GP 'missed chance to save Baby P'

Dr Jerome Ikwueke observed the boy was withdrawn and unlike his usual happy self when he saw him at his north London surgery on July 26 2007.

But the doctor failed to carry out an adequate examination or make an urgent referral for further checks despite knowing that the toddler – now named as Peter Connelly – was on the at-risk register, a GMC Fitness to Practise Panel heard.

If he had done so, it is likely Peter would have been removed from his family and escaped the final abuse that caused his death on August 3 2007 at the age of 17 months, the hearing in London was told.

Jeremy Donne QC, counsel for the GMC, said: "The GMC allege many failings against Dr Ikwueke relating to his care of Baby Peter.

"But by far the most serious is his failure to fully and properly examine him on July 26.

"If he had, we say he would almost certainly have made an immediate referral to hospital and it is likely that Baby Peter would have been removed from his family to a place of safety.

"In short, Dr Ikwueke had a unique opportunity to prevent the appalling abuse that was to occur in the following days, culminating in that unfortunate child's death."

Peter had head lice, a bleeding ear and healing scabs on his scalp when his mother, Tracey Connelly, took him to see the GP that day.

Dr Ikwueke noted that the child did not want him to come near and pulled away from him, and in a later interview described him as a "sorry sight".

Mr Donne said: "The obvious question, and one that should have occurred to Dr Ikwueke, is what had brought about that change?"

A post-mortem examination found Peter would have been in great pain at this time, having already suffered eight broken ribs and serious injuries to his toes and fingers.

Mr Donne said: "The fact that they must have been deliberately inflicted by one or more adults could of course account for Baby Peter recoiling from Dr Ikwueke's approach.

"We will never know if Dr Ikwueke would or could have found any of those injuries on examination because he did not do one, or at least not one worthy of the name."

In interview, the GP said he did not refer Peter to hospital because he thought he was already known to social services.

He arranged for Connelly to bring her son back to him a week later.

But Mr Donne said: "That, we say, was far too little, far too late.

"But the time of that appointment, Thursday August 2, which in fact was not kept, Baby Peter had suffered the appalling injuries which were to end his life."

Dr Ikwueke should also have taken into account Peter being admitted to hospital on June 1 with suspected non-accidental injuries, the GMC heard.

And around that time his practice nurse described a woman – presumably Connelly – who brought the little boy in for vaccinations that were a year overdue as "ill-tempered, abrupt and argumentative".

Dr Ikwueke, 63, had a series of consultations with Peter and his mother when he should have suspected child abuse and acted to stop it, the hearing was told.

Mr Donne said Dr Ikwueke appeared to have given "no consideration" to the possibility that Peter was suffering abuse.

In December 11 Dr Ikwueke referred a bruised Peter to the Whittington Hospital in north London but failed to mention previous injury.

The hearing is expected to last five weeks.