Doctor Was Financially Motivated in Treatment of Cancer Patients, Tribunal Rules

Kim Pilling

July 24, 2021

A doctor was financially motivated when he treated cancer patients on a high intensity focused ultrasound (HIFU) machine he co-owned, a medical tribunal has ruled.

Consultant urologist Paul Miller, 63, was said to be an "early advocate" of HIFU, described as novel and experimental, which emerged in the mid-2000s, with trials taking place in the UK, the United States, and France.

Private Company

In October 2005, he jointly formed a private company, Mobile HIFU Limited, of which he was joint shareholder and co-director with another clinician Tim Larner.

The company purchased a HIFU machine for about £440,000 with a bank loan and subsequently rented it out to privately run Spire Gatwick Park Hospital in Surrey where Mr Miller treated patients with prostate problems.

A Medical Practitioners Tribunal Service (MPTS) tribunal, sitting in Manchester, found Mr Miller acted dishonestly in having a financial interest and motivation for the patients to undergo HIFU treatment and did not disclose his interest to some of them.

However, tribunal chair Lindsay Irvine said the General Medical Council had not produced evidence that Mr Miller would personally financially benefit.

Mr Miller would benefit as a shareholder from the use of the machine, said Mr Irvine, and would also receive a personal surgeon's fee but noted the fee would be potentially less than for more standard treatment.

Inappropriate Treatment

The tribunal also found his recommendation and treatment with HIFU was inappropriate – either because the cancers were not of the kind for which HIFU was considered appropriate, or because standard treatments of radical radiotherapy or radical prostatectomy offered better prospects of a cure.

Five of the patients were initially treated in the NHS at East Surrey Hospital before being referred to Spire Gatwick Park, while the other three were private patients of Mr Miller.

Mr Miller was also found to have failings in his care of five other patients.

He had denied misconduct on various dates between 2004 and 2018.

Giving evidence, he denied wanting to make money from the machine and said he believed its use was in the patients' best clinical interests.

The company, which was sold in 2013 when Mr Miller resigned his co-directorship, did no more than break even between 2005 and 2013 and there was no evidence in its accounts that it made any profit, the tribunal was told.

The consultant said he had never received a salary, a dividend, or payment from the company.

The tribunal will reconvene in October when it will consider if Mr Miller's fitness to practise is impaired.

In October 2019, senior coroner Penelope Schofield criticised Mr Miller and Sussex and Surrey NHS Trust at inquests into the deaths of 10 of his cancer patients who died of natural causes but she found three had been contributed to by neglect, and "missed opportunities" were noted in three others.

This article contains information from PA Media.

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