Breast cancer care ‘cover-up’ claimed

NHS Tayside is at the centre of bombshell cover-up claims over its handling of a breast cancer treatment scandal.

Letters obtained by us reveal Dr Norman Pratt, a non-executive member of the health board, accused senior management last year of being “complicit in the cover-up of a major clinical service scandal”.

He is said to have described their behaviour as “on a par with those actions reported in respect of the most major public life scandals of the last 20 years”.

Around 200 patients were given lower-thanstandard doses of chemotherapy drugs by doctors in Tayside between December 2016 and March 2019 in a bid to reduce harmful side effects.

Dr Pratt alleges the health board’s “own medical management” privately accepts there is no clinical evidence patients were put at any increased risk – but have allowed doctors to remain in the firing line over a series of botched and disputed government reviews.

He was a member of the board when it signed off on those government reviews in 2019, but has since come to the view that they did not fully investigate the available evidence.

After raising concerns at the end of 2020, the clinician was issued with a copy of the board’s code of conduct and asked to reflect on his own behaviour.

That response has been described by North East MSP Michael Marra as “entirely insufficient” and having the appearance of trying to silence a complainant.

More than a year later, Dr Pratt has written to members of the Scottish Parliament’s cross-party cancer group still seeking answers for doctors and patients.

Dr Pratt, who has more than 40 years experience in the NHS, is chair of the

area clinical forum and healthcare science forum, sits on the audit and risk committee and is highly respected as head of genetics at the health board.

He believes he is “mandated to follow up on key clinical issues where there is a clear professional consensus that some definitive action is required”.

Dr Pratt claims that the consensus is “overwhelming” in the case of breast cancer care in Tayside.

In a letter on November 10 2020, chairwoman Lorna Birse-stewart told him: “In effect you have accused me, the chief

executive, the executive management team and the board of being complicit in the cover-up of a major clinical service scandal.”

She quotes Dr Pratt as stating the actions of the senior management team “are characterised by cover-up, damage limitation and lack of transparency”.

He is also quoted as saying: “I believe that the final bitter harvest of the breast cancer crisis will be bigger and more profound than our endowment fund scandal, where executive and nonexecutive colleagues were roundly criticised for an abdication of duty.”

In the letter, Mrs Birsestewart outlines “the detail of my deep concerns” over Dr Pratt’s statements, saying it is “impossible to overstate the seriousness of the allegations that you have made”.

He was also told not to contact Mrs Birse-stewart or any other board members until further inquiries were carried out.

It is not clear what further action, if any, NHS Tayside took in relation to the concerns, and the health board would not comment on the substance of the letter.

Scottish Governmentcommissioned reviews found that the lower doses of chemotherapy offered to patients resulted in a 1-2% increased risk of their cancer recurring.

The findings were accepted in full by bosses at NHS Tayside, but the doctors claim they were “deeply flawed” and did not properly consider practice in other hospitals or the available clinical evidence around lower doses.

They claim the handling of the revelations – described by one physician as a fiasco – was in part down to a drive to stamp out variation in cancer treatment across Scotland.

A series of investigations by us revealed one of the experts behind the increased risk claim later privately admitted it was “flawed, probably, but the best that could be done, really”.

The doctors were subsequently cleared of any wrongdoing by the General Medical Council in a ruling that appears to be in conflict with the government-ordered reviews.

The revelation has sparked fresh calls for an independent investigation.

IN CHARGE: Lorna Birse-stewart, chairwoman of NHS Tayside health board, stated that she had “deep concerns” about the cover-up allegations made by Dr Norman Pratt.

MSP Michael Marra.