Wakefield: An open letter

to Sir Graeme Catto, President of the UK General Medical Council
from John Stone

Dear Sir Graeme,

I should like to bring to your attention procedural anomalies in the present General Medical Council hearing against Andrew Wakefield, John Walker-Smith and Simon Murch.

It will be recalled that the investigation of these three excellent doctors was precipitated in February 2004 by allegations against Dr Wakefield by Richard Horton, the editor of the Lancet. Horton, himself, now faces questions about his claim not to have known about Wakefield's involvement in the MMR litigation at the time of the publication of the controversial Lancet article in 1998, about which he has given evidence under oath [1].

However, this is not this issue which I intend to address, but statements in his book MMR Science and Fiction: Exploring the Vaccine Crisis  [2], published a few  months after these events, and particularly to passages on pages 7-8, referring to the situation three days after he made his first public assault on Wakefield's integrity, and one day after the publication of an article by the journalist Brian Deer in the Sunday Times:

"A whirlwind of innuendo ensued which caught us all in its wake. Evan Harris, the MP who had mysteriously joined Brian Deer at the Lancet's offices, called for an independent inquiry into Wakefield's research. Put on the backfoot by the sudden escalation in media interest and by Harris's calls for a public inquiry, Britain's Health Secretary, John Reid, urged the General Medical Council (GMC, the body that regulates doctors) to investigate Wakefield as "a matter of urgency..."
"Indeed, the GMC seemed non-plussed by Reid's intervention. The best their spokeswoman could say was: 'We are concerned by these allegations and will be looking at what action, if any, may be necessary.' In truth, they had not a clue where to begin.

At a dinner I attended on 23 February, one medical regulator and I discussed the Wakefield case. He seemed unsure of how the Council could play a useful part in resolving the confusion. As we talked over coffee while the other dinner guests were departing, he scribbled down some possible lines of investigation, and passed me his card, suggesting that I contact him directly if anything sprang to mind. He seemed keen to pursue Wakefield, especially given ministerial interest. Here was professionally led regulation of doctors in action - notes exchanged over liqueurs in a beautifully pannelled room of one of medicine's most venerable institutions."

There must be two basic concerns about legality here, supposing Horton's account is essentially true.
The first is that the process is flawed and prejudicial if the GMC was going on a fishing expedition against a troublesome member at the behest of a politician, as described by Horton (which, moreover, is evidently the case).
The other is that the process seems further compromised if Horton could at the same time be involved in discussing how the prosecution could be brought about with the prosecuting agency, and act as a witness at the hearing.

If - on the other hand - Horton made it up, it would be disturbing that so much has been based on his word.

I would be grateful for your early comments on these matters.

Yours sincerely,

John Stone

Ref [1] Dr Horton and the GMC hearing, JABS briefing note 9th April 2008
Ref [2] MMR: Science and Fiction - Exploring a Vaccine Crisis: Richard Horton, Granta Books, London 2004.

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