In mid-December 1994 we approached Dr Wells and met to discuss our problem. He clarified our position confirming that we had a professional duty to report our concerns to the General Medical Council. In the following three months from December 1994 to February 1995 we discovered further evidence in the medical records of patients, including forged consent forms and appointment diaries clarifying how electrocardiographs (ECGs) were to be produced with fictitious dates. Up to three electrocardiograms were recorded from a patient consecutively. The date recorded by the machine on the tracing was changed between each ECG so that it appeared as if the traces had been recorded on different dates and times over a three-month period. Our practice nurse had been asked to do this on a regular basis by Dr Fairhurst. He could thus complete trial data quickly with the minimum of effort. It is a testimony to his charm and charisma that our nurse had been complying for some time with these requests. We were uneasy about our role at this time as we were almost acting as investigators; however, we knew that, to succeed, our case would have to be strong and supported by documentary evidence. All of the patients involved were shocked at the discovery of the falsified consent forms but all confirmed in writing that the signatures on the forms were not theirs.
Once completed, the document ran to many pages and was posted to the General Medical Council in February 1995. I felt as if the long fuse to a bomb had been lit. We waited many weeks for a reply from the General Medical Council. When it finally arrived it was a postcard explaining that the matter was receiving their attention. You can imagine our irritation, as there was nothing there to allay our fears and everyday work became almost unbearable because of the anxiety.
To clarify our position we contacted the British Medical Association (BMA) and the local industrial relations officer was extremely helpful. He accompanied us when we met the health authority to inform them of our action. The chief executive and medical director were obviously shocked but explained that they were unable to take any action or help us, and would await the General Medical Council's decision.
In July 1995 Geoff Fairhurst wrote to Dr Shah and myself to inform us he was ending his partnership with us. He would become single-handed, taking his 3500 patients, and share the jointly owned surgery with me. However, he gave me notice to quit our branch surgery, where we had around 2500 patients. Dr Shah decided to leave the practice and found another partnership locally. I had just a month to arrange alternative accommodation for my 1000 patients at the branch surgery and make arrangements for 2400 patients in total. With a friend I purchased a house nearby and obtained planning permission to convert it into a surgery. There would not be enough time to convert the premises and Dr Fairhurst would not contemplate an extension to the deadline. Fortunately a local general practitioner, Khalid Laghari, contacted me, offering to share his premises with me. These were only a few hundred yards away and the move was completed without problem or inconvenience to anyone. During that period I was very concerned that I would lose many of my patients and would not have a viable practice. I continue to work from Khalid's surgery and believe that his generous action ensured the viability of my practice.
The next year was a very stressful time both at work and at home. At times it was difficult to concentrate or find enjoyment in anything. My wife, Helen, had been involved since my first suspicions and had been supportive and encouraging from the start, but the state of affairs placed a great strain on our relationship. We discussed each twist and turn and, when Dr Fairhurst dissolved the partnership, Helen chose to become my practice manager. She had a degree in history and politics and brought many office skills to the practice and helped to manage change through a very difficult period for the staff. From my selfish point of view it was reassuring to have someone I could trust completely to manage the practice, and for Helen there was the advantage of viewing the problems at first hand. Even so those three years were a terrible torment for us both. I was worried about the effect the action might have on my career, so for insurance we applied for immigration documents for Australia.
During the period between the dissolution of the partnership in July 1995 and the General Medical Council hearing in March 1996, Dr Fairhurst was informed by them of the details of our complaints against him. I continued to work in the same building and our respective staff had to share the office and equipment.To look back, it is amazing that we could continue working normally during this period. All my staff are still working with me and their support and loyalty was invaluable. The health authority was aware of the difficulties of the situation and assisted where possible, but this was confined to chairing meetings and arbitrating between the two practices: for all practical purposes, we were on our own during this time, with no support locally. Dr Fairhurst continued to practise and sit on the local medical and ethics committees and lobbied for his cause, spreading misinformation to patients and colleagues in the area. As the date of the hearing approached, the tension built both at home and within the practice. There were no second thoughts now and even the patients involved were committed to their day under the spotlight.
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