What led to the review?

• December 2016 to March 2019 – around 200 breast cancer patients are given lower than standard doses of chemotherapy by NHS Tayside doctors. Fourteen die during this period.

• January to April 2017 – Dr Adrian Harnett is recruited by NHS Tayside for an internal review after a whistleblower raises concerns. The review is favourable to the oncologists and later leads Dr Harnett to sign a letter in their defence.

• May 2017 – NHS Tayside contacts Healthcare Improvement Scotland (HIS) after the whistleblower remains dissatisfied following the review.

• November 2018 -

The Royal College of Radiologists nominates Dr Harnett to be the clinical oncologist panel member for a separate Royal College of Physicians (RCP) invited service review.

• April 2019 – HIS releases its report and the findings are fully accepted by NHS Tayside and the Scottish Government. The oncologists say they have been “thrown under the bus” by the handling of the revelations and brand it “factually inaccurate” in a detailed response later obtained by The Courier.

• The Scottish Government and chief medical officer are made aware of Dr Harnett’s conflict of interest. The RCP is also told but states it has incomplete information so the review goes ahead anyway.

• A Scottish Governmentcommissioned review group states patients were put at a 1-2% increased risk of seeing their cancer return. The finding is disputed by experts and the oncologists but is accepted by NHS Tayside and ministers. The same month, doctors in Tayside say they have been forced to offer the stronger chemotherapy doses against their own professional judgment.

• June 2019 – The RCP receives further details of Dr Harnett’s potential conflict of interest through its “raising concerns” mechanism. A complaint is also made to the General Medical Council (GMC).

• July 2019 – An independent review to fully consider the HIS findings sets out 19 recommendations, one of which states patients should be explicitly warned about the risks of variation in their care from generally accepted guidelines.

• August 2019 – It emerges a probe into the treatment of the 14 patients who died found it was “unlikely” it had an effect on their prognosis. The findings are not released publicly but are obtained by The Courier.

• September 2019 – It emerges one of the experts behind the 1-2% increased risk statement privately admitted the finding was “flawed, probably, but the best that could be done really”.

• The GMC considers there is no conflict of interest in relation to Dr Harnett’s involvement in the invited service review and closes its case.

• October 2019 – The Courier reports that the long-awaited invited service review will never be published due to the conflict of interest. Three days later, we exclusively publish the details of the review, including calls for psychological support for staff left distressed by the treatment revelations.

• The Courier learns the GMC is investigating NHS Tayside’s interim medical director Professor Peter Stonebridge, his deputy Professor Colin Fleming and four members of the oncology team.

• November 2019 – A group of patients and family members reveal plans to sue NHS Tayside over their care and hit out at a “catastrophic breakdown in communication” with officials.

• January 2020 – The RCP writes to Dr Harnett stating a serious disciplinary offence occurred due to his failure to declare a conflict of interest in advance of the invited service review visit. The complaint allegation is upheld and Dr Harnett is ordered to pay back his fee for the review. This prompts the GMC to reopen and “promote” the case.

• June 2020 – The GMC puts a range of allegations to Dr Harnett, including that his conduct had been dishonest when signing a declaration on the invited service review conflict of interest form.

• July 27 2020 – Dr Harnett writes to the GMC to state his recollection of events. Two days later he applies for voluntary erasure from the medical register citing “retirement” as the reason.