Ashya King and parents reunited in Málaga - as it happened

Caroline has a bit more on Ashya’s ward of court status.

If there is a dispute between the parents and the medical authorities as to the right course of treatment, the court will make the decision, probably at the hearing on Monday. If the parties are in agreement, the court will endorse that agreement, and the judge indicated in court that he will be available at all times to give his approval if an agreement is reached before Monday so that treatment can be started without further delay.

From what Caroline has said, King seems to be over the top in claiming that he will arrested if he and his wife see Ashya. The Kings, however, will certainly not be able to take him to Prague unless the family court in London agrees.

Caroline Davies delves into the legal complexities of Ashya’s ward of court status.

Brett King’s comments appear to refer to the wardship proceedings. Ashya is a ward of court, which means the high court exercises parental responsibility. The legal papers relating to that order were served on the Kings while they were still in custody in a Spanish jail at around 3pm on Tuesday. It means that any major decisions about Ashya’s treatment or his movements have to be approved by the family court in London.

A hearing regarding the wardship proceedings was held before Mr Justice Baker at the high court on Tuesday and adjourned until next Monday. At present, the order remains in place even though the European Arrest Warrant has been withdrawn and extradition proceedings dropped. However, there is nothing in the court order which prevents the Kings visiting Ashya in hospital. On Tuesday Justice Baker said it would be “quite wrong” for him to make any decisions about Ashya’s future treatment without the input from the parents.

We are entering murky legal ground here.

The Kings have arrived in Málaga.

My colleague Sarah Boseley says there are some unanswered questions relating to Ashya’s treatment and prospects in spite of the parents’ press conference and statements from Southampton hospital. She writes:

We know about the dispute over the type of radiotherapy Ashya should receive, which was apparently the trigger for the parents’ removal of their son from hospital and their flight to Spain.

It is possible that the breakdown in trust between doctors and parents was more deep-rooted. Were the Kings unhappy not only about the type of radiotherapy but also the chemotherapy that is standard treatment in a case like their son’s? On Monday, the Kings’ lawyer, Juan Isidro Fernandez, said that in England, Ashya “was being subjected to chemotherapy and radiotherapy and the parents didn’t want that treatment, they wanted another option”.

The proton beam centre in Prague, however, has said that it will take Ashya for treatment after two cycles of chemotherapy, which could take several weeks so it appears that the chemo will have to go ahead.

• Brett King, Ashya’s father, claims he told Southampton hospital that the family were going to take him abroad, in direct contradiction of what the hospital said. He said he feared the hospital’s treatment would kill his five-year-old son or turn him into a vegetable.
• Ashya has been accepted for proton beam treatment in Prague, the Czech republic, but it is unclear whether he will have to go back to England first. Southampton hospital has sent complete medical records to the Proton Therapy Centre in Prague.
• Ashya and his parents will be reunited at Málaga hospital after the Kings were released from prison in Seville overnight. They were freed after the Crown Prosecution Service bowed to mounting pressure and withdrew its arrest warrant.

Ashya’s case cropped up during today’s session of prime minister’s questions in parliament. David Cameron told MPs that decisions taken in Aysha’s case were “not correct”.

“To be fair to the authorities involved in the case of Aysha King, they all want to do the best for the child. That’s what they are thinking of,” he said. “But I think what happened was that decisions were taken that weren’t correct and didn’t chime with a sense of common sense. That, fortunately, has been put right. What all of us in public life and public offices have to do is examine what the legal requirements are, but also make a judgment, and those judgments can sometimes be all-important.”

My colleague Caroline Davies has this wrap-up of the press conference.

The parents of Ashya King, released from a Spanish prison to be reunited with the five-year-old, have claimed they told the UK hospital where he was being treated for a brain tumour that they were going to take him abroad.

Brett King, 51, and his wife Naghmeh, 45, feared treatment advocated by doctors at Southampton General hospital would “kill him or turn him into a vegetable”.

As they left their lawyer’s Seville office to travel to Málaga on Wednesday, where Ashya is being cared for at a children’s hospital, the Kings spoke of their bewilderment that Hampshire police had sought at an international arrest warrant.

“They treated us like terrorists. They handcuffed me and my wife,” Brett King said. “I don’t know why they did this. From the beginning Southampton [General hospital] knew I was going abroad. They knew I wasn’t happy with the treatment.

“They knew about it. Not the day I left, but I told them: ‘I’m leaving because I’m not happy.’ They knew that.”

Earlier, at a chaotic press conference, he revealed he asked to be moved to another cell at Soto del Real prison near Madrid, because he could hear his wife crying and could not bear it.

“I asked to move cells because I was worrying and I couldn’t listen to my wife. When you are locked up, you can’t do anything and I was wanting to help my wife, my children”.

There was not a moment in custody “that went by without our hearts hurting to see Ashya”, he said.

“Being locked up, you can’t do anything, you can’t help your son, you can’t help your wife. You don’t know the future, what’s going to happen to Ashya without us.

“We didn’t know what was happening because they arrested us and directly they took my son away; they say he is not allowed any visitors. We said: ‘You don’t even know what is wrong with him. He needs therapy on his legs, on his arms, you need to move him from side to side.’”

“They said they are not interested. They just want to take him away from us.”

Josh’s latest snippet underlines the intense media interest in this story.

There are now five police officers standing guard outside the hospital doors. The media has been moved about 10 yards away to the opposite side of a road, allowing cars to drop off and pick up patients. A bank of photographers are set up on a small stretch of pavement, spilling into the road.

Josh Halliday has sent this update from the hospital in Malaga, where Ashya’s parents are expected to arrive around 1.30pm UK time.

There’s more police here than there was a couple of hours ago, but hospital security said they were here for a different case. It’s also now scorching hot - probably 30 degress - so vast majority of the media, a group of about 40-odd, has gathered in the shade outside the hospital doors. Meanwhile, life goes on at the hospital. Children in plaster casts come and go, while others come out clutching lollipops and balloons wondering why so many people with cameras and notebooks are hanging around.

The most interesting lines came not in the press conference but in the press scrum afterwards. Here’s what PA has filed.

He claimed he had previously informed the hospital about his plans to seek proton therapy for his son but kept the date that he intended to take him secret for fear he would be stopped.

“The hospital knew that we were going to get proton therapy, I told them,” he said.

“I told the doctor ... ‘I’m paying for it myself but I haven’t got the money, I need to sell my house’. I said to them ‘I’m going. The NHS is not going to pay, I’ve got to sort this out for my son’.”

But he claimed he could not disclose when he planned to remove Ashya because he had previously been “threatened”.

“I couldn’t actually tell them the day because they had threatened me previously,” he said. “When I just asked ‘What is cancer? How did my son get it? Is there any alternatives?’, straight away they said if I ask any more questions the right for me to make a decision would be taken away from me because they get an immediate court paper to say that they have right over my child. So from that moment I had so much fear to mention anything to them because they could have stopped my son getting any treatment and just forcing this very strong treatment on him. From that moment on I had to keep everything quiet.”

As the couple left Seville, Mr King told Sky News that he and his wife had been handcuffed and “treated like terrorists” and he had no idea why a European arrest warrant had been issued.

He said: “I would be happy to spend years in prison rather than my son being given treatment that’s going to kill him or disable him for the rest of his life.”

Mr King said he would do the same thing again if it meant getting his son the right treatment. “My son’s worth everything, worth me going to prison, worth everything because they were going to kill him in England or turn him into a vegetable.”

As we await the reunion of the King family in Malaga, here is another useful piece by Sarah Boseley on the dilemma parents face when their children have brain tumours.

Proton beam therapy has the potential to limit the damage caused by X-rays, which unlike protons go through the tumour and out into healthy tissue on the other side.

It seems like a kinder treatment to parents and it may well be – although there is not enough evidence from clinical trials to prove that it will work well and safely in all the many different forms of cancer and it may not be the most effective where cancers have spread to more than one site. But such are the horrors of much of the treatment for malignant brain and spinal cancers, such as medulloblastoma, and also neuroblastoma which causes tumours elsewhere and affects 100 children a year in the UK, that parents desperately seek it.

The treatment has for some years been offered by the NHS to children who could benefit, which usually means those whose doctors think it offers a good chance of a cure.

That will not include those whose cancers have spread – it is not clear yet whether Ashya’s has. Children have in the past been sent to hospitals in the United States and Switzerland, with not just the treatment but their flights and accommodation – and that of a parent – paid by the NHS. But those families that have been turned down have often been uncomprehending and angry.

Childhood cancer is rare – there are less than 1,600 cases a year in the UK and 250 children die. Treatments for childhood leukaemia have been one of the biggest cancer success stories, and most now survive it. But the lack of investment and scientific attention to the really aggressive cancers that kill and damage small children means that there will be many more sad stories like that of the King family, in which nobody is a winner.

You can watch a video of the press conference via ITV.

Naghmeh King, Ashya’s mother, told the BBC’s Jon Kay how she wanted to care for her son while she was in jail.

I just want to wet his mouth because he can’t drink through his mouth, brush his teeth. I want to turn him side to side every 15 minutes because he can’t move. I just want to do all those things I was doing.

My colleague Sarah Boseley wrote about proton therapy when the story first broke.

Proton beam therapy is a form of radiotherapy designed, like all the others, to kill cancer cells. The difference between this and conventional forms of radiotherapy is that it is thought to cause less damage to the healthy tissue around the tumour – and for that reason is particularly suited to children, who are more susceptible to harm from radiation because they are still growing. It is possible for large doses of radiation to cause secondary cancers in the long term.

Conventional radiotherapy uses x-rays to kill cancer cells. Technological advances have made it possible to target a tumour very precisely, so that the healthy cells around it are not irradiated. But x-rays pass through the tumour and out the other side, inevitably damaging tissue – in this case part of the child’s healthy brain.

Protons, which are positively-charged particles in the centre of any atom, cannot travel as far as x-rays. They stop when they reach the tumour. There should be less collateral damage, leading to fewer side-effects in the long term. But although that is the theory, and a number of countries have invested in hugely expensive machines on the strength of it (and the UK is now building two of them), there are still some questions over the efficacy and side-effects.

Proton beam therapy is not the best treatment for every patient – in fact, it is said to be suitable only for about 1% of all cancer patients. For some years, the NHS has paid for children who are thought to be likely to benefit to travel to the US or Switzerland for this kind of radiotherapy, at very high cost – the NHS pays for travel and accommodation for the child and a family member, as well as for the treatment.

The Czech Proton Therapy Centre claims that proton therapy is especially suitable for children, especially young children. Its website says:

Children are more likely to be injured by radiation than are adults. They also have longer for radiation-induced tumours to raise later in life. Since healthy tissue is exposed to much lower radiation doses than does with conventional therapy, proton therapy offers great benefits for younger patients.

Brett King has given an interview to the BBC’s Jon Kay.

The latest snippet from Josh Halliday in Malaga.

Outside the children’s hospital looking after Ashya there is an air of anticipation, with groups of Spanish and British camera crews camped outside the hospital’s main entrance. Every so often hospital staff peer outside the sliding glass doors to take pictures of the media, such is the level of interest in the story not just outside the hospital - but inside it as well. As we wait for the parents to give a press conference two hours away in Seville, there is an expectation that Ashya’s brother Danny will come visit this morning. Yesterday, he arrived at about this time and spent most of the morning by his brother’s bedside.

“I have to go and seen my son,” Brett King told reporters after his release last night.

Patricia King, Ashya’s grandmother, said a European arrest warrant should never have been issued in the first place and criticised Hampshire constabulary and Southampton general hospital for the way they had dealt with the situation. She said: “Everyone is trying to backtrack after lying - the police, the hospital. They have not told a word of truth to try and make themselves look good. It’s been lies and then U-turns.”

Ashya’s brother, Danny, told Radio 4’s Today programme: “They (his parents) are just happy to be out and they just want to go and see Ashya as soon as possible. We are just trying to get everything back to normal now. Physically he (Ashya) is fine but emotionally he is very confused because obviously he’s been without his family. But obviously that’s all going to finish now so he can have his family back with him now.
We are just grateful for the support that we have received back home in the UK and around the world. Now my parents are out of prison I can sit them down and explain all the options that are available for Ashya and they can make the decision what is best for Ashya and where they want to go. I think most probably they would still want to go with Prague.”

My colleague Haroon Siddique had this story about the legal jockeying that preceded the release of Ashya’s parents.

Lawyers have criticised British legal authorities for launching a criminal investigation into the parents of Ashya King for their decision to remove their son from a Southampton hospital while he was undergoing cancer treatment.

The warrant for arrest of the parents was issued on Friday for an offence of cruelty to a person under the age of 16 years as police warned that Ashya was in “grave danger” and the battery of his tube feeding unit was likely to run down. But the family subsequently said that they removed him to obtain proton beam treatment he could not get in the UK and that they had a power charger for the feeding unit.

Anthony Barnfather, partner at Slater & Gordon, said: “It might not have been the right action [to investigate criminal proceedings]. The way it was reported it was that he [Ashya] was going to run out of food and his batteries. I can see that satisfying [the requirement for] neglect but what seems to have transpired now is that there is difference of opinion [between the hospital and the parents]. I can imagine on these limited facts it would be very hard to prove neglect but the authorities didn’t know that at the time.”

Southampton University hospital trust last night put out a statement explaining their concern over Ashya, whose parents had taken him away without the consent of medical staff. They were mainly worried over a tube used to feed the child. Here’s part of their statement.

Ashya was dependent on a nasogastric tube for food and his parents are not trained to use it. Although the food pump had been removed with Ashya, the power cord had been left behind on the ward. The feed pump does have a battery but it is only for occasional use. If a nasogastric tube became displaced either accidentally or through vomiting there was a possibility that feed could enter the lungs with potentially fatal consequences. Ashya has no gag reflex and the family are not trained to deal with the (potentially serious) complications of choking. Ashya developed a temperature the previous day and there were concerns that he may develop an infection. Ashya needed to start his chemotherapy within the week to ensure the best chances of complete recovery

Previously, Ashya’s parents wanted him to undergo proton radiotherapy instead of standard radiotherapy although hospital doctors said in his case there is likely to be no difference in survival and overall no proven significant benefit. However, the hospital said it agreed with the family to refer Ashya for proton radiotherapy, as the family had indicated that they could fund it privately.

Brett and Naghmeh King, the parents of Ashya, were released from separate wings of a Spanish jail on Tuesday night after prosecutors in London terminated a European arrest warrant and said the couple would face no charges. The development meant the couple were free to leave Soto del Real prison near Madrid, where they had been held since Saturday.

The couple are expected to hold a press conference with their defence lawyer this morning in Seville, before making the two-hour journey by car to be reunited with their five-year-old son, who is receiving urgent medical care for a brain tumour at a children’s hospital in Málaga. Patricia King, Ashya’s grandmother, said she expected the family to take Ashya to Prague for proton beam treatment as soon as they were allowed to “get it done because there is no time to delay”.

My colleague, Josh Halliday who is in Malaga, has filed this latest update.

Ashya King’s father said he could not wait to see his son’s face before they are emotionally reunited on Wednesday.

Brett and Naghmeh King were released from separate wings of a Spanish jail on Tuesday night after prosecutors in London terminated aEuropean arrest warrant and said the couple would face no charges.

The dramatic development meant the couple were free to leave Soto del Real prison near Madrid, where they had been held since Saturday.

Speaking after his release last night, Brett King said: “We are grateful to Spain for the support and help we have received.

For yesterday’s fast-moving legal developments, the Guardian has this front page story.

The parents of Ashya King have been released from prison and heading to be reunited with their desperately ill son after the Crown Prosecution Service bowed to mounting political pressure and withdrew its arrest warrant. Brett and Naghmeh King were released from separate wings of a Spanish jail hours after prosecutors in London made a U-turn and said the couple would face no charges.