Tania Clarence killings: Doctors raised concerns over neglect
Doctors dealing with the family of Tania Clarence, who killed her three disabled children by smothering them, had raised concerns about neglect.
The 43-year-old admitted suffocating her three-year-old twin sons Ben and Max, and daughter Olivia, aged four, due to diminished responsibility.
After the killings she took painkiller tablets and drank a bottle of wine in a suicide bid.
The details were revealed at a mitigation hearing at the Old Bailey.
The children, who all had type 2 spinal muscular atrophy, were found at their home on 22 April.
Her husband Gary had taken the couple's eldest daughter on a holiday to South Africa a few days earlier, leaving Clarence alone with the other three children in New Malden, and had given the nanny a day off.
Prosecutor Zoe Johnson QC, told the court up to 60 professionals were involved in the care of Clarence and her children, sometimes visiting the family home unannounced.
The court heard doctors were considering "child protection measures on the basis of neglect," and there was a "fundamental tension" between the couple and medical staff over care recommendations.
'Boys in heaven'
Ms Johnson said Mr Clarence's decision to consent to a stomach operation on the couple's oldest daughter, was a "substantial trigger" for the killings, because she wanted palliative care over more invasive treatment.
"She smothered the boys first whilst they were sleeping using a nappy so they would not smell her," Ms Johnson said.
"She found it much harder to kill Olivia, and wrote a letter to her husband in the time between killing the boys and killing Olivia."
The letter read: "Gary, I cannot live with what I have done. I took the tablets but they didn't work. Please do not save me. Love you.
"This life is better without me. I am nothing," it continued.
"The only thing that gives me solace is that the boys are playing in heaven like they cannot play here. I can see them running around already."
'It's too late'
The mother of four was discovered bleeding and crying by her nanny, Jade Cuelo, and a neighbour, who had gone to the home after becoming concerned for her safety.
After she was found, Clarence told her nanny: "It's too late, it's too late, there's nothing you can do to help them, you can't help them."
In a separate letter to Ms Cuelo, Clarence wrote: " I also could not leave the children with Gary. It would have been too much for him.
"You have been such an amazing person in our lives over the last few years. Without you I most likely would have done this a lot sooner."
Concluding the prosecution case, Ms Johnson asserted: "Although Mrs Clarence and her husband believed that the only appropriate care for their children was palliative care, the children had not reached the stage when palliative care was required.
"Tania Clarence's rational belief that she didn't want to prolong her children's lives became distorted into an irrational decision to kill her disabled children, a decision she had formed well in advance of the killings."
The court has previously been told Clarence had been suffering "from an abnormality of the mind" and was depressed when she killed three of her four children.
The court also heard of tension between the Clarences and the social services department of Kingston upon Thames Council.
Social services managers replaced the family's social worker because they felt she was "getting too close" to the family, said Ms Johnson.
"This was perhaps an ill-conceived decision by the social services department," the barrister said.
Clarence had told a friend that Kingston social services had "made the children's care 1000 per cent worse," she said.
She had twice told family doctors of her desire to take the children away to South Africa so they could "all die together".
Jim Sturman QC, defending, said there was no evidence Clarence would have "harmed a hair on their head but for the illness she suffered" and urged the judge to impose a hospital order.
Clarence will be sentenced by Judge Mr Justice Sweeney on Tuesday.
Spinal Muscular Atrophy (SMA)
- A genetic disorder that affects nerves responsible for muscle function
- It causes the muscles to waste away over time, which can lead to skeletal deformities, such as abnormal curvature of the spine, and problems walking, eating, drinking and breathing
- It is rare, affecting one in every 6,000 babies born in the UK
- However, the most common of the three forms of SMA is the most severe, and usually proves fatal in a child's first year
- Children with a milder form of the disorder can live to adulthood
- The mildest form of SMA does not usually affect life expectancy