MANCHESTER—Cancer expert Professor Karol Sikora has defended intervening in the case of leading oncologist Professor Justin Stebbing, saying a letter he sent to former General Medical Council (GMC) chair Dame Clare Marx was only concerned with "speeding-up" their "cumbersome" prosecution not having it stopped, a medical tribunal heard.
Prof Sikora told a Medical Practitioners Tribunal Service (MPTS) fitness to practise hearing that the prolonged case was "almost like a Bleak House-type situation" and he'd hoped for a swifter conclusion.
Prof Stebbing is accused of failing to provide good clinical care to 12 patients between March 2014 and March 2017 and faces charges which include the inappropriate treatment of patients given their advanced cancer or poor prognosis, overstating life expectancy and the benefits of chemotherapy and continuing to treat patients when it was futile.
Prof Sikora, who wrote the letter to Dame Marx with fellow oncologist Professor Nick Plowman, was asked by Prof Stebbing's QC Mary O'Rourke about previous comments he'd made to the tribunal in relation to its content and his judgement.
He'd stated that he believed in evidence-based medicine but "it changes with time", said Ms O'Rourke, and "innovation can change that base provided it works", and she asked Prof Sikora how that was relevant in this case.
"The letter to Clare Marx was not about whether to carry on or not carry on the prosecution," said Prof Sikora.
"It was, 'Let's get this sorted out quickly.' Four-and-a half years, it's almost like a Bleak House-type situation.
"The tenor of the letter was to see if we could somehow speed it up.
"We understand COVID but we've treated cancer patients throughout COVID, and it beholds the GMC to bring this to a conclusion quickly - that's what the letter was about."
MPTS panel Chair Hassan Khan asked Prof Sikora why that was a "concern" for him and Prof Plowman, given the GMC's investigation, and why they had felt it necessary to write the letter.
"Because we're doctors," Prof Sikora said.
"Claire Marx is a medical chair. She's a doctor, a surgeon, and we felt basically we had to express our feelings.
"We're senior oncologists, oncology was watching what was going on and the process was so cumbersome.
"That's why we did that. It wasn't saying, 'Please let Professor Stebbing off.'"
Mr Khan then asked if Prof Sikora should have "kept out of it" given that he was an expert in the case.
He replied: "We weren't commenting on the right and wrongs of the case. We were commenting on the speed of the case."
Prof Sikora has repeatedly been accused by Sharon Beattie, QC for the GMC, of lacking independence and failing to provide "impartial" evidence to the tribunal.
And he was asked by Ms O'Rourke why - in an email to Prof Plowman - he'd said, 'We can defend this.'
Ms O'Rourke said Ms Beattie had suggested "that wasn't the role of an impartial expert because you were out to defend it come what may".
But Prof Sikora said he merely wanted to "argue for his beliefs" in the joint consultations he had with experts called by the GMC.
He repeated previous claims that the 12 patients had been "selected" to make a case against Prof Stebbing, saying there had been no guidelines on how they should be treated.
"These patients have been selected because there are no guidelines for them," he said.
"It's not obvious what to do and all of them are very challenging.
"Guidelines are, on the whole, very generic in cancer or there are very specific protocols.
"What is needed here, is someone to say, 'Do I carry on or do I stop?' There are no guidelines."
The tribunal heard that Prof Sikora had been instructed as an expert witness for the defence in two civil cases brought against Prof Stebbing by relatives of two of 12 patients.
This was after he'd been instructed as an expert for the defence in the GMC case.
However, he'd previously told the tribunal that he wasn't involved in any civil proceedings relating to the 12 patients and Mr Khan questioned why he'd stated that was his position.
Prof Sikora blamed "convoluted" questioning by Ms Beattie and said that so far his only role in civil proceedings had been to adapt his clinical reports.
Mr Khan asked Prof Sikora about the "appropriateness" of him acting as expert witness in the GMC's case and the civil cases.
"I assumed this [the GMC case] would be finished long before any further action is taken.
"Certainly, nothing has happened in the last year since I've had the reports."
The tribunal is continuing.
Prof Sikora comments on cancer issues for Medscape UK.
Ian Leonard is a freelance journalist experienced in covering MPTS hearings.
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Cite this: Ian Leonard. Expert Witness Wanted to Speed-up Oncologist's 'Bleak House' Tribunal - Medscape - Sep 13, 2021.