Neale case 'must lead to reform'

Neale has been called arrogant

The official inquiry into incompetent gynaecologist Richard Neale has called for reform of the way doctors are recruited and employed by the NHS.

Neale was struck off in 2000 after being found guilty of serious professional misconduct.

A General Medical Council hearing concluded he botched operations on 12 women. In total more than 250 women said they had been damaged by Neale.

The inquiry calls for a new body to oversee the employment of doctors.

The climate in which Richard Neale operated did not lend itself to full and objective examination of what was going wrong with the doctor-patient relationship. Official inquiry report

Neale landed a job at Friarage Hospital, Northallerton, North Yorkshire, despite having been struck off by the Canadian authorities in 1985 following an investigation into the deaths of two of his patients.

He also worked in Leicester and at London's exclusive Portland Hospital.

In total, he faced 35 charges of clinical incompetence, professional negligence and extreme rudeness relating to his treatment of 13 female patients.

The GMC, which considered the case for a month, found the facts proven in all but one case.

Better checks

The report of the official inquiry into the case says the government should consider setting up a new body, or expanding the power of an existing body, to take an overarching view of all aspects of the rules governing the appointment and employment of doctors.

All patients have the right to expect a high standard of care from clinicians. Richard Neale fell short of these standards and as a result caused the patients in his care unnecessary distress. John Reid

It also says that checks should be made on all doctors appointed from overseas as standard.

The report also says the complaints procedure at Friarage Hospital was poor. Patients were not actively encouraged to follow up their initial complaints, and were given little or no help with how to navigate the system.

"Generally speaking we have found that the climate in which Richard Neale operated did not lend itself to full and objective examination of what was going wrong with the doctor-patient relationship.

"His attitude to some patients and some colleagues was arrogant, dismissive and overbearing; it stifled complaints by patients and criticisms by colleagues alike."

Neale was over-confident, and over-reached himself in performing certain clinical practices, the report finds. He also deliberately allowed his employers to be misled on a number of occasions, including failing to disclose the fact that he had been struck off in Canada.

However, the report says that adequate checks on his clinical ability were not carried out.

"Vulnerable patients, such as many of those treated by Richard Neale, deserve better," the report says.

Government response

Responding to the report, Health Secretary John Reid said measures had already been put in place to try to avoid a similar case occurring again.

However, he said: "We are not complacent and we recognise the need for further improvements.

"If we are to learn the lessons when things go wrong we must ensure that systems are in place which have the confidence of patients who wish to raise concerns.

"All patients have the right to expect a high standard of care from clinicians. Richard Neale fell short of these standards and as a result caused the patients in his care unnecessary distress."

The official inquiry, ordered by the government, was boycotted by many of his alleged victims because it was not held in public.

Progress made

Simon Pleydell, chief executive of South Tees Hospitals NHS Trust which runs Friarage Hospital, said much progress had already been made on the issues highlighted in the report.

"The measures we have taken should reassure people we have systems in place to protect and enhance the quality of care we provide to our patients."

Tim Annett, solicitor for 30 former patients of Neale said he hoped "serious consideration" would be given to the recommendations of today's report to help improve patient safety.

He said: "In this way, we hope that patient safety will be enhanced and that a more open attitude towards complaint handling will develop."

In a statement, the GMC apologised for the way it had handled the Neale case in the 1980s.

"We cannot defend the GMC procedures that 15 years ago failed by allowing him to practise in this country despite his record in Canada.

"We have undertaken a fundamental programme of reforms and we are confident that this situation could not happen again."

The Medical Protection Society said it was important that, while genuine complaints were investigated thoroughly, not too much time was taken up dealing with trivialities.