KATE SILVERTON: Why have you obstructed the HFEA in carrying out legally required audits, and inspections of your clinics and your clinically reported data?
Mr. TARANISSI: I don't think you can say that because I know you are referring to it a particular inspection report that you sent to me in August but if you look at our response to it, it will explain to you that it is not exactly what you were told. I mean we try and work within the requirement, within the regulations, and we just require co-operation between those/both parties. I don't think you can put as obstructions because that was not the case and we cannot obstruct them because they've got the power to come at any time.
Mr. TARANISSI: Like if we try and find a way to work within what is acceptable for both parties I don't think you can describe this as obstruction.
KATE SILVERTON: But your 2 clinics come bottom, way bottom, in terms of reports for compliance with the HFEA.
Mr. TARANISSI: Again we need to really explain to people how these reports have been calculated because if you look at the figures, and I mean first of all I think they've been titled driving improvement or whatever. How can you expect any improvement if you are not actually communicating the results to the individual clinics, because we were never told what the results are before they were published? As we speak I mean we've put at least three or four or five requests asking them to give us the details of the break down of how they have calculated this cause and we still haven't got any response. But to give you an example; you could have a minus three on this scoring from what I understand for something like a signature that is not clear on a consent and you can have a minus one or probably nothing at all if you drop the embryos on the floor. So people need to understand that it's, its more table with compliance with paper work which can sometimes also be misrepresented.
KATE SILVERTON: But if other clinics can manage it why can't yours?
Mr. TARANISSI: I don't think we are not managing it it's just the problem is first of all if they won't to give us results we need to actually look at it and we need to be able make representation if we don't think it's right. This did not happen here despite several requests so I'm not quite sure how this can be helpful to anybody?
KATE SILVERTON: But it is quite clear from the reports that, publicly available inspection reports that, that the HFEA really have been¿.. ¿. met the challenges each step of the way not just with laws but in terms of late reporting figures it is not really a record to be proud of considering your success rates that put you as the most successful clinic in the country.
Mr. TARANISSI: Well, I mean, you need to see this in context because there is a long of history of problems between us and HFEA for a variety of reasons.
KATE SILVERTON: What reasons?
Mr. TARANISSI: I don't know I mean there is a lot of regulations that seem to be a bit apply to us more than other people and need sometimes to express views and discontent or whatever it's [bound] to cause a lot of friction but we are not against regulation as such we're trying to work within sort of the regulation and it is something that we are trying hard together and trying to improve it, that's, that's what we are trying to do at the moment.
KATE SILVERTON: But people say that trying is not really good enough you really are expected to co-operate within the boundaries of the law as required.
Mr. TARANISSI: Of course.
KATE SILVERTON: By the HFEA and at the moment it appears you are not doing so.
Mr. TARANISSI: It is not true because we are still working I mean this was, if this was a big problem as you, as you said I mean then the situation would be different, we still working with the HFEA, we are still trying to find the way to improve relationship and I think most of the recommendation and most of the stuff that we suggested that HFEA over the years they've taken them on a board, eventually, after two or three years of discussions so it, it, just goes to assure that we were saying was not completely irresponsible or something that can not be apply because they, they've started implementing some of the stuff, it just took them a bit longer.
KATE SILVERTON: How would you say is your relationship with HFEA now then?
Mr. TARANISSI: Well, I don't think it is any different from what is used to be over the years, we just do replaying to results and problems and we just hope that we can finish with this and move forwards for everybody because it takes a lot of time from my time which I need to ??? for patients because that's what I am good at and that's what I want to continue to do provide the results for people. It wouldn't stop me expressing my views because that's the way I am as a person.
KATE SILVERTON: But all they would ask that you get your statistics reported in on time and in full.
Mr. TARANISSI: Yeah, but that is what we do.
KATE SILVERTON: You are not doing that.
Mr. TARANISSI: No, no we are, because that's not, that's not, that's not correct, we do these things, ok we maybe delay sometimes like a lot of other clinics, I mean if you look at the inspection reports on HFEA website you will find a lot of other clinics, some of them are actually run by the members of the authority, who have also problems with the late reporting. It's not a problem, we put priority to clinical work, I mean if it means that you are gonna delay sending the people because you are very busy and people that doing this need to to pay attention to the patients then that's what I'm gonna do and I would continue to do that.
KATE SILVERTON: But then why not invest in a better administration and avoid all of this because what you are doing is opening your own reputation up to great criticism, they have got this great disparity at the moment with your clinic being the most successful in the country and yet you are bottom in the league in terms of compliance.
Mr. TARANISSI: It's not really that because when you talk about compliance it's, its most of it is paper work and most of it when it's presented on paper if you going challenge it and look exactly what they are saying you will find that it is misrepresented in a big way. You, you just need to look at our response to some of the inspection report that were given to you because I don't think you've seen that I think people that giving an inspection report they didn't give you our response to it. You need to look at both before you can make decisions. So¿
KATE SILVERTON: We talk about the figure because obviously there is a huge issue of trust when patients come to you they want to trust that your figures are reliable, that you are as reliable as you say you are, did you feel that patients are able to relay on your first great statistics how public valuate that they've given that you have this history of late reporting and sometimes not in full.
Mr. TARANISSI: Late reporting, I mean, I mean, I mean, I mean we need to be clear about what the accusation is, I mean are we saying that we are actually manipulating our results, is this what you telling me?
KATE SILVERTON: Well I might want to get into that, but in terms of, in terms of actually getting you're, in terms of your success rate, being sufficiently robust for patients to be able to trust them I just want to get your view on that, are they sufficiently robust given this history that you have with late reporting.
Mr. TARANISSI: Well, I think this is the question that needs to be put to the HFEA because I'm not the one publishing the there are results published by HFEA and I believe that they've got responsibility to make sure that, that before they publish they re satisfied with it so this has been published for eleven or twelve years in the I think it is good answer to that, so I'm not one who is publishing that.
KATE SILVERTON: You are calling for more stringent auditing then?
Mr. TARANISSI: For everything, I mean the, they, they come and the results are audited, they look at it and, and, and we prove that our relationship is a bit that they actually feel, we probably get audited more than everybody else, so over twelve years of auditing and reporting and all the rest of it we are happy and confident and that these results are true.
KATE SILVERTON: But they would say, I mean that looking at these reports they would probably they haven't been able to get access we're stalled, with legal challenges, we haven't had that access, why would you do that, why not just open the door and let them in?
Mr. TARANISSI: That's not, that's not true, I mean you need to give me an examples, you are in the one instance which was in August of 2006 when there was this dispute about a lot of other things but you need to look at this over twelve years period so you can not just take one instance without actually going into details and draw conclusions for, for the twelve years of operation that we had in this country. I don't think this is a fair reflection.
KATE SILVERTON: Ok, the national average of cancel cycle stands that thirteen percent, how can you explain your zero percent cancellation.
Mr. TARANISSI: Our zero percent cancellation rate in the last report is actually wrong, because there wasn't zero percent we've actually notified HFEA of that and I've got correspondence to say to them that actually this is incorrect and I actually showed them exactly what the levels should have been and because it was coming towards the time of the publication they decided to go ahead with the publication so that's something, that I'm not responsible for, that's what you gonna need to talk to HFEA about.
KATE SILVERTON: I don't know, why it would've been reported then, what was reported as¿?
Mr. TARANISSI: It was something that they've got the figures wrong and because I think the figures were sent for publication or whatever, they decided to just press ahead and do it.
KATE SILVERTON: So they've got it wrong?
Mr. TARANISSI: They've got it wrong and I've got the correspondence and I actually gonna give you some paperwork to assure you that it tell you exactly what correspondence lates and everything.
KATE SILVERTON: Ok, so¿
Mr. TARANISSI: I mean, let me just tell you another thing, If you look very carefully in the statistics in this particular year, there was other things on cancellation rate, so it wasn't something that was just particularly to us. and I'm telling you it was wrong and it wasn't my fault, it was some problem in the HFEA register that resulted into that.
KATE SILVERTON: So what was it?
Mr. TARANISSI: I don't know, they didn't have the figures right in because they calculate the figures and they send it a publication at the end of the day. Then they sent me to verify the figures and I actually told them at the time that these figures are incorrect and they said it's gone to the publisher and, and just leave it to that.
KATE SILVERTON: You see the lot of this is come from the fact that despite this new computer system being put in place in clinics have been up to you starting using it and it's been quite some time now.
Mr. TARANISSI: I'm telling you, no it's not quite some time. This computer business was actually introduced into this building on the nine, on the eighteens or nineteen's of December. It wasn't in operational before that and we had major problems with it working and it wasn't working until three days ago. And I can give you also the list of the times when we reported this to HFEA and so on. So introduced to this clinic for the first time just before Christmas and they expect you to, to rely on it hundred percent within a week of its installation and taking to account that there was Christmas and, and, and the New Year and all the rest of it, it's illogical.
KATE SILVERTON: Have you started using it now?
Mr. TARANISSI: I'd like to use it because its for me, it was, it will be brilliant, because it will stop all this hassle that we have interfered with HFEA, we have problems some times sending things, that they go missing or they send and then we ask to resend them. If you do them electronically, for me that's the brilliant solution so I don't have any problem with that, all what I was trying to say it as introduced to us at the very last minute and they wanted me to start using it completely within ten days.
KATE SILVERTON: Ok, but have you started using it now?
Mr. TARANISSI: Yeah, that's what we gonna do. The ordinary reporting from now is gonna be trough this, but while it is working.
KATE SILVERTON: So you accept your reporting could have been better?
Mr. TARANISSI: This is a system that has just been introduced and became more or less mandatory from the first of January of this year, let me tell you this as well, there is to my knowledge at least the other ten clinics in this country that have not using it.
KATE SILVERTON: But to be fair and with all due respect you quite right to raise it but with all due respect we are talking about your clinic which stands alone having high success rate in the country, I've got to come back to that because after all this puts you as masthead by which everybody to compare themselves, so ...
Mr. TARANISSI: Well, I mean in terms of success rates fine but then in terms of compliance we can see probably one of the clinics were the best compliance and zero success what is the one of the clinics had worse success rate in the country and has to close down because patients stopped going there.
KATE SILVERTON: Yeah, but can patients really trust your, people¿
Mr. TARANISSI: Why should they not trust because at the end of the day ...
KATE SILVERTON: Because you can't¿
Mr. TARANISSI: At the end of the day they want from me a baby, that's what they want from me, and that's what we try to do and try and give them that.
KATE SILVERTON: Above all else.
Mr. TARANISSI: Well I guess that's what you want if you're a patient coming to here you would rather have a baby rather than me have, fill in the forms and send this and so on. And were not saying we're not filling in the forms, we are trying but sometimes there are silly things like you get a form and they say to you, you didn't tick a box that says what happens to the frozen embryos if one of the partners dies. And that's a -3, but they don't have frozen embryos so why do you have to tick this box? Its things like that, if you go into dissection of the details it becomes very silly.
KATE SILVERTON: Well a few questions there that just came up. If I came to you, you said to me if I wanted a baby of course I would. I'd be desperate for that. But I would also be coming to you because you set yourself as being the gold standard as being the most successful. So I would need to trust your figures are reliable?
Mr. TARANISSI: That's what I'm saying, its not really my figures¿I mean the figures come from the HFEA, I'm not the one who's publishing the figures so¿
KATE SILVERTON: But they can only go on what's reported.
Mr. TARANISSI: Yeah fine but they've got ways, it applies to any clinic. So they have to have to have something in place to ensure the figures are correct. And we've been doing this for 12 years so I must be very clever to have just fooled everybody for 12 years. What about the patients who come in a walk away with a baby¿is this an illusion. They see this and talk among themselves and possibly if this goes on air there will be people listening to this and they will know what I mean.
KATE SILVERTON: Do you think wants you start using the computer system that you will remain at the top of the table?
Mr. TARANISSI: Of course, because if you think things are going to be different then, then you are implying that we aren't reporting or aren't doing this.
KATE SILVERTON: That is the concern Mr Taranissi.
Mr. TARANISSI: Well if we want to do this, we're still not going to put it onto the computer as well, how is the computer going to change that, its not going to change it¿if I'm not going to put them on paper, I'm not going to put them on the computer as well.
KATE SILVERTON: Do you think there is an issue of non-reporting of patients details?
Mr. TARANISSI: With us?
KATE SILVERTON: Just in general.
Mr. TARANISSI: I don't know I have no idea, I can only judge and then you have to remember I don't work in this place alone, I work with lots of people around me. I don't do the forms, the forms are don't by the people in the lab and stuff like that. So its not me.
KATE SILVERTON: But you do report all the patients that come through your door?
Mr. TARANISSI: Of course, of course¿that's very, very serious, and as I said I'm not working in isolation¿about 40 or 50 members of staff are here, people leave and go elsewhere. We cannot do things like that because its not possible, its not possible.
KATE SILVERTON: I know you say you have issues with the HFEA, but just looking at a quote from the HFEA, given that your 2 clinics were the worst in the table for compliance, it's a pretty strong quote that just jumped out at me¿saying this demonstrated the systemic problems caused by poor leadership and control. You've just said you are a busy clinic, you can't oversee everything, what are you going to do to get yourself back up the table in terms of complying with the HFEA.
Mr. TARANISSI: I don't agree whether we are at the bottom of the table or middle of the table of filing out paperwork. I mean I can only respond to this if the HFEA would disclose to us how they have actually worked out this table and how they individually score us, Which they haven't been able to do, then why because the figures have been compiled the tables have been published so if I request the methodology on how they have actually calculated the individual figures, I would have expected this to take one second. Press a button on a computer or something and give me the figures, but they haven't. I have requested it at least 4 or 5 times, the last time being yesterday, I still haven't got a response. And I am sure, if I get a response giving details I can tell you that at least most of it will be actually wrong.
KATE SILVERTON: OK why was the licence for your 2nd clinic, the RGI not renewed?
Mr. TARANISSI: Well that's again not correct, because if you look at what happened¿we were actually authorised a 3 year licence, with a condition attached to it saying you shouldn't really put 3 embryos in people above 40, which to me was completely not justified and was completely discriminatory to the women who come and ask for our services.
KATE SILVERTON: but to be fair, you're not the one making the law here?
Mr. TARANISSI: No, no I'm not but within my rights I can make a representation about that, which I said I wanted to do a representation which is something we have done over the years. Almost every licence renewal had something we had to make representation about it. And almost 100% of our representations were successful. So all that I said was I want to make representation which the lady who was dealing with our application said, that's no problem which is standard. It's only after 2 months that any discussion in the HFEA, that I was told, that because you have expressed a wish to make representation that you have effectively refused yourself your licence. Which never happened before, so this was a complete change of the goalposts. And it's completely different from my experience of the HFEA over the years. I we are still having a legal dispute about this which has not been resolved. We are hoping that ok there is a meeting in Feb. that will finalise this issue one way or the other. And it's just sad that you have to go into this kind of legal argument about paperwork and when you should sign it, and when you should have signed it and so on, stopping patients from having services. There has never been any issue about patient safety or laboratory problems to put us in this situation. All of this is a legal dispute whether it was within your right to make a representation about an offer of licence for 3 years. So its not that they have taken the licence away, its all paperwork again.
KATE SILVERTON: But it hadn't been reviewed, the licence hadn't been renewed from Dec. 2005, why then did you continue to treat women there at the RGI.
Mr. TARANISSI: Because, as I said, when¿it was customary practice when they send you an offer of a licence there is a paper that comes with it that has only one condition. Say I accept the licence, you sign it, you send it back, it's always been interpreted as the start of the licence and that's what I've done. That's nothing different from what I've done. 2 months later they decide that this was not good enough to trigger the issue of the licence. That's why we were working for the period, I didn't know that this was there interpretation.
KATE SILVERTON: Sure but they warned you¿
Mr. TARANISSI: Yes I'm coming to that. We had this discussion and they said to me "oh you have to understand that you have refused the licence and you have to continue work without the licence" At that time we were extremely busy, we've got hundreds of patients going through cycles, and stuff like that¿it was almost impossible for me to turn the patients away. There was no way I could have stopped¿what did they want me to do with the patients. And then we started arguing about it in terms of legal argument as to whether this is right or wrong. My priority was what will happen to the patient.
KATE SILVERTON: Absolutely, and it's a criminal offence to operate in an unlicensed clinic so that's not putting your patients first.
Mr. TARANISSI: It is because at the end of the day it is, I'm the one who is sticking his neck out for that and I don't understand why should I be stopped from working because of paperwork.
KATE SILVERTON: Another clinician might say that Mr. Taranissi and I'm sure you wouldn't want this to happen to say I'm going to operate outside the boundaries of the law¿
Mr. TARANISSI: I'm not justifying this, I'm not justifying this, I'm not saying its right. I'm just saying I was put in a difficyult position and I couldn't really do anything for the period of time because you cannot tell me, just at the drop of a hat, having planned patients and gone through the system and then send them away, for no reason. The only reason¿
KATE SILVERTON: So you'd prefer to act illegally¿
Mr. TARANISSI: No, I don't, honestly I don't, why should I¿I have enough problem on my plate, I don't really need to go and create some more problems for myself but this is something that has been created for me, to put it bluntly, but at the end of the day its not a situation that anyone would like to have. I'd rather work with people and find a way around it and will be sensible and try and move forward for the sake of the patients.
KATE SILVERTON: Absolutely and its those patients that might be watching now, well goodness I didn't know Mr. Taranissi was treating me at a clinic that was without a licence. That alone is going to undermine their faith in you, surely Mr. Taranissi?
Mr. TARANISSI: Well you need to explain what has been going on here, when you say there is no licence. The thing that comes to mind that there was serious safety issues, there was problems with safety patients, there was problem with laboratory issues¿
KATE SILVERTON: But its an unusual step for a licence authority to take?
Mr. TARANISSI: Well it was renewed, we had an offer of a 3 year licence, so that its not that its not renewed, they have given us an offer which it was the maximum, 3 years licence that's what we have been given. The whole issue arose 2 month later because of interpretation raised a legal dispute, I mean we also looked into it and I just didn't want o get into this whether section 12 or 14 applies or whatever, its just a situation that should have just not happened.
KATE SILVERTON: Well it paints quite a chaotic picture of your clinics because you're so busy, you have a pretty successful legal team behind you, why not get better administrators?
Mr. TARANISSI: It's nothing to do with the administrators, what we have done with this particular situation is no different from every year since 1995. You get an offer of a licence. You send it back and that's it. The interpretation of the HFEA is I believe is legally flawed this simply means every time you have a renewed licence if you want to make representations about its condition this means that your clinic should stop for a couple of months until you resolve this dispute with the HFEA¿
KATE SILVERTON: Were your patients fully aware of this?
Mr. TARANISSI: What! I wasn't aware myself, that's what I'm just trying to say.
KATE SILVERTON: but were they aware that you were operating both clinics and that the RGI didn't have a licence?
Mr. TARANISSI: I mean for a period of time I don't think you are going to go to patients and say we have a dispute, because this is still something disputed between us and the HFEA.
KATE SILVERTON: Don't you have a duty of care to your patients to do that.
Mr. TARANISSI: Well I have a duty of care to the patient is actually to get them the best result and a baby, that's my duty of care.
KATE SILVERTON: Ok, well in terms of the RGI, your figures show, your own figures show more women. More women are treated at the RGI are over 37, more women that are treated at the ARGC are under 37, why is that?
Mr. TARANISSI: If you know a bit about the history of the RGI, RGI is a specialised clinic that was set up in conjunction with a clinic in the States; essentially to supply a service called pre-implantation genetics screening and diagnosis. The commonest indication for this is maternal age, so it's not unusual for people who are older to go because they are going to need this service more and I don't understand what is the implication of this¿
KATE SILVERTON: Are your patients aware of this though?
Mr. TARANISSI: Of course.
KATE SILVERTON: So they don't think I'm coming to the ARGC, the most successful clinic but actually over 37, less likely to get pregnant, that I am going to be treated and reported by RGI?
Mr. TARANISSI: Well what difference does that make?
KATE SILVERTON: Well it means the ARGC on paper looks the more successful because you don't have to use those statistics.
Mr. TARANISSI: No, no they are not included anywhere because the HFEA don't report the results of the PGDA anyway. So whether they are actually done here or anywhere else they are not going to appear in the statistics anyway. But you have to remember that this is a situation that could only have been from 2003, did not affect any of the results apart from the last year, we were still top of the results from 1995 till 2003, then RGI did not exist.
KATE SILVERTON: Well when the RGI did exist it was less successful than the ARGC?
Mr. TARANISSI: Say again.
KATE SILVERTON: The RGI was less successful than the ARGCS.
Mr. TARANISSI: There's no reported results for the RGI.
KATE SILVERTON: Why was that?
Mr. TARANISSI: The reporting now is going to come from the next publication.
KATE SILVERTON: But you weren't reporting the statistics fully from the RGI.
Mr. TARANISSI: There's never been any problem in reporting the statistics for the RGI.
KATE SILVERTON: I don't understand, you have just said there were no reported statistics for the RGI.
Mr. TARANISSI: The way the HFEA reports statistics,. If you have a PGD cycle, it is excluded from the statistics, does not just apply to us, it applies to any clinic. So any clinic who do PGD cases are excluded from the overall reporting, that's the HFEA system?
KATE SILVERTON: But do you accept patients might not be aware of that, might come to the ARGC and are not aware of this difference and there are in fact ultimately 2 different success rates?
Mr. TARANISSI: There is no difference they are treated by us, it doesn't really matter.
KATE SILVERTON: So if you put the patient population together, the ARGC would still be at the top of the table.
Mr. TARANISSI: Yes of course, because that was the position from 1995 till 2003. so are you trying to say that because we have had an RGI for the last year, that all the last results for the last 8 years are flawed?
KATE SILVERTON: But you see where it does open you up, that it will have a more positive impact on the success rates by treating more younger women at this clinic.
Mr. TARANISSI: Well the results are presented by age group, the younger age group will always be presented as a separate group, regardless of where you treat them and if you look at our results, in the younger age group, they have always been at least twice or two and half the national average. That doesn't really matter because you are still going to present the results by age group.
KATE SILVERTON: But if you have got fewer older patients here¿
Mr. TARANISSI: But that doesn't matter, they are not going to come into this group, when you report the statistics, they are not going to appear in this group anyway, so it doesn't matter where they are treated¿
KATE SILVERTON: Do you think patients are sufficiently aware of that, because this is the criticism isn't it, that your figures are open to being massaged because you have 2 clinics.
Mr. TARANISSI: Even if I accept that, you need to look at the history before that. This is a situation that has only been available for the last year of reporting¿what about all the years before that. We are used to this, when we started the treatment everybody used to say we select our patients because results were published as an overall group. We are the one who has challenged the HFEA to trying to publish the results by age group, to show to people that this was not correct. We have really nothing to hid here.
KATE SILVERTON: In terms of reproductive immunology, immune therapies, controversial as you well know. What proof do you have that it works?
Mr. TARANISSI: What proof do you have that it doesn't work?
KATE SILVERTON: Well is that good enough when treating you're patients?
Mr. TARANISSI: Yeah it is. Because medicine is about views¿in our experience, in our set up it does work. And its not just my opinion, if you look at the medical literature there is medical evidence to say that it works and there are also evidence to say that it doesn't work. So it is still a very grey area.
KATE SILVERTON: But we work in this country on evidence based medicine, so it's not good enough to say I believe it works.
Mr. TARANISSI: Again I think we are not the only people doing it, there are other people that are doing it as well.
KATE SILVERTON: That's not the point, is it? We're asking you what you are doing here. And what proof that you have that it works?
Mr. TARANISSI: Because I look at the evidence that is in the literature as well. As I said to you earlier, there are reports that are equally say that it does work and report that say that it doesn't work. So you can rely on which ever one that you want.
KATE SILVERTON: But there has been no clinical trial to say ...
Mr. TARANISSI: But there will never be.
KATE SILVERTON: But don't you need a clinical trial without ...
Mr. TARANISSI: Ok just let me tell you another thing. What about IVF when it started, where was the clinical trial before that, before people started using it? What about HC(?) that we use for god knows how many years? What about a standard procedure that a lot of clinics do called assisted hatching, that's licensed by the HFEA and so on.
KATE SILVERTON: But it is a controversial, I mean two right s do not make a wrong, this is a controversial treatment¿
Mr. TARANISSI: But nobody is saying it is wrong, no body say that it is wrong, nobody say that assisted hatching is wrong. So if you want to apply the same rule, you have to apply it to everything across the board. You cannot pick and choose to make an argument.
KATE SILVERTON: Well I think you can when you are talking about potentially very dangerous drugs and giving people transfusions of antibodies from thousands of people, wherever¿
Mr. TARANISSI: I'll tell you my answer to this, its not unusual for people when going through IVF treatment and egg collection to have albumen. Which is a blood product that you give to people sometimes that you may hyper stimulate and so on. Honestly no-one raised this argument as being a blood product and why are you giving it to people. Again you can use the argument whichever way you want. We tell them about the risks, we explain to them the potential benefits, we explain to them the current state of knowledge, everybody knows it is still a gray area in medicine, its not proven 100% they make a choice at the end of the day.
KATE SILVERTON: Do you think vulnerable patients coming to you desperate for a baby are really in a position to make an informed choice, and I have to say, when they are not given the full information when they do come to you in your clinic.
Mr.TARANISSI: Why do you say vulnerable? In my experience is different from that I think that a lot of the people that we see, I cannot really describe as vulnerable, because a lot of the people that we see here who have failed repeatedly elsewhere, are very well informed, in this day and age with the internet and all the amount of information that is out there. I think I would say most people are very well aware of the current status of most medication and most treatment. And again it's a very easy way to say that people use vulnerable patients and so on, I don't accept this because that's not true.
KATE SILVERTON: Yes but they are not going to be as objective and questioning why it is¿and when the success rates of your clinic are linked to the success rates of this therapy.
Mr. TARANISSI: I've always tried to put it in a very simple way to people, if you're going to be successful you need two things. You need good embryos and you need equally what we describe as a good environment. One without the other, you don't go very far. And that's a problem not just for the patients, it's a problem for the medical profession because if you go to most IVF units the main focus is how they respond and how they produce the most embryos and so on. You may produce very good embryos and have extra embryos to freeze when you try again. To me this is wasting very good embryos without addressing implantation issues, your success rate is always going to be behind. That's my theory anyway.
KATE SILVERTON: My concern, as an objective observer is do you have proof that there are going to be no long-term negative impacts on the unborn child as a result of these therapies, because this is not a scientifically proven treatment.
Mr. TARANISSI: It is not, but you can say the same about IVF, IVF until today¿
KATE SILVERTON: But that's not the point.
Mr.TARANISSI: It is.
KATE SILVERTON: No but two wrongs do not make a right.
Mr. TARANISSI: You think IVF is wrong.
KATE SILVERTON: Are you, if your talking in terms of treatments that are validated in that way we are specifically talking about a treatment here that could potentially cause harm to that unborn child, you don't know that so. I don't understand how you are not worried that you carry out these treatments when there is that potential.
Mr. TARANISSI: We are worried but potentially anything that you do or drug can be seen in ten years or twenty years as having unknown problems. If we want to think like this.
KATE SILVERTON: You are worried though?
Mr. TARANISSI: I am of course, but let me just tell you one thing. I mean we try and put all this information as clear as possible to people.
KATE SILVERTON: But they are trusting you Mr Taranissi, they are trusting you.
Mr. TARANISSI: I know, I know.
KATE SILVERTON: ¿To really make these decisions. You are telling them that the treatment works. They are going to accept it, if you are worried I don't know how you can continue to treat patients on that basis?
Mr. TARANISSI: Actually this is part of the consent form that they all sign, before having the treatment so all the potential issues are explained in black and white, as far as I am concerned.
KATE SILVERTON: But they are not, I have to tell you. We'll get onto the patients, patients that are coming to you. It is a complicated subject, at the very least, that's why we have the debate ongoing, so how can your patients really make an informed choice.
Mr. TARANISSI: Well as I said you need explain to them the potential options, the current state of knowledge about everyone and tell them what we believe is going to work for them based on our experience. That's all that I can say. And actually most people that tell you that it doesn't work I don't think they have any experience in it. I've never actually been asked by anybody to say OK what is your experience with this drug, what do you think should be done.
KATE SILVERTON: Well why not publish your results?
Mr. TARANISSI: We will.
KATE SILVERTON: When?
Mr. TARANISSI: Very soon, but I mean there is already published results in the literature. I can actually give you reports from Jan 2005 about the particular use of IVF and its very clear that it does actually work in repeated¿
KATE SILVERTON: In reports and reports¿again we are based on evidenced medicine in the UK, there have been no clinical trials of this treatment, that's what it comes down to.
Mr. TARANISSI: Well let me tell you one thing, the clinical trials in those kind of situations is very difficult to do, for a particular reason. Most people will come wanting to this treatment who have failed repeatedly before. If they know that there is a drug that repeatedly can give them a chance they don't want to take part in a randomised trial, if they are in the arm that doesn't take any drugs¿
KATE SILVERTON: That's not really a good enough reason¿
Mr. TARANISSI: No I'm just trying to tell you, I know people who have tried to do these clinical trials with a budget of $2m in a year they have never managed to recruit anything less than 12 patients. So there are a lot of difficulties in trying to establish the clinical trials that can tell you categorically one way or the other. Plus, let me just finish, in IVF there are so many variables that can actually make a difference to the outcome at the end of the day. You can give IVIG because they've got implantation problems, the IVIG might work, the environment may be good if you produce 9 good embryos at the end of the day for whatever reason the patient is not going to get pregnant, this doesn't mean that the IVIG treatment has failed. It hasn't failed, it might have actually worked to produce what it is supposed to do. You still need to work on the other variables, that's very difficult to achieve.
KATE SILVERTON: My concern comes back to, and its very simple, you've accepted that you would be very worried about the long term affects and potentially long term impacts. And people watching are saying "well how can I trust that this treatment is not going to potentially harm my baby. I might be desperate for a child, I might have come to you after a number of times of trying but if you can't guarantee that this is a scientifically proven treatment, why on earth should I¿
Mr. TARANISSI: Well let me just tell you, can you guarantee patients having IVF they may not develop something like ovarian cancer in the future or anything like that? Can any doctor say that?
KATE SILVERTON: Well that's the worry isn't it?
Mr. TARANISSI: Fine, but it doesn't stop me doing IVF.
KATE SILVERTON: Well you would support more research, I mean do you think the GMC should investigate reproductive immunology...
Mr. TARANISSI: I don't know I mean.. that's another point if people tell you¿if they truly believe this is something harmful to patients and stuff like that, they are in a position to say that shouldn't happen in the country. So it's their responsibility if they really believe that it is harmful and black and white then fine then we will follow the rules.
KATE SILVERTON: So you would welcome an investigation, if the GMC said they would investigate it?
Mr. TARANISSI: Well fine then we will just have to go about what is actually the medical regulation in the country I have my own views about number of embryos and stuff like that, but ok we still have to work within what is the rules of the country.
KATE SILVERTON: You're a fellow of the RCOG; the Royal College of Obstetricians and Gynaecologists says there's no good scientific evidence and I'm just quoting here "there's no good scientific evidence to support the idea that reproductive failure is due to immunological abnormalities". You're a fellow of the RCOG and I'm wondering why you continue to treat your patients with something they say has no real scientific validity.
Mr. TARANISSI: Well if you, if you look at this report, this report is dated 2003, we are now in 2007¿
KATE SILVERTON: There have been more recent reports.
Mr. TARANISSI: No there haven't been. The, the report you're referring to is one that was published in 2003. It's already four years old. There's a lot of things that have changed over that time. It is due for review anyway and as I referred to¿to you before I think there are studies now in the literature that may challenge this view.
KATE SILVERTON: But not within the UK. I'm just wondering again if you believe so strongly that it works despite your worries as you've said, why not publish your results? Why not open it up to debate and in fact do a clinical trial yourself?
Mr. TARANISSI: Well I mean our results speak for themselves anyway. I'm just trying to say you wouldn't rely on one set of results coming from one sort of place. This is¿
KATE SILVERTON: Make a start by publishing¿
Mr. TARANISSI: Yes I know but there is already, there is already a lot studies in the literature. So it's not that it's never happened before. There are already studies that are published that would show, that would tell you that this treatment does work. It, it's already there. So I, I don't see wh¿.wh¿.they're not just waiting for me to publish results because it's already there and this is how I actually started using, by looking at the work of other people¿
KATE SILVERTON: But again that's not good enough Mr Tarinnisi you know we have no gold standard for this. This is a potentially very dangerous drug treatment¿
Mr. TARANISSI: It is not.
KATE SILVERTON: Of which¿
Mr. TARANISSI: No it isn't.
KATE SILVERTON:¿.many experts¿
Mr. TARANISSI: It is not. It is not. Because it is a drug that is actually available and it's used for all sorts of other reasons. It's not that it is something¿
KATE SILVERTON: Medication that is in desperate need not, we're not¿.there has been nothing that's done that's looked at the impact, potential impact on the unborn child¿
Mr. TARANISSI: No, I, I disagree with that because the, the evidence that is in the literature, particularly recent evidence actually show that it does work. I mean you can choose to, to pick and choose what evidence you want to rely on.
KATE SILVERTON: But the point though is that you're risking your reputation really by being so controv¿ you are risking your reputation by not¿
Mr. TARANISSI: I don't think so.
KATE SILVERTON:¿.being part of or helping to conduct clinical trials.
Mr. TARANISSI: I don't think so. I mean nobody has stopped the other people for conducting clinical trials. If they truly believe it doesn't work I mean they can do the clinical trials themselves. I mean¿.they, a lot of people are in a position to do that. So I'm not stopping anybody, I'm just reflecting on my own experience and I'm also reflecting on the experience that we draw from, from other people's experience in the medical literature. So it's not something unheard of or nobody has ever done. It is there. So to try and say that it, it's, it's completely alien to, to medicine and nobody has ever done it, I think it's, it's an exaggeration and twisting of the facts. I think that's, that's what it is.
KATE SILVERTON: Well I mean o¿other experts who, who would¿.if¿if you look at for example, the blood tests that are carried out; I'm just wondering why they're carried out in the way that they are and why they're sent off to Chicago necessarily which is again, when the tests come back they're not approved by the FDA? Why?
Mr. TARANISSI: I mean ah¿..ah¿.you don't need to have a lot of things approved by the FDA because th¿.that's again show that people are, do not understand how this works. I mean you don't need to have a test approved by the FDA. It's actually written very clearly on, on the sheet; that this is the status of the test, so it's not a, a requisite or a requirement.
KATE SILVERTON: Do you accept that there is sufficient doubt¿.over this treatment that, why should you continue to carry out until we have sufficient evidence to show its efficacy?
Mr. TARANISSI: Well I mean if, if we apply this to people who've had babies out of this treatment there would be hundreds of babies that have, that'd never been born as a result of that.
KATE SILVERTON: But you don't know what the long term impact on them is going to be.
Mr. TARANISSI: Well you can say this about a lot of other things including the standard IVF, including standard [HG?], including all sorts of procedures that are well established and people do them without b¿blinking. I believe in it. It works in our set up. It has given a lot of patients their babies and I'm sure, I mean they will be watching this and listening to this, looking at their children running round them and they know what I mean.
KATE SILVERTON: But if there's a seed of doubt that that might have caused potential harm to their children, is belief enough?
Mr. TARANISSI: Yeah but¿.ah¿there is a seed of doubt about everything. If you really want to doubt anything you can always find some items about that. I don't think this really good enough. There is, you'll never be a hundred percent sure about anything. That's, that's, that's a fact of life.
KATE SILVERTON: How many of your patients don't have immune therapy.
Mr. TARANISSI: I would say it's, it's something that is on the increase because the nature of the patients that we get here, I would say eighty percent if not ninety percent of the people that we get here are people who have repeated failures elsewhere and this is by definition one of the main indications for this kind of treatment. So¿
KATE SILVERTON: What eighty percent, ninety percent have the treatment?
Mr. TARANISSI: Possibly, I mean eighty percent maybe if we think that it applies in a certain situation then yes, it is.
KATE SILVERTON: Ah¿..ah¿.coming right at you on that, if it's eighty percent to ninety percent, the only way to have real¿you've spoken about the [unclear] of other treatments, then the only way to have progress in the whole IVF arena is to have more clinical trials. I'm still stuck on this issue of why you don't feel it's necessary.
Mr. TARANISSI: I, I didn't say I don't feel it's necessary. I'm just saying ok¿.it can be done but it's hard to recruit patients for those kind of trials because most people would like to have a result today.
KATE SILVERTON: I'm sure you'd have people lining up outside the door wouldn't you?
Mr. TARANISSI: No, no I, I've given you an example of a situation that I'm well aware of when there was the budget, there was the intent and, and they couldn't recruit patients because if you were a patient today and we believe that you might benefit from this treatment would you actually prefer having the treatment or being part of a clinical trial that may actually in five or six years down the line show that ok, this treatment is working, it's too late for you because you're getting older, you don't have the right embryos, which, which way are you going to go?
KATE SILVERTON: I prefer not to be experimented on, outside the realms of a clinical trial.
Mr. TARANISSI: Fine that maybe your choice but I mean there are other people when they, with this knowledge they prefer to do something different. So¿
KATE SILVERTON: But are they fully and sufficiently informed of the potential dangers?
Mr. TARANISSI: Well I'm sure they are because as I said to you, it's, it's not something that is just happening in, in here or, or, or in this country: it does happen in other places as well.
KATE SILVERTON: I know but within your clinic, when they come to you they want to know and be presented with the full risks and if we turn to the patients specifics we have ah Melody Cole, I know you're aware of the, her patient history, um¿.she was not given sufficient ah information¿ah sorry, Catherine Simmonds we'll start with, she was not given sufficient information about the potential dangers of this treatment. She was told one thing, that there may be a chance of anaphylactic shock.
Mr. TARANISSI: Well I mean it's very difficult for me to comment because I kept asking your people, I need to see exactly what you have in terms of the records of her consultation. You cannot actually pick and choose a sentence out of a conversation that could have lasted for forty, forty five minutes or an hour¿
KATE SILVERTON: Well we would have put that into context of course.
Mr. TARANISSI: Well but that's what I'm saying, I mean I¿I¿.I, I don't understand what was the problem in showing us the whole consultation so that we can try and make an assessment of whatever was said or not said in the full consultation. We have nothing to hide. Obviously Panorama has something to hide because I don't see why they cannot show us this.
KATE SILVERTON: W¿well it doesn't have something to hide but¿.
Mr. TARANISSI: Well that's what I don't understand, what is the problem? Why can't you actually give us the tape or the film so that we can look at it and we can try and make an assessment of whatever was said in its context? But to try and choose one word out of a, an hour consultation¿
KATE SILVERTON: It's journalistically we would be fair, we would not be picking one word out of¿
Mr. TARANISSI: Well I¿.I¿
KATE SILVERTON: It's within context we had seen the full¿
Mr. TARANISSI: Well I have to take your word for that. Well, I mean as I said I¿if you're accusing me or accusing people in this clinic of things I don't see what is the harm in showing us the evidence and give us the fair opportunity to respond? but you've chosen not to do this despite several requests. So there must be a reason.
KATE SILVERTON: Well no it's probably just...
Mr. TARANISSI: Well, well it doesn't make sense.
KATE SILVERTON: Well le¿.let's take it through and see what you can comment on. Catherine Simmonds, she was twenty six, she presented to your clinic with no history of fertility problems, she'd been trying to conceive she said for twelve months. She left the clinic last December having been told she would begin a cycle of IVF with IVIG and dexamethasone in January of this year. Now that treatment plan would have cost her over twelve and a half ah¿.
Mr. TARANISSI: Again¿.
KATE SILVERTON: ¿thousand pounds.
Mr. TARANISSI: Again you say you're not presenting things out of context but you are. This is exactly what you've just done. I've looked at the notes myself. I didn't see her. I think there was many options that had been discussed with her including simple options and trying with¿simple stimulation and trying either regular intercourse (?)
KATE SILVERTON: But she shouldn't have even had any of that at all¿..
Mr. TARANISSI: I mean I'm just trying to say¿.
KATE SILVERTON: she should have just been sent home to try again.
Mr. TARANISSI: No, no, I, I mean for me to make any kind of fair comment I need to see the context in which this kind of recommendation was made to her because that's not my understanding of how we operate here. If there is something that I'm not aware of it, I need to see it. You've got the evidence and I don't see why you, you've chosen to withhold this evidence from us.
KATE SILVERTON: No but you've accepted, you, you've seen the treatment that she was offered.
Mr. TARANISSI: No, in fact¿
KATE SILVERTON: But you¿you've just said that, that you've accepted that you've seen the treatment she was offered.
Mr. TARANISSI: No, no, no, no, let me, let me¿.
KATE SILVERTON: She shouldn't have been o¿offered any treatment at all, that's the point.
Mr. TARANISSI: But she, she might have not been offered. She might have not been offered. You're putting it as it's, there is a difference between offering something and insisting that this is the only way for treatment and so on and there is¿.patients sometimes who decide to do something that ok, it may wait for a month or a year or whatever, there's a big difference between the two situations and that's why it's very, very difficult for us to make any kind of fair comment without seeing it in context. I go to my point again, I cannot still understand what was the reason for not actually showing us the full consultation. So that I can make and I'm quite happy to do this right now, if you have this now, show me the evidence and I'll sit and I'll actually explain it to you. So if you can show me this right now, I'm not trying not to s¿answer the question but I need to know the facts. You should not have an extract¿.
KATE SILVERTON: It's the simple fact though is, that we had a young, healthy woman with no medical problems, fertility problems, she was twenty six¿.
Mr. TARANISSI: Well, that, that's incorrect.
KATE SILVERTON: Well she, she should have been sent home to be, told to try again. Surely, that is the industry standard, that a young woman of her age¿
Mr. TARANISSI: No¿
KATE SILVERTON:¿would have got pregnant naturally¿
Mr.TARANISSI: Are you, are you saying that, just that, that, that the judgement of how, how people may or may not get pregnant is just by age? Then if this was as simple as that then she really ...
KATE SILVERTON: She presented with a healthy¿
Mr. TARANISSI: But I mean the fact that she presented here means that she's got a problem. I mean she didn't just walk out of the street because she was passing by the ARGC, that's what I'm just trying to say; she must have realised that there is something.
KATE SILVERTON: What because she had been trying for a year? Not everyone is sufficiently informed to know that ninety five percent of young women will conceive within two years.
Mr. TARANISSI: Ok what about the five percent that may not conceive?
KATE SILVERTON: Absolutely.
Mr. TARANISSI: Fine.
KATE SILVERTON: So this young lady was put almost immediately on a cycle of IVF.
Mr. TARANISSI: No, that's not¿.
KATE SILVERTON: Without¿.
Mr. TARANISSI: Through the notes she was going, she was explained all the options and whether she can try naturally or she have simple stimulation or she can have this and she have¿.so all the options had been discussed with her. She, I assume from just reading between the notes, a¿asked for an explanation about extra tests and stuff like that. She was given this explanation. It was not something that was initiated by us.
KATE SILVERTON: But is it not the clinic¿.clinician's responsibility not to allow that to happen in terms that I'm sure you get a lot of women through your door who are desperate to have a baby now and quite frankly it's not always in their best interests. So if you're putting your patients¿ first and foremost¿.
Mr. TARANISSI: We are, we are of course. Are you¿.ah¿let's just be clear about this; are you accusing us of not taking the best interests of patients at heart? Well just answer me¿
KATE SILVERTON: No, I, I'm just wondering how¿.
Mr. TARANISSI: No, no, no, just answer me yes or no¿
KATE SILVERTON: Well I'm, I'm just wondering how a twenty six year old woman who entered your clinic as a healthy twenty six year old with no medical history¿.can walk away three weeks later already beginning a course, giving her blood¿.
Mr. TARANISSI: Medical history is not sort of related to infertility. You don't need to have a medical history to be infertile. I mean you can be healthy as far as your, your medical health is concerned but you can still have problems to do with infertility, so the two don't go hand in hand. So again I'm not quite sure¿
KATE SILVERTON: You've set an accelerated path though on, on her way. Instead of having a few simple tests that she was on her path to, to spending over twelve and a half thousand pounds in treatment.
Mr. TARANISSI: I don't know, where did you come with this figure? Twelve and a half thousand pounds, did she actually have the treatment?
KATE SILVERTON: This, well this was what was quoted, the treatment plan.
Mr. TARANISSI: Well I mean I, I don't know. I mean obviously as I said, you show me the evidence, let me have a look at it so that I can actually try and, and respond to you in context.
KATE SILVERTON: She was also told by one of your doctors that having a hysteroscopy could cleanse the lining of her womb.
Mr. TARANISSI: Yeah?
KATE SILVERTON: Do you accept that was misleading?
Mr. TARANISSI: I don't think it is misleading because if you look again at the medical literature I mean it, it is f¿a known fact and there are actually scientific papers that have looked at that. It is something that could be associated with improved implantation¿success after a hysteroscopy people even having laparoscopy [histrosurpangography]. I mean there's no clear explanation. I mean one of the things that can be put as an explanation is the fact that this can actually clean things inside the cavity or the tubes sometimes might be blocked and this can just flush them out. It's not something that is, is unheard of and I, I think a lot of people would, would have mentioned this to you.
KATE SILVERTON: Well actually the expert I spoke to because I was puzzled by that said it didn't make any sense at alout. It's not something that is, is unheard of and I, I think a lot of people would, would have mentioned this to you.
KATE SILVERTON: Well actually the expert I spoke to because I was puzzled by that said it didn't make any sense at all.
Mr. TARANISSI: Well you choose to believe whichever you want to believe. Medical opinion differs from one place to another. If everybody agree on everything then you wouldn't need to have a second opinion or third opinion so it's up to you.
KATE SILVERTON: Well, Melody Cole - I take your concerns into account, presented at your clinic having been trying to conceive for 7 years¿2 failed IVF cycles with her own eggs. She wanted your clinic to give her another IVF cycle. She was eventually told by your clinicians that there could be up to a 7% chance of her conceiving with her own eggs.
Mr. TARANISSI: Well again it's very difficult for me to respond to any of this because I need to see exactly what was said and in what ...
KATE SILVERTON: Well we can show you that it their on tapes.
Mr. TARANISSI: Well you need to show me everything. I can tell you people at this age their chances of success are very small and I have looked at you're notes and it was recorded that it was explained about the low chance of success, but for the individual things can be completely different.
KATE SILVERTON: Do you accept that could have been misleading, that 7% is much higher.
Mr. TARANISSI: But I don't know in what context, but everything here is much higher, so I don't know. She might have been somebody that might have good response, she might produce good embryos, and she might have testing of the embryos with chromos [unsure] might put her in a different category¿
KATE SILVERTON: But at that point, nobody knew so it gave her false hope.
Mr. TARANISSI: But that's what I'm trying to say that I haven't seen what was happening in the conversation, and this is again trying to put things in a certain light.
KATE SILVERTON: I understand that, I understand that but in terms of what is on the tape we had a 1% chance leaping to a 7% chance. If you were talking about a 45 year old, who as you say, somebody who has walked into your clinic, surely they are going to accept that, that they are going to grasp onto that, that great white hope¿
Mr. TARANISSI: Well I don't know¿
KATE SILVERTON: And go down that path.
Mr. TARANISSI: Well it's very difficult for me to comment, I have to go back to what I said earlier. There is a solution to this, responsible journalism as you call it, put the evidence to me, let me listen to it. I can ask the doctors who've told her and what the idea was and so on and then we can respond to you, but you have chosen not to give us this. So you can not just keep on asking me the questions because you have given me what you have chosen to give me.
KATE SILVERTON: Hmmm. Ok but 7% chance just to focus on that, its there on tape, you'll see it. According to accepted official data she has a 1-2% chance of conceiving with her own eggs, why was she not properly counselled about that?
Mr. TARANISSI: Well counselling is something you offer to all patients in the initial package that we send to them. So they are already aware of it. Secondly you say yourself this patient had 2 failed IVF cycles before so I assume she would have been offered the same counselling in previous attempts, thirdly if she goes through the treatment, which she didn't because she didn't have treatment here, there would have been another opportunity here maybe to talk about that. As far as I can see from her notes, all the issues about success rates, miscarriage RATES, even [indistinct] was discussed with her, that's what I can see from her notes. It would have been far better if you want me to answer specific questions to give me the whole history, but you have chosen not to do that.
KATE SILVERTON: Just to return to that 0% cancellation rate in terms of, as you say there is debate about your treatment, they are controversial there is debate which will continue in that respect. In terms of figures, the patients that come here, will come here as a result of you being top of the table, as it were. If you have a 0% cancellation rate¿
Mr. TARANISSI: which I told you we didn't ¿
KATE SILVERTON Well.
Mr. TARANISSI Well you keep going back to that.
KATE SILVERTONWell I am puzzled as to why the HFEA would publish something that you had told them was wrong
Mr TARANISSI That's what I'm telling you, you can just go and check it with the HFEA. They have got the emails and, and I don't want to mention the name of the girl that we had the conversation with, but it is a fact. Because you have got something in mind you don't want to believe something I am saying
KATE SILVERTON I will accept what you say¿
Mr. TARANISSI You're not accepting it
KATE SILVERTON: If you're willing to show me, I'm just clarifying something, I'm just puzzled about the HFEA because you're passing the buck to the HFEA to say what they have done is to publish incorrect data
Mr TARANISSI:It is, because that's what it is, I'm telling you on camera that this is what it is, it's as simple as that so, you want to go and verify this, your most welcome. It is a fact, and we have the correspondence to say that.. and I have mention that if you are so keen on this you can look at the HFEA web site and you can there are other clinics in that reporting who had a similar pattern. But that didn't seem to raise any suspicion because it is another clinic.
KATE SILVERTON: Why put yourself through all this, you want to get on with your job in giving women babies¿
Mr TARANISSI: But that is what I am doing
KATE SILVERTON: But you're getting caught up in controversy over paperwork, over late reporting figures, over ending up with both clinics way at the bottom of the non-compliance tables. Why not get that sorted, operate within the boundaries
Mr TARANISSI: We are operating within the boundaries, because we are still operating, it's as simple as that
KATE SILVERTON: But the RGI isn't
Mr TARANISSI: I explained to you the reason, I was offered the licence
KATE SILVERTON: You explained the legal reasons, why have all of that, why not get better administrators and get on with your work
Mr TARANISSI: Its nothing to do with administrators, I think it's a legal argument based on a dispute between the HFEA about the interpretation of the HFEA act. It can happen at any time, you can stretch it to extremes if you want to, you can be sensible and try and move forward because the real issue that should be in the mind of everybody is the safety of the patient and the quality of the service that they get¿
KATE SILVERTON: absolutely, which is why you should not have been operating within a clinic¿
Mr TARANISSI: No, there have never been any issues with that's what I keep telling you, there have never been any issues about patient safety or laboratory issues or anything like that.
KATE SILVERTON: Perhaps not, but that was because they were obstructed every which way trying to audit and inspect your clinics
Mr. TARANISSI: that's your word, there is no real evidence of that, as I said you have chosen to look at one piece of documentation, which again I am a bit puzzled by, because it doesn't seem to appear under the FOI act logbook of the HFEA. So I don't know who gave it to you¿
KATE SILVERTON: Well it was published under the FOI Act.
Mr TARANISSI: Its not because if you go and look¿let me just finish¿if you look at the HFEA log book, which is on the web site, this particular document does not appear anywhere¿so somebody must have given you part information, we have responded to this, our response is there, I'm going to give it to you today, so you can maybe read it, then you can understand that its not exactly the picture put to you by this inspection report. It's not true, it's not true.
Mr TARANISSI: Well you were just talking about responsible journalism and stuff like that, I am aware that you have sent patients here that you did not disclose to us Because they didn't get the message that you wanted to bring across because they were not offered any of these treatments, they walked away without any of the other stuff and that's not what you wanted and I have got there notes here, in front of me. So if this was responsible journalism, you have a responsibility to put both sides, together. It also puzzles me t6aht you seem to be trying to portray an image of this clinic based on the experience of two patients that didn't actually have treatment here.
KATE SILVERTON: well it's not just based on that
Mr TARANISSI: Let me just finish¿you must be well aware that having worked since 1995 in this country there will be hundreds and thousands of patients who can give you a better reflection of the quality of service that happens here, you have chosen to ignore that for whatever reason¿
KATE SILVERTON: Well we have chosen to focus about the complaints about your clinic to be fare.
Mr TARANISSI: Fine, but what I'm just trying to say if you want to give a balanced picture you need to see both sides
KATE SILVERTON: We have of course stressed that there have been a lot of patients who have been happy but equally there have been a lot of patients that have been very unhappy with the treatment they have received.
Mr TARANISSI: But you can't make everybody happy, that's just the way of life. I don't think, you'll be looking at an impossible situation if you think that everybody who was going to walk though the doors in any place albeit here or anywhere else will always be full of praise, it does not work it does not exist it will never exist¿but you have responsibility as a responsible journalist if you want to really cover the subject you need to put both sides and both views, which you haven't. and as I say I have info that you have sent undercover patients that you did not use in this programme, you didn't tell me about them, because it didn't get you the message you wanted to portray about this clinic and to me that is very irresponsible.
KATE SILVERTON: Thank You