One of Britain's most notorious doctors buffed his résumé for 14 years with a valued Canadian medical specialty qualification even though he had been stripped of his licence to practise medicine in Ontario because of incompetence.
It was just last December that Canada's Royal College of Physicians and Surgeons ordered Dr. Richard Neale to stop identifying himself as a fellow of the college -- and halt using the letters FRCSC (Fellow of the Royal College of Surgeons of Canada) -- after news reports appeared about a police investigation into the deaths of three of his patients at a hospital in Yorkshire.
The failure of the college to strip Dr. Neale of his fellowship qualifications in obstetrics and gynecology has now emerged as a factor that helped Dr. Neale resume his professional practice in Britain even though he was barred from practising in Canada in 1985.
The Royal College has acknowledged that in 1985 it was told that Dr. Neale had been banned from practising medicine by the Ontario College of Physicians and Surgeons for incompetence, after a woman died in a botched operation.
Yet the Royal College failed to act on the information, accepting his fees and identifying him as a fellow in good standing until Dec. 3, 1999.
"There were no specific sanctions taken at the time [in 1985] I don't have any explanation or reason why no action was taken," Dr. Michel Brazeau, the Royal College's chief executive officer, said in an interview from Ottawa.
"I can't comment on whether our practices were lax," added Dr. Brazeau, who took over his current position a year ago. "We're talking about another era."
The Royal College's 14-year delay in moving against Dr. Neale has angered his many British victims, who are expected to testify at his upcoming disciplinary hearing before Britain's General Medical Council, which suspended Dr. Neale from practising medicine last September.
"It seems a little bit like shutting the stable door after the horse has already left," said Sheila Wright-Hogeland, a founder of the Action and Support Group for Medical Victims of Dr. Richard Neale.
"It would have been extremely helpful if they [the Royal College]had done this 14 years ago when they struck him off the medical register. It seems that somebody dropped the ball."
Ms. Wright-Hogeland said Dr. Neale used to like to flaunt the qualification. He did so to her, she said, after she sought out a specialized gynecologist to treat her for endometriosis, a chronic condition of the lining of the uterus.
Under his care, Ms. Wright-Hogeland underwent an emergency hysterectomy and the removal of both ovaries at the age of 42. She suffered major complications after the surgery.
In an effort to explain how Dr. Neale managed to remain a fellow of the Royal College, Dr. Brazeau noted that in 1985 there was no automatic suspension of doctors in these cases, although the Royal College did sometimes take action.
In 1992, the college's bylaws were changed to require in all cases that physicians be stripped of their fellowships and cease identifying themselves as such if they had been barred for incompetence or misconduct in Canada or abroad.
All fellows were sent the new bylaws.
Still, nothing was done in the case of Dr. Neale or others who had lost licences before the change.
"There was no systematic review done at the time," Dr. Brazeau acknowledged.
As a result of the delay in the case of Dr. Neale, Dr. Brazeau has ordered an initial review dating back to 1980 to make sure that other doctors barred from practising medicine don't still identify themselves as fellows of the Royal College.
Canada's Royal College of Physicians and Surgeons accredits physicians in medical specialties, but the responsibility for licensing physicians and handling disciplinary complaints lies with provincial regulatory bodies such as the Ontario College.
Nevertheless, being a fellow of the Royal College is a prestigious appellation, and adds to a doctor's credentials.
In the case of Dr. Neale, patients say he sometimes dropped the final C from the FRCSC, making it seem he was actually a fellow of England's Royal College of Surgeons.
Steve Spoerry, director of operations at the Friarage Hospital in Yorkshire, where Dr. Neale practised for 10 years after leaving Canada, said being a fellow of Canada's Royal College wasn't a prerequisite for getting his job at the hospital because he was also a fellow of England's Royal College of Obstetrics and Gynecology.
But, Mr. Spoerry said, "there's no denying it looks better to be a fellow of both colleges."
At least 45 of Dr. Neale's former patients are planning to sue the doctor and Britain's National Health Service over his alleged operating-room errors. His case was a centrepiece of a British parliamentary investigation last year.
Dr. Neale also faces a police investigation into the death of three of his patients at the Friarage Hospital, where a total of 29 patients in his care died during his 10 years at the hospital.
A woman answering the telephone at Dr. Neale's home yesterday took a message but the doctor did not return the call.