expected B also to become infected. More widely, if it were relatively simple for the germ to survive outside the human host and be transmitted by non-sexual means, one might expect far more instances of gonorrhoea in adults and children, and community outbreaks, but there is no meaningful evidence to that effect. At the risk of repetition, the experts told me that there is no robust evidence that the germ, even if present on an inanimate surface, can be transmitted to a human being. iv) Finally, the germ, even if it were to survive on the towel or toilet seat, and from there on to F’s hand/finger, would then have had to be self-inserted by F herself beyond her labia majora to come into contact with the labia minora which is a mucous membrane. Touching in the vulval area is not sufficient; there must be inoculation on a mucous membrane. Both experts were convincing as to why this was highly unlikely given the sensitivity of that area. 71. An alternative theory put forward to the experts was that F was innocently infected in the eye (perhaps via a towel), then touched the infected eye such that the germ was on her finger, and then inserted the germ beyond the labia majora so that it would come into contact with a mucous membrane. It follows, according to this submission, that the eye infection was first. It was submitted on behalf of the mother and the uncle that as F displayed symptoms in the eye, but not in the vulval area, this was the most likely mechanism. I reject that suggestion which seemed improbable to me. It begs the questions of (i) how the eye became infected innocently in the first place, (ii) whether the bacterium would have been transferred from the eye to F’s finger in viable form, and survived on the finger for sufficient time to infect the genital area, and (iii) whether F would have opened her labia majora to touch her labia minora or other internal mucous membrane with the carrying finger. The experts were clear that these various steps were at best theoretical, and not the probable explanation for transmission of the infection. I am satisfied that the vulval infection did not occur in this way, essentially for the same reasons as set out at para 67 above. 72. I bear in mind that it is not for the mother or the uncle to establish an innocent explanation (e.g. the towel or toilet seat theories), or even to put one forward. It is not for them to prove anything. However, I am satisfied that in this case the probability is that the infection to the vulval area was caused by direct contact between mucous membranes rather than by fomite transfer. Thus, it was caused sexually, with a mucous membrane in F’s genital area coming into contact with another person’s penis, vagina or mouth. From that inoculation, the infection is likely to have spread to other parts of the vulval area. 73. I am not satisfied to the requisite standard that the ocular infection was caused by sexual contact. The experts agreed it was plausible that F touched an infected part of the genitalia (probably not the mucous membrane, but an external area to which the infection had spread) and then touched her eye which inoculated the NG bacterium. Their evidence about sexual contact focused primarily on the genital area and it seemed to me rather less likely that it occurred in the ocular area. The LA sought a finding that the eye infection occurred either through sexual contact or through auto-inoculation from the vulval area, and in closing submissions, the LA’s counsel did not quarrel with the latter. I do not consider that I can or should at a threshold hearing leave two options open, one innocent and one malicious. That runs contrary to the principle that the LA must prove its case. There is no room for me to proceed on this basis when determining whether harm has or has not taken place (unlike the pool of perpetrators line of authority which requires harm to be established, but allows the court to identify more than one potential perpetrator). I am satisfied that the auto-inoculation explanation for the ocular infection is more probable. 74. I take into account that on examination of F, there were no physical marks suggestive of injury although all parties accept that does not exclude sexual abuse. Further, there have been no disclosures by F against M or the uncle, although again that is not of itself determinative and in many cases of sexual abuse children do not give accounts for a number of reasons. 75. But the strong likelihood is that, absent innocent explanation such as fomite/nonsexual transfer, which I reject, this little girl was subjected to inappropriate sexual contact by the mother and/or the uncle at some point in May 2023. 76. In respect of the mother, she tested positive for gonorrhoea on 14 June 2023. Her counsel points out that there is no direct evidence that she was infected during the period between 5 May and beginning of June because she displayed no symptoms, although the trouble with that is that the mother’s failure to attend meant she could not be asked questions about symptoms and sexual partners. Further, it is not uncommon for an infected person to be asymptomatic, as the experts explained. Her lifestyle was characterised by a cycle of drug dependency, prostitution, theft and involvement with inappropriate men. Her written evidence that she only went to the house twice between 5 May and early June is undermined by the evidence of the grandmother, which I accept, that in fact she attended once or twice a week for a few hours. And importantly, the mother made no mention of staying overnight. I find that she stayed the night on at least one occasion and slept in the children’s bedroom. I am not minded to draw adverse inferences through her failure to attend court and give evidence, as she is a drug addict who appears to have been incapable of participating in the hearing before me. The LA, rightly in my view, did not suggest that inferences should be drawn as a result of her non-engagement given her chaotic and troubled lifestyle. However, she has not, as a result, given oral evidence to deal with these matters, and I am left with the grandmother’s clear recollection of the number of times the mother came to the house, and her overnight stay in the children’s room. The other parties did not have the opportunity to cross examine her. She could not be tested on these discrepancies, or any other relevant matters, so as to enable the court to weigh her evidence in the balance against all the other evidence, including that of the experts. The LA, on the expert evidence alone, has, on my findings, established a clear prima facie case that the infection was caused by sexual contact, but I am faced with a mother who has not come to court to set out her case. I do not draw adverse inferences. But her non-engagement means that I must proceed on the evidence I do have, which in her case is limited. 77. As for the uncle, his symptoms of gonorrhoea and subsequent diagnosis are in the timescale for infecting F. I do not consider I should attach any weight to the allegation of rape in 2024 (the LA does not seek a specific finding and the criminal trial has not taken place) or an allegation of indecent exposure in 2015 (again, no finding was sought and nothing was proven at the time). However, I accept that his lifestyle was, in May 2023, chaotic and heedless of boundaries; to have continued with unprotected sex after his diagnosis of gonorrhoea and chlamydia seemed to me to be a striking example of dysregulated behaviour, ignoring the possible effect on others. The inconsistency between his written statement suggesting that the mother may have been responsible for infecting F, and his oral evidence which said otherwise, was not readily explicable. 78. Both the mother and the uncle had the opportunity to perpetrate sexual contact during May 2023 which is the likely period for F being infected. The uncle lived at the house for a few days each week and spent time with the children, even if there was always another adult in the building. The mother went to the house on occasions and slept at least one night in the children’s room. Both tested positive for gonorrhoea, and in my judgment there is a realistic possibility that each of them was infected during May 2023 and, in terms of timeline, could have infected F. Both had the opportunity to infect F in the sense that they spent time in the same house as the children. Both led somewhat chaotic and boundaryless lives. Both were, I am satisfied, on occasions incapacitated while under the influence of drugs and alcohol: the uncle and grandmother used the phrase “her head has gone” to describe the mother, and the uncle in a police interview dated 11 June 2023 could not recall what drugs he had recently taken, describing himself as having been “bladdered”. 79. Drawing all the threads together, and after considering all the evidence in the round, I am satisfied that if, as I find happened, sexual contact with F took place, it was not both the mother and the uncle together. There is no evidence of a conspiracy, or a joint enterprise. However, sexual contact did take place with one or the other. I cannot say precisely when the sexual contact took place although I am satisfied that it was likely to have been in May 2023. Nor can I say how, anatomically, the sexual contact was perpetrated. I am satisfied that one of them transmitted gonorrhoea to F, but I am unable to conclude which one. Although Dr Ghaly told me that 90% of assailants in child sex abuse cases are male, (i) female perpetration is not ruled out and (ii) the value of this statistic is lessened in this case by the mother’s non-attendance. It is particularly difficult to make a specific finding as to which of them perpetrated the abuse in the absence of the mother giving evidence. It would be potentially unfair to make a finding against either in the absence of oral evidence from the mother, and on the basis of the evidence before me I cannot do so. I am satisfied that both fall within the pool of realistically possible perpetrators. Unsatisfactory though it is, I have come to the conclusion that I cannot decide on the balance of probabilities which of them is the perpetrator. 80. I have therefore concluded that the threshold findings sought by the LA are established, and that both the mother and uncle fall within the pool of possible perpetrators. In my judgment there is a real possibility, which cannot sensibly be ignored, that either of them was the perpetrator. I will, however, require the threshold document to be amended to delete para 5a (the reference to sexual contact directly causing the eye infection). For accuracy, and to avoid confusion, the references to vagina/vaginal at paras 4 and 5b should be replaced by vulva/vulval.