Relatives are furious that GP can continue practising
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* Clare Dyer

A GP who prescribed potentially hazardous doses of sedatives and painkillers to elderly patients has been found guilty of “multiple instances” of serious professional misconduct by a General Medical Council panel but is allowed to continue practising.

The fitness to practise panel decided that Jane Barton should not be struck off but should be permitted to practise, subject to conditions that will be attached to her registration for three years.

In an unusual though not unprecedented move the GMC was quick to state its disagreement with the panel’s decision. It thought she should have been struck off and could support an application by the Council for Healthcare Regulatory Excellence for a High Court ruling that the sanction is unduly lenient.

The GMC’s chief executive, Niall Dickson, said, “We are surprised by the decision to apply conditions in this case. Our view was the doctor’s name should have been erased from the medical register following the panel’s finding of serious professional misconduct.

“We will be carefully reviewing the decision before deciding what further action, if any, may be necessary.”

The Council for Healthcare Regulatory Excellence said that it had called for the fitness to practise panel’s transcripts and would announce its decision in due course.

Relatives of patients reacted with fury to the decision to allow Dr Barton to continue in practice, and one branded her a “monster.”

Dr Barton’s role as clinical assistant at the Gosport War Memorial Hospital in Hampshire from 1996 to 1999 was at the centre of an investigation that saw the police look into 92 deaths. The Crown Prosecution Service decided not to prosecute, but the GMC hearing followed an inquest last year into 10 deaths that concluded that prescribed drugs had been a factor in five.

The charity Action against Medical Accidents reiterated its call for an inquiry into the events at the hospital. Its chief executive, Peter Walsh, said, “Whatever one thinks about this individual doctor, there are systemwide lessons that need to be learnt from this. There is still inadequate supervision and monitoring of drugs in care homes.”

The panel, which heard that patients were left in “drug induced comas,” criticised media comment that compared the case to that of Harold Shipman, the GP who deliberately killed hundreds of patients with drug overdoses. But it found that there had been instances when Dr Barton’s acts and omissions had put patients at increased risk of premature death.

It listed a catalogue of failings relating to her prescribing practices, poor note keeping, failure to consult colleagues, and inadequate assessments, examinations, and investigations.

The panel said that although Dr Barton conceded that she should have refused to continue working in circumstances that were increasingly dangerous for patients, she insisted that she would not behave differently today if the circumstances were the same, giving an image of a doctor “convinced that her way had been the right way.”

On the other hand she had been practising safely for 10 years since then and produced nearly 200 testimonials from patients and colleagues.

The panel attached 11 conditions to her registration, including no prescribing or administering of opiates by injection and no involvement in palliative care.

Dr Barton, who still practises as a GP in Hampshire, said, “Anyone following this case carefully will know that I was faced with an excessive and increasing burden in trying to care for patients at the Gosport War Memorial Hospital. I did the best I could for my patients in the circumstances until finally I had no alternative but to resign.”

She said she drew “great comfort” from the evidence of the leading cancer specialist Karol Sikora, “who told the panel that, given the situation, my general practice and procedure were perfectly reasonable.”

Dr Sikora told the *BMJ*: “Gosport War Memorial Hospital at the time of the incidents was a busy dumping ground for elderly patients. The nurses did their best, and Jane devised a variety of strategies to keep things going. She was, after all, a part time sessional clinical assistant. There were two consultants and a pharmacist who reviewed prescriptions. The families were simply told a lie when their relatives were shunted there. There were absolutely no resources for rehabilitation at all. 

“I really believe she has been offered up as a sacrifice to save the stark reality of the failure of the NHS to provide any rehabilitation service for elderly patients coming to light. Places like Gosport still exist. Blaming a single doctor for all their failings will not make things better.”

## Notes

**Cite this as:** *BMJ* 2010;340:c619