Gynaecologist struck off the medical register
BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7256.258 (Published 29 July 2000) Cite this as: BMJ 2000;321:258All rapid responses
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After Mr Neale was found guilty on 35 charges of negligence,
incompetance, rudeness, and a tendency to deceive NHS patients into 'going
private' he gave an 55-minute impassioned speech to the GMC, arguing why
he should not be erased from the register.
During that speech he dsaid that he accepted the need to undergo
retraining and said that Professor Drife had put together a suitable
retraining package for him.
As Professor Drife is the BMJ's own obstetrician-gynaecologist
columnist, I - and doubtless others - have been looking forward to reading
him discuss the Neale case in his column. But, so far, nothing. When will
such an article be published?
Competing interests: No competing interests
It is fascinating to observe the debate in the BMJ about
incompetant doctors, and the apparent ease with which they
can continue to practice.
Please, be assured that Australia has exactly the same
problems, even if we have not yet began dealing with them so
publicly.
Most surgical trainees in any speciality would be able over
a drink or two to list the incompetant behaviour they have
seen in (thankfully) a few consultants. It is to our shame
that in the cold hard light of day so few of these same
people would be prepared to stand up and name their
complaints. The exception to this is perhaps our anaesthetic
colleagues.
And the question is why. One answer lies in the
institutionalization of medicine where doctors are
discouraged from formally complaining about their
colleagues, and a second in the the fear these same trainees
feel about the possible effects such "trouble making" could
have for their careers, particularly as they are employed on
a year to year basis.
And their fears are justified. Your own medical literature
records the consequences for such "whistleblowers".
As I write, an Australian O&G trainee is embroiled in a
hospital enquiry about her concerns over the
clinical skills of her consultant training supervisor.
Another consultant's response has been to draw her aside
and complain about her having brought her concerns to the
attention of the hospital administration. Not once in his
conversation with her did he mention standards of
patient care - which formed the basis of her concerns.
To those people who would seek to hide these problems I
would say that if we as a profession do not act, be assured
the lawyers for the injured patients will.
And are.
Competing interests: No competing interests
Dr Neale may indeed have been culpable.One has to ask however,how if
he perceived weaknesses in his operative technique, he might have been
able to correct this and still retain the respect of his
colleagues.Remedial help is not readily available in any system of which I
am aware for any surgeon in his forties or fifties who admits to needing
improvement let alone to serious gaps in his expertise.Facile judgement
comes cheap.A compassionate appraisal requires some effort.Slipshodness,I
submit, does not come naturally to surgical specialties; something
encourages it to develop.What is required is a way of halting this process
early.
Competing interests: No competing interests
It was shocking to read about the Gynaecologist struck off the
medical registrar. Mr. Neale seems to have committed a series of offences,
which is evident by this report. It surprises me that the GMC was so slow
to act. It is even more shocking to note that the GMC appointed him to
investigate other doctor’s fitness to practise.
I have always had a very high opinion of the GMC. I even live in the
eternal fear of being struck off the medical register for a mistake, which
I might some day, commit accidentally without any intention to do so.
Allowing a doctor to practice for 15 years after another reputed medical
council has struck his name off their register undermines the reputation
of the GMC. It would mean that doctors can start committing any offence at
the age of 35 and can happily retire with all the benefits before they are
discovered and penalised by the GMC. Is this late reaction extended to
overseas doctors as well or will the GMC be more vigilant about them?
Dr. Usha Kiran
Competing interests: No competing interests
Sir,
Boring as it is, I am sure I am not alone in being disappointed that
Ms Mellor [1] seeks to vent her considerable spleen on poor Dr John
Hopkins, who of course, cannot in any sense be held personally responsible
for what she sees as the real or imagined deficiencies and shortcomings of
the UK NHS, or indeed of the entire UK medical profession. Many of these
arguments have been played out before. Yes, doctors are human beings [2],
no they did not elevate themselves to the position of high status they
enjoy in society. They were placed there by ordinary people who seem to
think they are miracle workers. The parallel drawn by Dr Penney [3] with
royalty is a good one. They seem to be either eulogised or hated and there
seems little healthy middle ground judgement going for them.
Currently, they seem to be unable to do right for doing wrong.
When things go wrong, people then swing from glorifying them to
castigating them all as incompetent, arrogant buffoons who could not even
stitch a shoe let alone fix wounds or heal the sick. A little more steady
reflection and less emotional overreaction would not go amiss in
discussions of this type.
‘Moderation in all things.’ might well have been said by Kenneth
Williams or Charles Hawtry, in a Carry On film, but probably not by Oscar
Wilde. Nevertheless, it seems apt in this case.
Sources
[1] BMJ letter, Penny Mellor, Re RE The Emperor has no clothes, 6
August 2000
http://www.bmj.com/cgi/eletters?lookup=by_date&days=1#321/7256/258/EL11
[2] BMJ 2000;321:321 (5 August), News, Surgeon sacked for "misconduct
and misjudgment", Clare Dyer, legal correspondent, BMJ
http://www.bmj.com/cgi/content/full/321/7257/321
[3] BMJ letter, Re: Doctors are human beings, 6 August 2000, Brian J
Penney,
http://www.bmj.com/cgi/eletters/321/7257/321#EL3
Competing interests: No competing interests
I agree with John Hopkins in as much as the same degree of
incompetence found in the medical profession can be found within any
corporate setting except within the "corporate" settings the incompetent
aren't always responsible for the life of another human and when tragedy
occurs there are serious consequences for those that are guilty of that
incompetence.
Let's take the recent Paddington train disaster and previously the
Southall Train disaster, as a direct result of "corporate failings"
Corporate manslaughter will be legislated for. No such luck within the NHS
even though lives are put at risk by "dodgy doctors".
My partner is a director of a multi-national retailer and believe you
me incompetence to the degree of some of the high profile cases is not
tolerated, they would have been sacked on the spot for 1% of what some of
these doctors had done and any manufacturer of food who kept messing up
and putting lives at risk, would not only immediately be de-listed, but
would have Public Health crawling all over them, followed by prosecutions.
The point I am trying to make is this, we all understand human
frailty, we all understand under funding and over stretched hospitals, we
all make allowances for these things, however we are confronted with out
and out arrogance and excuses for the most appalling behaviour, none of
which seems to be anyones's fault. Well it is somebodies fault. If the
medical profession and the pathetic GMC can not put their own house in
order then I am afraid the time has come to change the face of the NHS and
put people in place who will run a "tight" ship and NOT allow the
incompetence, once spotted to continue.
The NHS is ours, the public's we pay for it, we pay the salaries of
all who work in it and the least we can expect is respect, however what we
get is God like attitudes from arrogant incompetents who believe they know
all there is to know about medicine and we the ordinary person have not
the mentation nor the right to question anything they do. Well times are
changing and it's about time the medical profession stood by it's
patients, it's "employees" and booted the bad apples as soon as any
dangerous practise comes to light.
Competing interests: No competing interests
Sir,
This case has profound and shocking implications for the entire
medical profession. It is just not good enough to say that there must be
an explanation for Neale’s behaviour [1] or asking why he was devastated
by being struck off [2]. The matter is also connected to a string of BMJ
letters about the possible future composition of the GMC [3].
There are far more serious problems attaching to this case. It
was not an isolated case, it was compounded by his being already struck
off in Canada and, even worse, he was reported repeatedly to a seemingly
comatose, docile and indifferent GMC, which failed to act against him
throughout the last 15 years. Thus, he has also shamed the very body that
is supposed to control the profession. Apart from the Register and the
GMC, the UK medical profession has no other sanction against the
misconduct of its members. Tiresome though it might be to cover the same
ground as raised by the Shipman case [4], nevertheless, does this case not
yet again highlight the tragic shortcomings of what amounts to an
unregulated medical profession? That is a profession regulated entirely by
its own members, blind to the possible deceits being palmed on the public
it serves, by this minority of wholly disreputable and shameless
practitioners?
Once the dust has long settled and the details of these example cases
have faded from view, the central problem will still need tackling. It
therefore becomes, what the profession chooses to do to tighten its
regulation procedures. That would seem to be the nub of this problem.
Either it spawns a GMC that at last does the job it was intended to do,
and regulates the profession properly, insisting on higher standards of
practice and behaviour, or it sits back and lets politicians and lawyers
remove from the profession the controls it has upon its own members. One
imagines that BOTH these things will happen as the words ‘greater
scrutiny’ loom large in the crystal ball of all professions.
Citations
[1] NEWS, Gynaecologist struck off the medical register, Clare Dyer,
BMJ 2000; 321: 258 - BMJ 2000;321:258 ( 29 July ); BMJ letter, What could
the problem be?, Dr. L. Reinecke (28 July 2000)
[2] BMJ letter, Re: What could the problem be?, Barry Maber,
Physician Vice President Saskatoon District Health (31 July 2000)
[3] MEDICOPOLITICAL DIGEST, BMA supports medical majority on GMC •
GMC continues discussions on its structure • Welsh LHGs could do better,
(22 July 2000); BMJ letter Re: Re: Re: Re: Patient advocates support lay
majority on GMC, Alison King, layperson (31 July 2000); BMJ letter, Re:
Re: Re: Re: Patient advocates support lay majority on GMC, Brian Morgan,
Freelance Journalist Cardiff (31 July 2000); BMJ letter, Re: Re: Re:
Patient advocates support lay majority on GMC, Dr. John Nottingham,
Consultant histopathologist, George Eliot Hospital NHS Trust, Nuneaton,
Warwickshire (31 July 2000)
[4] LETTERS, Fallout from the Shipman case, J M N Hilton, John
Havard, Stuart Horner, Raj Bhopal, Jim Hardy, Kath Checkland, Trefor
Roscoe, Peter Morrell, Andrew J Hartle, and Helen Clark, BMJ 2000; 320:
1271, BMJ 2000;320:1271 (6 May)
Competing interests: No competing interests
Dear Dr Smith,
I am grateful to Ms Mellor for taking the time to respond to my
posting.
I cannot agree with her view that there has been an absolute failure
among doctors to put their patients first.
The vast majority of doctors do their job to the best of their
ability in the same way that the vast majority of
journalists/parents/farmers/milkmen etc etc do their job to the best of
their ability.
The failings in the current system are the result of human frailties
which we all share. There will be around the same percentage of difficult
and incompetent people in a hospital as in a newspaper office or corporate
head quarters.
Dealing with them has to be done according the principles of openness
and accountability in an environment which is not as hostile as the one
which currently exists.
John Hopkins
Competing interests: No competing interests
Doctor's only allegiance in these sorts of issues is to their
patients, not to their careers or their peers.
I too have sat on committees and know the complexities and problems
of stating what other people just do not want to hear, however when it has
come to the safety of another human life I can hand on heart state that I
would never ever remain silent about it.
The price I have personally paid for daring to speak out about
doctors is having my house raided by the police and all my documents and
computer removed, my children prevented forcibly from seeing me by those
same police officers, personal attacks in various newspapers and the BMJ
making allegations that I have sent doctors hate mail and threatened their
person, allegations that I have threatened their lives, all
unsubstantiated yet printed as fact, because doctors "don't lie" do they!
If just one doctor had pursued their suspicions about Harold Shipman,
or Neal, or Ledward, or Southall, how many lives may not have been ruined.
The medical profession's duty is to it's patients first and foremost,
their absolute failure to put the patient first is responsible for the
current crisis in patient doctor trust and will ultimately cost the NHS
millions in compensation, millions that could have been spent on better
training and better support for medics if only one person had had the
courage of their convictions.
These "emperors" do have clothes, they have a cap and it fits.
Competing interests: No competing interests
Re:Neale-lets hear from Professor Drife
Indeed,it would be fascinating to see the alleged 'Neale-
rehabilitation package' of Prof.Drife.No doubt, there must be many others
who are eagerly awaiting this momentous publication.
Competing interests: No competing interests