Doctors' chief censured over patient care

A distinguished surgeon and former leader of Britain's doctors has been cleared of charges that he amputated limbs unnecessarily, left a surgical clip inside a patient and ignored warnings from colleagues.

James Johnson, 64, a former chairman of the British Medical Association (BMA) and one of the most highly rated vascular surgeons in the country, was said by his lawyer to have been "totally vindicated" after a catalogue of misconduct charges against him were rejected by a disciplinary panel of the General Medical Council (GMC).

But in three cases the panel found that Mr Johnson had carried out operations that were "not in the best interests" of his patients, and in four he failed to ensure that they received proper care after the operation when they developed complications.

In other cases he failed to discuss the operation with colleagues, consider alternative procedures, obtain consent or provide the right drugs.

At the 10-week hearing in Manchester, Mr Johnson, who holds a platinum merit award for surgical excellence, was accused of misconduct in relation to 14 patients on whom he operated between June 2006 and January 2008.

For almost half of that time he had been chairman of the BMA, and it was alleged that he had spent too much time pursuing his medico-political career and not enough looking after his patients at the two hospitals where he worked in Runcorn and Warrington.

Andrew Colman, counsel for the GMC, had told the hearing thatMr Johnson's behaviour "reflected rather a caricature of surgical arrogance that was out of place even decades ago, other than through the lampooning lens of cinema comedies".

During the hearing, Mr Johnson admitted losing his temper during one operation in July 2007, for which he later apologised. On that occasion while stitching the patient "quickly" he had stabbed another doctor in the forehead with a needle – but the doctor struck said it was an accident and "probably my fault" as she had got too close.

A surgical clip was also left inside the patient, but there were five incisions and the panel found that Mr Johnson had followed the correct procedure in ordering an X-ray to locate the missing clip before reopening them.

In three cases, Mr Johnson had carried out operations using artificial teflon grafts, which were more liable to infection and blockages, instead of natural veins taken from the patient.

Although some doctors still used the artificial grafts, the panel concluded that the practice was outdated and not in the patients' best interests. Mr Johnson said that he had since changed his practice.

The surgeon was sometimes absent from the hospital because of his BMA duties, which limited his ability to provide post-operative care. TheGMC said the "very least" he should have done was "pick up the telephone" to be kept informed of his patients' progress.

The panel said that he should have set up a suitable system to ensure that his patients received adequate care after their operations.

Mr Johnson was said to be "relieved" following the verdict. Martin Ford, his lawyer, said that the panel had found that no patient had suffered as a result of his care.

The hearing continues to consider what, if any, sanction Mr Johnson should face.