Mr. Tyler: May I, as I omitted to do so earlier, apologise for the absence of my hon. Friend the Member for Cheadle (Mrs. Calton), who had hoped to be here? [Hon. Members: She is behind you.] My hon. Friend has appeared. I now apologise for missing that fact.
The hon. Member for Broxbourne (Mrs. Roe) has just referred to the steering committee. I mentioned earlier that it was not clear to me, having read the report, whether there are Members of the Houseor members of her Committeeon the steering committee, or whether it is just an officer group.
Mrs. Roe: The group consists only of Officers, but of course they are accountable to the Administration Committee, so we shall consider carefully any proposals and recommendations that they make, and a case will have to be made for them. The membership of the steering group is listed in the report. They are very responsible Officers, and I am certain that any proposal that they make to the Administration Committee will have been thoroughly thought out.
I am grateful to the Minister for his support, as I said, and for his confirmation that any modernisation proposals will not interrupt a Line of Route programme and that times will not be reduced but merely rearranged.
I hope that the House will endorse the Committee's recommendations and allow the summer Line of Route to continue. The amazing reaction of visitors during the summers of 2000 and 2001, which, according to the visitor manager, is probably unrivalled by that of visitors to any other attraction in the country, points the way to the right decision, which is to acknowledge the success of the two trials and open the summer Line of Route to visitors on a permanent basis.
Mr. William Hague (Richmond, Yorks): I am grateful for the opportunity to raise a most important constituency matter on the Adjournment of the House. I am most grateful to Mr. Speaker for selecting the matter, as I know that he selects the subject to be raised on the Thursday Adjournment. For obvious reasons, it is a long time since I had the opportunity to raise a matter on the Adjournment of the House, and looking at the attendance for such debates, I think that this occasion will be much less noisy than those I was used to as Leader of the Opposition. I am grateful to the Under-Secretary of State for Health, the hon. Member for Pontefract and Castleford (Yvette Cooper), for being present to listen and respond to my remarks.
I want to talk about the case of the disgraced consultant, Mr. Richard Neale. It is a bizarre, tragic, deeply disturbing and utterly scandalous tale, and it will need briefly retelling in the course of my remarks, although it has become widely known. It is the story of a gynaecologist, Mr. Neale, who was struck off the medical register in Canada in 1985 because of serious incompetence after the death of two patients. He went on, despite warnings to this country from Canada, to practise in the Friarage hospital in Northallerton, which is the principal hospital in my constituency, for 10 years, leaving a trail of pain and sorrow behind him. He then went on, after being, in effect, dismissedin practice, he was paid offby that hospital, to practise in Leicester, the Isle of Wight and London, causing more pain and suffering to the women in his care, before finally being struck off for professional misconduct in the United Kingdom in July 2000, 15 years after he was struck off in Canada.
This is an extraordinary story. For the Department of Health, of course, it is an embarrassment. For the patients, whom we might more properly refer to as victims, it is a personal or family tragedy. For the House, it should be a vital matter to ensure that these things do not happen again. Some of the facts of the case have become widely known. They have been documented on the BBC programme "Panorama" and in The Northern Echo, a newspaper in the north of England. They have been documented by the action and support group for medical victims of Mr. Neale. I pay tribute to the people who formed that group, particularly Sheila Wright-Hogeland, who has been its inspiration. The decision of the General Medical Council to strike Mr. Neale off the register, albeit 15 years after he was struck off in Canada, was widely publicised at the time.
Some action has been taken; some procedures have been changed and, no doubt, some lessons have been learned. After many representations and requests, the Department of Health has established an investigation into what happened, although it was set out in a fairly low-key announcement last July, with carefully worked out terms of reference, which were set out in a Department of Health document to which I shall refer later.
I have a suspicion that the Minister will say in response to those thoughts that this is a tragic storyit isbut that it is not on the scale of the Bristol babies or the Shipman scandals and that we cannot have a public inquiry into everything. I suspect that she will put it more delicately than that, because it will be set out in a slightly more roundabout way in her brief, but that will be the gist of what she says. Those in the Department of Health may think that we cannot hold a public inquiry into everything that goes on.
I put it to the Minister that this is an almost uniquely chilling case because not only was serious harm done to unsuspecting patients over a long time, but warnings were given to some people, somewhere in Britain's health establishment. Some people working in the health service knew what was happening and how bad a doctor that man was, but nothing was done. So this case is different from many others, and it has not just come to light recently. For a long time someone, somewhere knew what was happening to women in the care of the health service in North Yorkshire and then elsewhere.
The people affected want to knowI want to know, as the Member of Parliament for many of themwhat really happened, and an inquiry into local services in a narrowly defined time frame with limited scope may well not be able to tell us all that we need to know about what happened or to ensure that every procedure has been put right and every precaution taken.
Let me develop this story in a little more detail; I am fortunate in having a little more time for this Adjournment debate than would normally be available. Let me make it clear that in no way is this related to current controversies about the national health service. The NHS is committed to openness. In its document on clinical neglect the Department calls for
Let me also make it clear that, in general, I have nothing but praise for the staff and management of the Friarage hospital, Northallerton. It is often short of resources, but it has many excellent consultants. What happened in this case is in no way representative of the service that my constituents generally receive from consultants in that hospital or of the management decisions taken by the local management of that hospitalbut it did happen, so we must face up to it.
Despite having been struck off the register in Canada, in 1985, incredibly, he was able to come to Britain and was employed as a consultant obstetrician and gynaecologist in Northallerton. His references were checked in what was described as the usual way and only later did it appear that there were inaccuracies in them, with the misrepresentation of the status of some of his referees. He did not declare his past record to the Yorkshire regional health authority, but no additional attempt was made to find out the truth about him and there was no automatic checking of his Canadian history.
What is far more alarming is the fact that no action was taken when his record began to come to light in 1986 and he was allowed to carry on practising. Dr. Andy Sear, a former friend of Neale in Canada, telephoned the GMC in Britain in 1985 or 1986 to warn about Neale and his record in Canada. In a statement, Dr. Sear said:
This is a very serious matter. At no time were patients warned about Neale's record. If they had been, of course, they would not have accepted treatment from him. Because no action was taken against Neale, he was also able to work at other, private hospitalsbased on a supposedly unblemished record at the Friarage hospital in Northallerton.
So the man went on. He even applied to go back on the register in Canada and he was again rejected in resounding terms. People there knew about this man. The Yorkshire regional health authority even provided him with a reference, saying that he was being promoted to chairman of the surgical division at Northallerton, but the Canadians turned him down. The discipline committee of the College of Physicians and Surgeons of Ontario issued a report in 1987 when he reapplied to the register in Canada, saying:
On the basis of deep-seated attitudinal and judgement problems, it was felt that Dr. Neale does not qualify for licence reinstatement."
In 1977, Neale so badly botched bladder surgery at the Shaftsbury hospital in London, where he was before going to Canada, that his patient is still undergoing intensive treatment and reconstructive surgery 25 years later. Neale told her that he would operate after he got back from a lunchtime drinking spree to celebrate his successful job application in Canada. A senior consultant later told the patient that Neale had "just ripped through everything" and torn apart several internal organs.
Neale discharged one patient from hospital prematurely in the face of strong protests from nursing staff. It transpired that the patient had a giant haematoma in her abdomen that caused her extreme pain such that she could not walk and had to crawl, even to the lavatory. Neale refused to re-admit her to hospital and insisted that she was "fine". The haematoma went untreated, became badly infected and ate into her bone, causing irreversible skeletal damage and permanent severe pain. She is now registered disabled. Another victim had the femoral nerve roots to her leg slashed as Neale performed a routine hysterectomy. She was left totally incontinent and unable to walk without the aid of two sticks.
That is just a glimpse of the medical incompetence of the man. The abuse that he also dished out to patients is almost beyond belief. A Jehovah's Witness who could not receive blood was near death after an operation, but Neale declined to order any blood substitute after he had promised to do so. After her husband offered to pay for it, he screamed across the bed over the fully conscious patient, "Can't you see she's dying anyway? It's not worth bothering to order the blood substitute. Either she'll be dead or she won't by the time it gets here." Such, apparently, is the conduct of the man.
Nurses have made statements saying that they knew how bad he was. One nurse of 27 years standing informed the action group for the medical victims that people were perfectly well aware of the clinical and surgical mayhem that he was causing at the Northallerton hospital, as well as being aware, from 1986, of his Canadian history. She said that the hospital insisted publicly that it knew of no clinical problems with Neale over the years, yet a gag order had been placed on all employees who were working with himthey were on pain of dismissal if they spoke openly about him.
The same type of statementagain harrowing readinghas been made by another nurse who worked with him at a private hospital, confirming his refusal to adhere to even the most basic hygiene procedures, pre-operatively or during surgery. She said that he never bothered to "identify structures" but "simply slashed through everything", often including vital organs. That has become the familiar story.
It is not a trivial matter, or even just a case of a problem doctor; the issue is more serious than that. After years of clinical negligence and incompetence Neale was finally dismissed in Northallerton on non-clinical grounds. Not being available when on call, bad treatment of junior staff, misrepresenting his role, false travel claims and appropriating NHS supplies for private practice eventually brought about his dismissal by the Friarage hospital. He was also arrested in 1991 and given a police caution after an incident in a public lavatory, behaviour that does not sit easily with being a respected medical consultant. Given that the case against Neale, later proven at the General Medical Council, showed negligence and incompetence dating back to 1986, and given that some people knew about it, it is not clear why no public authority was aware of that incompetence. It is unacceptable that he was not sacked for his conduct, both clinical and non-clinical.
Neale then received a pay-off and a reference from the Friarage hospital to shift the problem elsewhere, one of the most controversial aspects of the whole case. The former director of operations at the hospital told "Panorama":
Again, I must emphasise how serious this is. We have all heard of "kind" references about employees who are no longer wanted, but when it concerns a consultant gynaecologist with an appalling track record that many people knew about and who went on to practise on other patients, it is serious indeed. Neale went on to practise until a warning letter was sent out in June 1998 after publicity started to arise about the case.
In January 1998, a BBC North East documentary programme, "Close Up North", carried a story about Richard Neale. At the beginning of February 1998, the director of operations at Northallerton wrote to Professor Liam Donaldson, then regional director of the NHS for the north and Yorkshire, about Richard Neale's record in Canada and his dishonesty in the United Kingdom. It was five months later, in June 1998, before a warning letter was finally sent out around hospital trusts and authorities in the UK warning them about Richard Neale and advising them to consult urgently if they were proposing to employ him.
The story finally began to come out in public. In July 2000, the professional conduct committee of the GMC found Neale guilty of serious professional misconduct and directed his erasure from the register. They found him guilty of 34 out of 35 counts of serious professional misconduct. The president said that it was a shocking and disturbing case:
The case is tragic and extraordinary for hundreds of women and their families. It highlights many deficiencies in procedures and within the GMC. A doctor who should never have been allowed to practise in the UK was able to work unnoticed by the authorities for well over a decade, even though the truth about him was given to the authorities in various forms and at various stages while he was practising. I therefore believe that we need a more substantial, open and public inquiry than has been announced so far.