Doctors who abuse their patients

In December 2014, Dr Myles Bradbury, a Consultant Paedicatrian, was sentenced to 22 years imprisonment (reduced to 16 on appeal) for abusing 18 children at Addenbrookes Hospital in Cambridge. He would abuse his victims and secretly film what he did using a “spy pen”. Often the parents would be in the same room but behind a curtain. He was also found to have over 16,000 indecent child images. The exact number of his victims will never be known as he disposed of the hard drive on his computer.
The case is reminiscent of convicted breast surgeon Ian Paterson: in both cases patients regarded them as “God like” figures. We trust doctors; we have to. Sometimes they may have to touch us intimately to investigate an issue to make us better. We do not look at them in an intimate way and do not want to believe they could look us in a sexual way. This means it is very difficult for patients to speak out if there is any ambiguity in the doctor’s actions.

Many doctors often work alone and this may make it harder to pick up clues into inappropriate behaviour. This is especially so in the older hierarchical culture which is still prevalent today in some (not all) hospitals and which makes it harder to question doctors. Sex pests groom their victims and their environment to make detection harder. It is vital, therefore, that hospitals have systems in place to supervise their doctors. There were warning signs in Bradbury’s case which were not followed up. Was this due to a hierarchical approach? The most obvious failing was allowing Bradbury to see children without another health care professional present. Before April 2013 in cases of intimate examinations it was acceptable to have a parent present (inside not outside the curtain) but since then the offer of the presence of an independent health care professional such as a nurse must be made and this should all be recorded. It is possible for a doctor to falsify the notes but this would be more difficult in child cases.

The Harold Shipman Inquiries led to far ranging changes in the regulation and scrutiny of the medical profession by the General Medical Council. Doctors and staff have a duty by Good Medical Practice 2013 paragraph 25 to “take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised.”

This is backed up by specific Guidance: “Raising and Acting on Concerns about Patient Safety”, January 2012. Fellow doctors and nurses have a duty to speak up and if not heard have a duty to “go public”. The Francis Report led to the passing of the statutory duty of candour which again requires Trusts and doctors to alert patients to matters that have gone wrong. “Whistle blowers” are protected. It does take time to change a culture but as stated the older hierarchical approach is giving way to a more team-minded approach with voices being heard equally. Junior staff and nurses are encouraged to ask questions of more senior doctors and this should also be promoted in a more formal way.

Addenbrookes Hospital has already paid out substantial sums for Bradbury’s appalling assaults. This can never truly compensate for the life lasting mental trauma caused and it also diverts money away from proper patient care. Prevention is always better than cure.
Health Minister Jeremy Hunt MP has promised a Government Inquiry into how Paterson was able to practise in the way he did for years on end. Hopefully this will lead to even greater transparency and a resolve to apply the already existing duties in a more proactive way.