Features

For speaking frankly about the NHS, I was first silenced and then pushed out

8 August 2015

9:00 AM

8 August 2015

9:00 AM

On 31 March, I walked out of the Royal Marsden Hospital in London for the last time, after 28 years as a consultant cancer surgeon. At the age of almost 69, I had given six months’ notice of my wish to resign my contract by Easter, but to remain on staff in order to complete a research project on malignant melanoma.

That request was initially considered favourably, then withdrawn after I wrote a series of articles in The Spectator and the Daily Mail about what I thought was wrong with the NHS. One, in which I said that ‘GPs are part of the NHS’s problem, not the solution’, triggered a particularly vitriolic response. Doctors demanded that I be punished and attacked me on social media. The Marsden caved. I was told I had brought the hospital into disrepute; that I had behaved irresponsibly. My offence was considered unforgivable and deserving of a ‘clean break’. There was to be no contract renewal.

What was so bad about what I wrote? I had said: ‘Despite the heroic efforts of individual doctors, too many GPs no longer try to provide an even remotely personal service, to offer appointments at a convenient time or to take effective responsibility for continuity of care… General practice, as structured, is an anachronism and not fit for purpose.’ I gave examples of how the treatment of most patients, those with long-term illnesses such as asthma and diabetes, could be transformed.

Others have put forward similar proposals. In a debate in the House of Lords, health minister Lord Prior said that the ‘cottage industry GP model is broken’ and that more care needed to be delivered through health units working together. Perhaps his words were more emollient than mine, but no objections from GPs were recorded; there was no lynching on social media.

Before I started writing articles, my standing at the Royal Marsden had been high. I was its lead surgeon between 2008 and 2013. In writing for The Spectator and the Mail, I was not in breach of my contract, which stated: ‘You shall be free, without our prior consent, to publish books, articles etc., and to deliver any lecture or speak whether on matters arising out of your NHS service or not.’


What, then, caused my downfall? The arrogant, vicious and bilious response of some GPs whose professional comfort was being challenged. The senior managers at the Marsden were not courageous enough to withstand the onslaught. Professor Azeem Majeed, who runs primary care at Imperial College London, wrote to my chief executive implying that GPs might not continue to refer patients to the Marsden unless action against me was taken. Other GP trolls posted an unprecedented volume of vitriolic abuse on Twitter and Doctors.net.

The net drew tighter. Dr Maureen Baker, chair of the Royal College of General Practitioners, emailed her 40,000-strong membership to denounce my article. Dr Lucy Gaden, a GP from Nottingham, started a petition to have me reported to the GMC for unprofessional conduct. An aggressive letter arrived from Imperial College stating that my honorary professorship was being withdrawn.

I was summoned to the medical director’s office at the Royal Marsden. He demanded that I resign, accept disciplinary action or take ‘gardening leave’. I refused, arguing that I had the right to free speech. I explained that I had never quoted the name of my hospital in any of my articles and that my clinical reputation was unblemished.

The director imposed ‘authorised absence’ until a further meeting. I was not allowed to attend the hospital, nor any of my five clinics during that time. I was not allowed to perform my operating lists during the next week, which included two patients with complex cancers. Was this action taken in the best interests of my patients? Hardly.

At the second meeting with the medical director, I was told that I could return to work but that I would have to sign a document from the medical director which included the following sentence: ‘I made it clear that it is important that you do not write any further press articles, or if you do, then you must show these in advance to the chief executive so that she is reassured that the content will not affect the Royal Marsden’s reputation by association with your personal views.’ The trust does not consider this statement a ‘gagging order’; indeed when The Spectator wrote an article about me calling it such, the trust threatened this magazine with legal action.

I delayed signing the document until a reminder arrived from the medical director. The message was clear: I’d been excluded once: if I did not comply, they could do it again. By this time I was in bad way. My resilience and self-confidence had been tested and even I was beginning to believe that I had committed a terrible heretical sin by writing the article. I signed the document.

I still believed that my contract would be renewed in order to continue with my research project. Ninety patients were involved in the trial, all of whom I had looked after for five years, and a further two years were needed to complete the research.Understandably, some of these patients feel abandoned. I was absolutely forbidden to write to them to explain the circumstances of my unexpected departure.

At a meeting with the chief executive and the chief operating officer in February, I was told there was to be no reprieve. They wanted a ‘complete break’. My last working day would be 31 March. With the help of an employment lawyer, I issued a bullying-and-harassment complaint against the chief executive and medical director. It was dismissed by the board chairman, who refused my request for an independent investigation.

Earlier this year, Robert Francis QC published his ‘Freedom to Speak Up’ review, which concluded that there was ‘a culture within many parts of the NHS which deters staff from raising serious and sensitive concerns and which not infrequently has negative consequences for those brave enough to raise them. I heard shocking accounts of the way some people were treated when they have been brave enough to speak up.’ So pressing are the concerns that in a recent editorial in the British Medical Journal, Dr Kim Holt called for a public inquiry to tackle ongoing problems with bullying, intimidation and reprisals in the NHS.

If the NHS can treat a senior cancer surgeon this way, what chance does a nurse or a junior doctor with grave concerns about the health service have?

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Show comments
  • Rik

    The NHS,like AGW is a religion, heretics are always crucified or burnt at the stake we need a “reformation” in both areas so that honest dissent can be freely made.

    • husamgcd2

      Maybe the NHS in ISIS or some god forsaken place. Not in our NHS mate.

    • Vera

      No attempt to face the criticism and try to rectify the situation. Just let’s oust the whistle blower and ruin his career, and close ranks. Obviously there is lots to criticise in the NHS.

  • Bonce

    You hear and read about these stories all the time.

    NHS workers who genuinely want to improve the service or the organisation, frozen out, attacked and sacked all because they dare to criticise it slightly.

    The NHS needs strong leaders who will make difficult decisions and yes criticise it, because that is how you find solutions.

    The current crop of senior managers on 150-200k per year are clearly incapable for whatever reason, of actually doing their jobs… Which is to deliver the best service and treatment possible within budget to their patients.

    • rtj1211

      It happens all over the British economy. Universities, government, the City, football etc etc.

    • Rik

      Indeed, not only in the NHS but all over our public institutions,why,you might almost think there was a Common Purpose or something.

    • Vera

      NHS managers need a serious cull. They are only interested in their own empires not the patient. Never the patient. If their funding is cut, where do they economise? Not by sacking themselves or cutting down on waste. No, it is always front line staff and services

  • Freddythreepwood

    You signed the document. You are a senior surgeon, yet you allowed a bunch of twittering nonentities to bully you into silence. Sorry, but you and people like you are part of the problem. You should have been shouting your outrage from the rooftops. You remind me of those senior armed service officers who wait until their knighthoods and pensions are secure before speaking out. Supposed to be leaders; sniveling cowards instead.

    • rtj1211

      You’ll starve your children for your principles, will you?

      • Freddythreepwood

        Burn your straw-men somewhere else.

    • WFB56

      Ridiculous. He has to operate within the bounds of his contract and he did so.

      If you read the article you would know that the reason he was in this difficulty was specifically because he was voicing his concerns.

      • Freddythreepwood

        Not ridiculous. He is a senior surgeon and he should have been showing leadership, not compromising his case because his project was threatened. By allowing himself to be bullied into submission he betrayed the junior doctor or nurse we are trying to encourage to come forward and speak out. Yes, he voiced his concerns, but would he have voiced them if he had known in advance what the reaction of his pathetic management would be? His subsequent surrender would indicate not.

        • Peter Stroud

          We would, I’m sure, love to hear if, at any time, you blew the whistle on any perceived wrong doing?

        • LastmaninEurope

          I think you have a point here.

          His impending retirement surely refutes the financial mitigation voiced here.

          I agree with your observation re the example this could have provided for junior staff.

          His connection to the Mail and Spectator could have provide the platform to ensure that the argument was not one sided or buried within the system.

          That said, I have some sympathy (and empathy) for the situation he found himself in.

          It takes a mentally hard person to tough out such a situation. Additionally he would receive little or no support from his colleagues, so cowed and income dependent are the vast majority.

          Mr Thomas is a gifted surgeon, a talent requiring skill, intelligence and dedication. He can, perhaps, be excused for avoiding personal conflict with the egregious bullying and talentless common purpose type found in the NHS’ managerial ranks.

          • Adam Bromley

            Wasn’t it clear that he signed the gagging order in order to continue his malignant melanoma research project? It’s all there in article, just read it. Now you may not approve of that choice, but I can understand why five years into a seven year research project he put the completion of the research above other concerns. The hospital betrayed him and now he’s speaking freely. What else was he supposed to do?

          • Jab

            Articles in news dont seem to have much effect these days.The politicians are too brazen to care and top managers never resign.Democracy seems to have died under a pile of media trivia.

    • BananaHammok9

      You are blaming a cancer surgeon for not inviting even more abuse against himself, by ‘shouting outrage from the rooftops’?
      His track record in medical achievements, should have sufficed, to listen to him in a respectful manner.

      • JoeCro

        A cancer surgeon is not any more special or important than a GP. Being an expert in a very narrow field is not all that challenging.

    • mikewaller

      Were it in my gift, I would ensure that you got the 2015 “Shooting the Messenger” award. What I cannot understand is your motivation. This story demonstrates that vested interests of several stripes within the NHS are prepared to get very heavy with anybody who speaks out of turn. Anybody who does deserves our encouragement, not criticism for having failed to be even braver.

      • Freddythreepwood

        But there was nothing brave about his original disclosures. He thought his contract made him fireproof. He was on the verge of retirement anyway. When he had the opportunity to be brave, he chickened out. Just read the article. Until the point where he signed the gagging order, I was outraged on his behalf and ‘were it within my gift’ the people who bullied him would be out on their ears. Save your disdain for them.

  • john studd

    For those who do not know the background Mierion Thomas is probably the best and most experienced sarcoma and melanoma surgeon in the UK.As a gynae surgeon I have watched his brilliant surgery many times .He is correct that the overall commitment and value of general practice is decreasing.Thank heavens there are exceptions but the delay in obtaining a GP appointment and the delay of referral to hospital is the principle reason why the UK has about the worst cancer results in Europe We need to take note of these “whistle-blowers”not have them punished by half baked untrained managers more interested in their possible CBEs than listening to good advice from experts

    • Dr Baz.

      any evidence for his slander ? “delay in obtaining a GP appointment and the delay of referral to hospital is the principle reason why the UK has about the worst cancer results in Europe”

      • Lageraemia

        “He is correct that the overall commitment and value of general practice is decreasing” What absolute crap. You have no evidence for that statement. Stick to gynaecology you imbecile.

        • Jab

          The evidence isnt collected is it.

          • Not the BBC

            and where is your “evidence” for asserting the contrary?

      • Jab

        My mother -in -law went twice to G.P with family history of bowel cancer, anaemia and change in bowel habit.She aske to be examined.G.p gave ferrous sulpahte and didnt examine her.Unfortunately she told nobody what had happened until a few months on she found a lump….
        Died within 6 months.
        I have other anecdotes .perhaps the NHS could collect these as the G.P’s dont.

        • I am so sorry this happened to your mother-in-law. It is a problem for many. My friend has (after 2 years of GP appointments) now been told she has cancer and there is nothing they can do as it is too advanced. She now has to prepare her 5 year old daughter for a life without her mummy. That said, not all GPs are hopeless. There are still many, including my husband, who are increadibly consciencious and work far more hours than are healthy. For some GPs being a doctor is still a calling and they do care what happens to a patient.

          • Jab

            I accept what you say, sometimes cancer cant be diagnosed but the lady I wrote about had 3 symptoms which all are bloody obvious, she didnt want to bother anyone.There are some wonderful people doing thier best in G.P land, its just they are not measured and rewarded.

          • Agreed, I guess performance related pay might help but I fear it would just put more work on those GPs who already give 110% I think the sad fact is that the NHS will never be the way it was intended to be ever again. 3rd and 4th generation British public don’t know what it was like to pay to see a doctor and die or suffer in agony if you couldn’t afford it. The welfare system was only intended to support the most vulnerble in society or those made redundant not of their own making. Unfortunately that too is abused now with people on benefits living as a way of life. I find it hard when people say ‘I just got paid’ when referring to their benefit being placed in their bank account. Paid? what for?

          • Margot

            I don’t think there is that much mileage in mixing up the problems of the benefits system with the NHS. What would be worth looking at is the whole ethos of the NHS. Any of us who have had a lot to do with it over the last 20 years have seen the difference the marketisation of it has made with no-one seemingly accountable for where and how much (tax) money is spent (far in excess of the whole benefits system incidentally) and the managerial system the article writer describes which is more attuned to a cornershop (with under qualified managers paid far in excess of what they would get anywhere else. There is simply no-one running the show who has clout and is not in fear of their own lucrative post disappearing.

        • husamgcd2

          That is a tragedy if it happened to a family member I’d ask for that doctor to be struck off. But to be fair we get regular referrals from GPs on the 2 week wait clinics and have uncovered so many early cancers when most of what we get referred are cases where the GP was just being overcautios. So please do not let this paint the picture in your mind that the NHS is all at this low standard. It is important to seek a second opinion. GPs are not gods. They are prone to grave errors of judgement.

        • Vera

          Happily I have nothing but praise for my GP practice – an all women practice and no doubt some of them work part time. But I have other tragic experiences of NHS incompetence, the worst being the result of our hospitals virtually closing down at the weekend. Don’t whatever you do, agree to having an operation on a Friday. If anything goes wrong you will have to wait until Monday to find out what and how to treat it – you may not make the wait, my friend didn’t.

        • Sarka

          My mother aged 74 went to her GP who clearly suspected ovarian cancer (she was still on her feet but had quite severe symptoms like abdominal swelling, swelling of the legs). He used the usual euphemism about a “cyst” that needed investigation. He made her an appointment for tests at the local hospital – which had no special expertise in this area – for two months in advance.
          Meanwhile I (abroad) got in contact with an oncologist I knew in London who knew a fine specialist in ovarian cancer at a major London hospital. I talked to her and she said the London clinic would happily see my mother asap, and on the NHS. She also gave me a list of questions my mum should ask of the specialist at the local hospital with a view to finding out whether the local hospital was really up to scratch on the condition, surgery etc…
          I called my mum’s GP. I indicated that mum could go up to London and I would come over and be with her – from Google I had found the local hospital had no special expertise…Her GP was incredibly rude. He accused me of being one of those “pushy types”, “pulling strings” and told me that he didn’t see why the NHS should finance “a fun daytrip to London” (sic – from Cornwall BTW – I didn’t demand he pay the fare FFS!) for OAPs…Yes. she had a right to a second opinion, but she should wait the two months and more (until the local non-specialist had expressed a first opinion)…

          Mum staggered on bravely and finally got the tests at the local hospital, but a) they seemed inconclusive although definitely indicating cancer, and b) when I brought up the offer of the expert Middlesex Unit I was angrily fobbed off again. And the next day my mum collapsed in agony and was hospitalised. I flew over immediately….

          Mum was in a very bad state but the oncologist told me that as far as she could see it was a temporary problem – not immediately terminal related to the illness – and Mum would be better in a few days and I could take her home…I asked one of the doctors there all the questions about policy and expertise I had received from the expert ovarian oncology unit in London and he couldnt answer a single one them…

          That all became theoretical because Mum sank so fast. She died within a few days. The local oncologist registrar was a nice lady who said she couldn’t actually understand what was going on with Mum – apparently she had lots of patients with more advanced cancer who were not in Mum’s terrible state…Ten minutes after Mum died she came in looking very alarmed, and distinctly said to another doctor, “Oh God, I hope we didn’t puncture the bowel when we did the tests…I guess that might account for,,,” before actually putting her hand to her mouth and glancing at me and clearly hoping that in my emotional state immediately post-death of my mum I had not heard. I had! Later a junior doctor told me, “Well, sometimes cancer patients just deterioriate rapidly and we have no idea why…” he seemed desperately nervous and avoided my eye, but he was lucky…I wasn’t in the mood to pursue the issue…It all seemed so pointless with Mum dead.

          Mum died two and a half months after the GP first suspected ovarian cancer – and with the hospital having not as yet managed to diagnose anything really specific but probably having punctured her bowel – usually fatal – in the process of the non-diagnosis….and her GP had furiously fobbed me off (on financial grounds – and with the implication I was a trouble maker) when I suggested being allowed to take her to a specialist London unit that had assured me they could and should do so on the NHS (with me happy to pay the fares involved)…….

          There are problems with the health service where i live (Czech Republic), as there are problems anywhere…But I have never heard of anyone being treated like Mum in the Czech system….(serious symptoms and likely cancer diagnosis and you are in for tests and if necessary hospitalised within days)….My Czech husband was even more in shock about what happened to Mum than I was…

          • Margot

            Something similar happened to a friend. She was still fit enough (and well enough off) to take herself to a cancer centre. She was tested and operated on before the date of what would have been her first appointment at the local hospital. When she asked for the other referral she was told the GP was on holiday. She only obtained it by insisting someone else wrote it. There are two problems at present:
            1. You need to be super fit to be ill and deal with it all and
            2. we are most of us in a limbo between a free health service which has (mainly) stopped functioning and insurance which even if we had it dumps us it we do get ill.

        • Fried Ch’i

          English GPs don’t examine, they just don’t – full stop.

    • husamgcd2

      Sorry but writing in the media to twist a professional organisation’s arms is inappropriate. There is nothing special about sarcoma and melanoma that makes him more a surgeon than any other. Yet you don’t find a culture of media screamers among many like this contemptible person.

      • Janet Forgan

        If people don’t speak out nothing changes – doubt his patients would welcome your last sentence unnecessary.

    • Vera

      It’s so dismal that a man of Prof Thomas’s standing and reputation can be treated like a schoolboy caught smoking dope by, no doubt, talentless nobodies.

  • The Bogle

    Elsewhere
    in this issue in the context of the possible prosecution of those who openly harbour
    “doubts about gay marriage” Rod Liddle writes of “the new absolutism at work.”

    This new absolutism would appear to come in many guises in contemporary society, as we can see in Mierion Thomas’s case. Why do those in authority seek to curb freedom of thought and expression?

  • WFB56

    Fantastic article, lifting up the rocks and finding all the maggots underneath. Great that the villains are properly named and, hopefully, shamed. Any organisation that cannot withstand criticism is bound to atrophy and fail and the NHS is a perfect example of this.

    Thank you Mr. Thomas and it is a tragedy that you paid so high a price for honesty and offering solutions to the mounting problems within the NHS.

    • Fried Ch’i

      That’s what constitutes ‘bringing an organisation into disrepute’. This happens all the time, it always carries the same sentence in English society. Get over it.

      • UKSteve

        In other words, “this article, and some its comments, go WHOOOOOSH! right over my head.”

        As usual. No idea why you troll here.

  • global city

    Keeping the notion of the NHS pure is important for the Left as it keeps the door open to the still desired Soviet upland.

    • mikewaller

      This case has nothing to do with the Left or “Soviet uplands”. Most people in this country love the NHS because its existence means that the fear of illness is not compounded by the fear of having to pay for treatment. The issue in this story is that powerful forces within the medical profession are prepared to go to considerable lengths to silence criticism. Even worse, others in authority are seemingly perfectly happy to go along with this.

    • Davros64

      What Complete Horse Faeces, you Tool.

      • global city

        How so, Comrade?

        Loads of countries have socialised health systems, none of them modelled on our NHS. We are not allowed to even look at alternatives that may break that principle of the government dictating how resources are organised in the health sector here.

  • Ne11y

    It’s exactly the same in the state education system. As a teacher, I was bullied mercilessly until I had no choice but to leave.

  • StVince

    Prof Thomas was absolutely right to highlight the lack of customer service in the NHS. The NHS is paid by Whitehall not by its patients, and from that flows everything else. In the case of GPs, they are the system’s “gatekeepers” charged with rationing patient access to hospital services, such as Prof Thomas’s clinic. In these tickbox target driven days it’s an awful job (hence many GPs take early retirement, and few medical students aspire to be GPs). So when a hospital consultant comes along with criticisms, they don’t take it kindly. And since they are the gatekeepers – effectively the hand that feeds the hospitals – they can pressure the consultant’s employer into silencing him. Of course, that’s not in the interests of the real end customers – the patients – but since they have no real control over who gets their custom, there’s nothing they can do about it. And things will stay like this until the monstrous NHS is broken up and buying power put into the hands of patients.

    • post_x_it

      But can a GP really make a plausible threat to stop referring people to the Marsden?
      To stop referring cancer sufferers to the leading cancer hospital in the country, just because they have a beef with one of the consultants there?
      Where are the patients’ interests in this? And where will they go instead? It’s not as if all the other hospitals are awash with spare capacity.

  • Let’s face it – criticising the NHS is to much of the public, the media and pretty much the entirety of the left-wing in the UK, the equivalent of drawing pictures of, or criticising Mohammed.

    It makes no rational sense that it would generate white hot outrage and lose people jobs, but it does.

  • Sten vs Bren

    Nationalise General Practice. We tried stuffing their mouths with gold, as with the rest of the private sector but it didn’t quite buy us what we wanted.

    • Dr Baz.

      comedy

    • Lageraemia

      Clueless idiot. Not a bloody clue. General Practice has changed beyond recognition in the 8 years I’ve been doing it. THERE ARE NOT ENOUGH GPs TO DO THE WORK THAT HAS BEEN DUMPED ON US WITHOUT ANY ADDITIONAL RESOURCES TO EMPLOY STAFF TO DO IT. It is as simple as that.

      • cartimandua

        And then government says cheerfully just work weekends as well.

      • Vera

        No good telling us. Tell those that can do something about it. You criticise Prof Thomas for putting his criticisms in the press because he couldn’t get anyone in the NHS to listen to him, yet you are moaning here about too few staff and money – well get on to the NHS and tell them, not us, since you think it so easy. Good luck with that.

  • cartimandua

    Government makes impossible demands on GPs. You were right but it wasn’t the GPs fault.
    They are short how many now? And government are saying “and open on the weekend too”.
    Even government thinks we need 5000 new GPs. We have the lowest doctor patient ratio in Europe.
    So of course …..

  • JamesCovey123

    Thank you for speaking up.

    Speaking up might be almost as important as your fine work with cancer patients.

    Don’t give up.

    Give the Marsden a choice.

    “Back down, or I keep speaking up.”

  • Pioneer

    If that is accurate, the NHS is in an apalling state.

    We need more people with the courage of Mierion Thomas. He should get an award.

    • Hippocratica

      I agree completely. Meirion Thomas is a hero. He should be awarded definitely for telling the TRuTH.. Without people like him the indadequacies of the GP’s will continue. In my case I’ve had virtuallly no help whatsoever from GP’s for over a year, despite having Hashimoto’s disease (given the wrong medication) and symptoms of Multiples Slerosis.. All I do get are prescriptions and some referrals. I never see blood test results and any hospital test s for my muscle weakness are completely ignored.. I have often had to pay huge sums to see good specialists.

  • Huw Williams

    As an ex GP I completely agree with not only the right to criticise but many of the points that Mierion Thomas makes. I witnessed a huge deterioration in clinical standards in GP land and an insistence by the profession to go down a particular alley as promoted by the Royal College of GPs

  • banjounchained

    ‘Despite the heroic efforts of individual doctors, too many GPs no longer try to provide an even remotely personal service, to offer appointments at a convenient time or to take effective responsibility for continuity of care… General practice, as structured, is an anachronism and not fit for purpose.’

    Evidence please? If it wasn’t for GPs there would be no such thing as continuity of care. Prof. Thomas’ comment were insulting to an entire profession of people who work tirelessly for the good of their patients despite ever increasing workload from secondary care and reduced funding. Attacked from all sides, it is hardly surprising that GPs, including the chair of the RCGP, reacted as they did.

    • Vera

      Oh grow up. You know he was referring to ‘some’ GPs, not all.

  • fundamentallyflawed

    In ten years I don’t think that the NHS has “cured” me of any problem yet when you are given poor advice or question any treatment you are met with disdain and have little alternatives.
    I can only imagine the horror of someone who is diagnosed with Cancer or other serious illnesses and have to go through the lottery of NHS treatment when bad practices and poor Doctors are given protection from criticism

    • Maureen Fisher

      This was exactly what happened to me. A private doctor sorted it out in the end at considerable expense.

  • David

    I have become bored with commenting on the NHS.
    The NHS has become so politicised that rational discussion and name calling is all we seem to get now.
    Any suggestion of change is met with a battery of comments about the alleged shortcoming of the US system, as if that is the only other health service in the world. The arrangements that exist in most other countries (such as insurance based) are dismissed.
    Also, as this surgeon’s experience shows, the NHS takes Stalin as its mentor when it comes to reacting to anyone inside it who dares to discuss its shortcomings.

  • milford

    This is an total outrage. Common Purpose in action. This man is a genius, a hero and a great guy who’s gained the respect of the medical world and beyond. My daughter worked for him and he treated a friend of ours. He’s a great man and Cameron should be putting him in the Lords instead he’s putting the glamorous boss of Ultimo Bras in the Lords, that gives you a measure of that prick. This country’s finished if this can happen to someone who has served his community with great diligence and care his entire life.
    I’m stunned.

  • Lageraemia

    Calling JMT a ‘whistle-blower’ is offensive to whistle-blowers. Expertise in a narrow secondary/tertiary specialty does no excuse you from having to think critically and look for an evidence base for your conclusions. It certainly does not allow you to represent poorly thought out opinion as something more than that.

    • Vera

      In other words, you decide who is qualified to criticise. Surely anyone of sound mind should be able to criticise the NHS. We all have experience of it. If the NHS is unable to take criticism seriously and deal with it, then it is putting itself above criticism which solves nothing.

  • Hugh Jeego

    There’s no progress without informed criticism of the status quo in any field of human endeavour. Stifle criticism and you stop progress.

  • Malcolm Knott

    If the government is serious about promoting transparency in the NHS why not provide, by statute, as follows: That no term in any contract of employment (or severance agreement) shall be enforceable in so far as it purports to limit the employee’s freedom of speech.

  • Dr Galloway

    Prof merion I think you missed the point entirely about why people were upset with you. In a very heavy handed article you insulted an ENTIRE specialty. You lumped every GP into one bunch and blamed them for the downfall of the NHS. Did you serious think people would not be offended? You called an entire profession into disrespect. A profession, that as a tertiary consultant, I suspect you have very little day to day contact with. Please go and sit in with some GPs and see exactly what the pressures on us are. We know the NHS isnt perfect and most of us are working our socks off to prop it up. Few GPs want it to fail or be privatised (but Im sure if you look hard enough there must be a couple). Most of us want to provide the very best service for our patients but are increasingly struggling in today’s political climate, to do so. Look at it from the other side. If a GP had written an article in an INTERNATIONAL newspaper about how Consultant cancer surgeons were the reason for the downfall of the NHS or even just the reason the UK has such poor cancer statistics, would you and your former colleagues not be upset and up in arms about it? You havent been silenced and you are not a whistle blower.

    • mikewaller

      That you and your colleagues were upset does not constitute adequate grounds for this man to be banished from Planet NHS. All involved in this shameful action should be obliged to write out one thousand times, in their least execrable writing, the statement usually attributed to Voltaire: ” I disagree with everything you have said, but would die for your right to say it.”

      • Maureen Fisher

        Speaking out has got him sacked. That doesn’t increase anyone’s confidence that malpractices will be sorted out.

    • No Man’s Land

      Well I took the time to read the PULSE, the GP trade mag, and frankly comments appalled me. Your were offended, boo hoo, and so you called for his head and referred to the GMC. No good reason, although there is apparently some clauses for bedwetters in the code of practice which he had breached.

      I am sorry you were offended, but if his comments are so irrelevant why not just brush them off?

  • Mark Cade

    You are of course assuming that Mr Thomas, a specialist in a tertiary teaching hospital, is more qualified than a Serbian coal miner to speak out about the workings of NHS general practice

  • mrsjosephinehydehartley

    I would have thought it quite wrong for a professionals manager to curtail the terms and conditions of those who have consented to be subject to research. When these people consented to take part in the surgeons research work, they surely didn’t consent to any executive intrusion.

  • Jab

    I am so sad that this has happened to a dedicated and competant surgeon.I also have seen this behaviour in the NHS where I have worked and still do work in contact with NHS.its interesting the power that a trust has to change the definition of words such as, gagging.Maybe they could advise what to call Isis, the BBC has these problems. The pointless pedentry that comes out of some NHS managers is staggering.When I sold my pharmacy they had no idea what papers were needed to be signed and I had to wait for 2 months for them to sing names on a piece of paper.
    Yes these are the people running the show, bullies and incompetant ones at that.The G.P’s have largely given up being proper medics.I dont bother to see mine.I go private direct to the expert consultant.Some are still good but these days theres too much to know.
    The study done a few years ago by the kings fund and Lord Darzi showed variable quality of G.P services and how difficult it is to measure so Prof Thomas isnt saying anything much different.
    The words world class and best in the world are sprinkled freely and hope to convince us but my own experience is that g.p services are much better in Italy ,I lived there for 10 years, and France.Also they are paid less in continental europe.
    The NHS may be better privatised , I dont know.I do wish Prof Thomas a long and happy retirement and he can have a good conscience that he did his best whereas those who have persecuted him and blocked free speech can have no such consolation as they go to into that dark night

  • Joseph I am so sorry this has happened to you. It seems there is a lot of sensitivity surrounding the NHS at the moment. I am a GPs wife and know how hard my husband is finding the constant GP bashing. As ever there are in this profession those who do their utmost to help their patients and those who do not. Whilst it is unfair to blame all GPs, I agree that the movement away from a ‘family doctor’ who is very aware of your medical history and other factors has been a great loss, not just to the patient but also to the doctor. It has impacted the job satisfaction for GPs and reduced the consistacy of care. I do not believe that GPs are to blame for this but rather the changing society in which we live. The society we live in today is far removed from that in which it was concieved many years ago.

  • Shane Nicholas Glackin

    Huh. I could have sworn that what you lost your job for was being a vile sexist shit, in public. Like your dismissal notice says, an’ all…

    • BananaHammok9

      pi$$ off vile troll

  • BananaHammok9

    Thank you for this brave and exposing article. It is vital that voices such as yours, never get shut down.
    Great cancer surgeons are needed everywhere in the world, have you retired permanently now?
    As for the planet-sized elephant in the room: Britain is losing important and contributing members of society, joining the white flight, while at the same time it keeps absorbing parasites and allowing traitors to rule.
    The decision to force you out for speaking the truth, is just another nail of degeneration in our countries’ coffin.

    If I were you Doc, I’d take my money, give Britain the finger, and retire somewhere tropical and beautiful , you deserve it. Good Luck.

  • husamgcd2

    Don’t trust anyone who “voices concern” and decries colleagues to the media when there are professional channels to process such concerns. If you could not argue your case effectively within the specialty then writing to the media is just sour grapes. Pathetic and unprofessional.

    • Vera

      I think it you who is unprofessional.

    • No Man’s Land

      Work in the NHS do you?

  • husamgcd2

    If what was written is true then I am glad that the “managers” have cut this man off the Marsden. We are completely demoralised because NHS is constantly being attacked by the ungrateful and the sensationalists. Now a senior surgeon is setting an example where you can force the NHS to lend you an audience by crying out loud to the media. I’m glad you no longer serve on this great institution. Good riddance.

    • Vera

      So the NHS is above criticism?

      • Maureen Fisher

        Obviously.

  • Tim McCarthy

    Spineless, too many people in senior positions are far too busy protecting their own positions/interests. Freedom of speech? It’s not just the NHS that’s in a mess…..the whole country is crumbling. Seems like from the inside out……like a cancerous growth. 🙁

  • eldertree

    Apropos John Studd’s comments – for those not in the know, never look to surgeons for serious intellectual insights, they are highly trained carpenters who generally come from the middle or lower reaches of the medical class, and who often mistake the adulation of their patients and the vast earnings they make from the well off desperate (particularly in a city of oligarchs like London) as evidence of their genius. Those who trained with them know better.

    So it is with both Studd and Thomas, taking the statement about the reason for poorer cancer survival in the UK. As specialist cancer surgeons, I presume both would be aware of the recent voluminous review of this topic which finds the evidence to say the least uncertain. But let’s asssume they’re right and ask why it is that people are referred late? First up anecdote is meaningless. There are millions of consultations in general practice every month, the evidence shows the very best doctors can only get 83% of decisions right! mistakes willi be made. Unless of course, GPs awe provided with what they need – continental levels of time to see patients quickly and access to quick investigations and specialist advice. Which is exactly what hey do not get.

    Now let’s ask why they don’t and what role specialists have played in this. Since the national cancer plan was launched around 13 years ago, led by specialists, billions upon billions of pounds have gone into new kit, new theatres, new specialist clinical staff. Tiny fractions of this have gone into general practice or investigations available to general practice. Now, when all specialists’ promises of improvement have been shown to be quit overplayed, what do they do? Blame the GPs of course. But at least surely, you may say, they support diversion of funds to the diagnostic part of the equation? Not a bit of it. The cry from specialist cancer specialists continues – more kit! More of us! General practice just needs to do better. While seeing 40 people a day in 10 minutes!

    Someone with a bit of insight and imagination would see this and make the obvious connection to what needs to be done. Do not look to specialist surgeons for that.

  • Anglocynic

    From a patients perspective I completely agree with the comment about the lack of any sense of personal service from any of the GP’s that I have seen at my local surgery. Almost all appointments lasted less than 5 minutes and end up with me being referred to a specialist at my local hospital. Indeed on one occasion a female doctor wouldn’t examine me, because I think the problem was in the groin area, and she was of Asian origin, and simply referred me to hospital. I have yet to see the same doctor twice and have little or no confidence in what I believe is nothing more than a business and no longer a doctors surgery.

    • JoeCro

      You should move to another practice.

      • Anglocynic

        Unfortunately there isn’t another practice within 5 miles that is accepting new patients.

  • eldertree

    The funny thing is that whenever surveys are done of the Great British public general practitioners come up as the most trusted group of all – ahead even of consultatants, and vastly ahead of the business folk, lawyers, bankers and others who no doubt post here. Which just goes to show that your comments and others similar are essentially meaningless personal opinions devoid of any balance that should allow a rational direction of policy. But hey, that’s good enough for spectator commentators.

    • Margot

      How long ago? I know of no-one now who has a good word to say for their GP. They should be paid on a European level and then more could be employed. Most seem to be on almost continual long-haul holidays. Now there’s a survey that would be worth doing. Q. How many long-haul holidays have you had in the last year? A. a. 3-4 b. 2-3 c. 1-2 No point in putting d.!

      • eldertree

        There have been several surveys, though I don’t suppose you bothered to try and find these. Here is a report of one from 2015 – http://www.instituteforgovernment.org.uk/blog/10350/public-trust-in-public-servants-in-six-graphs/. Mind you your comments and name suggest you’re one of the crew who don’t give much credence to the views of the plebeian masses, and I suspect you and your chums expect to see an ENT surgeon every time you get a runny nose. As for reducing salaries of GPs, do you propose doing the same for consultants? Otherwise I wonder how you think they’re going to recruit to all those extra GP positions and how you’ll persuade even the few junior doctors planning to enter this current dogsbody job to do so?
        Asinine comment, no doubt appreciated by the commentators on here.

        • Margot

          Well, I have worked in the NHS and also in the health services of several other countries. Also have experience from the other side (not from the spiritual other side – though that seems increasingly luck of the draw that you don’t arrive on it!). And yes, I do think consultants are overpaid – though not as ridiculously as some management salaries that seem to be being paid in a totally different economy.

  • mikewaller

    There must be some way in which readers of this article can make clear, en masse, their heartfelt contempt for the jobsworths who ended this man’s career.

  • DennisHorne

    Seems to me the problem is not who is right or wrong about patient treatment but weak leadership.

    Isn’t this exactly parallel to Sir Tim Hunt’s downfall, sacked from UCL and The Royal Society for talking ‘too much’?

    A professor at Imperial warns the RM it might lose referrals. So? Might lose mana. So?

    Did my father and his two brothers leave these New Zealand shores to fight for a country they’d never seen — their English mother by then dead — for its institutions to surrender to cyberspace and the social media?

  • Magnolia

    I obtained a uk medical degree in the 1980s. The old doctors and old consultants that taught me then would be turning in their graves if they knew how medicine is practised within the NHS today. I was taught to listen to the patient telling you the diagnosis and after a proper medical history I was then taught how to find signs of disease by examination. These days it is not uncommon to have the GP making a diagnosis at the end of a telephone line based solely on the patients complaint for how else is telephone triage to assess for an appointment to be described?
    Even though I am medically qualified and my local GP doctors well aware of this fact they still tell me garbage when I make helpful criticisms if I feel that something is not right with the way they are working. They are singularly uninterested in me as both a patient and a person and they have such big egos that they cannot take a drop of critisism. 5-10 minutes is not long enough to assess whether a dog has four legs or not never mind to diagnose complicated medical problems. They used to get you to pop pills or have a blood test for every symptom but now their cost savings requirements determine that even that is unnecessary and patients are literally being told to put up with it or lump illnesses that could be diagnosed and may be very easily treated.
    The GP service, to coin a phrase, is not fit for purpose.

    • Maureen Fisher

      Certainly very reluctant to refer patients for a blood test unlike continental Europe.

  • johnhenry

    Well, Doc, your problem is your risible commitment to your patients clients over loyalty to your colleagues. Get with the program or get lost.

    Signed, J. Swift

  • susan behrmann@hotmail.com

    This is disgusting, Meirion is one of the best doctors I have ever seen and I would use him for anything. I can’t believe this nonsense, he has also been involved in fund raising for the Marsden. Everything he has said in his articles is true re. health tourism and unfortunately female medical students. A big mistake from Imperial College and the Marsden.. how about all those patients in the study? I have been with Meirion ( as a private patient at the Lister) when he has almost been crying down the ‘phone because there wasn’t an intvensive care bed for a seriously ill patient, needing an operation. My son gave up medicine, Meirion’s 2 sons are not doing surgery.. why is that.. because u want yr. patients to live.

  • susan behrmann@hotmail.com

    Me again, I used to live in South Kensington and had an excellent G.P. called John West, he referred me to Meirion for a small adhesion, saying meirion was a slightly difficult man, but the best and fastest surgeon he knew, not to be bothered by his attitude, however we got on really well ( perhaps due to a mutual love of horses) and he removed my small cancer immediately., that was a surprise.John West became disenchanted with the NHS and moved to London Wall, I am shocked by these events as I almost rely on Meirion as my second GP .

  • MathMan

    ‘In a time of universal deceit, telling the truth is a revolutionary act’. George Orwell.

  • DennisHorne

    Police refuse to open a gate for a cabinet minister on a bike and the cabinet minister is sacked for talking.

    A Nobel laureate talks and is sacked.

    The lead surgeon at a top hospital talks about patient care and is sacked.

    Dog wins “Britain’s Got Talent”. Doesn’t talk.

  • cartimandua

    The NHS’s is short five thousand GPs at least.

  • scampy

    Did you never consider yourself a greedy old bastard past your sell by date denying a younger consultant a position?

    • susan behrmann@hotmail.com

      I know the man; he is totally motivated by medicine, his family, and his patients and works v. hard; as I said before he helps fund raise for the Royal Marsden, this is a tragedy for medicine, incidentally he has treated my son on the NHS, knowing that I have private medical insurance.. so that is hardly some-one who is money grabbing. Pls. don’t judge some-one that you have never met.

  • saj

    As a practice nurse with a Husband who is a Hospital Consultant we both agree with every word you have written to date. Fed up with patients who need to be referred to a Consultant but GP’s think they know best even when totally out of their field of expertise. This is why they are Consultants …an extra 10 years of specialising in the subject.

  • Partner

    The key thing here is to recognise, as my lawyer advised me when I was considering whistleblowing in my own profession, “life is not Hollywood”. Most of the time the cards are held by authority and there is nothing those in authority detest more than criticism, especially if it is true. Very, very few whistleblowers have survived professionally, whether or not they have ever secured compensation for the inevitable financial penalties that will flow from their actions. honestly and acting morally has a price as Mr Thomas has sadly discovered.

    The NHS is particularly given to this kind of thing which is especially disgraceful given that it is a public service not a private company.

  • Maureen Fisher

    I’ve been on the receiving end of a misdiagnosis by a GP who is still practising. These people can rely on each other to cover their tracks.

    • johnhenry

      Dr I. M. Wikipedia, by any chance? Such a common name amongst GPs, so I may not be thinking of your GP necessarily.

      • Maureen Fisher

        People like you are part of the culture the article is referring to.

        • johnhenry

          …and people like you suffer from a common medical condition known colloquially as “tin ear”.

  • trace9

    Yes indeed, most GPs are gut-gnawing money-grabbing rats. Recently I asked my Practice if they communicate re ‘community health’ with the single chain-store supplying most food locally in this remote-ish district – which had huge chocolate displays at the doors. The GPs retorted that I was asking them to be Policemen. A follow-up asking how much money they made from the ill effects of fatness elicited the direct & blatant lie – still in my emails – that they made no money. These liars constitute The Portree Medical Centre. But they get away with all that because – No-One Cares. Or almost. Recent GMC pronounciamentos wholly agree with my standpoint, but nothing will ever be done to stimulate shitty GPs, et al, into working against their narriowly selfish financial interests. Because: No-One Really Gives a Damn. That’s why they can be so blatant. At least I have the goods to put comments like this up & they can never sue me but – so bloody what?

    That’s: The Portree Medical Centre, Isle of Skye. Shitheads all. A ‘recommend’ to Dr. J. – Et al; et few al…

    • johnhenry

      Good whisky, though. On Skye, that is. Might help if your GP personnel there prescribed it instead of pretending to know a lot. My da (RIP) was a GP and – along with his partners – a fairly good one, as I had many opportunities to observe in my early years as an ambulance attendant, but their knowledge was perforce limited by the nature of their calling. GPs would do well to humbly admit their limitations.

    • DennisHorne

      Not sure what your complaint is but I don’t think GPs can make money out of fat patients or stop shops selling food.

      I’m sure having you on their books must bring tears to their eyes…

  • No Man’s Land

    Doesn’t suprise me in the slightest. My mother is a nurse with over 40 years of experience and she’ll recount tale after tale of bullying and incompetence within the NHS.

    If you speak out your forced out or your life mad a misery. If you’re incompetent

    you’ll lost your job only to be moved sideways into an equivalent role in a different trust. The latter is particularly true of management.

    As for GP’s, I’ve been lucky to have had a very fine one, but it’s telling that with every change their mouths must be stuffed with gold.

  • Michelle Collin

    Thank you for having the courage and insight to write as you did.

  • Katie Teakle

    You have every right to your opinions. Courage to challenge and question shibboleths should be applauded. It is the only route to reasoned imaginative debate; delivering a globally respected medical philosophy within limited/changing parameters. A tragic price to pay and a great loss to your patients, colleagues and students.

  • Sarah

    As a junior doctor who had the misfortune to work for J Meiron Thomas ten years ago, I can tell you that his vitriol has little to do with the problems faced by the NHS and far more to do with his own personality. I can remember countless occasions when the ‘professor’ spoke to me in front of patients little better than a naughty toddler with no provocation whatsoever (and on several occasions he was so unforgivably rude to patients themselves that I still recall it now). I am now a consultant surgeon and can say that whilst he is an adequate surgeon, the NHS is very well rid of these misogynist, nasty individuals. The NHS, with all its problems, will grow stronger without him.

    • DennisHorne

      Did you try crying?

      • JoeCro

        Bullying in the work place is no laughing matter.

  • Marcus

    It is very sad that GPs have been reduced to being represented
    by doctors like Professor Azeem Majeed. If anyone should be investigated by the
    GMC for unprofessional conduct; it is him. How can you justify not referring
    your patients to a world renowned cancer unit because a surgeon working there has
    written an article that you find offensive? Even, if Marion Thomas had been
    genuinely offensive to GPs, which is not the case.

    What has the medical profession become in the UK? Once we pioneered
    treatments. Now, professors write letters asking colleagues to boycott cancer
    centres on the basis that one of the surgeons has said something they find a
    but nasty. And more concerningly this is deemed acceptable practice.

  • Henry

    I am a former sarcoma patient of Professor Thomas, and someone who almost certainly owes him my life. I can only say what a great tragedy it is that such a skilled and experienced surgeon has been unnecessarily lost to the medical community, and to so many patients, both present and future, who could have benefited from his work.

  • Kasperlos

    In answer to the last paragraph: None. The good doctor found out the hard way about the nature of the human condition, viz. that the biped is one mean beast. For all the caring he dished out his reward in the end, at least from his fellowes within the NHS organisation, was a swift kick in the can. Such is the nature of organisations, petty and ruthless regardless of the competency one holds or the years of service rendered. Stray out of line and the knives come out. C.G. Jung’s advice on organisations? Don’t.

  • patrickirish

    Whether what he says is true is irrelevant. He has been treated shamefully, and those he names should be sacked. Any decent bunch of people would be up in arms over this treatment of a colleague – I mean, who is next?

  • Liam
  • bviktor

    It is a very sad state of affairs, indeed. I also read your “Why having so many women doctors is hurting the NHS” article, and was baffled by the incredible amount of “why shouldn’t women have babies?” and “then just provide more places in medical school” comments with their glaring stupidity and ignorance.

    We live in an absolutely crazy society these days. There seems to be a rule set in stone that prohibits making offending (but true) statements. If something goes in a way that’s unfavourable to a certain group of people, then it should be ignored and covered up with money, sensitivity trainings, and so on. And that’s it. The only group of people you are allowed to offend and oppress is: white males. To no end.

    New world order. Gotta love it.

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