A case that undermines confidence in the NHS and the medical profession

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The case of the disgraced former gynaecologist Richard Neale is one of the more disturbing in the annals of medical incompetence. In July 2000 the General Medical Council found him guilty of ruining the lives of 13 women. He did operations without consent and carried out botched and unnecessary surgery, leaving patients disfigured, in constant pain and unable to have children. Of 35 charges against him, 34 were found proved.

The GMC only heard complaints from 14 British women – one of which was dismissed. More than 60 had claimed to have suffered at his hands, and it is thought more than 200 could have been affected. As well as messing up operations, Neale bullied patients into paying to go private and flew into a rage if they questioned his methods. He lied about his CV. And all this after having fled Canada, where he had been struck off following the deaths of two patients.

Yet incredibly, despite this track record, Mr Neale was offered a job in August last year by the South Manchester and Wythenshawe NHS Hospital Trust. It may not have been a front-line position in medical practice, but it was a job that was far too close to the clinical work of the hospital for comfort. Mr Neale was thought a fit and proper person to be appointed clinical audit officer in cardiology at the Wythenshawe Hospital, a particularly bad choice of role given that it was failures of professional supervision that had allowed him to go about his malign business for so long.

Mr Neale completed his contract in April. The fact that he was given this job having been struck off is a frightening indictment of the lack of adequate checks and controls on the employment of staff in the NHS. What's more, in the course of an extraordinary interview on the Today programme yesterday, Mr Neale declared that he had made his history known to the medical authorities in the course of his interview for the job, but that, after a delay, they employed him anyway.

That tells us a good deal about the smug "protect your own" ethos of the medical profession that all too often puts the vital interests of the patient behind the prestige of the profession. Indeed, Mr Neale's chutzpah is so outrageous that he declared "patients should have no fears about my activities" and seemed to be asking for sympathy when he claimed that it would be a waste of his "talents" if he wasn't given a job by the trust. He pleaded that he was still having nightmares about his experiences.

This dreadful egotist has not rehabilitated himself, and the continued indulgence shown by the medical authorities has almost certainly put back that moment of Damascene self-awareness. Mr Neale, and those like him, should be given an opportunity to make a living and to make amends as best they can for their misdemeanours, but this does not mean they should be welcomed back into the health service. This doctor betrayed his patients in the most appalling and fundamental manner, ruining the lives of many of them, and it is extraordinary that the health service appears to believe that the right way to rehabilitate him is to find him a cushy job behind a desk.

There is, of course, everything to be said for forgiveness. However, in the case of Richard Neale, the milk of human kindness may have run to excess. This is certainly not a tale that inspires confidence in the quality of NHS management, the self-regulation of medical miscreants or the attitudes of the profession. It is not just Mr Neale who should have a guilty conscience.

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