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TX:听 17.09.2019听 2040-2100
PRESENTER:听 听听听听听听听 PETER WHITE
PRODUCER:听 听听听听听听听听听 LEE KUMUTAT

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White

Good evening.听 Quote: 鈥淢oney first, patients second鈥� 鈥� the damning indictment of an ophthalmologist by a medical tribunal.听 We鈥檒l be looking at the implications of this case in a moment.听 And the visually impaired British sailors on top of the world again.

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Eye surgeon, Bobby Qureshi, has been found guilty of behaviour amounting to misconduct by a medical tribunal.听 The hearing has been investigating a series of complaints relating to the treatment of Age Related Macular Degeneration 鈥� the biggest cause of blindness amongst older people in the UK, while Mr Qureshi was medical director of the private London Eye Hospital, now under different management.

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The procedure related to the implant of lenses in patients鈥� eyes with the aim of diverting light to the strongest part of the eye.听 People like Marie Bannister鈥檚 father.

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Bannister

After a few weeks it was very evident that something wasn鈥檛 right and he returned to the London Eye Hospital and they said that the lens had moved.听 Eventually, they did another procedure to replace the lens.听 Once that procedure had been done my dad developed an infection that went on, the infection became so severe that he was in hospital for a little over two weeks because the cornea had become ulcerated.

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White

And how bad was your father鈥檚 sight at that point?

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Bannister

The left eye was quite bad, his right eye was his stronger eye and at that stage he was sort of able to read his newspaper with some help of magnifiers and things but he was able to read.听 He led a very, very independent life.

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White

And what was he promised?

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Bannister

For my father being able to read his newspaper was his main criteria.听 So, the promise was that he would find that much, much easier to manage.

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White

And in the event, what happened?

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Bannister

As a consequence, my father has no vision at all in his right eye now.听 So, the stronger eye has lost everything, the weaker eye 鈥� which is the left one 鈥� has barely any vision, so that he is virtually blind now.听 So, the consequence has been just catastrophic.听 You know, for my father it was going to be an enormous advantage to have a little more sight and he鈥檚 had to come to terms with losing the eyesight sort of prematurely really because if he鈥檇 have just stuck with its perhaps normal decline he would have had his eyesight for a lot longer.

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White

To what extent do you feel that you and your father had enough information before the procedure took place?

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Bannister

Those sorts of things really weren鈥檛 brought to our attention 鈥� the potential for it going wrong.听 I鈥檓 assuming, like most people, we tend to focus on the benefits of the outcome, rather than the consequences when things don鈥檛 go to plan.听 I could kick myself now inevitably and I feel deeply regrettable that we did it and so sorry for my dad.

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White

Marie Bannister.

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Well, it鈥檚 a story which people working at the Macular Society heard many times, making up much of the evidence which they鈥檝e presented to the medical tribunal.听

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Cathy Yelf is their chief executive.

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Cathy, first of all, I mean how much evidence did you have?

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Yelf

We had calls from scores of patients over quite a long period of time, probably more than 50 calls in the end that were very serious in the concerns that they raised with us.听 We had more with minor concerns but we had quite a lot of really quite serious concerns.听 And in the end, we decided that the only way of dealing with this comprehensively was to submit a batch of these cases to the General Medical Council.

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White

What kind of things were people telling you?

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Yelf

In the main the problem was that they had spent a great deal of money, in some cases as much as 拢24,000, for lens implants that essentially didn鈥檛 work, that was the overriding complaint.听 And then alongside that came out evidence that people had felt that they were subjected to high pressure sales techniques, so given special offers that were time limited and things like this and that they didn鈥檛 really 鈥� overrule there was a constant theme that they weren鈥檛 aware of the risks of this operation, the potential risks.

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White

And I suppose the problem really is the level of hope that people have that this is going to solve their problem, change their lives.

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Yelf

Well this is the most distressing thing really about this case is that Mr Qureshi was taking advantage of people who are quite vulnerable because they were so desperate.听 To lose your sight is a terrible thing, particularly later in life when you have so much less chance to adapt to the consequences of that, and these people were desperate to retain the sight that they had and, in many cases, they were promised that their sight could be improved.听 So, they were quite vulnerable patients and they were obviously, in many cases, quite elderly patients as well.听 So, yes, it was a great exploitation of a particularly vulnerable group of particularly desperate people.

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White

Now there are a variety of forms of macular disease and a range of treatments for them, like drugs injected into the eye, as just one example, where does the implanting of lenses fit in to this spectrum?

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Yelf

Well it鈥檚 all experimental really at this stage, so there are quite a few groups around the world who are looking at the potential for special lens implants in the eye to help with macular degeneration.听 So, this wasn鈥檛 in and of itself anything to cause concern, there are lots of reputable people who are looking at the potential for this and in fact the Macular Society is about to start funding a small clinical trial into one of these types of lenses.听 So, they are plausible as a solution, at least temporarily, for people with otherwise untreatable macular degeneration but it鈥檚 all pretty experimental at this stage and we don鈥檛 have a great deal of evidence to say which of these lenses or which particular methodologies for these lenses might prove to be the most useful in the end.

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White

Because obviously what we don鈥檛 want to do is discourage people from taking on treatments that might be helpful to them because somebody has abused their level of trust.听 I mean can we say how effective is this kind of treatment, what the general range of risk associated with it might be?

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Yelf

Well the general level of risk isn鈥檛 much more than an ordinary cataract operation.听 So, cataract operations happen by the million every year, with the natural lens removed and an artificial lens put in its place.听 And I believe that Mr Qureshi had a lot of expertise in cataract surgery.听 So, it鈥檚 plausible that a particular type of lens might be useful, I mean people use magnifiers, for example, external lenses, to help them see when they have macular degeneration, so there鈥檚 a plausible idea that an internally implanted lens might be able to do the same thing.听 And there are lots of different theories as to what is the best approach for this but we haven鈥檛 really got anything, that鈥檚 why we鈥檙e funding a clinical trial into one of the most developed of these lenses to find out how useful they actually are.听 And one of the problems, of course, is how do you predict the outcome for a particular individual, you have to do simulations and do your best guessing.听 So, it鈥檚 an imprecise science at the moment.

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White

And presumably the same problem with how you predict the risk, I mean do we know how to predict the risk?

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Yelf

Well Mr Qureshi鈥檚 lenses were his own invention; I think he鈥檇 worked with some other scientists who helped develop at least some of his lenses.听 And as I say, for most of them if it鈥檚 a single lens implant that鈥檚 replacing a natural lens then the risk level would be pretty much the same as it is with the millions of cataract operations that are done.听 So, in other words, low, the risk is low.听 However, some of his lenses were more complicated than that.听 So, one of the lenses that Mr Qureshi used, the so-called IOLMAD was a double lens, it was a sort of a miniature telescope.听 Now there are other miniature telescopes on the market as well but the risk, because they鈥檙e bigger, they are much bigger than an ordinary single lens implant, if you need to make a bigger cut in the eye to get it in, another lens type was a sort of a foldable one that expanded once it was in the eye.听 So, there are lots and lots of techniques and overall the risk probably isn鈥檛 huge, the difficulty was with the patients having complications or that they simply couldn鈥檛 benefit from these lenses, that was the main issue.听 We never, in fact, made any complaint about the lenses Mr Qureshi was selling themselves, it was the difficulty of them not benefiting the people he sold them to.

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White

And to be clear, the tribunal hasn鈥檛 found any specific problem with the lens has it?

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Yelf

I don鈥檛 think they considered it.听 I mean we have had lots of conversations with various experts about how these lenses are supposed to work, the idea that they would direct light on to a healthier part of the retina.听 And there are mixed views about this, many people say they don鈥檛 know how that would work.听 So, we don鈥檛 know really how useful the lenses would be even in the right people.听 But they鈥檙e certainly no use in the wrong people.

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White

Cathy Yelf, chief executive of the Macular Society, thank you very much.

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At the time of recording the General Medical Council is still deciding what sanctions to impose on Mr Qureshi.听 One of its options is to remove him from the Medical Register.听 Bobby Qureshi was found, by the tribunal, to have put money above the welfare of his patients.听 In his defence, he insisted that he had offered further treatment and compensation to patients who experienced problems.

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Now, a happier story.听 The numbers of visually impaired people signing up to blind sailing, we鈥檙e told, are increasing.听 Which might have something to do with the current performance level of the British sailing team.听 Well their good form kept up over the recent Blind Sailing World Championships that were held in Kingston in Ontario, Canada.听 And Chris Albert was one of the team which retained the world championship, the fleet world championships, and he joins me now.

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So, obviously, a very successful few days.

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Albert

A very successful week, yeah, I mean there was a lot to prove and I think we鈥檝e come back and proved that the blind sailing team for GB is really strengthened and continuing to maintain our form.

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White

And just explain, because you won the fleet world championship, what does that mean, presumably there are quite a lot of boats involved?

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Albert

There are a number of boats on the circuit, we have three fleets, there鈥檚 a B1 fleet, which is the vision level where you can only get light perception and the B2 fleet and the B3 fleet, which is the last fleet that鈥檚 allowed to compete internationally which is what I鈥檓 in, so I鈥檝e got slightly more sight than the B2 fleet.

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White

How did your B3s get on specifically then?

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Albert

The B3s, we competed neck and neck with Canada for the first five days on their home turf with their knowledge of the area and with a boat that鈥檚 only sailed in Canada, so we had no previous knowledge of the boat and to level peg them all the way through for five days and then to lose it on one particular day was absolutely gutting.听 But speaking to their coach afterwards we couldn鈥檛 have done anymore, he said you were sailing the best you could possibly sail, the knowledge that you had of the area.

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White

Is that mainly knowledge of the wind and stuff like that?

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Albert

It was more the wind, yeah, because the wind shifts in cyclical mode and they managed to pick the right area of the cycle to just get ahead of us and just managed to maintain that lead for that day.

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White

So, Chris, for those who don鈥檛 know, how does blind sailing actually work?

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Albert

Okay, so we have a four-man crew, two of the crew are visually impaired and their positions on the boat are the main sheeter, which is what I do, so I control the big main sail and keep the boat flat and powered up.听 And then the helm, so the person steering the boat is also of the same sight impairment.听 So, it鈥檚 quite difficult.听 The other two on the boat are both sighted, one is allowed to use the fore sail and maintain the fore sail and help balance the boat.听 And the fourth person is a tactician, they鈥檙e not allowed to touch any controls on the boat, they鈥檙e purely there to paint the picture of what鈥檚 going on and to talk to the tactics to us and say how we鈥檙e going to compete in the next leg of this race.

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White

So, for things like steering how does that work?

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Albert

It鈥檚 difficult to see with the different fleets.听 The B1s, I鈥檝e sailed with some B1s who鈥檝e got no vision at all, and you use your ears a lot to feel the wind direction and feel where the boat鈥檚 going and it鈥檚 your stance in the boat to feel how much the boat鈥檚 heeling.

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White

I mean are you using any technology for steering, is it radar?

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Albert

We鈥檙e not allowed to use technology, it鈥檚 purely the tactician painting the picture and telling us what we need to do, they can see the wind shifts on the water, the dark patches on the water, they鈥檒l try and steer us towards those to gain the advantage.听 So, it is quite a sighted game but they鈥檙e only allowed to paint the picture for us, we have to then interpret that and use that.

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White

And I gather there are things that you have to do because I think you鈥檙e all quite 鈥� the boats, your competitors 鈥� you鈥檙e all quite close together, so they might hear what鈥檚 going on?

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Albert

We鈥檙e very close together and the Canadians did tell us afterwards that we鈥檙e quite a loud team in my boat.听 We鈥檙e very vocal, we鈥檙e very passionate about what we do but our reaction time is brilliant because the minute something鈥檚 said it鈥檚 already happening.听 So, you need that bit of a trigger in the communication but you鈥檝e got to try not to give away too much information to the other boat on what you鈥檙e planning to do and when you鈥檙e going to execute that move.

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White

And why are there different sight categories in blind sailing?听 You know, do you have different modifications or rules?

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Albert

The rules are exactly the same for all three fleets, all it鈥檚 about really is having a level playing field for people with the same impairment competing against each other.听 You don鈥檛 want to have the advantage of somebody with a little bit more sight over somebody else and to that end we all have to get sight classified before we leave the UK and then you get reclassified when you get to the actual event, so they鈥檙e checking that nobody鈥檚 cheating and getting into categories they shouldn鈥檛 get into.听 So, it鈥檚 quite an intense first day making sure your team is going to get through the testing.

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White

So, how did you get into it 鈥� blind sailing?

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Albert

I got into it absolutely by chance.听 I ski every year with a guy who works for the Department of Work and Pensions, he鈥檚 got sight only in one eye and he鈥檚 hearing impaired and I鈥檇 skied for years and then one day, Lucy Hodges, who鈥檚 the Commodore of Blind Sailing, sent a flier out to other government agencies saying look, we鈥檙e looking for some more blind sailors, is anybody interested.听 He said to me, do you fancy coming along to Windemere for a taster weekend.听 We went over there and it was an absolutely glorious weekend, it was t-shirt and shorts sailing all weekend and I absolutely loved it and I just keep going back.

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White

What is it about it that you love?

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Albert

For me, it鈥檚 a replacement for not being able to drive because I had to stop driving over 12 years ago and till you have to lose something like that you don鈥檛 realise how much adrenaline you get from making the decisions, controlling the power, having the freedom to go and do what you want, when you want and sailing gives that back to me, I鈥檝e got all this power in my control and it鈥檚 up to me how I do it, how I use it and to make those decisions.

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White

And I mean, I think when you lost your sight it was fairly traumatic wasn鈥檛 it?

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Albert

Yeah, it was very traumatic.听 I was working for an aerospace company at the time, I was just about to get delivered my first ever brand new company car, it was being delivered that week and I had to make the decision, nobody makes the decision for you, I had to make the decision to say 鈥� I can no longer drive.听 I can still do the job but I can no longer drive.听 But within 24 hours I was made redundant.听 I had a really strong case, I had a solicitor lined up and my sister funded the solicitor but it sucked so much energy out of me losing that job and it became the only focus in my life and that wasn鈥檛 me, so I dropped the case, I went off and I just went self-employed and did my own thing and carried on in engineering, proved to myself that I could still do that role, the visual impairment wasn鈥檛 such a major impact as the company had foreseen it as.

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White

But clearly the sailing has been a major thing in your life.

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Albert

Yeah, the sailing came along at just the right time for me, both in the losing the job and later in a divorce stage, it just sucks me in, takes me away from it, gives me that to focus on and nothing else.听 And I think that鈥檚 what helps drive us all really 鈥� that we鈥檝e got such a passion that pulls the team together and we鈥檙e all there to help each other, we鈥檝e all been through similar circumstances so we all work together and just support each other.

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White

And team 鈥� from all over the UK?

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Albert

The team is spread all over the UK.听 In my boat, in particular, there鈥檚 four of us.听 One is from the Isle of Wight, one is from the Gloucester area, one is from Windemere and I鈥檓 from the North East, so we鈥檙e spread far and wide.听 We all do our own sailing week on week with our own local clubs but we come together once a month at one of the venues, either Windemere, Isle of Wight, Hollingworth Lake near Manchester or wherever we can get together really.

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White

And just one final thing, you know, retain the world championship, why are we so good?

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Albert

I think it鈥檚 the passion of our Commodore, Lucy Hodges, she gets us together as much as she can.听 She pulls the venues together and we run on volunteers 鈥� the sighted guys are volunteers; they are not paid at all.听 So, it鈥檚 the commitment of them to help us move forward, retain what we鈥檝e got and improve the people coming through.听 And part of my job is I work in the education service with people who are visually impaired and part of my role has sort of developed into finding things that these kids can move on to, to give them the drive and passion and to say look, you鈥檙e not limited in what you can do, here鈥檚 something we do, it鈥檚 slightly different to how anybody else does it but look at what you can achieve.

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White

Chris Albert, many congratulations and many thanks.

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Albert

Thank you very much Peter.

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White

And that鈥檚 it for today.听 Do let us hear your reactions to that and also our other story today.听 You can call to leave us a voice message on 0161 836 1338.听 You can email intouch@bbc.co.uk.听 Or go to our website:听 bbc/intouch where you can also download tonight鈥檚 and previous editions of the programme.听 From me, Peter White, producer Lee Kumutat and the team, goodbye.