On 18 September this year, ophthalmologist Muhammad ‘Bobby’ Qureshi, was ordered to be struck off the UK medical register (although he is presently suspended from registration pending an appeal). This followed a lengthy hearing before the Medical Practitioners Tribunal which makes independent decisions about whether individual doctors are fit to practise medicine.

The Mail on Sunday referred to Mr Qureshi as a celebrity eye surgeon. It initially carried an advert for his services but later pursued a campaign criticising him, following complaints by his patients. He evolved two innovative replacement intraocular lenses and advertised surgery involving inserting these lenses as a treatment for wet age-related macular degeneration. It was accepted that the lenses had the potential to be helpful in some patients with this condition, but the concern was as to the degree to which he misled patients over the likely improvement in their eyesight.

Wet age-related macular degeneration is an incurable and progressive condition. Because of the nature of this disease, the tribunal did not find that his treatment had worsened his patients’ condition. What it did find was that he had made false representations about the likely success of his treatment.

His attitude to patients was also criticised as showing lack of empathy or understanding of their disappointment or distress. When improvements of vision did not occur with a particular patient, he insisted that he knew better than this individual, denying that she could not see but justifying that position by saying that he was ‘a world-famous ophthalmologist’ and as such knew better than the patient whether she could actually see.

On a review of 24 patients, the tribunal found that Mr Qureshi had made false representations as to the likely outcome in 11 cases. Patients described being attracted by newspaper adverts for his service, which were later ruled as misleading by the Advertising Standards Authority. They were first seen by Mr Qureshi and then passed to his aggressive sales staff at his London eye hospital in Harley Street. Criticism was made that often vulnerable patients were deliberately misled as to the need for a procedure and its likely outcome.

A particular feature of these cases was the excessive charges made. It was said that this ophthalmologist’s motives were purely financial and that he paid no regard to the risks to which he was exposing his patients. It was found that he allowed his staff to exercise similar pressure on his patients.

During the hearing, the report from which exceeds 280 pages, he expressed no regret or remorse and was criticised for failing to properly engage with the tribunal procedure. He was noted to be a highly regarded and eminent ophthalmologist but his conduct was found to be incompatible with continued registration as a doctor.

Mr Qureshi’s conduct flies in the face of the recently developing relationship between patient and doctor. Since the Supreme Court decision in Montgomery v Lanarkshire Health Board, the importance of patient autonomy or self-determination in the area of information disclosure has strengthened. Society has moved away from a relationship between patient and doctor based on medical paternalism - let alone what appears to be almost bullying by the clinician. Most importantly, the doctor cannot impose treatment on a competent patient. The patient’s right to accept or refuse treatment must be based on an unfettered personal decision.

Tim Wright, senior associate in the clinical negligence team at Penningtons Manches Cooper and a member of its specialist ophthalmic group, comments: “A substantial dossier of evidence highlighting inappropriate treatment by Mr Qureshi was put before the tribunal and it is particularly upsetting that many of the patients who received poor care were extremely vulnerable. There may well be further cases of treatment under this clinician where individuals have clinical negligence claims over consent or unnecessary treatment.”