The doctor who lost her patients

Dr Helena Daly has spent nearly three years fighting suspension from the hospital where she was a consultant. What was her crime? Being a woman, it seems. Angela Lambert reports

Picture, for a moment, a hospital consultant. The popular image is of a godlike figure, authoritative and demanding, sweeping through the ward followed by a flotilla of junior doctors, nurses and medical students. This stereotype is all very well if the consultant is a man, but a consultant who happens to be a woman is expected to be more like the popular image of a nurse; sweetly dispensing healing and soft words.

Dr Helena Daly, the former consultant haematologist at Treliske Hospital in Truro, Cornwall, is closer in character to the first stereotype than the second. This has been her problem. In a complicated saga that began two years and nine months ago, the hospital suspended her for "personal and professional reasons". Her battle to have her reputation restored ended on Tuesday, leaving Dr Daly - a slight, dark-eyed woman in her early forties - shattered and exhausted after the long legal wrangle with her employers. The hospital has admitted that its charges and criticisms of her professional conduct - allegations principally of rudeness and upsetting colleagues - were entirely without foundation, yet she has not been reinstated, nor has she received any apology.

She was suspended initially by John Saxby, chief executive of the Royal Cornwall Hospital Trust at the time, and the man Dr Daly describes ambiguously as "her closest friend" - then, though not any longer. Mr Saxby has since admitted that he was wrong to suspend Dr Daly; that he over-reacted and then found there was no going back.

"Had I known at the outset what it would involve, I wouldn't have gone ahead," Dr Daly says. "It's been a tremendous trauma. I'm vindicated now, but I still feel devastated that the patients haven't got what they fought for so hard - my reinstatement. I ended up in a situation where it just wasn't practical or possible to go back and work with the people who had accused me.

"Officially, suspension is not meant to be a disciplinary sanction, but in fact it's the most unjust form of discipline I know because you're taken away from your professional life, the worst thing that can happen to a doctor, often without even knowing what you're meant to have done."

Dr Daly's situation was exacerbated by the time taken to negotiate the appeals procedure. "One of the problems was that, originally, the prima- facie case against me was one of personal misconduct, which entitles one only to an internal hearing. I knew I wouldn't get anywhere with that. I believed the allegations were misdefined, and what they were really alleging was professional misconduct, which entitled my case to be heard before an independent panel.

"However, I had to go through their process first, so in 1993 I went through a secret hearing lasting 20 days, at the end of which they found me guilty on 23 out of 33 allegations. Last June, I won the right to appeal, which took another year. This process has led to my being virtually unable to work for nearly three years, to the very great detriment of my patients. I have 11 large ringbinder files of evidence about my side of the case, and I am shattered. It has cost the trust at least pounds 200,000, plus my full salary of pounds 50,000, paid throughout the period when I was suspended."

The medical profession, as Dr Daly has discovered, remains extremely conservative. Although the intake of medical students is divided almost evenly between the sexes, women consultants are in a tiny minority - fewer than 10 per cent of the total.

Dr Daly is keen to point out that she is far from being "anti-men". "Some male consultants have championed me and supported me greatly. But there are some individuals, both among consultants and managers, who seem to feel threatened by a woman competing at their level."

Does she believe that women have a harder time than men if they do succeed in being appointed? "Not all of them, no, but very many. It is, to say the least, a startling coincidence that there have been several women consultants who've had allegations made against them - Wendy Savage, Helen Zeitlin (who was made redundant), Pauline Bosanquet and others - and who, after fighting their cases at huge expense, both financial and emotional, were all exonerated. I have met these women. I didn't walk in and see witches but articulate, caring, competent individuals, very committed to their career and their patients. I ask myself, why does this happen to these women?"

Dr Peter Tomlin, of the Suspended Doctors' Support Group, points out that the number of allegations of incompetence proved is minute: only three in the past 10 years; also that the odds of suspension appear to be weighted against women consultants. "In only one in five cases of suspensions of male doctors are they proved guilty; but only 6 per cent of accusations against female doctors are ever proved justified. Thus, proportionately, twice as many women are suspended yet only 6 per cent are found guilty compared with 20 per cent for men. As for reinstatement, when this happens, men on the whole return to work in their original posts, but women are subjected to such intense harassment that they may have a breakdown or be forced to resign. The one outstanding exception was Dr Wendy Savage and even though she too was subjected to intense harassment, she stuck it out."

Sue Maddock, an "equality consultant" who offered her services as an expert witness in Dr Daly's case, says that women suffer from "gender expectations". "They are expected to be medically competent yet at the same time docile and deferential towards the male consultants and the hospital authorities."

Ms Maddock believes that "assertive" women doctors are disliked because they pay more attention to patients' interests than to management guidelines. "Helena put pressure on the hospital to respond faster and more sympathetically to patients," she says. "The trust's management was not used to this, they didn't like it, even though she was trying to fulfil the requirements of the Patients' Charter.

"The hospital managers had a responsibility to look at the causes of conflict, rather than just making a scapegoat of Dr Daly. Their job was to address any organisational difficulties; that's why they were paid senior managers' salaries. There are three other recent clinical cases from the same area. The needle left inside the baby - that happened there. A woman was discharged with a headache, only to die in the car park at Plymouth. What is the local health authority doing? The issue for patients is, how do we make our hospitals accountable?"

Dr Daly was accused, among other things, of being "rude and overbearing". When I talked to her on Wednesday, after her case was over, I asked whether she accepted this. "Nobody would say they were never rude and overbearing; nobody can claim to be perfect. I am direct in the way I speak, and this is something patients commend me for, but no patient, ever, has accused me of being rude.

"Patients supported me so wholeheartedly because they knew that if, for example, their test results didn't turn up punctually, I wouldn't simply say, 'I'm afraid they're not here; come back in a fortnight's time.' I would ask someone to go and fetch them, now. If that is being rude, I very much regret it - but, in any case, the allegation has been withdrawn."

Dr Daly is certain of one thing: "My patients supported me because they knew I was always willing to see people and take their calls, whatever the hour, even at home. Now such things are becoming standard practice, but I was already doing it nearly 10 years ago. I would sit down and talk to patients, and look them in the eye when I was talking. Some consultants don't, you know."

What will she do next? "I haven't been able to relax since 1992. I'm going to have a few days' rest. I want to go home and see my family in Dublin, then start a refresher course and obtain another consultant post. I have only been able to work as a doctor for a few weeks in the last two and three-quarter years. I have to make up for that lack of clinical work.

"My eventual return to full practice will depend on my mental and physical ability to regain the position that was unjustly removed from me. It has been absolutely harrowing. The Suspended Doctors' Support Group has figures which show that there is a significantly higher risk of illness and even death among doctors who have suffered suspension from their posts.

"Suspension is normally reserved for people who are either ill, or who put their patients at risk. It is not something that should ever be abused. Above all, I conclude this: professional women should be treated as professionals and not as women."