Doctor Denies Profits Drove HIFU Cancer Referrals 

Kim Pilling

April 09, 2021

A doctor denied wanting to make money when he referred eight cancer patients for treatment on a machine he co-owned, a medical tribunal has heard.

Consultant urologist Paul Miller, 63, was said to have had only the "best clinical interests" of his patients when he recommended high intensity focused ultrasound (HIFU).

The General Medical Council (GMC) argues HIFU in its early stages was "novel and experimental", was still not a standard treatment for prostate cancer and was inappropriate for the patients concerned.

Mr Miller was said to be an "early advocate" of HIFU, which emerged in the mid-2000s, and in October 2005 jointly formed a private company, Mobile HIFU Limited, of which he was co-owner and co-director with another clinician, Tim Larner.

The company purchased a HIFU machine with a bank loan in the region of £440,000 and received payments every time it was used at privately-run Spire Gatwick Park Hospital in Horley, Surrey, where Mr Miller treated patients with prostate problems.

Catherine Cundy, for the GMC, said Mr Miller alone performed more than 150 procedures between 2005 and 2013 at Spire Gatwick Park which would have generated in excess of £500,000 in fees and a "substantial profit".
 

Financial Interest

David Morris, representing Mr Miller, told the Medical Practitioners Tribunal Service (MPTS) hearing: "Mr Miller knew he did not have a financial interest in the machine.

"He was at no personal financial risk if the company defaulted on its bank loan.

"There is no evidence he had provided any personal guarantee to the bank."

The manufacturers of the machine had also offered to buy back the machine if the venture was unsuccessful, the tribunal heard.

Mr Morris said fees were paid to the company, which was sold in 2013 when Mr Miller resigned his co-directorship, and it was "speculative and wrong" to suggest substantial profits were made.

The company did no more than break even between 2005 and 2013 and there was no evidence in its accounts that it made any profit, the tribunal sitting in Manchester was told.

The consultant said he had never received a salary, a dividend or payment from the company, said Mr Morris.

Mr Morris said: "If you find that Mr Miller did have a financial interest in the machine then it is still clear that the nature of that interest did not put him at any financial risk or give him any financial benefit.

"He believed that the use of HIFU was in the patients best clinical interests."

'Vanguard Group of Surgeons'

Mr Miller was in "the vanguard of a group of surgeons" seeking an effective prostate cancer treatment with less serious side effects than standard treatments such as radiotherapy and HIFU had eliminated high levels of incontinence and reduced erectile dysfunction, said Mr Morris.

Five of the eight patients were initially treated within the NHS at East Surrey Hospital in Redhill, where Mr Miller also worked, before they were treated privately at Spire Gatwick Park.

Ms Cundy said Mr Millers assertion that he had no financial interest in HIFU was "ludicrous" and "disingenuous".

She added: "Mobile HIFU was plainly set up as a commercial enterprise.

"It was not a charity.

"It was not a not-for-profit organisation."

Mr Miller faces other allegations of misconduct, which he also denies, including failing to provide adequate care to five other patients.

In October 2019, senior coroner Penelope Schofield criticised Dr Miller and Sussex and Surrey NHS Trust at inquests into the deaths of 10 of his cancer patients who died of natural causes but she found three had been contributed to by neglect, and "missed opportunities" were noted in three others.

The hearing is continuing.

This article contains information from PA Media.

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