6th February 2003 (* must be misdated)

Dear Ms H

Thank you very much for your letter of the 23rd February. I am sorry that you felt that I had not answered your questions completely, but many of the questions you posed did relate to your own case and I am not in the position to answer them as I do not know the circumstances.

With regard to your most recent letter you first ask if a procedure is legal or illegal. In terms of operations the requirement is that informed consent is obtained for a procedure. However, if you read the wording of that consent you will see that is(*) says that where other procedures are required that may be life saving they can be carried out at the discretion of the surgeon. When a patient is asked to sign a consent form and she specifically wishes something not to be done then that should be recorded on the consent form.

I recommended that you instigated a complaints procedure because it seems to me that many of the questions that you posed have not been answered. Your questions can only be answered by somebody who has access to your medical notes and can familiarise themselves with your case. If you feel dissatisfied with the answers that the surgeon in question gave to you then this is a reason for making a complaint to the Chief Executive of he hospital. I do realise that what has happened to you is something that you are gong to have to live with for the rest of your life and that it may have considerable impact upon you, particularly when it has deprived you of the ability to have more children. I am sorry that you feel you have been denied answers to your questions but again they can only be answered by somebody who has access to your notes. If you feel that something has gone seriously wrong and that an operation was performed which you specifically stated you did not want and you cannot get answers, then you have recourse either to an official enquiry or you can make a direct approach to the General Medical Council who will take up the case on your behalf. Please understand that the College does not refuse to answer your questions; it is mearly that the questions you pose are difficult to answer in the circumstances. Statistics do exist about the incidence of caesarean hysterectomy and it is roughly one per thousand births in the UK.

I do feel that it would be in your best interests to sit down with your consultant and go over the various questions that you ask in your letter of 23rd January. many of them are of a general nature regarding caesarean hysterectomy and the removal of the cervix and these can be easily explained to you. I feel for your sake and that a one to one conversation would answer your questions much better than a prolonged correspondence.

With best wishes

Yours sincerely

(signed)

Peter Bowden-Simpkins
Honorary Tresurer

** Again this person feels that they are evading answering the actual questions
(*) Their spelling not mine

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