Circumcisions were botched by retired doctor

News  The Independent (London). Tuesday, 14 August 2001.

Lorna Duckworth

A GP pressurised two mothers into having their baby sons circumcised by a surgeon he knew, who botched the operations and caused them excruciating pain, a General Medical Council ( External link GMC) hearing was told yesterday.

Dr Michael Harbinson gave the mothers no choice about who would perform the operation when he referred them to Peter Silverstone, a retired obstetrician and gynaecologist he had known for years, the GMC's professional conduct committee heard.

Mr Silverstone, who was paid from Dr Harbinson's GP fund-holding budget, had done religious circumcisions but had insufficient medical experience. He failed to anaesthetise either boy properly, causing them both to scream uncontrollably. Later one of the boys bled for several hours after he was sent home and needed two stitches to his penis, the GMC committee was told.

Dr Harbinson, a GP, of Rowlands Gill, Tyne and Wear, and Mr Silverstone, of Newcastle upon Tyne, both deny serious professional misconduct by providing sub-standard treatment to patients before, during and after operations.

Zoe Johnson, counsel for the GMC, said Dr Harbinson encouraged the parents to have their six-month-old boys circumcised and did not explain alternative treatments.

He presented the case as a fait accompli. He didn't give the parents choices in procedure and choices in the type of surgeon when he referred them to Mr Silverstone.

It appears there was some sort of arrangement whereby Dr Harbinson paid Mr Silverstone out of his GP fund- holding budget. Mr Silverstone was insufficiently experienced in circumcision for medical purposes.

The first mother, referred to as Mrs A, consulted Dr Harbinson at his surgery in Stanley, Co Durham, about cysts under her son's foreskin.

The GP insisted on circumcision because the cysts could have led to infection, the GMC hearing was told.

But during the operation in 1998, Mr Silverstone failed to ensure the boy had appropriate analgesia, Miss Johnson said.

As she [Mrs A] waited she heard her son screaming as if in agony. The screaming went on for 20 to 25 minutes without interruption until Mrs A was invited into the treatment room and handed her son.

A was taken home but the screaming continued. He would eventually fall asleep but would wake up screaming.

Every time the second mother, Mrs B, took her son to Dr Harbinson's surgery, he would try to persuade her to have him circumcised, Miss Johnson told the hearing.

When the boy caught a urinary infection, Mrs B finally agreed to the operation, believing it was her only choice.

But Mr Silverstone failed to provide adequate analgesia and allowed the boy to go home without stopping the bleeding, Miss Johnson said.

The boy had screamed so much during the operation that he developed a purple rash from his chest to his forehead. Later that day Dr Harbinson and Mr Silverstone visited Mrs B, and applied two stitches to the baby's penis to stem the bleeding.

Miss Johnson said that although Mr Silverstone was practised at performing religious circumcisions, he had no experience in such operations for medical purposes.

Mr Silverstone also denies allegations that he failed in his treatment of two women on whom he performed hysterectomies, the details of which will be heard at a later date.

The hearing into the treatment of the two boys, being held in London, isexpected to last two weeks.

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