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The Real Story: Review After the January 2000 conviction of Dr Harold Shipman for the murder of 15 of his patients, and the extensive public inquiries and recommendations that followed, (1) the British public might be entitled to believe they are now better protected against rogue doctors. Though Shipman was an anomaly, and many safeguards have since been put in place, patient abuses of a lesser if still serious magnitude are by no means uncommon, and continue to blight the medical profession. It is well known that police officers can do no wrong in the eyes of the legal establishment provided they are only "bent for the job"; the same hear-no-evil, see-no-evil mindset permeates the medical establishment to a great extent, but while police officers who engage in criminal activity for personal gain are regularly brought to book, doctors who flout the law, even when this law-breaking involves the abuse of vulnerable women, are shielded to an extraordinary extent by the powers-that-be. On Monday, November 8, BBC1 screened a disturbing half hour documentary. The debut episode of the new Real Story series presented by Fiona Bruce (co-presenter of Crimewatch) focused heavily on Dr Clifford Ayling, whose case made national headlines when he was gaoled for abusing female patients. Other less well-known cases also featured, including doctors who had engaged in unethical medical trials for profit. The programme revealed that in a five year period, no less than 183 GPs had been found guilty of serious professional misconduct, of whom Ayling was by far the worse (bar Shipman), and that in the past four years, no less than seven GPs have been gaoled for sexually assaulting patients. Dr Clifford Ayling received a four year prison sentence in December 2000 after being convicted of no less than thirteen indecent assaults on female patients between 1991 and 1998. During his trial, many more victims came forward, and it will probably never be known how many he abused in total. Prior to his conviction, Ayling had been sacked by no less than four hospitals, although astoundingly no further action was taken at the time. So outrageous was his behaviour that his conviction led to an official inquiry and the publication of a White Paper (Cm 6298) in September 2003, followed by an independent investigation into how the NHS had handled allegations of his misconduct. The results of this investigation were published a year later, on September 9, 2004; the report can be downloaded from the Department of Health's website. Fiona Bruce interviewed Laura Smith, who was fifteen when she first visited Ayling, and Angela Hodges, a mature woman who also suffered at his hands. Smith was told she should have a smear test. When she suggested she take it at a local young person's clinic, Ayling became aggressive and bullied her into submitting to his will. When later she became pregnant (not by him), he subjected her to rough and unnecessary internal examinations. Hodges found Ayling to be "very nice" but he would "turn like the wind". Both women found themselves in a state of disbelief at his behaviour. Ayling was parolled on August 18, 2003 but was recalled to prison after less than three weeks for referring to himself as a doctor in a letter to the registrar of the Bankruptcy Court. He challenged the recall, but the High Court dismissed his appeal, taking the view that his continuing to use the title after being struck off the Medical Register was "sinister". The September 2004 report recommended that women patients who were subjected to internal investigations should be offered chaperones, an imminently sensible suggestion that not only protects patients from abuse but also protects doctors from false allegations, (2) but when Angela Hodges asked for a chaperone, her request was met with disbelief. On the programme, a spokesman for the GMC told Bruce that it was not the direct responsibility of the GMC to arrange for chaperones, which begs the question whose responsibility is it? The programme also reported on the case of a woman doctor in Scotland who was found to be using vaccines and drugs that were as much as six months out of date. The practice manager reported the case but no meaningful action was taken; after another such complaint, patients had to be re-vaccinated. A third complaint led to further action. Eventually, the GMC imposed restrictions on the offender, but she was not struck off. Two far more serious and potentially dangerous cases were those of Dr Robert Adams and Dr Vasu Agrawal. Adams, a GP who practised in Hertfordshire, prescribed a woman patient unspecified drugs for migraine (she was given anti-depressants), and a male patient was given similar medication for high blood pressure. He suffered serious side effects but only discovered years later that he was being used as a guinea pig. Numerous other patients suffered the same treatment. Adams was suspended by the GMC, and later quietly retired. He was said to be the tip of an iceberg which involves not only subjecting patients to unethical medical experiments (without their informed consent), but to fabricating data and forging consent forms. Dr Agrawal was suspended for a year for using patients in clinical trials (for profit) without their consent. The Adams and Agrawal cases were highlighted in an investigation by the Observer newspaper in early 2003, but as a rule very few cases involving improper behaviour by doctors are picked up by the mainstream media. One that slipped through the net appeared in a local London newspaper. In October 2001, Dr Cyprian Okoro was reported to have been banned from treating women patients alone "for another year" after being found guilty of two charges of serious professional misconduct the previous April. He was said to have asked a schoolgirl "to touch his penis and to guess its size", and to have asked a cancer sufferer if she liked oral sex. (3) A member of the public who made such an improper suggestion to a schoolgirl would most likely find himself on a criminal charge, probably inciting a minor to commit an act of gross indecency; it remains to be seen why the GMC should have taken a less stringent approach than the Metropolitan Police. It is the public perception that the medical authorties are often unduly lenient when disciplining those rogue doctors who are brought to book. When Angela Hodges phoned the GMC to complain that she thought she had been sexually assaulted by Ayling, she was told there was no one to take her call, a response she would surely not have received from her local police station, regardless of her perceived mental state. Reforms are said to be in the air, but the impression given by Bruce is that four or five years down the line the BBC will screen a similar programme in which the same questions and issues will be raised - la plus a change. Notes and References (1) The first public hearing of the Shipman Inquiry chaired by the High Court Judge, Dame Janet Smith DBE, began on June 20, 2001. Shipman committed suicide in Wakefield Prison on January 13, 2004, by which time the Inquiry had sat for a staggering 218 days. The Shipman Inquiry website contains extensive documentation on the case and related issues. (2) Doctors are particularly susceptible to false allegations of this nature, see for example Wife accused of false rape claim, published in the Daily Telegraph, June 13, 1990, page 7. The unfortunate Dr Ghias Chamas spent two weeks in prison before the charge was withdrawn; his accuser was granted bail. Dr Peter Thornton was falsely accused by several women, see Doc cleared of groping women, by John Askill, published in the Sun, February 18, 1999, page 7. (3) Doctor restricted for dirty-talking: Chaperone now needed for women patients, published in NEWS SHOPPER Beckenham & Penge, October 17, 2001, page 7.
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