Two senior doctors accused of failing to stop Ian Paterson begin legal battle to save their careers

Rogue breast surgeon Ian Paterson was free to butcher cancer patients for eight years despite nine separate reports of botched treatments, a tribunal heard. 

Paterson carried out ‘experimental mastectomies’ on women that left the breast tissue in place, allowing the cancer to return. In some cases he advised treatment for women who did not have cancer, offering them more expensive procedures.

He worked at NHS hospitals in the West Midlands and private clinics including those run by Spire hospitals. 675 out of 1,207 women who underwent the unregulated treatment had died by 2017.

Now a medical tribunal has heard allegations that issues were raised about the doctor as early as 2004, but he was allowed to carry on working.

Senior colleagues at the Heart of England NHS Foundation Trust (HEFT) were aware of nine separate reports of botched treatment by 2007 – but in 2010 only one was reported to the General Medical Council for investigation, it was claimed.

Fresh details of the scandal emerged at the Medical Practitioners Tribunal Service where two senior doctors accused of failing to stop Paterson began a legal battle to save their careers in medicine.

Mark Goldman and Ian Cunliffe are facing misconduct charges after a two-year investigation concluded that a culture of ‘denial’ enabled Paterson to perform more than 1,000 botched or unnecessary operations.

Mr Goldman, who was Chief Executive of HEFT, quit in 2010 with a £2.7million pension pot just three months before news emerged of a recall of Paterson’s patients. 

Mr Cunliffe, a former medical director at the trust, was accused of attempting to block a full recall of patients despite concerns their health was at risk.     

Nick Clarke QC, for the GMC, told the Manchester hearing: ‘Mr Patterson was working at the hospital in 2003 and in 2004 a number of concerns had already been raised. 

‘By 2007 issues had arisen about his conduct towards colleagues and inappropriate and incomplete mastectomies having been undertaken. There was already an awareness and potential for there to be risk of harm posed by Mr Patterson.

‘But between June and August 2007, there are failures to inform the trust board of a number of matters and to recognise significant lack of informed patient consent.

‘The real give away was a plethora of reports then coming in, interim reports and final reports from a number of individuals – nine in number. Initially none of that information was shared with the GMC so the matter was not reported to the GMC.

‘There was no formal complaint or procedure at any time in 2007, 2008 and 2009, so when the interim orders panel came to consider the position of Mr Patterson in 2010 they had to deal with it first on the information provided to the GMC.’

Paterson is currently serving a 20-year prison sentence following a 2017 conviction of 17 counts of wounding with intent and three counts of unlawful wounding between 1997 and 2011. 

Mr Clarke continued: ‘We are dealing here with the very harrowing actions of physical trauma that was inflicted by a surgeon. 

‘But the fitness to practice hearing will be dealing with not patients’ complaints in this case – but with professional concerns about what was going on and about steps that should have been taken to stop what was happening in order to protect patient safety.’

The hearing was told of six Interim Order Panels (IOPs) between 2010 and 2012. The first in December 2010 concerned a single complaint in relation to an operation that Mr Paterson had undertaken in 2006 and no order was made.

A second review took place in July 2011 by which time the number of complaints had risen to four but Paterson was allowed to carry on working under supervision. 

Further reviews took place on 19 December 2011 and 31 May 2012 at which conditions were maintained.

Additional complaints gave rise to a further review in July 2012 by which time there were twenty complaints – but the conditions on Paterson’s registration was maintained. 

By October 2012, there were thirty complaints under investigation and he was formally suspended.

He had already been excluded by the health trust in 2011.

Goldman and Cunliffe face various misconduct charges including delivering inadequate managerial responses following concerns raised about Paterson, failures to share the full history of concerns with investigators, failures to respond in a ‘timely manner’ to concerns, failing to stop him from undertaking breast surgery, and protecting patients from the risk of harm and failing to notify the GMC of concerns about the surgeon.

Defence lawyer Mark Sutton QC told the hearing: ‘The GMCs allegations against Mr Goldman include seven that relate to failure through a period of 2007 to 2009 to place adequate restrictions on Mr Patterson practices.

‘But the GMC cannot reasonably criticise Mr Goldman for not restricting Mr Patterson’s practices when an IOP didn’t impose an order. What material did IOP have in front of it to justify imposing no restrictions? 

‘It does overlap with a period of time when both my clients are being criticised for their decision making.’

The panel ordered the GMC and lawyers acting for the doctors to disclose legal documents ahead of a full disciplinary hearing next year.