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6 Jul 2005 : Column 125WH—continued

Dr. Ghosh

4.30 pm

Mr. Ronnie Campbell (Blyth Valley) (Lab): It is difficult dealing with doctors. I have been a coal miner all my life and have always been in trade unions, and dealing with miners is a lot better than dealing with doctors, I can tell you, Mr. O'Hara. They are always at each other's throats, that is for sure. I will demonstrate that later.

Basically, the argument between Dr. Ghosh and Northumberland primary care trust has been going on for some time. To give the background of how the situation developed, Dr. Ghosh was accused of sexual harassment last year. He was taken to the Crown court by the girl in question, an employee of his who had worked for him for six months, and he was tried by judge and jury. The jury unanimously found him not guilty. Of course, I recognise that the Crown court is, in some people's eyes, just a Mickey Mouse court.

The girl in question had done something similar to her previous boyfriend. She said that he had raped her. Again, that case went to the Crown court, but there was not enough evidence, so the judge threw it out. That was a few years ago, and the girl later did the same thing to Dr. Ghosh. Then, she decided to take the matter to an industrial tribunal. As hon. Members will know, in a tribunal, three sit on the panel and a solicitor is always one of them. The tribunal decided to err on the side of probability—it might have happened, so he lost the case.

Dr. Ghosh was suspended from the time he was charged until he was found not guilty by the Crown court. When the industrial tribunal's verdict was reached, he was immediately suspended again. The primary care trust decided to have an investigation into the matter. That has gone on for a long time. In the meantime, we have had trouble with locums who were not turning up for patients. Patients had to be turned away and came to my constituency surgery saying, "It's not good enough. What's happening with Dr. Ghosh?"

Dr. Ghosh believes that he has lost about 100 patients. People just got fed up. At this moment, and after a lot of pressure from me, we have a locum who is doing a fairly good job. I think that we are talking about a deliberate act by the primary care trust systematically to destroy Dr. Ghosh's practice.

So, Dr. Ghosh was suspended and there is an investigation, which has been going on for a long time. I accompanied Dr. Ghosh to an inquiry once. They brought in someone from Newcastle, a Pauline Fryer, head of corporate affairs at Newcastle primary care trust. I do not know what experience she has of investigations, but, if I have time, I might read some of the questions that Dr. Ghosh was asked. They are absolutely appalling. I do not know what they have to do with the charge. Quite honestly, I do not know which was the higher court—the tribunal, or the Crown court. He was not guilty in one, guilty in the other. In the eyes of the trust, he was guilty in any case.

Whatever happens here today, and whatever the Minister says to me, Dr. Ghosh will be sacked. His contract will be determined, and he will go, because we have it on good authority that the doctor who has taken over one of the practices is being told that he will get
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Dr. Ghosh's practice in due course. I did not know this before, but every doctor who practises has a code number. This new doctor is not even sitting in that practice yet, but I was told yesterday morning that he has Dr. Ghosh's code number. If that does not tell us something, what does? It seems to be game, set and match.

The solicitors who deal with doctors have, like me, been trying to get through to the trust. I have asked for meeting after meeting, until I had to write to the Under-Secretary of State for Health, my hon. Friend the Member for Don Valley (Caroline Flint) and say, "Look, these people won't see me, but I want to talk about this case." That went on for a long time, but only last week did Jim McKay, the chief executive, come to see me on the Friday morning. He came into my office and, lo and behold, said, "I can't talk about the case." "But I need to know," I replied, "I've got an Adjournment debate and I want to know your take on it." "I'm sorry," he said, "I can't talk about it." "So what are you doing here? If you can't talk about it, you'd better leave", I replied. So, it was a useless meeting. He came to see me only because he was forced to by the Minister, but he would not talk about the case. I thought, "Is this a court of law? Is there a law thing with these people in the trust? Is there something they can't discuss?" Why can they not discuss the case with a Member of Parliament and instead ignore him when he is trying to get to the bottom of it?

Dr. Ghosh's solicitor has written that she remains concerned about the interpretation of the regulations governing suspension post-Shipman, which I understand are complex. The solicitor has interpreted those regulations and the nature of the advice given. In other words, she has questioned the PCT's interpretation of the rule under which Dr. Ghosh was suspended. She wrote letter after letter to the PCT and never received an answer.

Dr. Ghosh is up on the 19th, but he has been told that he cannot have legal representation. I do not know whether that is true, so perhaps the Minister can tell me. Can a doctor bring a lawyer or solicitor in such cases? Apparently not. Dr. Ghosh can bring a friend or someone from the British Medical Association, but he cannot bring his solicitor. Some 20 people from his ex-staff will be interviewed, all of whom have made allegations—very poor allegations, I might add, which I have here—but he is not allowed to question or to cross-examine them. If that is the case, anyone could say, "Well, if I'm not going to be cross-examined, I'll stick one on him—not a problem." That is disgraceful and unfair. Dr. Ghosh has a right to cross-examine those people and what they say about him.

One of the people in the investigation has claimed that Dr. Ghosh was having an affair with one of his staff. Dr. Ghosh was shocked at that. The girl in question has not been interviewed. What happens if I pick the phone up and say to that girl, "Look, you're in a report saying you had an affair with Dr. Ghosh. I would go and see your solicitor and sue"? There is no proof—the allegation came from a third party. Pauline Fryer, the head of corporate affairs at Newcastle PCT, alleged that Dr. Ghosh paid his staff money when he took them places. Well of course he paid them money—he had to pay them subsistence allowance, which was in their
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contracts. If they went anywhere with him, he paid them their subsistence allowance. What is the investigator suggesting he paid them for? Sex?

I do not know what is going on. The Minister should have an inquiry and consider the matter seriously to see exactly what has been happening. Who is right in their interpretation of the law? The solicitor has said that Dr. Ghosh should be entitled to legal representation, but the PCT says that he is not. Who is right? They go on to say that there is a similar case pending in the administrative court. They suggest that Dr. Ghosh's case should be put off until it has been heard. I know nothing about the pending case; that is what the solicitors say. However, doing that will mean that Dr. Ghosh will be suspended for a lengthy period, unable to practise and to care for his patients as he wants to. That is the state of affairs at the moment, but it gets worse.

I want to challenge the committee. It is supposed to be independent. There is only one independent doctor on it, whom I do not know. I know everyone else on the committee, and they have been involved in the case from the beginning. It is as if a detective were the prosecutor, a chief constable the judge, or a policeman the jury. Dr. Ghosh does not have a chance in hell of getting a decent decision. The same people who wanted the investigation and started the suspension will make sure that he does not practise again.

On what grounds is that happening? Because someone won a tribunal. People might want to say that, but Dr. Ghosh can equally say, "Wait a minute. I was found not guilty by a unanimous jury in the Crown court." There are balances. However, they want rid of him. As I said, they have already given his practice away to another doctor. We must wait to see what happens when they get rid of him—because they will; the decision has already been taken. I was told that on the grapevine by some members of the primary care trust, who told me "You are wasting your time, Ronnie. They are going to go for him."

In the end Dr. Ghosh will have to take the matter to court; he will have to sue. That is the only answer that I can see. The allegations are grave, but none of them can be defended. If the girl who worked for him is supposed to have had an affair with him, which is what they have claimed, in writing, she should take the matter to the High Court, too; she should sue.

There are other aspects to the case. A doctor—he has gone now—called Dr. McCullen made a racist remark to Dr. Ghosh, about which Dr. Ghosh obviously complained to Mrs. Frazer, who is chairman of the trust. She made some investigations. There was evidence and there were witnesses. To this day, Dr. Ghosh has never received an apology for the racist remarks.

Another case came to light of Mr. Sayeed, a Pakistani who has shops in Blyth. His daughter went to see Dr. McCullen because Dr. Ghosh was suspended and Dr. McCullen was seeing some of his patients. A racist remark was made to her. Her father made a complaint to Dr. Frazer, who is chairman of what I call the kangaroo court. Nothing happened. There was no letter of apology. Two proven racist remarks by a doctor were swept under the carpet by Dr. Frazer.
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I sent Dr. Frazer a letter, asking what was going on, why the complaints were not being investigated, and why there were no letters of apology. I am still waiting for a reply from the primary care trust. I never received a reply, so I do not know what they are trying to hide.

I talked to another doctor, who I have known for some time, who said, "There was a lot of trouble in north London a few years back, when Peter Mitford was in charge of the committee"—the kangaroo committee. "Dr. Mitford was the chairman and he hounded Dr. Aman and Dr. Khan." Dr. Aman was interviewed in a general medical magazine about how he was hounded out. I have been trying to get a copy of the magazine, but it was published a few years ago. He cited racial abuse in the relevant primary care trust in north London at that time.

Dr. Khan left the area. I think that he is now practising somewhere in Newcastle. I have been trying to trace him. He had the same problem. He was harassed out by Dr. Peter Mitford. I suddenly found out that Dr. Mitford and Dr. Frazer were in the same practice in Morpeth. I am not making any suggestions, but I am drawing a comparison. Two complaints about racist comments were made about which nothing was done. Those two doctors worked in the same practice, and they have now left to take up big jobs in the PCT.

It is difficult to get any information on this matter at the PCT because the people concerned will not talk to me. They will not meet me—well, I did manage to arrange a brief meeting with someone, but they would not talk to me. I cannot get anywhere with them. That is why I have had to have this Adjournment debate. I thought about meeting the Minister, and perhaps I should have done that first, but I got very upset because I was told by a good friend on the health authority that what would happen to Dr. Ghosh was signed, sealed and delivered.

If Dr. Ghosh has done wrong, he should be sacked—doctors should get sacked if they do wrong. However, I must repeat this because it vexes me: he has not been found guilty in a court of law—in a Crown court of law, before a judge and jury. He has been found guilty at a tribunal, with a solicitor and two lay people deciding. I do not know why one route has been taken rather than another. It is as if such decisions are plucked out of the sky—"Well, we'll do that, because it seems like a good idea." I have now been told that Dr. Ghosh's clinical record will be examined. They are not satisfied with the questions asked so far. They want to take a look at other matters. They are having a go at him, and I do not know why. If Dr. Ghosh is a serial abuser, he must pay the penalty, but people who have known Dr. Ghosh for years do not believe that he is a serial abuser.

I wrote down some of the questions that were asked. "Did Dr. Ghosh comment to the staff that he liked them to wear short skirts?" Dr. Ghosh paid a lot of money for uniforms for his staff. He took that money from the budget. They all wear the same uniform. So why did the investigator ask about that? "Did you ask one of your staff to marry you?" He is a single man, so I suppose that he can propose to anyone he wishes to marry. It is funny that Dr. Frazer, who chairs this kangaroo committee, married a practice manager. I wonder whether he asked her to marry him in the surgery.
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Those questions show what that investigation is really like—when a man's livelihood is on the line. Another question was asked about a named employee, but I will not mention her name because I do not think that names should be mentioned. Dr. Ghosh was asked if he had touched her neck. Who is making these allegations? "Did you touch her neck?" What does that mean? Another question was, "Did you stand close to your employees?" I have been in the practice and it is not very large. I hope that the Minister does not stand too close to me at the bar this evening, because she might get into trouble over it.

Some of those questions are not worthy of comment. That is the sort of stuff that this doctor has to endure, and he now sees his livelihood and practice disappearing. If what has been predicted comes true, he does get the heave-ho, and his practice does go down the Swannee, I will return to this Chamber to remind the Minister that I told her that that would happen, and she might be able to reply then as well.

4.49 pm

The Minister of State, Department of Health (Ms Rosie Winterton) : First, I congratulate my hon. Friend the Member for Blyth Valley (Mr. Campbell) on securing the debate. This matter is clearly of great concern to him and, as he said, he has made representations to Ministers about it in the past.

I hope that my hon. Friend will understand that it is difficult for me to comment on individual cases, but I thought that it would help if I set out the procedures by which general practitioners in the NHS are regulated. GPs are covered by the Health and Social Care Act 2001, which requires them to be registered on primary care trust lists to provide or to assist in providing general medical services. That enables PCTs to refuse to admit doctors to, or to remove them from, the lists on grounds of unsuitability, inefficiency or fraud, and to suspend GPs to protect patients or act in the public interest. The Act also abolished the NHS tribunal and established the Family Health Services Appeals Authority as an independent tribunal.

Under the National Health Service (Performers List) Regulations 2004, which came into force last year, a PCT is expected to investigate any concerns about any aspect of a doctor's performance. Those concerns can be based on information from any source. In the most serious cases, the sanction can be dismissal—removal from the PCT's performers list. As I have said, the grounds for removal from the list are unsuitability, inefficiency and fraud. The PCT can also consider suspension from NHS practice as an interim measure to protect patients or to act in the public interest while an investigation is under way. When considering a suspension—which is not considered punitive, but a neutral act—PCTs are free to consider any information brought to their attention by a patient or other person or body, information obtained through the PCT's management of primary care in its locality, or any combination of the two. The suspension must be reviewed regularly.

Each primary care trust is responsible for carrying out its responsibility for maintaining its performers list, and the regulations set out the decisions that the PCT can make and the notifications and time frames with which
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it must comply. Each PCT is responsible for drawing up its own procedures for carrying out the process, including the composition of the panel if there is to be a hearing. Panel proceedings are for the PCT to determine, but they have to be in line with guidance produced by my Department. If a PCT decides to remove a doctor, there is a right of appeal to the FHSAA, which, as I have said, is an independent tribunal. There is not a right of appeal against suspension, because that is considered to be a neutral act designed to protect patients or the public. Given that framework, I hope that I can assure my hon. Friend that the Northumberland care trust has followed due process in their treatment of Dr. Ghosh.

Once the trust was made aware of the serious allegations against Dr. Ghosh and the serious nature of the employment tribunal's findings in January, there was a duty to investigate.

Mr. Ronnie Campbell : I referred to the committee: basically, it was the judge, jury and hangman. It had one independent doctor on it. I do not know who he is, but I know the others who sat on it. They should not be involved at that stage. The committee should hear the case but remain independent. Why are those people sitting listening to the case? They should be independent.

Ms Winterton : I will come to the composition of the panel and to the options that will be available to Dr. Ghosh in the light of the outcome of any hearing.

A formal complaint was made to the trust about Dr. Ghosh and, in a sense, that can run separately from the employment tribunal. The investigation was not dependent on it. If allegations had been made, the PCT had a duty to investigate.

Under the regulations, an internal investigation was set up at the end of January, chaired by a non-executive director of the trust, which included the acting chief executive of the trust and an independent member. The investigation was conducted, as my hon. Friend said, by the head of corporate affairs of a neighbouring PCT in order to ensure independence from the panel.

Mr. Ronnie Campbell : Was she—Mrs. Fryer, the head of corporate affairs—sitting on the committee?

Ms Winterton : The head of corporate affairs carried out the investigation and reported to the tribunal. That was in accordance with the regulations. A number of current and former members of Dr. Ghosh's staff were interviewed. The interim findings led to the extension of Dr Ghosh's suspension until the investigation is complete and any decisions dependent on it are reached.

I am told that the investigation has now reached its conclusions and that a panel meeting is to be held on 19 July to discuss the results of the investigation and to reach a decision. My hon. Friend asked whether a solicitor could be present. Under the guidance issued by the Department, neither the PCT nor Dr. Ghosh can have at the panel meeting a solicitor who comments directly. However, his solicitor can certainly attend the meeting with him to observe.

Ministers are not empowered to intervene between a trust and a doctor on the matter of the performers list, because primary care trusts are independent
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organisations. However, Dr. Ghosh will have a right of appeal to an independent tribunal if he is not satisfied with the outcome of the hearing on 19 July. In addition, if he chooses to go to appeal and that appeal fails, he will be able to go to judicial review.

My hon. Friend made it clear that he was dissatisfied with the locum provision. I have been informed that locum cover arrangements were put in place and that those involve the use of a locum previously approved by Dr Ghosh. The arrangements have meant that it has been possible to cover his practice on all but a small number of occasions.

I understand that Dr. Ghosh was contacted about the allegations of racism that were investigated by the trust. That is obviously a difficult situation and I understand my hon. Friend's concerns. However, I think that the trust has followed procedure as laid down in NHS guidance. I hope that I have been able to outline the alternatives that Dr. Ghosh will have if he is not satisfied with the outcome of the investigation and the hearing on 19 July.

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