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Judge questions why GMC took three years to investigate sexual assault claim

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4579 (Published 03 October 2017) Cite this as: BMJ 2017;359:j4579
  1. Clare Dyer
  1. The BMJ

A High Court judge has called for an independent review of the General Medical Council’s delay in investigating a patient’s sexual assault claim against a foundation year 1 doctor, which was thrown out by a medical practitioners tribunal nearly three years after the investigation opened.1

Mr Justice Holgate made the call in a judgment quashing all the tribunal’s findings against Michael Brookman, along with the decision to strike him off the UK medical register.

The tribunal had rejected the patient’s evidence that Brookman had touched her genitalia while undertaking a sexually motivated inappropriate examination when he was working as a foundation year 1 doctor in October 2013. But it went on to strike Brookman off the register in February 2017 after finding him guilty of dishonesty in not immediately telling a locum agency and an NHS trust that were using his services about interim conditions placed on his registration. He was also found to have been dishonest in not telling Swansea University, where he was applying for jobs as a lecturer, about a brief period of employment at Bournemouth University and about the reasons the conditions had been imposed.

The conditions, which included a ban on seeing female patients without a chaperone, had been put in place pending the outcome of the investigation into the patient’s allegations.

The GMC notified Brookman that it had opened an investigation into the case in April 2014. The tribunal hearing began in October 2016 but was heard in stages in October and December 2016 and February 2017, when the patient’s allegations were finally rejected by the tribunal.

Holgate said, “First, I found it difficult to understand why it should have been necessary for some two and a half years to elapse before the hearing began in order to deal with the limited range of allegations in this case. Second, it was also difficult to understand why the weaknesses in the evidence of the patient and her husband could not have been identified during the investigation and a more realistic view taken of the chances of proving [the] allegations.”

The judge said that the allegations were “of a very serious nature and needed to be resolved as soon as possible,” as did those alleging a breach of the conditions. Further witness statements relating to essential factual aspects of the patient’s allegations were not obtained until towards the end of 2015, and a statement from the ward matron in January 2016. A similar timescale applied to the July 2014 allegations about the conditions.

“These are matters which ought to be reviewed independently for the MPTS [Medical Practitioners Tribunal Service], to see whether any delay was truly justified and, if not, whether these were merely isolated incidents,” Holgate added.

His call came after two tribunal cases in the past month in which patients’ allegations against doctors were held to be unreliable and the cases discontinued around three years after the initial complaint.23

Holgate said that the tribunal had been “unjust” to go on hearing the case against Brookman, in which he was defending himself without a lawyer while taking an antidepressant, and should have adjourned for a further health assessment.

The transcript of the tribunal hearing made it plain that Brookman was “having great difficulty in representing himself adequately,” Holgate said. Brookman had said in evidence that the antidepressant made him treat as unimportant matters that were important.

The tribunal had been concerned about the drug’s effect on him during the hearing and in the three years preceding it and considered adjourning for a further psychiatric assessment. But counsel for the GMC argued that this was not needed, and the tribunal decided not to adjourn. Holgate said that he had reached the clear conclusion that this was “both wrong and unjust because of a serious procedural irregularity.”

In addition, he said, in deciding to erase Brookman from the register, the most serious sanction available, the tribunal took into account only four points of mitigation. It excluded others that were material, such as the extent to which his behaviour was influenced by the stress and pressure of having to deal with the patient’s allegations.

Brookman, 57, spent a long career as a science teacher but decided to train as a doctor late in life, qualifying in 2011. He has been left with a substantial debt and has had to enter an individual voluntary arrangement with his creditors, a step away from bankruptcy.

A GMC spokesman said that it would be reviewing the judgment carefully.

References

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