Rogue breast surgeon Ian Paterson seen as ‘divisive’ and difficult, inquest told

Disgraced breast surgeon Ian Paterson was regarded as a “divisive character” at his NHS Trust who “was ploughing his own furrow” before being investigated, a coroner examining more than 60 patient deaths has been told.

The third of 62 inquests being held for patients of Paterson, who is serving a 20-year sentence for wounding, has been told Christine Baker died aged 59 in 2015 after putting her trust in his advice to have a “skin-sparing” mastectomy in 2005.

Giving evidence to the inquest last week, Paterson described claims he may not have completely removed Mrs Baker’s tumour as speculation, and said he “fought hard” for her to have the form of treatment she wanted in 2005 and when her cancer “returned” in 2007, requiring a second mastectomy.

Addressing Birmingham Coroner’s Court via a video-link on Monday, a former colleague of Paterson who also worked as a breast surgeon in the West Midlands said he regarded practices described by the rogue surgeon as being oncologically “risky”.

Consultant surgeon Alan Jewkes, who retired in 2019, told the judge-led inquest he had never worked directly with Paterson, whom he replaced as a surgeon at Good Hope Hospital in Sutton Coldfield in 1998 when Paterson moved to Solihull Hospital.

Answering questions from counsel to the inquests, Jonathan Jones KC, Mr Jewkes said of Paterson: “He certainly was regarded as a very strong … to some extent a divisive character.

“There was a strong personality clash between himself and the then clinical director for surgery – I think he found his (Paterson’s) behaviour difficult.

“He was not playing his part on the team. He was very much a loner – ploughing his own furrow if you like. He was certainly a difficult character.”

Mr Jewkes said he had not worked with Paterson at all until an NHS merger in 2007, which brought Good Hope and Solihull hospitals into the same health trust.

The retired surgeon said he became aware of rumours about Paterson prior to investigations launched into the rogue surgeon’s conduct and questions about his “surgical skill” in 2007.

“Anecdotally, there were people grumbling about him … as a difficult person,” Mr Jewkes said.

Asked to comment on a witness statement he had made that he and others had been aware of gossip about Paterson having “left behind” tissue during operations, Mr Jewkes told the inquest: “It’s what people were telling me. I obviously didn’t witness this myself.”

In medical evidence to the court, Mr Jewkes was asked about claims made by Paterson that he would leave “thicker” fatty tissue behind to form the appearance of a cleavage.

“Oncologically it would be risky. It just goes against the principles of the procedure,” Mr Jewkes told the inquest. “There is nothing in the surgical literature that would support that, that I am aware of.

“It’s not a recognised procedure at all.”

The inquest was told Mrs Baker was not informed that Paterson was under investigation during a meeting to explain delays to performing her second mastectomy in 2007, with staff being told the inquiry must remain confidential until a finding was reached.

Her husband, Stephen Baker, has told the inquest that his wife, an English teacher at a Birmingham secondary school, had been advised that there was “no additional risk” to a reconstructive element of the procedure she underwent.

Commenting on the meeting in 2007, Mr Jewkes said that the NHS trust had not restricted Paterson’s ability to practise in any way at the time.

“I was not at liberty to share details of the investigation with Christine,” Mr Jewkes said.

During evidence to the hearing last week, Mrs Baker’s husband told the coroner: “I think people in the Trust were starting to have concerns about Mr Paterson but we were totally unaware of those concerns.

“So, really, we were being asked to make a decision without all the facts. We were still of the belief that Mr Paterson was the best surgeon available.”

Paterson, originally from Glasgow, is currently serving a 20-year sentence for wounding imposed after a trial at Nottingham Crown Court in 2017.

Paterson, who was living in Altrincham in Greater Manchester when he was convicted, was employed by the Heart of England NHS Foundation Trust and practised in the private sector at Spire Parkway and Spire Little Aston.

He was appointed as a consultant at Solihull Hospital in 1998 and practised there until May 2011.

The inquests continue.