Dr James Ip
Is it relevant to the practice of medicine if you cheat the tube?
EXCLUSIVE: Great Ormond Street children's doctor is suspended from NHS job for six months... for using his wife's free TfL travel pass
- Dr James Ip used his wife's free travel pass more than 55 times over 3 months
By JOHN ELY SENIOR HEALTH REPORTER FOR MAILONLINE
UPDATED: 15:10, 23 March 2023
Dr James Ip, who lives in a £1.7million home in west London, was found to have acted dishonestly in a case brought against him by Britain's medical regulator
A leading paediatrician has been suspended from his NHS job for six months for using his wife's free TfL travel pass.
Dr James Ip, who lives in a £1.7million home in west London, was found to have acted dishonestly in a case brought against him by Britain's medical regulator.
The General Medical Council (GMC) claimed his actions risked undermining public confidence in the profession.
But the decision sparked fury among medics, who called it disproportionate given no patients were put at risk from Dr Ip's actions.
Commentators said the GMC was harming patients by taking a hardworking medic out of the NHS while the health service wrestles with record backlogs in the wake of the Covid pandemic.
Dr Ip, who is in his mid-40s, works as a consultant paediatric cardiac anaesthetist at Great Ormond Street Hospital (GOSH), one of the world's leading children's hospitals.
He originally qualified in London almost 20 years ago.
Dr James Ip is employed as a consultant paediatric cardiac anaesthetist at Great Ormond Street Hospital as one of Britain's - and the world's - leading children's hospitals
Dr Ip was caught using his wife's travel pass by a Transport for London (TfL) ticket inspector at Hammersmith Station on February 7 last year.
He also admitted to using the card, which entitled his wife to free travel, on 54 other occasions between 13 December 2021 and 4 February 2022.
It is not clear why his wife, who was not named in the tribunal's report, was given a free travel pass.
Dr Ip admitted entering a compulsory ticket area without a valid ticket in court in July and was convicted and issued a £500 fine.
He was also ordered to pay compensation of £297 and costs.
The GMC, who presented the case for Dr Ip to be suspended to the medical tribunal panel, admitted that his actions didn't pose a risk to patients, there was no evidence his care was substandard, and that he is a 'well-respected and a skilled clinician'.
However, they said Dr Ip had acted dishonestly by using an free travel pass that he was not entitled to.
Regulators also raised the alarm because it was not an isolated incident, with it happening over a period of two to three months.
They added that Dr Ip's actions also represented a significant breach of GMC's code, which states: 'You must make sure that your conduct justifies your patient’s trust in you and the public’s trust in the profession.'
In a statement Dr Ip claimed that part of the reason he used the pass was resentment about NHS staff having to pay to use TfL services during the pandemic, but added he now recognised that as wrong.
'I see now that this rationalisation was illogical, immoral and wrong,' he wrote in a statement explaining his actions to the tribunal.
'I recognise that fare evasion is a form of theft and free loading from other passengers and there was no excuse for not paying for my tickets.
'I have since admitted my wrongdoing and apologised to Transport for London for my conduct.'
But the GMC noted the dates given for using the card were after Covid lockdowns had been lifted.
They also noted his admission that over half of the 55 journeys related to his private practice or personal journeys, not his work at GOSH.
The tribunal sided with the GMC, noting that Dr Ip's action represented a course of sustained dishonesty and, given the dates, they were unable to accept his account for his actions.
'On each occasion the tribunal determined that Dr Ip must have known that what he was doing was wrong, but he did not stop until he was caught,' they said.
His 'dishonest' behaviour was brought to light by a TfL ticket inspector at Hammersmith Station in February last year
The GMC's decision promoted outrage and ridicule from other medics, such as Dr David Nicholl
But others, like Dr Joel Giblett, said medics said the sanction made sense as the dishonesty was over a longer period of time.
In terms of mitigation, the panel noted that Dr Ip had admitted the behaviour at the earliest opportunity, had engaged with the GMC, and expressed remorse and some insight regarding his actions.
But they ruled that, on balance, a six-month suspension was the most appropriate and proportionate sanction to issue.
'He has breached one of the fundamental tenets of the medical profession by acting dishonestly,' they wrote.
The ruling was made by Medical Practitioners Tribunal Service which makes independent decisions on regulatory matters for British medics referred to them by the GMC.
But their decision promoted outrage and ridicule from other medical professionals.
Neurologist Dr David Nicholl from Birmingham wrote sarcastically on twitter: '“Dear parent, Gt Ormond St are REALLY sorry but your child’s heart op is delayed 6 months… as our cardiac anaesthetist has been suspended 6 months by the GMC for using his wife’s Oyster card, for which he was already fined, we’re sure you’ll be pleased with this".'
Others labelled it as 'pathetic', 'appalling', and 'a travesty', with some noting that as Dr Ip cannot work while suspended it was equivalent to issuing him a £50,000 fine.
Other medics asked if they should report themselves to the GMC for sharing Netlfix passwords.
Dr Matt Bigwood of the Doctors’ Association UK was another who slammed the ban handed to Dr Ip.
'We at The Doctors’ Association UK are again left shocked and angered by the actions of the GMC,' he said.
'The suspension of six months for Dr Ip for the offence committed is totally disproportionate, with other much more serious offences (e.g. drink driving and sexual offences) often getting commensurate suspensions.
'He has already admitted to the fraud, shown remorse and accepted the punishment.'
He added that the suspension could even harm patients by 'possibly delaying paediatric cardiac surgery in his absence'.
Dr Bigwood said doctors from ethnic minorities have repeatedly faced disproportionate sanctions from the GMC and called for action.
'There does not seem to be any change to the institutional racism coming from inside the GMC. We call for an immediate independent review into this,' he said.
But some medics said doctors were not above the law and should face professional sanctions if they broke the law.
Dr Joel Giblett, a cardiologist at Liverpool Heart and Chest Hospital NHS Foundation Trust, said: 'You can’t dishonestly commit fraud repeatedly over an extended course and think there’s no consequence. It wasn’t a one off. It only stopped when he was caught.'
And Kathye King, who claimed to be the mother of a child waiting for surgery at GOSH, said she supported the suspension.
'I am a parent of a child waiting for surgery at GOSH and quite honestly I would prefer a member of staff who was honest because if someone is willing to break the law over one thing means they are likely to be doing so elsewhere,' she wrote.
MailOnline approached the GMC but it declined to comment.
Dr Ip has 28 days to appeal the tribunal's decision which was handed down on March 9.
Doctors make mistakes - live with it
I'm a doctor who has made mistakes while treating patients - here are my golden rules to protect you from medics' errors
By PROFESSOR ROB GALLOWAY FOR THE DAILY MAIL
UPDATED: 21:28, 27 March 2023
Can you imagine the distress of going to hospital for an operation and having to return to theatre to have forceps removed because they were left inside your abdomen.
Or going in for a left hip operation because of years of agonising pain and waking up to find out they had operated on your good hip. Or having surgery to preserve your ovaries — but they are accidentally removed. Or, worst of all, realising you have had a procedure intended for a different patient.
Fanciful stories made up for a TV drama? Sadly not. These were just some of the awful mishaps that occurred in hospitals in England over the space of just ten months. They appeared in a list of ‘never events’ published a few weeks ago by NHS England.
Never events are the most serious of the serious medical mistakes. They should literally not happen. Yet between April 2022 and January this year, there were 325 of these ‘never events’ in England alone.
Some argue that for an organisation that’s treated millions of people in that time, it’s a relatively small number. But many of the patients behind the statistics have been left facing the catastrophic consequences.
Can you imagine the distress of going to hospital for an operation and having to return to theatre to have forceps removed because they were left inside your abdomen, writes Professor Rob Galloway
These stories hardly inspire the public to put their trust in medical professionals.
So why am I telling you this? Well, because behind the tragedies there are important lessons for all healthcare professionals — and also for anyone having medical treatment.
Clearly these patients have been failed; but pointing the finger of blame at individual doctors or nurses isn’t the answer. Aside from isolated cases of individuals who should be in prison, healthcare staff do not go to work and deliberately cause harm.
And simply blaming and scapegoating won’t resolve the issue; it will lead instead to staff hiding errors for fear of retribution. It will also prevent future patients benefitting from the learning.
Nor is it right for medics themselves simply to blame the pressure that everyone is working under, or lack of resources, or say ‘It’s just one of those things’.
These errors happen just as often in better funded hospitals abroad and in the private sector.
And it’s not just at huge personal cost to the patient: the NHS paid out £2.4 billion in negligence claims in the year 2021/22 — and while the patient, or their loved one’s instinct is understandably to seek compensation, what they most often want is to ensure that this doesn’t happen to others.
It’s not just the patient who is affected. A number of years ago, I was involved in a case where medical harm happened because I prescribed too much fluid.
The patient ended up in intensive care and I was guilt-ridden, became depressed and was close to leaving the profession.
Professor Rob Galloway, pictured, admits he has made mistakes while treating patients, writing: 'I have come to realise that most mistakes aren’t down to a lack of care or knowledge, but because humans are human'
Indeed, I have seen many colleagues come to major psychological harm and quit their jobs because of medical mistakes.
So how can this be happening in 2023? And, importantly, what can you do to protect yourself? In very simple terms, the reason why most errors occur is ‘human factors’: modern medical care is incredibly complex and we as humans are not designed for this level of complexity.
Trying to understand why medical errors happen has occupied my mind a lot over the past 22 years as a doctor: I run courses and speak at conferences on this. You might therefore have thought that, with my experience and obsession with the subject, I should not be making mistakes. Sadly, that is not the case.
The more years I work as a doctor, the more I have come to realise that most mistakes aren’t down to a lack of care or knowledge, but because humans are human and our brains are designed for hunting, running away from woolly mammoths and procreating; anything more complex is difficult for us.
We are not truly able to multitask, we are poor communicators, we assume we are right, we don’t like people challenging us and we don’t notice things which, viewed from another angle or with time, can seem obvious.
In essence, we are prone to error.
But we work within a culture that doesn’t acknowledge ‘human factors’ and therefore doesn’t take steps to eliminate them.
Professor Galloway wrote: 'A number of years ago, I was involved in a case where medical harm happened because I prescribed too much fluid. The patient ended up in intensive care and I was guilt-ridden, became depressed and was close to leaving the profession'.
Years ago, I was looking after a critically ill patient. She sticks in my mind because although we saved her life, my care could and should have been better.
I’d asked for four units of ‘cross-matched blood’ (blood of the same type as the patient).
Thirty minutes later, I asked what had happened to the blood and was told that someone had told me that her blood sample had been mislabelled. Because of this, no blood had been sent from the lab.
But I hadn’t heard that message. I was too fixated and worried about other aspects of care she was getting. So? I ordered new blood and it arrived 30 minutes later.
However, the delays affected her blood pressure and her kidneys — and she then needed a significant stay in intensive care.
This wasn’t because I don’t care. I do care. It’s not because I’m lazy: I’m not. It’s not because of a lack of knowledge — I have a long list of letters after my name. I made this mistake because I am human.
The solution is simple. My colleague could have spoken in a way to grab my attention and make sure I was listening: ‘Rob, it’s important you listen: I have an update.’
Then, I would have just needed to repeat the crucial information back. That’s normal practice in high-risk industries such as airlines. It’s even common practice in non high-risk industries such as Chinese takeaways. I’ve never got the wrong meal because, when I order it, it’s repeated back to me.
This is the social and accepted normal practice in takeaway settings. But that’s not always the case in healthcare settings.
Just last week, I was asked by one of my junior doctors to review a patient with a nasty infection and low blood pressure. I made a plan, with a list of steps which included kidney function tests and an antibiotic drip. After I asked the junior doctor to repeat the list to me, she became defensive, saying she had been listening. But I do this because in the past, when I haven’t, treatment plans have not always been followed through and the patient suffered.
One of the things we medics need to do is use plain English and not medical jargon. It’s so easy to confuse hyperkalaemia with hypokalaemia, with tragic consequences; less easy to confuse high and low potassium.
Another key way to improve patient safety is making sure that following standardised ways of working is the norm.
I introduced ‘prompt cards’ for my team for treating time-critical conditions, such as sepsis, with step-by-step reminders. These were based on Wetherspoons recipe cards for cocktails, and they’ve helped transform the care we give, helping to reduce errors.
But what can you, as a patient, do to protect yourself? If you tell someone you’re allergic to something, get them to repeat this back to you.
If you’re being injected with a drug, then ask to see what it is you’re being given.
If you are about to have an operation, make sure you see the consent form and speak to the surgeons doing it. Ask: ‘What am I having done today’ — and always check that the arrow marking where the operation will be is drawn on the correct side of your body and in the right area.
Crucially, if you think something is going amiss, speak up. Remember: you are the last line of defence. Do not be intimidated by the medical staff . Help us to help you.
As doctors, our Hippocratic Oath tells us we must do everything we can not to harm patients. But as humans, we are prone to making mistakes and need to do everything we can to reduce the chance of these happening. And that means really listening — to patients and staff.
And every day I remind myself of the mantra: ‘Don’t trust me — I’m a doctor.’
- Professor Rob Galloway works as an A&E consultant. Twitter: @drrobgalloway