Intended for healthcare professionals


Doctors who ran rogue breast surgeon’s hospital failed to prevent patient harm, tribunal hears

BMJ 2021; 375 doi: (Published 27 October 2021) Cite this as: BMJ 2021;375:n2613
  1. Clare Dyer
  1. The BMJ

The former chief executive and the medical director of the NHS trust where the jailed breast surgeon Ian Paterson worked are facing allegations of failing to prevent patient harm, at a medical practitioners tribunal hearing that opened this week.1

Mark Goldman, who was chief executive of the Heart of England NHS Foundation Trust from 2001 to 2010, and Ian Cunliffe, its medical director from 2007 to 2010, face rarely brought charges that they failed in their duty as doctor managers.

Paterson is serving a 20 year prison sentence for carrying out needless operations at private hospitals.23 In 2017 he was convicted of 17 counts of wounding with intent and three counts of unlawful wounding from 1997 to 2011.

He subjected more than 1000 patients to unnecessary and damaging operations over 14 years before he was stopped, concluded an independent inquiry in February 2000 chaired by Graham Jones, former bishop of Norwich.

In Paterson’s main job as a consultant surgeon with the trust he carried out unapproved “cleavage sparing” mastectomies that left tissue behind, risking the return of cancers. Goldman and Cunliffe failed to recognise the significance of the lack of informed consent for these mastectomies, the General Medical Council (GMC) alleges.

Reporting concerns

The GMC claims that Goldman, who retired in 2010, failed to promote a blame-free culture for reporting clinical concerns and neglected to promptly inform the trust’s board that the multidisciplinary team had been performing poorly for many years.

Both Goldman and Cunliffe are charged with failing to report Paterson to the GMC and failing to stop him carrying out breast surgery from June to December 2007 or, alternatively, to enforce his verbal agreement to stop doing cleavage sparing mastectomies.

The managers, the GMC alleges, failed to formally report to the trust’s board on the progress of investigations into the surgeon’s practice after receiving nine reports from December 2007 to May 2009.

The GMC claims that they failed to share the reports’ concerns and recommendations with other clinicians in the multidisciplinary team and allowed Paterson to review and refer patients himself and to be involved in discussions after introducing a protocol to identify patients for cleavage sparing mastectomy.

The Medical Practitioners Tribunal Service hearing, listed for 60 days, is scheduled to run until February 2022.