Consultant 'told to use spoon for hip surgery'

An NHS consultant in Britain was asked to use a dessert spoon instead of a proper surgical instrument for hip replacement operations, a tribunal heard yesterday.

An NHS consultant in Britain was asked to use a dessert spoon instead of a proper surgical instrument for hip replacement operations, a tribunal heard yesterday.

Godfrey Charnley was so disgusted by the failure of his bosses to supply the proper equipment that he threw the spoon on the operating theatre floor and later used £150 of his own money to buy the correct implement.

He says he was also embarrassed and horrified to be presented with the sterilised metal dessert spoon because the operation was being watched by a leading expert on hip replacements from a Swedish university who was amazed to see what was going on.

Nurses made fun of the incident and arrived for an operation a few days later with plastic spoons taped to their surgical masks.

Mr Charnley says he was also bullied by managers into fiddling waiting lists to avoid his hospital losing £2.5m (€3.7m) in government fines.

The 43-year-old quit his job at Plymouth’s Derriford Hospital in disgust at the way it was run and today blew the whistle on how he was pressurised to put off urgent operations to meet government waiting list targets.

He says that he was asked to invent a bogus medical reason for delaying an operation on a female patient with a complex hip problem so she did not have to be treated within the waiting list limit.

Consultant orthopaedic surgeon Mr Charnley, who now lives in Coggeshall, Essex and works at a hospital in the area, is claiming constructive unfair dismissal at an employment tribunal in Exeter.

Mr Charnley took a metal dessert spoon similar to the one he had been asked to use at Derriford to the tribunal along with an example of the sharp edged, spoon-shaped implement he should have used.

He said: “When we prepare the hip for a re-fixing we should use a sharp spoon with the proper CE mark. What I was offered at Derriford was a dessert spoon.

“If shards of bone had got into the interface of the hip replacement it could cause the operation to fail within weeks or months and it would have to be redone at huge cost in pain to the patient and in time and money to the NHS.

“Our department spent time drawing up lists of the equipment we needed but on several occasions I was offered the dessert spoon and rejected it.

“On this occasion I tossed it on the operating theatre floor in the hope it would never be offered to me or to any other consultant again.

“There was a consultant there from the University of Gothenburg in Sweden who was writing a paper on hip surgery and he was astounded to find a modern-day hospital where we were being given common or garden cutlery to perform orthopaedic surgery.

“It was later alleged I threw it at a nurse but that is not true. I simply lobbed it away hoping it would never be used again.

“There was some humour attached to the incident because two days after a lot of the nurses came into an operation with plastic spoons attached to their facial masks.”

Mr Charnley went on to allege that he was pressurised to overrule his own clinical judgment of the needs of patients to make sure the hospital did not breach government waiting list targets.

He says managers also bullied his secretary over lists to the point where she was often reduced to tears.

He said in one particular case he was asked to cancel a more urgent operation and substitute a patient who was on the verge of exceeding the waiting list limit.

When he refused he was asked to invent a genuine medical condition which would allow the limit to be breached. He refused and the deadlock was only broken when another scheduled operation was cancelled through the ill health of the patient.

He said: “The trust have tried to slur my reputation and portray me as a trouble maker rather than somebody working to support my department and look after patients and protect junior staff from bullying and intimidation.

“There were occasions when the decision on who to operate on, which would normally be made by the consultant, was compromised by waiting list targets and pressure from non medically qualified staff.

“Pressure was put on secretaries who were drawing up the operating lists. The decision on clinical priorities was normally made by myself because I knew the patients. Others were not fully aware of the facts.

“At one meeting with managers I was warned I could not run my list efficiently and there were concerns about my relations with staff and told if I did not watch my back I would be in trouble and the spoon incident was brought up.

“I felt very intimidated. I was told that if I did not operate on one particular patient I would be responsible personally for losing the trust £2.5m because they would have to tell the Department of Health we had breached targets.

“I felt it was emotional blackmail. I was looking for support and all I was getting were threats and intimidation and if I did not watch out I would be a marked man. I stood my ground.

“On another occasion it was suggested I should make up a clinical reason why a patient did not need a hip replacement when there was no such reason and the patient needed a replacement. There was no way out until another patient was unfortunate enough to cancel.”

The tribunal continues today and is scheduled to last another three days

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