Dying nurse vents anger over NHS secrecy

For Debbie Westwick, the future is bleak. “I’m dying,” she says. Before her cancer kills her, however, she has one last battle to fight.

The 49-year-old nurse is campaigning against secrecy in the medical profession that allows doctors under sanctions by the General Medical Council or suspected of serious failings to continue working without their patients knowing of their alleged faults.It happened in Westwick’s case. She was told in 2006 that she had breast cancer; she now has tumours on her spine, skull, hips and bones. A punishing regime of chemotherapy and radiotherapy can extend her life but not save it.

She did not know that Howard Smedley, the oncologist treating her at the Kent and Canterbury hospital, had been made subject to supervision by the GMC for reasons that it will not disclose.

Midway through her treatment David Jackson, the surgeon who operated on her, was suspended and subsequently sacked. Again, Westwick was unaware of any doubts about his work. Jackson is now suspended from the medical register and faces GMC charges dating back to 1989.

Nobody can say the outcome for Westwick would have been any different had she known of the doubts about the two doctors leading her treatment. But she won £155,000 in damages from the hospital trust in 2009 because of failures in her care.

“I don’t want this to be a sob story,” she said last week at her home in Harbledown, near Canterbury. “It’s not really event about me. It’s about the way in which we don’t know the trust about our doctors.”

There are 818 doctors working in the UK who are subject to supervisory undertakings or conditions demanded by the GMC. A further 400 have been suspended while investigations take place.

Undertakings are voluntary agreements between the doctors and the GMC, whereas conditions are imposed, often by an interim orders panel, which is part of the GMC’s disciplinary procedure.

The results are usually the same: the doctors are supervised by a colleague and have to report changes in their employment to the GMC. There may also be other requirements. Yet nobody is told why they have been imposed.

“It never occurred to me to look Mr Smedley up on the GMC register. Why would it? He was a consultant oncologist at the same hospital I worked at. I had no reason to doubt his work.”

Even if she had looked him up, she would have seen only that in October 2005 he gave undertakings to the GMC that involved supervision of his work. There was no record of the reason for his doing so.

The system of undertakings is often used where there are questions about a doctor’s health and the GMC says that in such instances they have a right to privacy. However, “health” is also used for doctors who have a drink or drugs problem.

The GMC said: “We do not disclose information about why a doctor’s practice is restricted if it relates to their health or if an investigation is ongoing.”

Records held by the GMC, and available to view online, show that Smedley was subject to undertakings given to the GMC between October 2005 and October 2008, during which time he was treating Westwick. From September 2010, he was then subject to further conditions imposed by an interim orders panel of the GMC.

Jackson is facing a total of 75 GMC charges involving 16 patients between 1989 and 2007. None relates to Westwick.

Westwick complained to the GMC about Smedley in August 2009 but he was not referred for a public hearing at a fitness-to-practise panel until last June. It is listed to start this June.

Smedley has applied for “voluntary erasure” which would have involved removing his name from the GMC register. The GMC has refused and will hold a full hearing. Smedley declined to comment.

Kent and Canterbury hospital said: “If we were concerned and were referring a doctor to the GMC we would do our own peer review and, if necessary, would restrict the doctor’s practice ourselves. But we would not publicise it because we have to protect the doctor unless they are found guilty.”

Niall Dickson, chief executive of the GMC, said: “Our priority is to protect our patients. Our procedures are designed to do this by making sure we stop unsafe doctors from practising … this year, we will continue to implement reforms of our fitness to practise procedures.”

Any reforms will probably be too late for Westwick. Not that that will lessen her resolve.

“Cancer victims are vulnerable,” she said. “You rely on your doctors to give you the best advice and appropriate care.

“You want someone on your side – you never think they might be hiding something about their own work from you.”

Published on Sunday, 1 April 2012 in the Sunday Times.

Reproduced here with the kind permission with the Sunday Times.

Nick Fairweather represents Debbie Westwick and others treated by Dr Smedley and Mr Jackson.