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12 noon

Mr. Barry Gardiner (Brent, North): The subject that I raise is by far the most distressing case with which I have had to deal since I became a Member of Parliament.

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One of the things that parents come to realise is just how intimately their own happiness is bound up with that of their children. Therefore, one of the things that parents dread is the diagnosis that their child has meningitis. The disease strikes fast and can be fatal, and I remember the pain of my own son and his fear as he submitted to a lumber puncture when he had meningitis five years ago.

My son is now 15, the same age that Wassan Khatib was in February this year. In February, her father wrote to me as follows:


Dr. Rapp advised Wassan's parents to give her sips of water and paracetamol. Mr. Khatib says that he had never seen a slight sore throat cause high fever and vomiting, but he accepted Dr. Rapp's professional opinion, as did his wife, and they did what they were told.

Wassan's condition continued to deteriorate in the afternoon and by 7 o'clock that evening, her parents had become sufficiently worried to call the emergency number at the Chalkhill health centre. They requested another doctor to make a house call to see Wassan. Dr. Chowdhury, a locum, arrived at about midnight--five hours later. By that time, Wassan's condition was very bad. Her father says:


Dr. Chowdhury asked Wassan about her condition and she told him that she had a severe headache, had been vomiting and that she was very disturbed by light. Dr. Chowdhury examined her chest and back using a stethoscope and visually examined her throat. Her parents advised Dr. Chowdhury of his colleague's diagnosis. Dr. Chowdhury diagnosed that Wassan had a migraine. Wassan had never complained of a migraine before, and her parents could not understand how that explained her vomiting. They asked Dr. Chowdhury to explain. His response was simple: "Oh, it happens."

Dr. Chowdhury gave Wassan's parents four capsules of solpadol, with a prescription for further tablets if required. Once again, Wassan's parents deferred their doubts in favour of the doctor's professional opinion. Solpadol is a

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strong painkiller and it alleviated some of the headache from which Wassan was suffering, and she slept for a few hours.

At 7.30 the following morning, Mr. and Mrs. Khatib checked on Wassan to discover that her body was covered with a rash and that she was extremely weak. She continued to vomit and have a high fever. They decided that she must go to hospital and told her to dress, only to find that she was unable to support her own body weight. They called an ambulance, and it took Wassan to Northwick Park hospital in my constituency. The parents were left in no doubt about the seriousness of the matter by the ambulance crew, who radioed ahead to tell those at the hospital to prepare an intensive care bed. That was seven hours after Dr. Chowdhury had told Mr. and Mrs. Khatib that Wassan had a migraine.

The staff at Northwick Park acted promptly and efficiently. A specialist unit at St. Mary's hospital was requested. Wassan arrived at Northwick Park at 10 o'clock in the morning and staff spent the next few hours attempting to stabilise her condition for the transfer to St Mary's. She was finally moved to St Mary's at about 3 o'clock. She survived at St Mary's for a further two hours before her fight for life ended at about 5 o'clock.

A formal complaint was submitted to the General Medical Council about the conduct of Dr. Rapp and Dr. Chowdhury. I obtained a copy of the medical notes of both doctors at the time of their examinations of Wassan. Dr. Rapp's notes were not contemporaneous; they were printed on a computer system on the Monday morning, the day after Wassan had died. They seemed to indicate a level of 20:20 hindsight at variance with Wassan's parents' recollection of Dr. Rapp's visit. Under the heading "Comments", Dr. Rapp recorded:


I believe that those notes are not a true record of Dr. Rapp's examination of Wassan. I believe that they were manufactured subsequently to protect Dr. Rapp against the repercussions of his failure properly to diagnose the disease that subsequently killed that young girl. Dr. Chowdhury's notes, which were contemporaneous, record no tests for photophobia, body rash, or any other classic symptom of meningitis. The diagnosis is simply: migraine.

What Mr. and Mrs. Khatib did not know when they wrote to me or when they registered the complaint--indeed, they do not know now--was that Dr. Chowdhury was already very well known to the General Medical Council. On 12 August 1994, Dr. Chowdhury was telephoned by a registered general nurse and asked to visit a seriously ill patient whom the nurse thought was dying. Dr. Chowdhury refused to attend the patient. On 9 September 1996, the national health service appeals authority had exhausted its complaints procedure and, owing to the seriousness of the case, submitted the complaint to the GMC.

It took a further one year and two months until, on 10 November 1997, the professional conduct committee of the GMC found Dr. Chowdhury guilty of "serious professional misconduct". At the conclusion of the proceedings, the chairman announced the committee's determination as follows:


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The House will note two extremely disturbing matters. First, Dr. Chowdhury continued to practise for three years and three months until he was finally found guilty of serious professional misconduct. Secondly, he was not suspended during that period. I ask the House to compare that with the complaints procedure that is applied to teachers, when anyone who is the subject of a complaint of serious professional misconduct is subject to an instant suspension from teaching duties pending an investigation. It is the same with the police force, as senior police officers have the power to suspend from service any officer accused of gross misconduct. The Government must examine why medical complaints take so long to determine and why doctors are so rarely suspended after the GMC has established that there is a prima facie case for the doctor to answer.

Sadly, the GMC's severe admonishment in November 1997 is not the sum total of complaints against Dr. Chowdhury. On 8 April 1998, less than six months later, Dr. Chowdhury began to sexually harass a patient. On 2 November 1998, that case too was brought to the GMC as a formal complaint. At this point, it might be thought that, with full knowledge of Dr. Chowdhury's disciplinary record, the GMC would act to suspend him. It did not do so. It did not even hold a preliminary proceedings committee until 9 September 1999, almost a year later. When it met, the committee still did not suspend the doctor, but referred the matter to the professional conduct committee, which did not meet for a further nine months until 2 June this year. On that occasion, it determined as follows:


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That was on 2 June this year. Wassan Khatib died on 6 February, after Dr. Chowdhury had failed to diagnose her as having meningitis.

The Government must review the procedure and the length of time taken whereby doctors can continue to practise for years until they are eventually the subject of disciplinary procedures. There must be a proper process for suspending doctors.

Mr. Khatib wrote:



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