Accused surgeon offered ‘two for one’ mastectomy
Medical guidelines ‘not written in stone’, he says
A SCOTS breast surgeon accused of carrying out unnecessary operations for money has told a court he offered to perform one patient’s mastectomy for free.
Ian Paterson said alleged victim Frances Perks’s insurer only offered to cover surgery on her left breast, adding: ‘I told her I would do it [the right breast] for no fee.’
He added that ‘the anaesthetist and the reconstructive surgeon refused to do their part for free (and) to be fair, their part was longer and more complicated, but they wouldn’t do it’.
Paterson, on the fourth day of his cross-examination at Nottingham Crown Court, also said professional surgical guidelines were ‘not rules or laws, written in stone’.
He told the Crown’s barrister, Julian Christopher, QC: ‘You’re looking at guidelines, I’m treating a patient – that’s where we differ.’
The Glasgow-born surgeon denies 20 counts of wounding with intent against nine women and one man relating to procedures he carried out between 1997 and 2011.
Jurors have previously heard claims he carried out completely unnecessary operations for ‘obscure motives’ which may have included a desire to ‘earn extra money’.
Referring to the case of Mrs Perks in 2006, Mr Christopher asked Paterson if he was familiar with the 2005 guidelines of the British Association of Surgical Oncology (BASO).
The 59-year-old replied: ‘Broadly, yes, we tend to follow them, but they’re not rules or laws, written in stone.’
He added the guidelines were ‘entirely appropriate’ for most patients, but were not perfect for every case.
Paterson said: ‘What you’ve got to say is “here’s the guidelines, here’s the patient, does that patient completely fit the guidelines?”.
‘We followed BASO guidelines as being the professional body that oversaw the work we did, day in, day out, as strictly as possible – with the caveat that individual patients didn’t necessarily fit into the guidelines.’ Mr Christopher then asked if he had engaged in ‘a fishing expedition’ and sought to ‘justify’ a double mastectomy on Mrs Perks, when potentially pre-cancerous disease had only been found in one of her breasts.
The surgeon said he was ‘reacting to the lady’s obvious distress’ in offering a double mastectomy, and went on: ‘She even considered funding the anaesthetist’s part of the right side herself, but it transpired that didn’t happen – I think it was too expensive for her.’
Mr Christopher asked: ‘Did you tell her she would get breast cancer if she didn’t have a double mastectomy?’ Paterson replied: ‘I’m not sure I was as stark as that – to be that cruel to a patient – but she was aware of her risk. There was no pressure and there never had been.’
Paterson also told the court he had not called his alleged victim ‘a lying b **** ’ while she was giving evidence against him.
Responding to a prosecutor’s claim that he had used the term, he said: ‘No. Why would I use that language about a patient?” I said I thought she wasn’t telling the truth.’
The surgeon said he did not believe any of his ten alleged victims were ‘liars’, but that their memories had become confused over time.
Paterson, of Altrincham, Cheshire, was formerly employed by Heart of England NHS Trust and also practised at Spire Healthcare.
The case continues.
‘There was no pressure’