‘The health secretary has ordered an urgent review of vetting procedures for foreign qualified doctors after a Times investigation exposed how medics banned from practising overseas have been cleared to treat NHS patients.
Wes Streeting described the findings as “horrific” and “a serious failure in our medical regulatory systems that I will not tolerate”.
One doctor was fired when The Times approached their employer with its revelations, and another is under suspension.
Sujan Thyagaraj, a psychiatrist employed by a Bradford NHS trust, lost his US medical licence for having sex with a patient. Sattar Kadhem, a radiologist, lost his Swedish and Norwegian medical licences for misreading scans.
Despite this, both were granted the right to practise in the UK.
They were among 22 doctors identified by The Times who have been subject to discipline or restrictions overseas but with no record of it showing on their General Medical Council (GMC) licences.
In each case the GMC had either failed to spot the overseas findings — despite in some cases this information being public record — or it did not think the information should be available to patients.
Kadhem has since been dismissed by his employer and referred to the GMC. A Bradford District Care NHS Foundation Trust spokeswoman said it would be “factually inaccurate” and “libellous” to suggest it only took action after The Times approached it for comment, but repeatedly declined to say when it discovered Thyagaraj’s US misconduct.
Other doctors cleared to work in the UK included one found to have sexually harassed colleagues in Canada, another on the run from stalking charges and a third convicted in the US following an assault charge.
A lack of transparency about medical malpractice can be deadly. Dr Ajit Pothen wrongly discharged an NHS patient who later died after being permitted to work in a Nottingham hospital despite being suspended by a hospital in the Netherlands.
The findings come from a cross-border investigation co-led by The Times, the Organised Crime and Corruption Reporting Project (OCCRP) and the Norwegian newspaper VG, which for the first time collated doctor misconduct data from across the world.
Using a computer program, reporters compared the names and biographies of doctors who had been disciplined abroad with the names of doctors registered with the GMC, and where there was a match, verified this was the same person.
Doctors must normally prove that they meet GMC practise standards and provide evidence of their good standing in the countries where they previously worked to be admitted to the register, membership of which is necessary before working as a doctor in the UK. Some of the disciplinary notices were published by regulators, and could have been found by GMC vetting staff through a search engine. In other cases where these were not public, overseas medical regulators could have shared the information with the GMC if requested.
As of May, of
NHS
England’s 148,000 doctors, 57,000 were non-UK nationals.
A spokesman for the GMC said it was reviewing the findings to establish what regulatory action would be necessary.
From New Mexico misconduct to Bradford NHS trust
Sujan Thyagaraj specialises in treating vulnerable patients with conditions such as bipolar disorder and schizoaffective disorder.
He lost his medical licence in New Mexico in 2019 after the state medical board found he had had sex with a patient in his office.
He fled the country after US law enforcement attempted to collect his DNA.
He was later charged in absentia with sexual assault in relation to the case, but the criminal case was eventually halted.
The medical board concluded that he had had sex with the patient in the same appointment in which he prescribed her a powerful opioid.
As a result of the New Mexico investigation he also lost his licences in California and Texas.
He then attempted to obtain licences in other states, including in Montana, Hawaii and the US territory of Guam, but he was rejected based on his New Mexico suspension, which appeared on the first page of Google search results.
He succeeded, however, in his application to the GMC.
Thyagaraj obtained a UK medical licence this January before taking a role at Bradford District Care NHS Foundation Trust, the GMC register shows.
The trust declined to comment on when it became aware of the misconduct, citing the ongoing investigation.
Thyagaraj declined to comment, also citing the investigation.
Radiologist who missed key issues screened patients
One doctor was able to work for a radiology firm that treats NHS patients, despite having had his licences revoked in both Sweden and Norway.
The Swedish medical regulator revoked Sattar Kadhem’s licence in June 2023.According to a copy of his Swedish disciplinary report, Kadhem made repeated errors, and patient harm was only avoided because other colleagues spotted his mistakes.
The Swedish medical board found he was incompetent in his professional practise in a way that could impact patient safety in 2021, and placed him on a three-year probation.
He failed to appeal in the Swedish courts.
The mistakes at Swedish hospitals reviewing patient scans included missing a large blood clot, air trapped in a patient’s lungs, bone abnormalities, a spine fracture and misdiagnosing a bowel obstruction.
Kadhem did not meet the terms of the probation order, claiming illness meant he could not discuss his training requirements with regulatory officials. Because of his failure to engage, his licence was revoked.
Shortly afterwards, his Norwegian licence was revoked on the basis that he had lost his Swedish licence.
Kadhem declined to comment.
A spokesman for Hexarad, Kadhem’s employer, said that he had been immediately suspended after an approach by The Times, and had now been fired and referred to the GMC following an internal investigation.
Until 2022 Kadhem worked in the NHS, after his initial Swedish probation order.
A spokeswoman for the Royal Free London NHS Foundation Trust declined to comment on Kadhem’s case, but said all its radiologists were subject to regular internal audits to ensure the highest standards of patient care.
GP sexually harassed colleagues in Australia
Even where doctors with misconduct findings are spotted by the GMC, a lack of communication between health regulators can still leave patients exposed.
Dr Mark Anthony MacKenzie had his Australian medical licence revoked after the country’s regulator ruled that he had sexually harassed colleagues at a GP practice.
The Australian Health Practitioner Regulation Agency found that MacKenzie had made unwanted physical contact with staff at a practice, as well as touching himself inappropriately in front of colleagues. He was also found to have mishandled prescriptions.
MacKenzie left Perth, returning to the UK in 2021.
The GMC noticed his Australian ban and issued him with restrictions, preventing him from practising as a doctor unless the GMC approved. However, there is no record of any restrictions on his profile on the register of the Health and Care Professions Council (HCPC), which regulates specialist medical practitioners who are not practising as doctors.
MacKenzie is registered with the HCPC as a podiatrist and has been working at the Medipod podiatry clinic in Hinckley, Leicestershire.
The Times was able to photograph MacKenzie attending work at the clinic this year.
There is no record on Medipod’s website about him being struck off in Australia, and he did not disclose his work as a podiatrist during the open sections of his GMC hearing.
Medipod declined to comment, but MacKenzie’s profile has been removed from the company’s website.
The HCPC declined to comment on the specific case but a spokeswoman said that anyone who joined the register must declare if another organisation responsible for regulating a health profession had made a finding against them, and that if an individual was subsequently found to have not declared this information, it was possible that their application would be considered fraudulent.
MacKenzie said he had now notified the appropriate bodies but could not comment further until he had sought advice.
On Wednesday he received a nine-month suspension from the GMC.
‘
He gave my mum a death sentence’
A failure to properly check a doctor’s practise history can have deadly consequences.
Ajit Pothen discharged Denise Barnes, who had attended Queen’s Medical Centre Campus in Nottingham with breathing difficulties, without properly reviewing her symptoms.
Barnes, 67, died shortly after.Pothen was struck off in the UK in 2021 for lying about his suspension in the Netherlands, and for wrongly discharging Barnes. He also lost his Dutch licence in 2022.
Despite this, Pothen has continued to work as a doctor in Germany. Barnes’s daughter, Nicola Bradley, said she was “very, very angry” to learn of his continued ability to practise.“He gave my mum her death sentence and he’s still living, and he is still working treating other people. What is it going to take before he actually loses his licence — is somebody else going to die under his care?”
The German-educated doctor was able to work shifts at Nottinghamshire Healthcare NHS Foundation Trust despite having been suspended by a hospital in the Netherlands. It is alleged in an official inspection report that Pothen made errors in treating four patients while working at UMC Utrecht.
These included one case in which he failed to conduct proper imaging before conducting a procedure, and one in which he accidentally caused “serious damage to a vital structure”.
While the hospital was found ultimately culpable for these cases, he was suspended and was under investigation when he moved to the UK to continue practising, without telling the GMC or the Nottingham NHS trust that he was not permitted to treat patients at the Dutch hospital.
He now co-runs Hansen and Pothen, an ear, nose and throat medical practice in Umkirch, Baden-Württemberg, where it is still possible to book appointments with him.
Lawyers for Pothen said the four cases of medical errors in the Netherlands did not result in any professional consequences for their client.
They said he downplayed the significance of the Dutch investigation to the NHS trust because of “a personally challenging phase of life”, but that his UK and Dutch revocations had “no effect on his German medical licence”. They said the relevant authorities in Germany had been informed, and there had been no complaints about his practise in Germany.
In relation to the death of Denise Barnes, the lawyers said Pothen “extends his sympathy”, but that “the deceased was not autopsied, and therefore there are no factual findings regarding the cause of death”.
The inquest into Barnes’s death shows a post-mortem examination was completed.
The Times sent a request for any “lessons learnt” reports completed by the trust following this case under freedom of information laws. The trust confirmed it had no record of any such report being completed.
The trust said that Pothen had not disclosed his full employment information at his appointment, and was referred to the GMC and later dismissed. It did not comment on what measures it had taken to check on his competency with his previous employer or why it had not completed any exercise to identify how to prevent a similar incident from happening again.
US arrest warrant was no bar to GMC licence
The Times analysis shows how the GMC repeatedly either failed to spot, or did not think it material to publicly disclose, serious concerns about a doctor’s personal conduct.
Dr Enyinnaya Ezema, a psychiatrist, received a four-month suspension in Nova Scotia, Canada, in July 2018 after a complaint against him for sexual harassment. The medical board found that he had made repeated sexual advances towards one colleague, including saying she “looked expensive”, and put his arms around another and ran his tongue along her bottom lip.
Ezema said that he had a “terrible” reference letter from the Nova Scotia medical board, which an overseas doctor must normally provide to the GMC before it will allow them to practise, but was able to obtain a licence to practise in the UK in 2019 by attending a “boundary course”. There is no record of this on his GMC page.
He claimed he told his employers about his practise history. He said the Nova Scotia findings were made by an “all-white panel”, questioning whether he had been the victim of institutional racism.
According to public records, in January he was listed as working as a locum psychiatrist at Omagh Hospital in Co Tyrone.
A Western Health and Social Care Trust spokeswoman confirmed that Ezema had worked at the trust as a psychiatrist, but said was no longer working there. She declined to comment further.
Another psychiatrist, Dr Edward Olugbemi, gave up his New Mexico licence in the US after a complaint was filed with the state medical board against him.
According to a separate civil action in the state, it is alleged that “within a few weeks after Olugbemi began working at [the hospital], Olugbemi commenced a pattern of sexually harassing employees at the facility”.
The case was eventually settled out of court. He is currently licensed as a locum doctor in the UK, and did not respond to a request for comment.
An aggravated assault conviction did not prevent Dr Adel Regaila from obtaining a UK medical licence. He was struck off by Florida’s medical board in 2006 for repeatedly sexually assaulting a patient. He admitted to lesser charges of assault at a criminal trial. He was granted a UK medical licence by the GMC in January. While appearing to be based in the Middle East, when The Times approached Regaila undercover asking for a remote consultation, posing as a UK patient, he responded later the same day offering his services.
When approached about whether he had told the GMC about losing his US licence, he did not respond, but days later relinquished his UK medical licence.
In another case, a US arrest warrant was no bar to a doctor from being licensed by the GMC.Dr Karim Sarhane had his medical licence suspended in Tennessee after being charged with stalking offences.
The plastic surgeon was arrested in 2022 after female residents in Nashville reported a man peeping into their windows.
Sarhane was charged with two counts of stalking and one of unlawful photography. The court said that he had not attended a hearing, and a warrant had been issued for his arrest.
He was granted a UK medical licence last year. He retained it despite his Tennessee licence being suspended in January. He now appears to be working in Abu Dhabi. He was approached for comment.‘
The current system is not working
’Streeting, the health secretary, said: “The public rightly expects that any doctor practising in this country meets the highest standards of professional conduct and these horrific allegations represent a serious failure in our medical regulatory systems that I will not tolerate.“Patient safety is my priority which is why I have taken immediate action, requesting urgent clarification from the General Medical Council about their processes for vetting international doctors seeking to work in the UK.
“I have also instructed NHSE to identify the status of these doctors and work with trusts to ensure patients and staff are kept safe as a matter of urgency. No doctor with serious misconduct findings should be able to slip through the cracks and practise in our NHS — no exceptions, no matter where they trained.
”Gary Walker, a partner at clinical negligence solicitors Enable Law, said: “The current system isn’t working and could put patients at risk.” He called for the GMC to conduct an urgent review of information-sharing arrangements.
He said: “Patients in the UK deserve and need to be able to trust that there are robust systems to ensure any doctor working in the UK is not subject to any restrictions or relevant criminal sanctions in another country.
”Paul Whiteing, chief executive of Action Against Medical Accidents, said it was “deeply worrying” that these doctors were able to continue to treat patients, saying regulators must have “fool-proof” systems for those who “try to move between countries in order to evade detection”.
A spokeswoman for the General Medical Council said: “We take our role protecting patients extremely seriously.
“Doctors wishing to gain registration should be under no illusion about their duty and responsibility to tell us about anything that might affect their ability to practise safely in the UK.
Our professional guidance makes this very clear.
“We will continue to review each case carefully and thoroughly and, where doctors are registered with us, decide what action we might need to take.”’
George Greenwood
www.thetimes.com/uk/healthcare/article/b...-streeting-m33rc9dtz
Additional reporting by Laurence Sleator, Alanah Hammond, George Willoughby and Lara Wildenberg