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Expert says Lola’s eye injuries suggest abusive head trauma

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LOLA’S eye injuries are indicative of abusive head trauma, the first medical expert to take to the witness stand told Swansea Crown Court on Friday (Mar 10).

Dr Ian Simmons, Consultant paediatric ophthalmologist gave his opinion on the findings in his report into the retina injuries sustained by the toddler.

Dr Simmons has been an expert in the field since 1999 and has contributed to major studies and literature looking into retinal findings in non-abusive head trauma and abusive head trauma.

Including reviewing and contributing to a review into differential retinal injuries in abusive vs non-abusive head traumas in September 2020.

Swansea Crown Court heard how Lola had multiple haemorrhages in both her right and left eye, which also was evident in all four quadrants; during medical examinations, eyes are split into quarters and referred to as quadrants to locate any significant anomaly.

The injuries were detected through a range of diagnostic methods, including visual, 2d scans, retcams (3d) and the findings during the course of a post-mortem.

These included two large macular haemorrhages to the right eye which were present in all four quadrants, along with multiple other haemorrhages, noted there were too numerous to count.

The court heard how Lola’s left eye had a massive dic haemorrages along with others in all four quardants and macular changes due to retinal splitting. There was also bleeding to the oribital and optical nerve in both eyes.

Dr Simmons went on to say how bi-lateral retinal heamoraghes; those affecting both eyes, are highly indicative of an abusive head trauma as opposed to accidental.

He went on to say that injuries of the retina, such as those sustained by Lola are usually present in children who have sustained a very significant crush injury or a fall from a height such as a house window.

The court heard how the presence of macular folds is more prevalent in an abusive head trauma injury by the tenfold.

Dr Simmons confirmed that before compile his expert opinion report he was privy to reports from all medical professionals who treated Lola, including reports and scans, the autopsy report, police statements and photographs of the family home namely the stairs the defence claim Lola fell down.

The court heard that Dr Simmons bore no knowledge of a child presenting with optical nerve sheath haemorrhages in both eyes ever being presented in an accidental head trauma.

The court heard how Dr Simmons had gone through an extensive exclusion procedure and ruled out any underlying diseases, or anything within the statements from the police that would suggest anything other than abusive head trauma would cause the injuries.

Bevan’s Barrister, John Hipkins KC brought to the court’s attention a case study from 2013, by Dr Adams, another paediatric ophthalmologist, in which a child had a fatal fall down 10 steps, with multiple impacts and noted that the injuries received by that child were similar to that of Lola’s.

He explained that this was a witnessed accidental fall and the injuries were received as a result of accidental head trauma.

Dr Simmons went on to clarify that although those injuries bore a ‘striking resemblance’ to this case, that child did not present with peri-macular folding and sheath haemorrhages that Lola did, and those indicate it is more likely in this case as a result of an abusive head trauma.

In his report Dr Simmons said: “With a combination of extensive bilateral retinal bleeding in all four quadrants affecting multiple layers in both eyes with possible retinal splitting along with evidence of left per-macular retinal fold and presence of bilateral optic nerve sheath haemorrhages, that combination pointed towards abusive head trauma rather than an accidental fall down the stairs.

“Highly unlikely the above combination would have been caused by falling down 10 carpeted stairs.”

Dr Simmons suggested that based on the other injuries Lola had and reading the medical reports it points towards abusive head injury from that such as violent shaking with a possible form of impact.

John Hipkin KC, went on to question Dr Simmon on the language used in his report stating it was all based on medical science which meant they were left to deal with “likelihoods instead of certainties”.

Dr Simmons explained that medical science is not definitive, but certain retinal injuries are highly suggestive towards abusive head trauma based on medical evidence from data collection.

Mr Hipkin KC went on to ask if Dr Simmon had been given Bevan’s statement of his account of the accident, which he confirmed was received and had used that evidence to make his conclusion.

Suggesting that shaking could have been part of Bevans attempts to wake the tot.

However Mr Hipkin went on to say that Bevan’s statement was not included on Dr Simmons summary of evidence documents used to support his claims.

Dr Simmons could not recall whether he had simply forgotten to include them or whether they were together with another set of reports in a bundle which is included on the summary of evidence on the report.

James’ Barrister Mr Elias did not cross examine the witness.

The next medical expert witness is due to take the stand on Monday.

The case was adjourned and will continue on Monday, March 13 at 10am.

Health

Resident doctors in Wales vote to accept new contract

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RESIDENT doctors across Wales have voted to accept a new contract, with 83% of those who took part in a referendum backing the agreement, according to BMA Cymru Wales.

The contract includes a four per cent additional investment in the resident doctor workforce and introduces a range of reforms aimed at improving training conditions, wellbeing and long-term workforce sustainability within NHS Wales. The BMA says the deal also supports progress towards pay restoration, which remains a central issue for doctors.

Key changes include new safeguards to limit the most fatiguing working patterns, measures intended to address medical unemployment and career progression concerns, and reforms to study budgets and study leave to improve access to training opportunities.

Negotiations between the BMA’s Welsh Resident Doctors Committee, NHS Wales Employers and the Welsh Government concluded earlier this year. Following a consultation period, a referendum of resident doctors and final-year medical students in Wales was held, resulting in a clear majority in favour of the proposals.

Welsh Resident Doctors Committee chair Dr Oba Babs Osibodu said the agreement marked a significant step forward for doctors working in Wales.

He said: “We’re proud to have negotiated this contract, which offers our colleagues and the future generation of doctors safer terms of service, fairer pay, and better prospects so that they can grow and develop their careers in Wales.

“This contract will help to retain the doctors already in training, and also attract more doctors to work in Wales, where they can offer their expertise and benefit patients.”

Dr Osibodu added that the BMA remains committed to achieving full pay restoration and acknowledged that challenges remain for some doctors.

“Whilst this contract sets the foundations for a brighter future for resident doctors in Wales, we recognise that there are still doctors who are struggling to develop their careers and secure permanent work,” he said. “We need to work with the Welsh Government and NHS employers to address training bottlenecks and underemployment.”

The Welsh Government has previously said it recognises the pressures facing resident doctors and the importance of improving recruitment and retention across NHS Wales, while also highlighting the need to balance pay agreements with wider NHS funding pressures and patient demand.

The new contract is expected to be phased in from August 2026. It will initially apply to doctors in foundation programmes, those in specialty training with unbanded rotas, and new starters, before being rolled out to all resident doctors across Wales.

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Crime

Swansea man jailed for online child sex offence dies in prison

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A SWANSEA man who was jailed earlier this year for attempting to engage in sexual communication with a child has died while in custody.

Gareth Davies, aged 59, of the Maritime Quarter, was serving an 18-month prison sentence after being convicted in May of sending sexually explicit messages to what he believed was a 14-year-old girl. The account was in fact a decoy used as part of an online safeguarding operation.

The court heard that Davies began communicating with the decoy between November and December 2024 and persistently pursued the individual, later attempting to arrange a face-to-face meeting. He was arrested after being confronted by the decoy operators.

Davies had pleaded not guilty but was convicted following a trial. At the time of sentencing, police described the messages as extremely concerning and said his imprisonment was necessary to protect children.

It has now been confirmed that Davies died at HMP Parc on Wednesday (Nov 27) while serving his sentence.

The Prisons and Probation Ombudsman has launched an independent investigation into the death, which is standard procedure in all cases where someone dies in custody. No cause of death has been released at this stage.

A coroner will determine the circumstances in due course.

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Farming

Welsh Conservatives warn climate plans could mean fewer livestock on Welsh farms

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THE WELSH CONSERVATIVES have challenged the Welsh Government over climate change policies they say could lead to reductions in livestock numbers across Wales, raising concerns about the future of Welsh farming.

The row follows the Welsh Government’s decision, alongside Plaid Cymru and the Welsh Liberal Democrats, to support the UK Climate Change Committee’s Fourth Carbon Budget, which sets out the pathway towards Net Zero greenhouse gas emissions by 2050.

The Carbon Budget, produced by the independent Climate Change Committee (CCC), states that meeting Net Zero targets will require a reduction in agricultural emissions, including changes to land use and, in some scenarios, a reduction in livestock numbers.

During questioning in the Senedd, the Welsh Conservatives pressed the Deputy First Minister and Cabinet Secretary for Climate Change and Rural Affairs on whether the Welsh Government supports reducing livestock numbers as part of its climate strategy.

Speaking after the exchange, Welsh Conservative Shadow Cabinet Secretary for Rural Affairs, Samuel Kurtz MS, said the Welsh Government could not distance itself from the implications of the policy it had backed.

Mr Kurtz said: “By voting in favour of these climate change regulations, Labour, Plaid Cymru and the Liberal Democrats have signed up to the UK Climate Change Committee’s call to cut livestock numbers in Wales, and they cannot dodge that reality.

“The Deputy First Minister’s smoke-and-mirrors answers only confirm what farmers already fear: that Labour, along with their budget bedfellows in Plaid and the Lib Dems, are prepared to sacrifice Welsh agriculture in pursuit of climate targets.”

He added that the issue came at a time of growing pressure on the farming sector, pointing to uncertainty over the proposed Sustainable Farming Scheme, the ongoing failure to eradicate bovine TB, nitrogen pollution regulations under the Nitrate Vulnerable Zones (NVZs), and proposed changes to inheritance tax rules affecting family farms.

The Welsh Government has repeatedly said it does not have a target to forcibly reduce livestock numbers and has argued that future emissions reductions will come through a combination of improved farming practices, environmental land management, and changes in land use agreed with farmers.

Ministers have also said the Sustainable Farming Scheme, which is due to replace the Basic Payment Scheme, is intended to reward farmers for food production alongside environmental outcomes, rather than remove land from agriculture.

The UK Climate Change Committee, which advises governments across the UK, has stressed that its pathways are based on modelling rather than fixed quotas, and that devolved governments have flexibility in how targets are met.

However, farming unions and rural groups in Wales have warned that policies focused on emissions reduction risk undermining the viability of livestock farming, particularly in upland and marginal areas where alternatives to grazing are limited.

The debate highlights the growing tension between climate targets and food production in Wales, with livestock farming remaining a central part of the rural economy and Welsh cultural identity.

As discussions continue over the final shape of the Sustainable Farming Scheme and Wales’ long-term climate plans, pressure is mounting on the Welsh Government to reassure farmers that climate policy will not come at the expense of the sector’s survival.

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