Bloodgate physio free to practise again
The debate continues over the striking off of "Bloodgate" physiotherapist Steph Brennan. As I blogged before, Steph was struck off the physiotherapy register by the Health Professions Council (HPC) in September 2010 when he pleaded guilty to helping the rugby team for whom he was head physiotherapist, Harlequins, cheat by providing a fake blood capsule to one of the players on the pitch. By this time, he had already been banned from working in rugby for two years. In contrast, the pitchside doctor (who cut the player's mouth to "prove" that he had been injured) was deemed fit to continue practising by the General Medical Council.
Steph - by all accounts a superb clinical physiotherapist - appealed to the High Court against his striking off. The High Court agreed that he had grounds to appeal to the HPC; and last month the HPC (after initially claiming that the High Court had no jurisdiction) revoked its decision, imposing instead a five-year "caution period".
Since the HPC initially struck Steph off, there has been hot debate among physiotherapists as to whether striking off was the correct action for the HPC to take or whether it was excessive. Some have taken the view that Steph failed to maintain the "high standards of personal conduct" which form a part of the HPC's regulations and that he therefore deserves all he gets. My own view is that it was excessive: that Steph clearly made a stupid mistake to put Harlequins before his profession and his morals; but that the public (whom the HPC exists to protect) is not better served by banning this man from practising. He has also shown very public remorse and has clearly been reflecting on his actions, having undertaken a series of lectures to physiotherapy students on the importance of medical ethics. I am therefore very glad that the HPC has overturned its own decision.
However, I'll leave the last word to Steph, who feels that his case has highlighted not just the pressure that is faced by physiotherapists working in elite/professional sport but also the importance of withtanding that pressure and keeping a cool head under fire: "I want the profession, and most importantly sports physiotherapists, to learn from my mistakes. Sports physiotherapy is a very different role for the physiotherapist than any other job in public or private health, but that should not mean we forget our standards of ethics and practice."
Victory and the City
Last week I took an afternoon off to join personal trainer extraordinaire Dave Thomas from The Foundry, who was playing for Citi Rugby in the Norton Rose City Scrum, a corporate touch rugby event held at the Honourable Artillery Company's grounds in Moorgate. As Dave is more commonly known as "Hospital" Dave, I was attending in the role of his personal physiotherapist - despite being a touch tournament, he was apparently carted off by paramedics last year with a badly-sprained ankle. Opting to minimise the risk, I taped the dodgy ankle firmly in place before I allowed him anywhere near the pitch!
The event did have a serious side - it's run for charity, plus I had the additional responsibility of fixing Dave and his team! - but was also a lot of fun, and the HAC is a fabulous venue. Each team is "coached" by a member of the Harlequins team (many of whom have never played touch rugby) - and this year, Citi were coached by Quins' captain Chris Robshaw, pictured here with Dave.
After a slowish start, Citi hit their stride and Dave - with a freshly flexible back and hamstrings - performed a try-saving ankle-tap diving tackle to deny UBS a win. Unfortunately, in doing so, he managed to face-plant into the sand around the try line, temporarily blinded himself, and had to come off; but the vital tackle had been made and there was no real damage to Dave (which, I confess, was a relief to his physio!)
In the semi-final, Citi played against last year's winners, JP Morgan. A stalemate ensued, and at full time the score was 0-0. Each team lost a player and they played 5 v 5 for a few minutes... still no score. 4 v 4... still no score. The teams went down to 3 v 3 and suddenly the pitch looked much bigger. Dave - on the left wing - received the ball at about the half way line. Accelerating off his right foot, he sprinted left, and - throwing an outrageous dummy - scored in the corner. Citi were in the final.
As Dave had to train some clients, we left at this point. I'm not sure whether he was more sorry to leave before the final, or happy to leave on a high. But a text message an hour later confirmed that Citi had won the final - with Will Myers as player of the tournament. Well done Citi!
Bloodgate physio wins high court appeal
Moving back to the theme of HPC sanctions, do you remember Bloodgate?
On 12 April 2009, Harlequins rugby player Tom Williams was taken off the pitch by the team physiotherapist, Steph Brennan, with blood pouring from his mouth. As he approached the Harlequins' bench, Williams grinned at his teammates, arousing such suspicion in Quins' Heineken Cup opponents, Leinster, that the Leinster team doctor requested to see the injury at the end of the match.
The problem was that there was no injury: Brennan had carried a fake blood capsule onto the pitch and Williams had bitten it in order to fake an injury which would allow him to be benched in favour of another key player. In a panic, Williams approached the Harlequins' team doctor, Wendy Chapman, and asked her to cut his lip, so that he would have an injury to show the Leinster doctor. Initially, she turned down his request but eventually gave in to the pressure and made a cut with a scalpel, as requested.
Following an investigation, the Rugby Football Union discovered that there had been four other incidents in which Brennan had facilitated the fake blood injuries. He was banned from working in rugby for two years, while the chairman Dean Richards was banned for three years and the player, Tom Williams, for 12 months, reduced to four on appeal.
Chapman, the doctor who had deliberately cut her patient, was initially suspended by the General Medical Council (GMC) but the suspension was lifted in August 2010 when the GMC decided that her fitness to practise was not impaired.
In contrast, Brennan, the physiotherapist who had facilitated cheating but who had not injured a patient and whose physiotherapy expertise was not in doubt (at the time of the scandal, he had been about to take up a post with the England rugby team) was struck off by the Health Professions Council (HPC), meaning that he could no longer work as a physiotherapist.
As I'm sure you can imagine, this was pretty controversial, certainly within the physiotherapy community - a super-hot topic of debate on online physiotherapy forums. Some felt that striking off served him right for cheating; more felt that the rugby ban was enough of a punishment in itself and an online petition asking the HPC to reconsider has so far gained 1175 signatures.
I think I agree with the petitioners. Steph Brennan was clearly wrong to provide Tom Williams with a blood capsule, so the ban from rugby is fair; but his actions were not in any way dangerous. The HPC's own Indicative Sanctions Policy states that a sanction such as striking-off is not to be used to punish wrongdoing, but to protect the public. I'm not sure how striking off an experienced and well-regarded - albeit misguided in this instance - physiotherapist who has done no harm, is a move towards public protection.
Last week, Steph Brennan's lawyers successfully argued that his actions had not merited a sanction of such "gross severity" and Mr Justice Ouseley at the High Court ordered the HPC's Conduct and Competence Committee to reconsider the case.
Currently, the HPC are refusing to do so, saying that the striking-off order is not open to legal challenge.
So, should Brennan have been banned altogether from practising his profession - or just banned from rugby? It's an interesting debate - what do you think?
Blog for Victory
Hi, I'm Nell Mead. I'm a former Army physiotherapist and I specialise in sports medicine and back pain. This is my blog, where I write about issues that are on my mind. Some of these are about issues that are specific to particular injuries or medical conditions but I will also be updating you on events occurring inside Victory and in the wider world of medical rehabilitation. I also publish guest posts by Victory's other therapists whenever I can persuade them to sit still for long enough to write something!
When we're not writing, we're offering appointments at The Foundry in Liverpool Street. We'd love to see your comments on our posts - and we'd love to meet you even more, so do pop by and meet the team.