Expert Witness' 'Regrets' Over Letter Supporting Accused Oncologist

Ian Leonard

September 15, 2021

MANCHESTER—A leading oncologist "regretted" co-signing a letter to the former chair of the GMC because it appeared he and another cancer expert had wanted the case against Professor Justin Stebbing stopped, a medical tribunal heard.

Dr Nick Plowman said it had been “foolish” to put his name to the letter to Dame Clare Marx after being instructed as a defence witness but he’d become concerned by delays in the case.

World-renowned oncologist 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.

Prof Justin Stebbing

'Extreme Sloth'

Dr Plowman, a senior oncologist at St Bartholomew's Hospital, London, with a private practice on Harley Street, was questioned by Sharon Beattie, QC for the GMC, about the contents of the letter sent to Dame Clare in March 2020.

Dr Plowman said his motivation for co-signing the letter - drafted by cancer expert Professor Karol Sikora - had been the “extreme sloth” in Prof Stebbing’s case and the 3 years, up to that point, he'd faced GMC allegations..

Ms Beattie said that wasn't an issue for Dr Plowman who was "meant to be independent" in the case and "giving impartial evidence".

One section of the letter, she said, referred to how experts for the defence had responded to supplementary reports written by experts for the GMC.

It read: "We have submitted responses to these supplementary reports which, when read in conjunction with our other reports, we believe counter the serous allegations.

"We now understand this already lengthy tribunal has been arrested and postponed for 9 months or more and all momentum will have been lost by both parties."

The letter added: "We request the evidence is weighed at this time and the decision taken."

'Foolish'

Ms Beattie said the last line had referred to proceedings being "stopped", although Prof Plowman disagreed.

But he said that the paragraph beginning, ‘We have submitted responses…’ was "unfortunate" and shouldn't have been included because "it implies bias".

Dr Plowman agreed the letter could be interpreted as wanting proceedings to be halted but the main motive behind the letter were the delays in the case.

He said he “regretted” being a signatory to the letter and admitted to not reading a draft thoroughly enough.

Ms Beattie said: "You're talking in March 2020 about a decision being taken 'at this time'.

"The only logical conclusion is you were seeking to persuade Dame Clare Marx or the GMC to stop the proceedings at that point and take the decision to do so."

Dr Plowman questioned whether Dame Clare Marx would have had that power and said the purpose of the letter was “to get to a conclusion in the case”.

But he agreed with MPTS panel Chair Hassan Khan who said the letter suggested the GMC "weigh the evidence" in favour of the defence and that their reports "trumped" those of the GMC experts.

Dr Plowman said he had been "foolish" to sign the letter, given both he and Prof Sikora had been instructed as defence witnesses.

Impartiality

Earlier, Ms Beattie had asked Dr Plowman about a statement he'd previously given to the tribunal in which he said he would not allow his friendship/collegiality with Prof Stebbing to influence his evidence.

Dr Plowman said he'd drafted the statement as he'd wanted to pre-empt any "perceived dichotomy of interest".

Ms Beattie said Dr Plowman "understood the importance of the issue" and yet he'd only drafted the statement the evening before his first day of evidence.

She asked whether he'd read reports on Medscape relating to evidence given by Prof Sikora, who was forced to seek legal advice after his impartiality had been questioned by Ms Beattie.

Dr Plowman said he'd been presented with one article by a secretary but he'd "ignored it" because It was "tittle-tattle".

He said he had no knowledge of what Prof Sikora had said in evidence, outside of discussions with Prof Stebbing's QC Mary O'Rourke.

But he told the tribunal he'd also had "helpful" discussions "in the abstract" with others - one a QC  - about a dichotomy of interest.

That advice, he said, had included "choosing one side of a bridge to fall off' when defending a colleague and the need to remain impartial.

He said that's why he'd declared in his statement that his "final advice will be impartial" and the 12 cases were highly complex.

Dr Plowman, who said he’d had around 20 patient referrals from Prof Stebbing since 2017 as a consequence of practice restrictions, was asked why his reports in the case had been "unusually favourable".

He told Ms Beattie: "I am happy to lead you there by evidence.

"Medicine is an evidence-based profession. The time for criticism comes later."

Mr Khan asked him to clarify if his reports had avoided any criticism of Prof Stebbing.

"You are correct, with the proviso I'm happy to provide evidence to support that conclusion."

The tribunal is continuing.

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

Credits:
Lead Image: MPTS
Image 1: Kerry Elsworth

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