GMC Accused of Trying to 'Blindside' Oncologist's MPTS Tribunal

Ian Leonard

September 14, 2021

MANCHESTER—A leading oncologist has accused the General Medical Council (GMC) of making allegations against world-renowned oncologist Professor Justin Stebbing which may "thumb their nose at the rule of law" and "blindside" a medical tribunal.

Prof Stebbing is appearing before a Medical Practitioners Tribunal Service (MPTS) fitness to practise hearing accused of failing to provide good clinical care to 12 patients between March 2014 and March 2017.

The 36 charges, 25 of which he's admitted, include inappropriate treatment of patients given their advanced cancer or poor prognosis, overstating life expectancy and the benefits of chemotherapy, and continuing to treat patients when it was futile.

Dr Nick Plowman, who admitted to being a friend and former supervisor of Prof Stebbing, also told the medical tribunal that he wouldn't let that friendship "influence his answers" as he gave evidence as an expert witness.

Prof Justin Stebbing

'Impartial' Evidence 

Dr Plowman, a senior oncologist at St Bartholomew's Hospital, was questioned by Prof Stebbing's QC Mary O'Rourke about whether he knew him personally.

He said he'd been Prof Stebbing's supervisor in 2016 and they'd had "quite a good relationship".

He said Harley Street was a "relatively small community" and Prof Stebbing had once been to his house but it had been a "professional/collegiate acquaintance rather than anything closer than that".

Reading from a prepared statement, he then said: "Although I am being called as a witness for a friend/colleague.

"I wish to make it clear that I am not allowing friendship/collegiality to influence my answers, which will be my clinical judgement.

"Final advice will be impartial, but on the way to my final advice I will counter GMC assertions where they are untrue, debatable, unreasonable, or possibly even thumb their nose at the rule of law and might blindside the tribunal from logical and modern medicine/oncology."

Dr Plowman also defended Prof Stebbing's alleged inappropriate treatment of five lung cancer patients, saying he couldn't see "what the problem" was with the treatment in some cases.

Patient B

Among the charges denied by Prof Stebbing is giving doublet chemotherapy to one such patient - Patient B - beyond six cycles when he was developing impaired renal function and then continuing treatment at a higher dose after 10 cycles.

Dr Plowman said it was important to consider "cumulative" dosing which was just an important a parameter as the number of cycles, and in Patient B's case he'd received lower doses on occasions.

"Cumulative dose is important. Personally, I wouldn't be happy with six cycles of that low dose chemo," he said.

"There are plenty of tumours where we now give weekly chemo, taxol in breast cancer for example, where one wouldn't dream of giving six cycles in full dose."

And he described Prof Stebbing's treatment of the patient as "very good oncology".

Patient C

Prof Stebbing has also denied inappropriately escalating the care of another patient - a 70-year-old known as Patient C - by giving her assisted ventilation and second-line full-dose chemotherapy.

Dr Plowman said although the patient had had a performance status of four this was based on a "multiplicity of potential reversible factors" which included her advanced lung cancer.

He said Prof Stebbing had been right to treat the patient, who'd shown a "remarkable" response to the first cycle of chemotherapy, and questioned whether she'd had lymphangitis, as claimed by experts called by the GMC.

Ms O'Rourke was asked whether he agreed with the same experts who'd claimed the woman's poor prognosis and limited life expectancy meant she shouldn't have been treated in ICU.

Dr Plowman said Patient C's presentation had been "analogous" to Patient B, and Prof Stebbing had believed he could achieve a similar outcome for her - Patient C having lived another two-and-half years after treatment.

 "I don't understand the allegation," he continued.

"I am sure he [Prof Stebbing] would've said this is a high-risk patient.

"All the 12 patients are high-risk and extremely complex cases.

"But he did achieve it in one of the chosen 12 and I am sure he did it many of the other ones as have I and others."

He said a study pointed to survival rates of 6 months for 23% of lung patients taken to ICU and "he'd go for that if he wanted to live".

Ms O'Rourke asked Dr Plowman to rate the seriousness of the allegations faced by Prof Stebbing for each of the 12 patients on a scale of 1-10, with one being the least serious and 10 the most serious.

For most patients he gave a score of 3 or less but for two patients - Patient G, a 73-year-old lung cancer patient who was given chemotherapy despite his "rapidly deteriorating" condition, and Patient L, who was given chemotherapy when it had been vetoed by Prof Stebbing's supervisors, he scored the allegations 4/5.

Dr Plowman is due to be cross-examined by Sharon Beattie, QC for the GMC, on Tuesday.

Ian Leonard is a freelance journalist experienced in covering MPTS hearings.

Credits:
Lead Image: MPTS
Image 1: Kerry Elsworth

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