Breast clinic director accused of bullying and incompetenceBMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7315.709a (Published 29 September 2001) Cite this as: BMJ 2001;323:709
The “bullying, offensive, and incompetent” clinical director of the East Devon Breast Screening Service missed cancer and failed to perform crucial diagnostic tests through “sheer unimaginativeness and laziness,” the General Medical Council was told last week.
Dr John Brennan, 51, worked for the unit from 1990 until 1997, when he was suspended and an independent inquiry was set up. He resigned in 1999 after the inquiry's report led the then health secretary Frank Dobson to brand the East Devon service a “disgrace.”
Joanna Glynn, counsel for the GMC, said Dr Brennan's behaviour “created a climate of anxiety and fear in which his views could not be challenged. Members of staff resorted to clandestine means to make sure that the women had appropriate treatment.”
Dr Brennan and consultant radiologist Dr Graham Urquhart, 55, who worked for Torbay health authority and South Devon Healthcare NHS Trust, deny serious professional misconduct in failing to ensure adequate quality of screening images and neglecting to perform needle biopsies in patients with suspicious test results.
The inquiry found that 24 women had been wrongly cleared of cancer and 61 had a seriously delayed diagnosis. Eleven of those women later died of breast cancer.
This week Dr Brennan acknowledged having missed malignancies in images taken of nine patients between 1991 and 1997. Both he and Dr Urquhart also admitted failing to recall two other women with symptoms of cancer.
Senior radiographer Janice Price told the hearing that Dr Brennan had sent home a woman with a suspicious dense area on a breast x ray. “He thought it was a benign condition. In my opinion he should have done an ultrasound or FNA [fine needle aspiration], but he said he didn't have time. At that point I realised we were not doing things as thoroughly as we should.”
A former colleague, Dr Anthea Kelsey, told the GMC's professional conduct committee that she had offered to take on extra patients to reduce the lengthening waiting lists but had been forbidden to do so by Dr Brennan, who complained of “inappropriate increases” in referrals from general practitioners. She saw some extra patients in secret while he was on holiday.
Standards fell so far that “by 1995 the rate of pre-operative diagnosis was almost nil. It should have been almost 60%.”
Dr Brennan had argued that the unit was short of money, staff, and equipment, but the independent inquiry judged that from the beginning of 1995 to his suspension in June 1997, a further 550 patients could have been seen.