Pair clashed on treatment

THERE WAS never any meeting of minds between Graham Barker and Desmond Barton. Mr Barker had been running the colposcopy service at St George's for seven years when Mr Barton arrived as his boss in July 1995.

Mr Barker was well known in his field and had published books and papers on gynaecological cancer. He resented the criticisms of the newcomer who disapproved of his technique.

Mr Barton had practised in the US and brought what he saw as a fresh approach.

The two men had "prolonged discussions" but failed to resolve their differences. The scrutiny panel refers to a "clash" which degenerated to become "adversarial and focused on reviewing specific cases rather than trying to put the service on a better footing".

Their row led to a costly recall exercise that alarmed hundreds of women, disrupted the work of the hospital and has settled nothing. Although it showed Mr Barker's work fell below the national standards it did not prove that more women had developed cancer as a result.

Mr Barker had a conservative approach to treating women with warning signs of cervical cancer, and sought to avoid excessive treatment of healthy women. Mr Barton favoured a more interventionist approach, which, after 1996, was backed by national standards published by the National Cervical Screening Service.

The panel criticised both men. It said Mr Barker "behaved unacceptably" in failing to respond to requests for change or answer correspondence, and his apparent attempts to "delay the development of a protocol for the colposcopy service". Mr Barton is criticised for being "single minded but insensitive".

However, the panel reserves its strongest criticism for the hospital trust. It states: "The failure of the clinical management arrangements to act decisively at an early stage led to the deterioration of the situation ... so that the stakes for the two key individuals were raised and the chances of a constructive in-house resolution faded."