NHS announces sweeping changes to prevent sexual abuse in surgery

Surgeons say the operating theatre is an almost sacred space – a place of sterile precision, ritualised order and sanitised control where lives are saved and professional boundaries should be protected. One consultant describes the environment as so “precious” that it is “a bit like a church”. Too often, that sanctity has been corrupted by male doctors sexually harassing and assaulting their female colleagues even with a patient lying unconscious between them on the operating table.

Two thirds of women working in surgery have been sexually harassed by a colleague at work, according to a 2023 survey. Nearly a third have been sexually assaulted and there were 11 instances of rape reported to the researchers. Patients are undoubtedly being put at risk. One surgeon described a male doctor lifting a female patient’s gown when she was under anesthetic and feeling her breast, even though the operation was nothing to do with that part of her body.

I’ve been reporting on this issue for three years now and every time I return to it I am shocked. There is something about the mismatch between these brilliant, articulate, highly skilled women who are saving lives every day and the way they have been belittled and sometimes brutalised at work, then seen their complaints batted away by the NHS. Several were reduced to tears as they described their experiences of being sexually assaulted in and around the operating theatre and the “grossly inadequate” sanction delivered to the men who abused them. Often they told me: “The process was as traumatic as the sexual misconduct itself.”

That could be about to change. Wes Streeting, the health secretary this week announced plans for sweeping changes to medical regulation that would ensure doctors who are convicted of serious sexual offences are automatically struck off. There will be a new duty on the General Medical Council (GMC) to remove these medics from the approved list and it will no longer have to undertake its own “fitness to practise” procedure before erasing them.

At the same time, the government is planning to scrap the “five year” rule so that the regulator can consider older complaints of sexual misconduct. Under the biggest shake up of the GMC for over 40 years there are also reforms to ensure doctors who use “intolerably racist and antisemitic language” are removed from the register.

Streeting’s allies say he has been appalled by the testimony of the female doctors and patients who have spoken out about their experiences of sexual misconduct.

Only 17 per cent of consultant surgeons are women and they describe a “God complex” among some of their male colleagues. “If you’re a transplant surgeon you are literally giving life to people who would otherwise not be alive,” explained one who was subjected to abuse by a renowned transplant specialist James Gilbert when she was a trainee and he was her supervisor. “It’s male-dominated, individuals can do no wrong and so the advantage rests with the perpetrators. Things are hidden and not discussed.”

The astonishing thing is that doctors found guilty of sexual misconduct have until now been able to continue practising. Gilbert, who sexually harassed and assaulted women colleagues in and around the operating theatre over a period of 13 years, has already been allowed back into the operating theatre. Although a tribunal ruled in 2024 that his fitness to practise as a doctor was “impaired” after finding that he had touched women “inappropriately” without their consent and created “an intimidating, hostile, degrading, humiliating and offensive environment” for female surgeons, he was only suspended for a year. In January he told The Observer he had used his suspension to “reflect upon and remedy” his behaviours “so as to ensure they never occur again” as he returned to work.

Another doctor, Cian Hughes, was found guilty of “serious sexual misconduct” by a medical tribunal over a relationship with a young woman who had been his patient – they had met when she was only 13 and became sexually involved when she was 17. But instead of being struck off he too was suspended for 12 months.

A recent study found that in nearly a quarter of cases, the sanction imposed for sexual misconduct by the MPTS is more lenient than the one proposed by the GMC.

Mei Nortley, a consultant vascular surgeon and lead author of the report warned last year that “sexual harassment has been normalised” in her profession. She welcomed the government’s proposed reforms. “These changes are hugely welcome and represent increased recognition of the seriousness of sexual misconduct and the effect on targeted individuals - with reporting often significantly delayed due to fear,” she said. “We urge the GMC and MPTS to continually assess whether their processes and outcomes align with both professional and public values.”

There are still some questions. It is unclear how “serious sexual misconduct” will be defined and it appears that doctors will only be automatically struck off if there is a criminal conviction. What does this mean for those – like Gilbert and Hughes – who had rulings against them by a medical tribunal rather than in a court of law? For the women who have suffered, though, it is a sign that the government has at last listened to them. “As a victim you need the system to hold you safe and take adequate measures to protect others,” says one. “I hope these changes represent a wider move towards recognition of the seriousness and impact of this behaviour and the fear which holds victims silent, often for many years or indeed forever.”

Photograph by Natnan Srisuwan / Getty Images