Sunday, 15 August 2010

Prison doctor who played key role in release of the Lockerbie bomber had no specialist cancer knowledge

[This is the headline over a report in today's edition of The Sunday Telegraph. It reads in part:]

Dr Peter Kay, who until now has only been identified by the Scottish Government as an unnamed "primary care physician" of Abdelbaset Ali Mohmed al-Megrahi's, provided a crucial medical report which led to the conclusion that the prisoner was likely to have three months, or less, to live. (...)

This newspaper can also disclose that American senators investigating Megrahi's release will this week launch an unprecedented request for British "whistle-blowers" to disclose details about the decision to free the Lockerbie bomber. The appeal is a remarkable sign of US-British rifts as it indicates that US investigators do not believe they are obtaining the full story from politicians in London and Edinburgh. (...)

Dr Kay, the prison doctor, when approached at his home in Scotland, initially denied that he was formerly the doctor at HM Prison Greenock, where Megrahi was serving his life sentence. However, he later said: "You'll be aware of the hypocratic [sic] oath [on patient confidentiality]? I just can't say anything."

The GP was a key contributor to medical evidence supplied to Dr Andrew Fraser, the director of health and care of the Scottish Prison Service, who in turn drew up the report upon which Mr MacAskill's decision was reached.

Dr Kay trained at Glasgow University and became a qualified doctor in 1998. During his time at Greenock Prison, which ended earlier this year, he is understood to have combined his role as the part-time prison doctor with work as a local GP.

According to the General Medical Council, which contains information on all qualified doctors, he has been registered as a GP since 2006 and he is not on any specialist register. (...)

A spokesman for the Scottish Government refused to confirm that Dr Kay was the prison doctor involved in the assessment. However, he said: "It was Dr Andrew Fraser, Director of Health and Care of the Scottish Prison Service, who concluded in his report to the Cabinet Secretary for Justice that his clinical assessment was that a three month prognosis was a reasonable estimate.

"Dr Fraser is a professional of unimpeachable integrity. It was his professional responsibility to provide the clinical assessment of al-Megrahi's condition, and his report, which has been published by the Scottish Government, was the only medical report submitted to the Justice Secretary – along with the reports of the Parole Board and Prison Governor, which also supported a compassionate release decision.

"Dr Fraser drew on expert advice from a number of cancer specialists in coming to his clinical assessment that a three month prognosis was a reasonable estimate for al-Megrahi – it was not based on the opinion of any one doctor.

"These specialists included two consultant oncologists, two consultant urologists and a number of other specialists, including a palliative care team, and Mr al-Megrahi's primary care physician."

[A report on the website of the Agence France Presse news agency headed "Experts not consulted over Lockerbie bomber's release" contains statements from certain of the consultants to the effect that Dr Andrew Fraser's three-month assessment was made without consultation with them. They state clearly, however, that they would not have given a prognosis of the length of Mr Megrahi's survival. As I have said on numerous occasions on this blog, that is precisely why estimating the length of a patient's survival is invariably a matter for his GP, reaching the best conclusion that he can on the basis of the consultants' reports. That is exactly what Drs Fraser and Kay appear to have done in this case.

Today's edition of The Observer runs an interview with the egregious Professor Karol Sikora, headed "Al-Megrahi's doctor: 'I just provided an opinion. Someone else let him go free'". An Associated Press news agency report also has extensive quotations from him. Professor Sikora's increasingly frantic attempts to distance himself are become tiresome. The Scottish Government has already stated clearly that his opinion, and that of the other specialists engaged by Libya, played no part in Kenny MacAskill's decision.

Incidentally, I give full marks to Dr Kay for sending doorstepping Telegraph journalists away with fleas in their ear. His reference to the Hippocratic oath is entirely to the point. I wonder whether the other doctors who are talking to journalists have heard of it or (unlike Telegraph reporters and sub-editors) can spell it.

A regular commentator on this blog has made a complaint to the Press Complaints Commission about The Sunday Telegraph's disclosure of the identity of Dr Kay.]


  1. "This newspaper can also disclose that American senators investigating Megrahi's release will this week launch an unprecedented request for British "whistle-blowers" to disclose details about the decision to free the Lockerbie bomber"
    If this is true, and surely it is not, then presumably they will suggest the whistle-blowers use Wikileaks, or similar. The irony of this, in a week where the US government has been getting heavy on it's own whistle-blowers, seems so evident.
    But then most Americans don't recognise irony - I wonder if they will even see it as duplicity?

  2. This Doctor should be able to sue surely? The Telegraph's irresponsible approach by naming him is a breach of his rights. They could in a worst case scenario be putting him in personal danger.

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  4. To clarify, in the medical reports already released the names of medics were not visible. I'm assuming this was done because the only people entitled to know the identities of Megrahi's doctors were Megrahi, his people and the Authorities with access rights to his medical records (including MacAskill).

    I will repeat the worst case scenario as I think it is worthwhile. Such is the sheer hatred in this debate internationally I think it is absolutely necessary and correct to protect medical professionals involved in these assessments. For ultimately I am certain there are people who would at best harass them and at worst physically hurt them. No medical professional carrying out a job should have to take that risk. And governments in the UK and Scotland have an absolute duty to protect them. The Telegraph should be publicly condemned for such appalling behaviour but the Health Ministers in London and in Edinburgh should be sending formal letters to the Telegraph warning them about gross misconduct on their part. It is not acceptable.

  5. There's nothing to stop you Jo G, going to the Press Complaints site and making a complaint - it's an on-line submission process - and the code of conduct is there too, to be checked.

  6. I agree Bloggy, but I would say the more the merrier. The PCC needs to be knocked over by complaints about this irresponsible behavior by the Telegraph. And I've read the code of conduct. There isn't a clause covering breach of Data Protection Law. Interesting that, eh?

    If the SG was obliged under the law to protect the identity of Dr Kay and others then no newspaper has the right to defy the same law. I hope no harm comes to Dr Kay as a result of their reckless, politically motivated, morally indefensive conduct. I also hope he sues them.

  7. Jo, in case you aren't aware of this and it's helpful, the Wall Street Journal named Dr Kay on 6 August:

    "...a single doctor, who people familiar with the case identify as Peter Kay...."

    "The nonspecialist who treated Mr. Megrahi was Dr. Kay, his primary-care physician in prison."

    This isn't the first time the Telegraph or Sunday Telegraph has made up facts: on 7 August the Daily Telegraph said they had newly-published documents about the medical advice, which in reality were published last year.

    Last year the Sunday Telegraph said on the front page there was a new investigation. Strongly suspecting that this was based on an email to families which did not imply anything of the sort, I rang the police and asked them - a two-minute journalistic job. They confirmed there wasn't.

    Other notes on journalism and the "prison doctor" story:

    1. The story is saying what was already easily inferred about his non-specialist status, since

    a) he was named in one version of the published medical advice as a primary care physician, and

    b) neither Dr Fraser nor anyone in the Scottish Government tried to defend their position by saying he had specialist knowledge.

    2. As quoted by Prof Black, and by Martin Frost elsewhere, the story says after talking about Dr Kay:

    "This newspaper can also disclose ".

    That's what I remember it saying yesterday. The words imply falsely that the paper was "disclosing" Dr Kay's identity.

    The story now reads

    "This newspaper can disclose".

  8. I'd like to tidy up what I say about the Telegraph and false implications in the 14 August story.

    It could be that the Telegraph was falsely implying it was disclosing that the doctor was a non-specialist. That would be clearly false because the fact was mentioned by the Wall Street Journal, apart from being unsurprising given previous official information.

    It might be that the ST was truthfully, or falsely, implying it had disclosed something else; but it's not clear to me what that might be. The points it made about celebrations and chemotherapy were not given prominence.

    By focusing on these instances I don't mean to imply that any particular other media organisation, journalist or commentator has more successfully avoided stating, or implying, untruth about this case.

  9. Matt thank you very much for that additional information. It is indeed helpful.

    The only medical professional I had seen named was Fraser, from the prison. All other names on reports had been greyed out.