Brighton and Hove health chiefs have explained their handling of an incident that was featured in a Channel 4 television programme this evening (Monday 3 October).
Dispatches, the current affairs programme, looked at questions around family doctors and what happens when they make mistakes.
The programme was presented by the journalist Jon Snow and included the case of a Brighton doctor who was criticised after the death of a three-year-old boy from Hove.
Joseph Seevaraj, of Hallyburton Road, Hove, died from septicaemia as a result of acute tonsillitis.
His parents, Jean and Nicola Seevaraj, told the programme that they had contacted their GP surgery on a Saturday in January 2008 but it was closed.
A recorded phone message directed them to Brightdoc, part of South East Health, a company which provides out-of-hours cover.
The couple said that they had spoken to Brightdoc a number of times but decided against taking their son to hospital on the advice of Dr Tilo Schippers.
Mr Seevaraj wiped away tears as he described waking to find his young son Joe dead.
Brightdoc was contracted by Brighton and Hove City Teaching Primary Care Trust (PCT) which is also known as NHS Brighton and Hove.
Brighton and Hove coroner Veronica Hamilton-Deeley said at Joe’s inquest: “He needed basic medical attention.
“The failure to provide it was gross failure.
“I am satisfied there is a clear connection between this gross failure and his death.”
Dispatches said: “Incredibly, until we told them, the GMC (General Medical Council) knew nothing about this case.
“Neither the PCT nor the coroner told them.
“Under their own guidelines, PCTs should refer cases like this.”
Niall Dickson, chief executive of the GMC, said: “It is bad. Any case like that should be referred.”
The GMC is the organisation that is responsible for investigating and disciplining doctors who break the rules of the medical profession and fall short of its high standards.
In a statement the PCT said: “The coroner criticised the response of Dr Schippers, a Brighton GP working a shift for the out of hours service, who took the last in a series of calls from Joseph’s parents expressing concern about their son.
“Dr Schippers had left the UK by October 2008 when the coroner made her conclusions.
“Dispatches has asked the PCT why we did not refer him to the GMC following the coroner’s conclusions.
“We have confirmed that, in retrospect, this would have been helpful.
“However, as he was no longer practising in the UK at that time, we made it clear on his file that the details must be shared with any future employer.
“At the time we judged that this was sufficient given that this terrible tragedy was an isolated incident and the only issue relating to the quality of care provided by Dr Schippers during the four years he worked in Brighton as a GP.
“In 2010 Dr Schippers returned to the UK and applied for re-inclusion on the Brighton and Hove performers list.
“The PCT sought guidance from the Kent, Surrey and Sussex Deanery and from the National Clinical Assessment Service (NCAS).
“We also contacted Dr Schippers previous employers who confirmed there were no concerns about his work.
“The PCT again considered the option of referral to the GMC.
“It was decided that there was no suggestion that Dr Schippers was not fit to practice, nor that his clinical practice was likely to put patients at risk.
“After careful consideration Dr Schippers returned to work as a GP under certain restrictions.
“As well as undertaking significant retraining, Dr Schippers was required to work for six months in a practice where other doctors would be available to support him.
“Dr Schippers continues to work at various practices in Sussex as a locum GP.
“The GMC are clear that most concerns about doctors will continue to be handled locally, with referral to the GMC if there is evidence that a doctor may not be fit to practice.
Performance
“We welcome the GMC’s plans to develop thresholds for referring doctors and we are currently drafting a local policy to ensure referral to the GMC in any case where the coroner expresses concerns about the performance of a clinician.”
Since returning to Britain Dr Schippers has worked for, among others, the Willow Surgery in Heath Hill Avenue in Lower Bevendean.
He could not be reached this evening but another doctor said: “When a doctor makes a mistake it can have terrible consequences.
“If it’s a one-off and it’s an honest mistake and lessons are learnt then it may be better for all concerned if he or she is allowed to put those lessons into practice and continue treating patients.
“In such cases the GMC may order that the doctor concerned undergo extra training or be supervised for a period of time.
“Obviously in certain circumstances that would not be appropriate and in the most serious cases a doctor can be struck off.
“In isolated cases, though, I am sure we would all want to be mindful that it takes a long time and a lot of money to train a doctor and we don’t want to throw that away lightly.
“This is not to try to underplay the serious consequences that can occur but to maintain a sense of proportionality and not to lose the services of an otherwise able and conscientious clinician.”
A very overhyped tv programme. Who knows what REALLY happened?
I know Tilo Schippers from my studies on. He was and certainly is an extraordinarily skilled MD with an impressive range of knowledge, responsibility and a very pleasant character. I agree to the other comment that nobody knows what exactly happened and that also Doctors are human beings. I would give Tilo Schippers the full responsibility for my own ill children without any hesitation. It´s a shame to give all the names to the general public, which certainly is an incredible pressure for everyone.
PD Dr. med. Philipp Kuwert, M.D., Senior Lecturer, University of Greifswald, Department of Psychiatry