An account of the suspension, contingent removal and termination of Devon GP Dr Roger Stephenson's contract, the subsequent High Court judgement against Devon Primary Care Trust and ongoing developments in this case.
...an unwitnessed conversation as I was the sole investigator in the practice at the time...
Text that disappeared from Dr Lockerbie’s Report into Dr Stephenson’s Practice - March 2008
Dr Graham Lockerbie – Investigating Officer
Dr Graham Dempster Lockerbie MB ChB DRCOG (GMC Number: 2549169) until December 2011 a GP in the Dartmouth Medical Practice
He graduated from Dundee in 1980 and after training to be a GP became a Principal at Dartmouth in 1985
On 1st September 2011 Dr Lockerbie was appointed Medical Director for NHS Devon, Torbay and Plymouth, reducing his practice work to just one day a week, and announcing that he was “proud and excited” to be selected. But within a couple of months the Dartmouth Medical Practice announced that he would be leaving altogether. See:
Media Release ByTheDart
In December 2014 it was pointedly and inexplicably announced that Dr Lockerbie was “not appointed” as Medical Director of a newly realigned southwest area of NHS England. In April 2015 he will also be replaced as the GMC’s Responsible Officer for Devon, Cornwall and the Isles of Scilly.
He graduated from Dundee in 1980 and after training to be a GP became a Principal at Dartmouth in 1985
On 1st September 2011 Dr Lockerbie was appointed Medical Director for NHS Devon, Torbay and Plymouth, reducing his practice work to just one day a week, and announcing that he was “proud and excited” to be selected. But within a couple of months the Dartmouth Medical Practice announced that he would be leaving altogether. See:
Media Release ByTheDart
In December 2014 it was pointedly and inexplicably announced that Dr Lockerbie was “not appointed” as Medical Director of a newly realigned southwest area of NHS England. In April 2015 he will also be replaced as the GMC’s Responsible Officer for Devon, Cornwall and the Isles of Scilly.
Dartmouth from the estuary
Dr Lockerbie’s report into Dr Stephenson’s practice was riddled with factual errors and misinterpretations. Why?
Background to Dr Lockerbie’s report
In March 2008, at short notice, Dr Lockerbie was appointed to carry out an investigation into Dr Stephenson’s practice. He was untrained in the role as investigator.
Prior to this, Dr Stephenson had been called to a disciplinary hearing on 4th March 2008 at 4.30 p.m. at PCT headquarters in Exeter. The panel had just concluded a hearing into the performance of Dr Andrew Bower, Dr Stephenson’s probationary partner and source of the original allegations. Dr Stephenson’s hearing never took place as both his solicitor and his LMC appointed supporter pointed out to Dr Kevin Snee that a) the panel was not quorate and b) it was improper that the panel who had just heard from Dr Bower should sit in judgement on Dr Stephenson. The hearing was cancelled and a compromise arrangement was agreed that Dr Stephenson would go on “gardening leave” whilst an investigation was conducted into his practice.
Prior to this, Dr Stephenson had been called to a disciplinary hearing on 4th March 2008 at 4.30 p.m. at PCT headquarters in Exeter. The panel had just concluded a hearing into the performance of Dr Andrew Bower, Dr Stephenson’s probationary partner and source of the original allegations. Dr Stephenson’s hearing never took place as both his solicitor and his LMC appointed supporter pointed out to Dr Kevin Snee that a) the panel was not quorate and b) it was improper that the panel who had just heard from Dr Bower should sit in judgement on Dr Stephenson. The hearing was cancelled and a compromise arrangement was agreed that Dr Stephenson would go on “gardening leave” whilst an investigation was conducted into his practice.
Investigation Process
When Dr Lockerbie was appointed as the investigator, Dr Stephenson expressed his anxiety that the investigation would coincide with Dr Bower working in the practice. On 7th March Bevan Brittan, the PCT’s solicitors wrote “We can confirm that Dr Bower will not be involved in the investigation process other than as a witness.”
Dr Lockerbie then conducted his formal investigation at Bow Surgery for the three days 12-14th March. Dr Lockerbie expressed awareness of the danger of off-the-record discussions with Dr Bower, commenting, according to the transcript of the 19th March hearing, “I had no initial contact with Dr Bower, other than to introduce myself, as I was conscious of Dr Stephenson’s concerns in respect of bias.”
Afterwards, on 11th April, Bevan Brittan wrote “We can confirm that Dr Bower had no involvement in the investigation undertaken by Dr Lockerbie, other than when interviewed on 13th March 2008.”
Dr Lockerbie then conducted his formal investigation at Bow Surgery for the three days 12-14th March. Dr Lockerbie expressed awareness of the danger of off-the-record discussions with Dr Bower, commenting, according to the transcript of the 19th March hearing, “I had no initial contact with Dr Bower, other than to introduce myself, as I was conscious of Dr Stephenson’s concerns in respect of bias.”
Afterwards, on 11th April, Bevan Brittan wrote “We can confirm that Dr Bower had no involvement in the investigation undertaken by Dr Lockerbie, other than when interviewed on 13th March 2008.”
Why was Dr Lockerbie’s draft Report altered?
The investigation resulted in a report which included unfounded allegations not mentioned in Dr Bower’s interview transcript. On Saturday 15th March, Dr Lockerbie emailed his draft report to the PCT and SHA, asking for comments.
Copy of header of Dr Lockerbie’s email (eventually disclosed in response to a Data protection Act request):
The final version of his report was dated 17th March and was used in all the hearings. The text of the draft and final versions was almost identical - with one important exception which is shown below:
These missing words were used to describe an off-the-record discussion that, according to Dr Lockerbie’s own testimony to the suspension panel, did not happen. Furthermore, according to investigation guidelines and the lawyers’ assurances (see above), it should not have happened. It is not clear who recommended that these words be removed from the draft report.
It can only be assumed that many of the unfounded allegations came from off-the-record discussion. Dr Stephenson has never been allowed access to the notes of any such discussion, so has been unable to contest all the allegations. Dr Lockerbie referred to Dr Bower’s allegations in subsequent hearings and has since admitted that some were based on hearsay evidence.
The Panel has relied upon the strength of the process and investigation undertaken by Dr Lockerbie. Dr Lockerbie is very competent and hard working. The Panel has not relied upon Dr Bower’s evidence, given the difficult relationship between the two of them. The Panel’s decision [to suspend Dr Stephenson] is based upon Dr Lockerbie’s evidence.”
This conclusion is undermined by the fact that much of Dr Lockerbie’s evidence was wrong, some of it arising from unchallenged off-the-record allegations.
Concerning the writing of reports, the General Medical Council states in its advice on doctors’ probity:
“You must do your best to make sure that any documents you write or sign are not false or misleading. This means that you must take reasonable steps to verify the information in the documents, and that you must not deliberately leave out relevant information.”
Dr Lockerbie later conceded that his report was “hurried” and recommended that a second investigation be conducted. Yet this did not take place until five months later, in August 2008. The report of this second investigation, despite also containing many factual errors, was more balanced and did not agree with many of Dr Lockerbie’s comments.
Update June 2012: According to Dr Lockerbie (.pdf) his new role as Medical Director of NHS Devon and Responsible Officer is to ensure that "all investigations are conducted in such a way that fairness, appropriate rigor (sic), consistency and support are ensured in all cases". In this he is still assisted by Kevin Hale (Assistant Director Primary Care (Performance) – NHS Devon)
Addenda:
As of 1st April 2015, Dr Lockerbie is no longer a Medical Director for NHS England
Sept 2015: GMC rejects Dr Lockerbie’s complaint about this website's content, which he describes as: “6+ years of paranoid nonsense”.
See Dr Lockerbie talk about his Dartmouth Practice on YouTube.
These missing words were used to describe an off-the-record discussion that, according to Dr Lockerbie’s own testimony to the suspension panel, did not happen. Furthermore, according to investigation guidelines and the lawyers’ assurances (see above), it should not have happened. It is not clear who recommended that these words be removed from the draft report.
It can only be assumed that many of the unfounded allegations came from off-the-record discussion. Dr Stephenson has never been allowed access to the notes of any such discussion, so has been unable to contest all the allegations. Dr Lockerbie referred to Dr Bower’s allegations in subsequent hearings and has since admitted that some were based on hearsay evidence.
This is how the PCT panel concluded their hearing:
The Panel has relied upon the strength of the process and investigation undertaken by Dr Lockerbie. Dr Lockerbie is very competent and hard working. The Panel has not relied upon Dr Bower’s evidence, given the difficult relationship between the two of them. The Panel’s decision [to suspend Dr Stephenson] is based upon Dr Lockerbie’s evidence.”
This conclusion is undermined by the fact that much of Dr Lockerbie’s evidence was wrong, some of it arising from unchallenged off-the-record allegations.
Concerning the writing of reports, the General Medical Council states in its advice on doctors’ probity:
“You must do your best to make sure that any documents you write or sign are not false or misleading. This means that you must take reasonable steps to verify the information in the documents, and that you must not deliberately leave out relevant information.”
Dr Lockerbie later conceded that his report was “hurried” and recommended that a second investigation be conducted. Yet this did not take place until five months later, in August 2008. The report of this second investigation, despite also containing many factual errors, was more balanced and did not agree with many of Dr Lockerbie’s comments.
Update June 2012: According to Dr Lockerbie (.pdf) his new role as Medical Director of NHS Devon and Responsible Officer is to ensure that "all investigations are conducted in such a way that fairness, appropriate rigor (sic), consistency and support are ensured in all cases". In this he is still assisted by Kevin Hale (Assistant Director Primary Care (Performance) – NHS Devon)
Addenda:
As of 1st April 2015, Dr Lockerbie is no longer a Medical Director for NHS England
Sept 2015: GMC rejects Dr Lockerbie’s complaint about this website's content, which he describes as: “6+ years of paranoid nonsense”.
See Dr Lockerbie talk about his Dartmouth Practice on YouTube.
Devon Primary Trust judgement Last Updated October 2015 Web Page by IT Solutions URL: http://www.devonpctjudgement.co.uk