HIV surgeon is cleared to operate

Landmark decision by West Glasgow NHS Trust gives hope to infected health workers

A Glasgow surgeon yesterday became the first doctor in Britain infected with the HIV virus to be given the all-clear to resume surgical practice.

Professor George Browing, 55, an internationally renowned ear, nose and throat specialist, was given the news by his employers, the West Glasgow NHS Trust, following a year's deliberation and advice from an advisory body at the Department of Health. He said: "It's fantastic news. It seems like an awfully long wait for the decision, but now it's been made, I can get on with things. I'm in superb health and hopefully I've got a long career ahead of me."

Since going public with his HIV status nearly two years ago, Professor Browning has been restricted to a non-surgical role, conducting clinics and teaching at the Glasgow Royal Infirmary and at Gartnavel General Hospital.

He said: "The hospitals have quite lengthy waiting lists for the surgery I perform, so my return will help with that." He hopes to be back in theatre before Christmas.

Professor Browning specialises in problems of the middle ear and the type of surgery he will undertake is performed with long-handled instruments, where the surgeon is "remote" from the patient. He is now able to recommence five such otological procedures, which are deemed risk-free to patients by the Department of Health UK Advisory Panel for Health Care Workers Infected With Blood Born Viruses (UKAP), the expert body to whom he first appealed for advice about his case in October last year.

"Basically, I will be able to perform all forms of surgery that would help a patient's hearing," said Professor Browning. "If you look at the medical facts, there is no reason why I shouldn't go back. Patient fears are not grounded in fact, and it is my job to dispel such fears."

Precautions will be taken with tool-handling procedure, as well as normal procedure, to guarantee safety. He will also be subject to regular check- ups.

No British health worker has ever transmitted the HIV virus to a patient. According to International Disease control studies, there has only ever been one case of a patient being infected by a health worker, a Florida dentist who failed to take sufficient precuationary measures. There is much more likelihood of a health worker catching the virus because of exposure to patient blood.

Medical director of the West Glasgow NHS Trust, Dr Adam Bryson, said that all patients joining the waiting list for otological surgery will be asked if they object to having a surgeon who is HIV positive. "No one will be under any pressure to give their consent," he said. "However, I hope Professor Browning will be shown support by their choice."

No patients will be disadvantaged by opting not to be treated by Professor Browning.

Professor Browning, who is married with three grown-up children, is bisexual and believes he contracted the virus through gay sex. In December 1994, the press discovered that a surgeon in Glasgow had tested HIV positive and named the wrong doctor. Professor Browning made his condition public to avoid further confusion.

Since appealing to UKAP a year ago, he has been waiting while his employers, with whom the final decision rested, considered his case. The West Glasgow NHS Trust set up a special working committee to consider patient safety as well as medical, ethical and legal issues. The chairman of the Trust, Derek Mason, said: "As a provider of public health care services, our priority has been to handle our deliberations prudently and responsibly."

Nick Partridge, chief executive of the Terence Higgins Trust, welcomed the decision and said: "It is clear that Professor Browning presents no risk to his patients. This is a sensible and mature decision based on the reality of how HIV can be transmitted rather than on public and media hysteria."

By the end of 1995, there had been 25,635 reported cases of HIV infection in the UK. Yesterday's announcement will set a precedent in the UK for health workers rights. Professor Browning said that he hopes the decision would encourage other infected health workers to come forward without fear of discrimination.

"Equally, it means they have a precedent with lines of discussion as to what is and what is not safe for patients."

For employees who work in non-medical areas, the case may also be a landmark, leading to fewer barriers to employment, such as insurance costs to employers which are 200 to 300 per cent higher for infected workers.

Professor Browning said: "The issue is public knowledge, not HIV."