General Medical Council | MPTS

'From: "Lewis Stubbs (0161_)" <lewis.stubbs@
Subject: RE: GMC Ref: 4155241
Date: 6 March 2019 at 12:59:36 GMT
To: SashaMBE <sasha@mybeautifuleyes.co.uk>

Dear Ms Rodoy,

Thank you for your email and call yesterday and for allowing me to take time to respond to the important points you raise.

I have now had the opportunity to seek clarification on these matters. In summary, it appears your main concern is that Dr Niall Patton, the GMC-instructed expert, misled the Tribunal when he stated he did not perform refractive surgery. You have noted a number of enquiries you have made suggests that Dr Patton does in fact carry out refractive surgery.

The issue of Dr Patton’s expertise and practise was discussed a number of times throughout his evidence on 7, 12, 14 and 15 February. In answer to this question, Dr Patton confirmed that he performs cataract and retinal surgery as the bulk part of his clinical practice. Strictly speaking, there are elements of this which are refractive surgery, however Dr Patton does not carry out refractive surgery in the absence of the context of cataract surgery and in light of this is not a refractive surgeon.

Dr Patton has confirmed that he does not carry out Clarivu procedures. I note in your email you state that calls to Optegra recently confirmed that Dr Patton does in fact do this. In response to this suggestion, Dr Patton has confirmed that he has checked the Optegra website and seen that it does indeed state he carries out Clarivu procedures. Dr Patton has confirmed that this is an error and he has not performed any Clarivu procedures in the 8 years he has worked for Optegra. In your call to Optegra, you will have spoken to an individual in a call centre working for Optegra who would have advised of the services carried out by Dr Patton based on that as advised on this website, which as noted above was in error.

The error on the Optegra website has been made apparent to them. The have confirmed that it is in error and they will correct it as a matter of urgency to prevent any further confusion.

Furthermore and central to the suggestion that Dr Patton misled the Tribunal in claiming to be a refractive surgeon, although the above evidences that Dr Patton is not a refractive surgeon, even if he had been it would in no way affect the validity of his evidence before the Tribunal at this hearing.

I hope the above clarifies matters for you and as such you will be removing what has now been established as wholly inaccurate comments regarding the GMC expert from your blog. This includes confirming that you will not be uploading the email below as I note you mentioned you had considered doing when we spoke yesterday.

With regards to the emails you sent to me on 3 March, I note that it appears [redacted] states his complaint has already been investigated by the GMC. It may be that the further information you have received from him was not uploaded with his initial complaint and as such he is at liberty to provide this to the GMC so we can consider whether it justifies reviewing at this complaint.

Kind regards

Lewis Stubbs
Solicitor
General Medical Council'

I replied...

'On 8 Mar 2019, at 11:49, SashaMBE <sasha@mybeautifuleyes.co.uk> wrote:

Dear Mr Stubbs

Thank you for your detailed response.

Before I address your points, please note that there is an error in the sixth paragraph of your email.

And, with respect, by its very definition, you are wrong to say that their are elements of refractive surgery in cataract and retinal surgery: cataract and retinal operations are performed for medical reasons, while refractive surgery is not, hence it being unavailable on the NHS.

I would also like to make it clear that I employ due diligence before publishing any information on my sites, and can assure you that it was not only an individual in Optegra’s call centre who advised that Mr Patton performed Clarivu.

In fact, across a period of two weeks, a total of four phone calls were made to Optegra’s London and Manchester clinics, when both a colleague and I were advised that Mr Patton definitely performed Clarivu, and would be available for a consultation with that procedure in mind. I do not accept that the individuals we spoke with had to refer to the Optegra website for their information.

Although I note that Optegra have now removed ‘Clarivu’ from under his list of specialities on their website, I have recently discovered further information to support my argument that Mr Patton misled the tribunal, and I believe it most definitely casts doubt on the validity of his evidence in this case, and I intend to provide the GMC with this as soon as possible.

I will therefore not be removing anything from my ‘blog’ - as you so describe it, but in the interests of transparency I will be publishing both my previous email and your response...'

So whilst Optegra have removed Clarivu from Mr Patton's list of specialities, Doctify have not.


www.doctify.co.uk/specialist/mr_niall_patton

And I understand that clinicians who advertise on Doctify are personally responsible for the content of their page, or would Mr Patton have us believe this was yet another error?

And while I would be very surprised if Niall Patton's ego had never led him to read his Optegra page during the eight years he's worked there, I leave you to make up your own mind

Simon Jackson QC, lead counsel for the GMC, has been cross examining Dr Bobby Qureshi since Monday afternoon, during which time the doctor has provided the tribunal (and me) with some fascinating information!

But before telling you more, this was my email to both GMC and defence solicitors





GMC response to follow...

(Read 7 February post for more about Niall Patton)

Update on Dr Bobby Qureshi's MPTS hearing - ‘New case of impairment by reason of misconduct’.

NB: When I have time, I will photocopy and publish the GMC’s lengthy list of allegations: 24 patients, anonymised as Patients A to X.

For the last two days the doctor has been giving evidence, opening yesterday with a Power point presentation to illustrate his tutorial on cataract surgery techniques, explaining the difference between wet and dry macular degeneration, and the intended benefit of iolAMD and EyeMax Mono lenses.

And that’s all I'm going to say on the presentation, because although interesting and informative, way too long for me to attempt to summarise!

Questioned by his own counsel, Mr Russell Davies, Dr Qureshi was asked to respond to the GMC’s allegations point by point, and this will continue on Monday, so it's possible that the GMC’s cross examination may not start until Tuesday or Wednesday.

When Mr Davies asked for his client's response to one of the allegations concerning financial motivation, I had to smile when Bobby Q disarmingly replied, ‘I don't believe I was financially motivated in any procedure I performed.’

There goes another flying pig

Last week I was contacted by one of Bobby Qureshi’s Light Adjustable lens patients: left with serious problems after bilateral implants in 2011, he underwent numerous reparative operations and subsequently made a complaint to the GMC, who told him there was no case to answer!

I have criticised the GMC on countless occasions, and will continue to do so, because in my opinion, like most of these organisations, they’re not fit for purpose.

And I have no doubt that had the Macular Society not stepped in and complained to the GMC, then Bobby Qureshi would be indulging his hobby of flying helicopters in Monaco, schmoozing with Sir Philip Green and others of his ilk, and his only problem juggling UK visits as a tax exile!

Meanwhile, another hypocrite - not least because Saj Khan operated on a number of London Eye Hospital patients whose complaints to the GMC are included in the allegations levelled at Bobby Qureshi, while Saj Khan is nowhere to be seen at the MPTS hearing, and nor has ever offered to support My Beautiful Eyes campaign for regulation!

www.rcophth.ac.uk/wp-content/uploads/201...keting-Standards.pdf

4.6 The following are considered socially irresponsible and are prohibited:
4.6.1. Time-limited deals
4.6.2. Financial inducements
4.6.3. Package deals, such as ‘buy one get one free’ or reduced prices for friends and family.
4.6.4. Offering eye surgical procedures as competition prizes.

I've struggled with this post, not least because my notes are very lengthy - sometimes illegible, often unable to see what I'm writing due to poor vision, but I've also had difficulty deciding what to include or leave out, so finally decided to focus on my observations concerning Niall Patton


www.optegra.com/about/why-choose-us/our-...ons/mr-niall-patton/

I have never previously met Niall Patton, nor mentioned him on my sites, and don't think I'd never heard of him until told his name as the GMC’s medical expert witness in Dr Qureshi's tribunal hearing. But I have of course mentioned Optegra many times (with their own thread on this forum should you care to read it), and made numerous complaints to the ASA about their misleading advertising (mostly upheld), so perhaps that might explain Mr Patton’s rudeness and complete lack of civility towards me.

His antagonism was almost tangible, not even thanking me when I held a door open for him, whilst even Dr Bobby Qureshi now greets me with a smile, often politely gesturing for me enter the tribunal hearing room in front of him, and I believe that he, like many other refractive surgeons, has the intelligence to appreciate that it's not personal, I am simply doing my job.

Niall Patton's churlish behaviour was in fact a compliment, because I must be doing something right to have upset him, so I simply smiled sweetly in response to his childish pretence that I was wearing Harry’s invisibility cloak.

The hearing began with GMC counsel Christopher Rose asked Mr Patton for details of his qualifications and clinical practice.

Casually dressed, in a nondescript colour suit with just above ankle length trousers and a pale coloured open necked shirt, Niall Patton explained that he’s a consultant ophthalmologist, with a specialist interest in vitreoretinal surgery, at the Manchester Royal Eye Hospital.

Asked about the nature of his private practice, he said that it was primarily conducted at the Optegra

www.spectrum-uk.co.uk/news-events/events...d-macular-vision-iol

Searching for an image to accompany this post, I was surprised when I Googled ‘Bobby Qureshi‘ and my Facebook page came up, and even more surprised when I read the content I’d written almost three years ago - and totally forgotten


www.facebook.com/100003049068810/posts/807556542689307/

Back in Manchester to hear Dr Niall Patton give his evidence tomorrow at the MPTS hearing, I arrived just in time this afternoon to hear the evidence from Patient/Mrs W and her daughter Miss L.

Paying £15,000 for bilateral lenses, she and her daughter were both adamant that Dr Qureshi had assured Mrs W that while there were no guarantees, ALL of his patients had gained at least 30% improvement to their vision after surgery. Denied by the defence, but exactly what I’ve heard most of the other witnesses say.

Miss L said there had been no improvement to her mother’s vision after two operations in October and November 2016, and that the London Eye Hospital had subsequently and voluntarily offered a refund of £3,000. However, this was rescinded when they were informed that the hospital’s medical director was not authorised to make this offer.

Mr Davies seemed to be in the dark much of the time, confused as to whether Bobby was Dr or Mr Qureshi, and repeatedly referring to the London Eye Clinic, and even I was irritated after the fourth or fifth time, wanting to remind him it was the ‘London Eye HOSPITAL’, and I could sense Bobby cringe each time. (Although he might soon want to totally erase the name from people’s memories if he too is erased from the GMC register.)

Some of Mr Davies’ questions seemed pointless, as if he knew he was fighting a losing battle but needed to make an attempt to justify his fee: appearing exasperated when he was unable to budge Miss L on some of her evidence, and frustrated when he couldn’t elicit the answers he wanted from Mrs L, tiredly holding his head up with his hand by the end of the day.

I won’t bother with more about this, because it really is repetitive, but I do want to comment on the fact that, yet again, it was ophthalmic surgeon Mr Saj Khan who operated on Patient W, not Dr Qureshi.
www.lasereyesurgeryhub.co.uk/mr-saj-khan/

In no way am I defending Bobby Qureshi, but it seems to me that Saj Khan is also culpable. He was fully on board with The London Eye Hospital, performed many of these ops, and profited from them!

It will be interesting to see if Saj Khan will at the very least be offering evidence in his colleague’s defence.

The GMC’s medical expert, Dr Niall Patton, was listed to give evidence at Bobby Qureshi’s MPTS hearing today, but due to unforeseen circumstances it was disappointingly necessary to suspend the hearing until Wednesday.

As yet it’s unknown when Dr Patton will now appear before the tribunal, but I will of course let you know as soon as I do

Dr Bobby Qureshi's MPTS hearing continued

Three more witnesses gave evidence on Friday, and Mrs D was the first, via video link.

Her husband (deceased) had surgery in 2014, and when asked why he’d gone to the London Eye Hospital, she said it was her fault, because she'd seen so much advertising, and after googling Bobby Qureshi had no reason to doubt anything.

Patient D was a surgeon himself, and told his wife after the second procedure that he was disappointed to be told that Miss CW would be operating, under Bobby’s supervision.

Mrs D told the tribunal that he didn't say anything at the time because he’d been put into an embarrassing situation, with Miss CW introduced only when he was on the table, but that he was not happy having paid for Dr Qureshi. And a letter from Patient D to Bobby Qureshi after surgery repeated this allegation.

Denied by the defence, they claimed that Miss CW was an observer. Mrs D argued that, as a surgeon himself, with an excellent memory, she did not believe that her husband was mistaken.

Patient D was quoted £15,000 per lens, but Dr Qureshi said he was entitled to a discount because he was 'a medical man’. Yet Patient A was not a ‘medical’ person, given a £2,000 discount on condition she signed up on the day of her consultation (see 24 Jan post). Again, similar sales tactics to OE!

Post surgery, approximately four to eight months maximum according to his wife, Patient D was experiencing misting, but was unable to get an appointment with Dr Qureshi.

Mrs D said, ‘Off record, personally for Dr Qureshi, very disappointed that there was no aftercare, my husband would never have done that.’

She added, if he refuses to see patients post op, ‘How good is your research?”

Patient U and her sister both gave evidence after lunch.

With AMD, Patient U was registered legally blind before her surgery.

Promising her 30% improved vision in her left eye (with no sight at all in that eye she thought she'd be able to see), and 70% improvement to the limited vision in her right eye, Dr Qureshi fitted her with two lenses per eye.

Patient U's sister was a senior nurse with the NHS, and told the tribunal that she'd read up about the lens, that it was connected to NASA (OE make similar claim about laser), and that because BQ was so confident, expressing no doubts, telling them he’d done hundreds of these ops without problems, they believed there was nothing to lose.

Patients U’s sister said, ‘We thought he was the Messiah, that he would perform miracles.’

But Patient U told the tribunal, ‘I still go round in a fog, as I did before surgery.'

On the way back from Manchester last week it occurred to me that if BQ’s miracle treatment could have given sight to so many patients with AMD (Age-related macular degeneration), then surely this ‘revolutionary’ new treatment would have been made available on the NHS?

So I asked the opinion of an expert in this field.

He explained that the problem with the iolAMD and EyeMax Mono lens was that it was very early days, and should not have been used on patients without good trustworthy data.

He added, had he invented the lens, then he would have carried out a free ethics approved trial, and if that proved successful, over a period of 6-24 months, only then would it have been acceptable to ask patients to pay for this treatment, but even then with an inclusion criteria, refined during the trial process.

In layman’s terms, with a trial you would see who benefited most from the procedure, and of course those who don't, and future patients would be selected accordingly. Whereas Dr Qureshi seemingly sold this procedure to any desperate patient with AMD, some spending their life savings to pay for this!

I questioned Dr Qureshi’s extremely high fees, £11-15,000 per lens, compared to approx £2.5-3,000 for a regular lens used in cataract surgery performed at a private clinic.

I was advised that even though the Research and Development costs would need to be recovered, Bobby Qureshi’s fees were way too high. And, remembering that like most others with AMD, Patient U paid £22,000, so if there was no extra charge for her additional two lenses then it’s his time BQ was pricing so high.

And of course with thousands of people desperate to believe they could improve their vision with these lenses, had they been successful, there would never have been a shortage of customers, and BQ would have recovered his R & D costs relatively quickly.

Sadly, it's apparent that Bobby Q’s motivation was £££, leaving so many people not only without vision, but penniless too.

And I wonder if actress June Brown (aka Dot Cotton) paid for her surgery, because, just like Alan Titchmarsh, she provided priceless advertising for Dr Bobby Qureshi and his London Eye Hospital



The witness accounts are repetitive, so I have done my best to pick out salient points, and those I think will be of most interest to my readers. However, press and legal teams are welcome to contact me for more detail.

Meanwhile, some of you might be interested in reading this, 'CQC inspects London Eye Hospital after patients complain’.
www.cqc.org.uk/news/releases/cqc-inspect...er-patients-complain

Following the letter from health minister Steve Brine (prev post), this is a case in point proving the absurdity of the government’s repeated claim that the CQC are doing anything worth a damn to prevent damage being inflicted on so many thousands of people every year!

Government regulation is the ONLY hope for any control of the industry, who - just like the police - virtually self regulate, with anything from the omnipotent Royal College of Ophthalmologists quoted by the press, NHS choices, etc… without question!

The Royal College, just like the GMC, are funded by their surgeon members, and I am highly critical of both organisations, as I’ve often written.*

But while the College have no regulatory powers, the GMC does, yet closed so many complaints against ophthalmic surgeons, even when GMC appointed independent experts report that they performed below the 'reasonable standard expected from a consultant ophthalmologist’.

In my opinion therefore, the only reason Dr Qureshi is at a Fitness to practise hearing is because of the pressure exerted by the Macular Society.

I'm back in Manchester tomorrow, when the GMC’s medical expert will be giving evidence, and I will of course update you…

Meanwhile, to everyone reading - ophthalmic surgeons included - please keep in mind that I have to pay for travel and accommodation to attend the hearing, so any contributions to my costs are welcomed and much appreciated - DONATE link at top of page ????

* If you’ve only recently started following this page, scroll through the history and read how David Moulsdale (Optical Express founder/CEO) colluded with members of the RCOphth, including the chair, Moorfields surgeon Bruce Allan, to remove me from my nominated position as Lay Adviser to the Refractive Surgery Standards Working Group in 2015.

A late start this morning, because the first witness didn’t show up, and to everyone’s amusement the proceedings began with Michael Hayton saying that he was struggling with eye problems

Explaining only that he has one good eye and one bad eye he didn’t elaborate, but I noticed his left eye became progressively red as the day progressed, and he often dabbed at it with his handkerchief.

Tim Bradbury responded with a comment - not clear, but something like - that he had the right help sitting beside him, and even Bobby laughed along with the rest of us.

Over the last two days I’ve listened to evidence provided by three of Bobby Qureshi’s patients, and two of their relatives, and each one of them has said that they went to the London Eye Hospital because of the editorial cover, including the Alan Titchmarsh Show in 2014!



Like so many other TV presenters, Alan Titchmarsh has a lot to answer for, his unbridled praise and promotion of Bobby Qureshi’s ‘miracle’ procedure supporting the argument that celebrity endorsements should be banned.

Not forgetting of course that Alan Titchmarsh didn’t have this surgery himself, while Eastenders actress June Brown did, adding more gloss to Qureshi’s sales promotion when the story was given high profile coverage in the Express.
www.express.co.uk/news/uk/789605/June-Br...e-surgery-60-seconds

The London Eye Hospital website still advertises this, although a recorded message simply says, ‘I am unavailable.’
www.londoneyehospital.com/landing/easten...-dot-cotton-has-amd/

The first witness today was Mrs H, the daughter of a woman in her nineties who had surgery on her left eye in October 2014, with the lens repositioned in March 2015.

Mrs H explained that Bobby Qureshi had told her mother that she would gain 60% improvement to her vision, which she said was not a lot as she had poor vision to begin with, but that her mother’s expectations were modest, not rising to Michael Hayton’s many ‘suggestions’ that Dr Qureshi had been very clear that the procedure might not work. He also argued that it was not normal for a doctor to put a percentage on surgery results - I beg to differ!

Mrs H rejected all his attempts to discredit her evidence, saying that her mother would not have gone ahead, ‘unless there was a possibility of maintaining a slight improvement’, and that Dr Q had described her mother as ‘a good candidate for the procedure.’

As other witnesses have also told the tribunal, Dr Qureshi apparently spent only ten minutes with Mrs H’s mother at her initial consultation. And Mr Hayton has ‘suggested’ to each of them that it was more likely twenty to thirty minutes. Again Mrs H stood her ground, replying that 20 minutes would be ‘pushing it’!

Mrs H explained her mother had only expected a small improvement, to allow her some independence; only able to use the microwave she wanted to be able to read food labels, to see the kerb so she could go to the nearby coffee shop, to be able to look at people’s faces so she could react properly to them.

She said, ‘60% sounds wonderful, but if there’s nothing there [to begin with]...’’

Mrs H was dismissed, and the tribunal broke for lunch, reconvening at 1.15pm.

Getting into a lift with Michael Hayton during this break, I asked him if he could tell me would Bobby be attending the hearing every day. He replied that he couldn’t provide that information.

The first afternoon witness was Patient A, questioned via video link, who’d undergone three procedures with Dr Q in 2014. She’d had glaucoma in her left eye for fifteen to sixteen years, and a ‘ wet cataract’ in her right eye.

When asked by Mr Rose if Dr Q had discussed risks with her, she said she didn’t remember him having done so, describing him as ‘very charming’, and she did remember him telling her that the surgery would ‘definitely’ improve vision in her right eye, that it would be ‘100% better’.

She took his word for it, that her surgery would be as successful as it had been for others, wanting to continue with her charity work four days a week for the Heart Foundation.

Many of you reading this who’ve undergone unnecessary refractive surgery, laser or lens, will have heard the following!

Dr Q told Patient A that he would also put a lens in her left eye for ‘balance’, even though it wouldn’t make much difference.

Someone thought to be named ‘Roger’ then explained the cost - £22,000! But added that if she signed up that day there’d be a £2,000 discount.

At which point I looked at Bobby, sadly shaking my head in disgust - sales tactics just like Optical Express!

And just like Mr L told the tribunal yesterday, Patient A was also only able to pay £1,000 on her credit card, so that was accepted as a deposit on the understanding that she’d be able to get the rest of the money together without problem.

Following surgery on both eyes in August 2014, her left eye was worse than it was before. Explaining that the lens had slipped ‘out of line’, Dr Q told Patient A that he would insert a new lens he was getting in six weeks time.

Meanwhile, her right eye was also worse than when she was being treated by the NHS, and she described her vision as ‘looking through net curtains’.

The bottom line [sic] is that all witnesses I’ve heard so far have provided almost word for word accounts of Dr Q’s sales tactics, the information they say they were and were not given, all consistent with their evidence.

And going by some of Mr Hayton’s questions to witnesses today, it seems that the defence are leading towards claiming that some patients were advised that these ops were experimental, and therefore Dr Bobby Qureshi has done nothing wrong. But that’s just my impression and I could be totally mistaken.

The last witness, again via video link, was Patient A’s son, referred to as Mr A. Much of the same evidence, but when asked if he thought the £2,000 discount had affected his mother’s decision, he replied, ‘I believe it pushed to persuade her to go ahead.’

Asked if he knew of any downsides of the op having been discussed, he said not really, they were just aware that it might not work, but not that his mother’s vision could get worse as a result. And that they’d read only positive testimonials on the London Eye Hospital website.

Welcome to OERML, where you won’t read ANY positive reviews about these unregulated and risky procedures, only the facts and truths about the very real downsides and risks of unnecessary refractive surgery, no matter whether performed by Bobby Qureshi or someone else!

I should also mention that when the tribunal reconvened in the afternoon, Tim Bradbury apologised for that fact that I (the only person in the gallery) was unable to see the video screen, entirely due to the layout of the room, and that they were going to try and eat with that in future.

I was later told that he had actually tested the position of a chair during the lunch break to see if it would be possible for me to sit there, but decided not as I would have been able to see Mr Rose’s laptop.

If only he knew, with my damaged vision that would be impossible!

With no more witnesses today, the hearing was adjourned around mid afternoon, and before leaving I was chatting with one of the tribunal clerks when Bobby Qureshi appeared, heading towards the door behind me. I asked if he wanted to give me a comment (for publication), but he said ‘not right now’, or at least I think that’s what he said between gritted teeth.

Three witnesses tomorrow, all via video link.