The Three Inquiries: Richard Neale

Terms of reference: To identify the procedures in place during the period 1985 – 1995 within the local health services to enable members of the public and other health service users to raise concerns or complaints concerning the actions and conduct of health service professionals in their professional capacity. To document and establish the nature of and chronology of the concerns or complaints raised concerning the practice and conduct of Richard Neale in respect of his employment as a consultant in the Northallerton Hospital. To investigate the actions which were taken for the purpose of (a) considering the concerns and complaints which were raised; (b) providing remedial action in relation to them; and (c) ensuring that the opportunities for any similar future misconduct were removed. To investigate cultural or other organisational factors within the local health services which impeded or prevented appropriate investigation and action. To assess and draw conclusions as to the effectiveness of the policies and procedures in place. To make recommendations informed by this case as to improvements which should be made to the policies and procedures which are now in place within the health service, (taking into account the changes in procedure since the events in question). To provide a full report to the Secretary of State. The terms of the Inquiry were later amended to include the whole of the period 1985 to 1997 during which Richard Neale was employed as a consultant in the NHS at a number of hospitals in North Yorkshire, Leicester and the Isle of Wight.


Chair: Her Honour Judge Matthews QC

Panel: Christina Funnell (an independent practitioner) and Derek Caldwell (the former Chief Executive of the Stockport Acute Services NHS Trust).

Dates:

  • Inquiry (along with two others) announced on 13 July 2001
  • Hearings: commenced 1 May 2003, evidence heard from 2 May 2003 to 2 September 2003 (24 sitting days).
  • Report: published 9 September 2004

Link to download report:

www.dh.gov.uk


Description of the events which caused the public concern: In 1985, Richard Neale was struck off as a doctor in Canada following the death of two patients after treatment by him. He began to work in North Yorkshire in 1984 and in 1993 media stories revealed that he had been struck off in Canada, and also that he had received a police caution for an incident in a public toilet. In 1995 his employer set up a disciplinary hearing into various allegations and Neale negotiated a severance practice. He worked elsewhere in the NHS in 1995 and 1996 and was struck off by the GMC in July 2000.

Litigation

R (Howard) v Secretary of State for Health [2003] QB 830

R (Haward) v General Medical Council [2007] EWHC 2236 (Admin)

Summary of report’s recommendations:

27 recommendations covering the following areas:

  • A new body, or an expanded Council for the Regulation of Healthcare Professionals to take an overarching view of all aspects of employment of doctors
  • Security of tenure for consultants should be abolished
  • Model declaration forms made mandatory, and job application forms should include appropriate declarations with relevant personal matters declared in a confidential side letter
  • Confirmation of qualifications and fitness to practice for all appointments made directly from overseas
  • References should seek specific information and standard application forms should be used
  • Clear roles for members of interview panels and full notes retained
  • Declaration of police cautions and police checks to include cautions
  • Medical colleagues must not give references which are misleading by omission
  • Copy discharge letters should be sent to patients and explain any complications
  • Doctors should be familiar with the Patient Advocacy and Liaison Service (PALS)
  • PALS officers should be of middle/senior grade and appropriately trained
  • Complaints handling training for all staff
  • Statutory provision for the reporting of adverse events