Leading doctor nicknamed patient ‘Little Miss Trouble’

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(file photo)  (PA Archive)
(file photo) (PA Archive)

A Harley Street cancer doctor who nicknamed a vulnerable patient “Little Miss Trouble” and texted her kisses was on Monday facing restrictions on his ability to work.

The Medical Practitioners Tribunal Service, after more than two years of investigations and hearings, ruled that Professor Justin Stebbing’s fitness to practise was “impaired”.

A further hearing will decide what sanctions, if any, to impose. These could range from a warning or retaining conditions currently placed on his working practices in the NHS, to suspension or being struck off the medical register.

Documents published by the MPTS on Monday show how Professor Stebbing in November 2015 began treating a 47-year-old woman with a rare intestinal tumours known as ampullary cancer, which had spread to the liver.

He put the woman, known as Patient E, on the immunotherapy drug Pembrolizumab, despite it not being recommended in her circumstances.

He referred to her as “LMT” – Little Miss Trouble – in text messages that they exchanged during the course of her treatment.

In response to Patient E saying he never included an x on text messages, he replied: “Xxxxxxx”.

Then, after she invited his wife to a dinner he was attending but stated that she would prefer to have his undivided attention, he replied: “Love to lmt”.

In February 2016, in response to being told that she had feelings for him, he replied: “I don’t want you to be a guinea pig in any way – I just want to make you better LMT!....Stay strong LMT xx”

In March 2016 he texted her: “I adore you x”

She travelled to Chigago in May 2016 and wrote to him from hospital a month later, saying: “Look professor there are things called feelings which I think you have a tendency to deny or obliterate. You know you have stirred them in me so when I lie in a hospital by myself across the Atlantic w a fuck off cancer problem you might think hmmmm maybe lmt needs some tlc poor thing…”

He replied: “Crikey … How are you?” , to which she responded: “Justin open up your heart for Christ sakes you know there’s something between us yet you try and deny it all the time. You only have one life an done lmt and although you cant cope w me at the moment be I don’t fit into your plan maybe you should try and follow your heart a bit more. Life is so much more interesting and beautiful when you do. I am in love w you and you should be so lucky. Xxx”

Professor Stebbing admitted failing to maintain an “appropriate degree of professional distance” with the patient and engaging in “inappropriate communications” while knowing she was physically and mentally vulnerable.

At the end of June he asked for the emails to be placed on the records system. On July 4, he wrote to her GP “expressing his frustration that the patient was contacting him 20 times a day and was incredibly rude and obnoxious”. She died later that month.

The misconduct case was brought by the General Medical Council after concerns were raised, including from relatives of patients and healthcare professionals, about an “alleged failure to provide good clinical care” to 12 private patients between 2014 and 2017.

Among those raising concerns with the GMC were the chief executive of The London Clinic private hospital, the HCA Healthcare group and a palliative care consultant at a hospice. In 2016, HCA conducted an audit of about 1,200 of Professor Stebbing’s patients.

The allegations related primarily to “over-treating” cancer patients at the end of life, often with chemotherapy or immunotherapy, when treatment was futile.

Concerns were also raised about poor communication, failing to secure consent for treatment, failing to thoroughly assess patients prior to treatment, and record-keeping failures. He also admitted dishonesty, in relation to an application to BUPA for funding for a patient’s treatment.

Of the 36 counts he faced, 33 were admitted or found proved. The hospitals involved included the Princess Grace, Leaders in Oncology Care – which is part of HCA Healthcare - and The London Clinic.

On one occasion he told a woman who was concerned at the amount of chemotherapy due to be administered to her elderly father: “Just leave the dosing to me, darling.”

In another case, the daughter of 73-year-old man transferred to The London Clinic in 2016 was told that her father was “a very sick bunny” but that Professor Stebbing was going to “get him a lot better”.

On another occasion, he claimed The Christie, the NHS cancer hospital in Manchester, was delaying giving treatment when in fact it had decided not to continue treatment.

Professor Stebbing, 50, had previously treated Sir Michael Parkinson and actress Lynda Bellingham and was dubbed “God” by some patients.

He qualified in 1995 and had previously worked at Barts and the London NHS Trust (now Barts Health) and the Royal Marsden. He has written many medical research papers.

Professor Stebbing has done a small amount of NHS work under supervision at Imperial College NHS trust, where he is professor of medical oncology, while the case has been progressing.

In evidence, he said his private patients were “typically highly motivated to maximise their survival and quality of life”.

There was no suggestion that his actions were financially motivated. His QC Mary O’Rourke said his actions had been taken in “good faith” and for legitimate reasons.

“He made it clear what he was trying to do was give them a chance but he’s been over-optimistic, maybe a bit cavalier,” she told an earlier hearing.

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