A troubled health board has refused to say whether it will welcome back a surgeon who had a sexual relationship with a patient while repeatedly prescribing her morphine under the counter. Dr Chirag Patel, a consultant neurosurgeon at Cardiff’s University Hospital of Wales, avoided being struck off over the misconduct – to the disbelief of some in the medical community.
The doctor was recently handed an eight-month suspension by the Medical Practitioners Tribunal Service (MPTS) after he was found to have given the patient highly addictive painkillers without noting this in her medical records. He claimed he did so because he was “blackmailed” with threats she would expose their relationship.
Explaining why it had opted for suspension, the misconduct panel said the hospital would face “considerable hardship” should Dr Patel be permanently barred from practising medicine.
Striking him off would have been “nothing short of a disaster for the people of Wales”, according to the hospital’s clinical director for neurosurgery, who had told the panel that Dr Patel was the only surgeon in NHS Wales able to carry out certain surgeries for neuropathic pain.
But after we reported on the case, several doctors posted on social media questioning why Dr Patel had not been barred. “This is horrendous,” wrote Dr Deiniol Jones, deputy chair of the British Medical Association’s Welsh resident doctors committee. “The proportionality with MPTS still needs improvement.”
He added: “Sexual misconduct cases that should get erasure don’t (this isn’t the first) and yet so many innocuous things (for example saying you need a laptop) get slammed.”
This was in reference to a much-derided case from 2022 in which a Manchester GP, Dr Manjula Arora, was suspended for a month after telling an NHS IT department she had been “promised” a laptop. This was deemed by a misconduct panel to be “dishonest” because, rather than being promised, she had been told: “We don’t have any laptops at present, but I will note your interest when the next roll-out happens.” The General Medical Council later said the findings against Dr Arora would not stand.
Some felt the case of Dr Patel to be a cautionary tale of what can happen when a region relies on one doctor for certain key responsibilities.
Neurosurgery doctor Ollie Burton wrote on X: “I guess it’s a consequence of superspecialisation and centralisation of particular services, which neurosurgery probably does more so than other surgical specialties.
“If you have only one surgeon who does a thing well in the unit (or country) then big problems if [they are] suspended or sacked.”
Dr Patel qualified from an Indian university in 1994 and moved to the UK eight years later. He has worked at the hospital in Cardiff since 2015, his tribunal heard.
The panel was told Dr Patel first operated on the woman at the centre of the case (Patient A) in February 2019, removing the damaged part of a disc in her spine, and then performed further surgery on her in August that year. The following month they began a sexual relationship.
He would go on to operate on the patient a third time, inserting a spinal chord stimulator in December 2021.
Tribunal chair Remi Alabi said: “By February 2023 the relationship had deteriorated. Patient A made accusations against Dr Patel to the police in February 2023.”
Police did not pursue the allegations but did notify Cardiff and Vale health board, which runs the hospital. A disciplinary investigation then began.
Up to January 2023, Dr Patel had prescribed the woman an opioid painkiller known as MST (morphine sulphate tablets) as well as an addictive muscle relaxant, diazepam.
He did this without informing her GP or making a note in her records, and he continued with the prescriptions even after she had missed appointments.
A barrister for the General Medical Council (GMC) argued the woman was vulnerable due to a previous drug addiction, although the doctor claimed he was not aware of any “ongoing dependency”.
Dr Patel admitted the sexual relationship and sending the patient “explicit images”. He was “going through some marital difficulties” at the time his relationship with the patient began, said Mrs Alabi.
The doctor said: “When I persisted in telling her that the relationship had to end, Patient A threatened to reveal our relationship to others, such as my employer and colleagues.
“I was afraid if she did so I could lose the job I so loved and had worked so hard to obtain. Given my speciality this would have a knock-on effect on other patients if I was unable to work.
“With the benefit of hindsight I know I should nonetheless have ended the relationship and been honest with my employer. However, at the time I felt panicked and unable to break it off – a decision I now bitterly regret.”
The panel concluded the patient was “vulnerable” and that her repeated requests for painkillers may have been the result of addiction – a risk the doctor should have recognised, said Ms Alabi, who added that he had shown “a reckless disregard for patient safety”.
“Dr Patel had put his personal interests – namely securing his career, reputation and family relationships – above Patient A’s proper care,” she said.
The panel heard a voicemail left for the surgeon by the patient, demanding she “have that prescription” and threatening to report him to police.
She went on: “Chirag, you had one chance, two chances, three chances and more chances. You’re in the country doing your job, I don’t want to f*** you over but my spine is f***ed, right?
“I’ve given you chance after chance after chance. Do you know what? I could just write a book on you, okay? You going to man up and meet me, or are you going to be a cowardly c***, like I think you are? You’re no God, love.”
In his evidence, Dr Patel claimed: “I would only see her under the threat of blackmail and to appease her. Any romantic or friendly relationship had completely ended at this point, and our ongoing relationship was based purely on hostility and blackmail by her towards me.”
He went on: “Patient A had asked for £11,000 previously, which I did not have, so I instead offered to give her £5,000 from my savings.”
Dr Patel claimed to be “deeply remorseful” for prescribing the medication while in the “personal relationship”, adding: “It is no excuse that I did this under the threat of blackmail and exposure.”
The tribunal was told the complaint against Dr Patel arose when the patient was in “a period of psychosis”.
GMC barrister Robin Kitching argued the doctor should be struck off, pointing to the panel’s own findings that there was a risk of him repeating his behaviour as he had not shown “sufficient understanding” of why he behaved as he did.
The panel took into account that the hospital would encounter “considerable hardship” should he be struck off and concluded an eight-month suspension would be sufficient to “protect the public from the risks posed by Dr Patel’s misconduct”.
A Cardiff and Vale health board spokeswoman refused to comment on “individual employment matters” when we asked if Dr Patel would return to the hospital after his suspension. She added: “We are committed to upholding professional standards and have arrangements in place to continue providing safe and high-quality care for patients.”
The health board has been hit by a near-constant stream of scandals over the last year or so. You can read our exclusive reporting on drug abuse, violence and chaotic management at the University Hospital of Wales here.
If you would like to let us know about a story we should be investigating, email us at conor.gogarty@walesonline.co.uk
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