The Three Inquiries: Clifford Ayling

Terms of reference:

To identify the procedures in place during the period 19852000 within the local health services to enable members of the public and other health service users to raise concerns or complaints concerning the actions and conduct of health service professionals in their professional capacity. To document and establish the nature of and chronology of the concerns or complaints raised concerning the practice and conduct of Doctor Clifford Ayling, a former GP from Kent during this period. To investigate the actions which were taken for the purpose of (a) considering the concerns and complaints which were raised; (b) providing remedial action in relation to them; and (c) ensuring that the opportunities for any similar future misconduct were removed. To investigate cultural or other organisational factors within the local health services, which impeded or prevented appropriate investigation and action. To assess and draw conclusions as to the effectiveness of the policies and procedures in place. To make recommendations informed by this case as to improvements which should be made to the policies and procedures which are now in place within the health service, (taking into account the changes in procedure since the events in question). To provide a full report on these matters to the Secretary of State for Health for publication by him. The ambit of the Inquiry was later expanded to include Aylings career in the period 1971 to 2000.

Chair: Mrs Justice Pauffley

Panel: Mary Whitty (a former Chief Executive of Brent and Harrow Health Authority) and Peter Berman (a solicitor and the Honorary Secretary of the National Association of Lay People in Primary Care, and now Vice Chairman of Taunton Deane Primary Care Trust).

Dates:

  • Inquiry (along with two others) announced on 13 July 2001
  • Hearings: commenced 29 April 2003, evidence heard from 30 April 2003 to 25 July 2003 (27 sitting days). Inquiry formally closed on 31 July 2003
  • Report: published 15 July 2004

Link to download report: www.dh.gov.uk

Description of the events which caused the public concern: Clifford Ayling worked as a doctor in Kent in the period 1973 to 1998, latterly as a GP. In 1998 he was arrested and charged with indecently assaulting former patients. In 2000 he was convicted of 12 counts of indecent assault relating to 10 female patients, and acquitted on 9 other charges. A number of charges were asked to lie on the court file. The charges all related to inappropriate touching of women during medical examinations.

Litigation:

R v Ayling (unreported, 20 December 2000, Maidstone Crown Court)

R (Howard) v Secretary of State for Health [2003] QB 830

Summary of reports recommendations:

  • Development of guidance as to best practice and whistleblowing procedures for dealing with sexualised behaviour
  • Accredited training of Patient Advocacy and Liaison Service officers and ICAS staff
  • Requirement of formal declaration of other concurrent employment, such as in a deputising agency
  • Complaints to be placed on personnel files and reports to Trust boards should identify whether individuals have been the subject of previous complaints
  • Specific support programmes for single-handed practitioners and their practice managers
  • Chaperoning by trained staff with Trusts adopting chaperoning policies
  • Local medical committees should make it clear that they do not handle complaints, and should pass those complaints to the PCT
  • A memorandum of understanding between the NHS, regulatory bodies and the CPS for dealing with potential criminal activity and guidance for NHS bodies in dealing with such incidents