Doctor circumcised second boy without parent's consent

The boy needed surgery in hospital after his circumcision (stock photo)

A doctor suspended for circumcising a baby without a mother's consent has since circumcised a boy without a father's consent.

Dr Balvinder Mehat was suspended by a medical practitioners tribunal in 2019, but did not lose his job because he was deemed to pose "no risk to patients".

The most recent boy needed surgery in hospital after his penis became infected following the circumcision.

Dr Mehat said he believed that "appropriate consent" was in place.

Dr Mehat previously circumcised a baby boy in July 2013, after the child's paternal grandmother took him to have the procedure without his mother being aware.

In the latest case, the boy - who was seven at the time - was circumcised on 19 October 2022, when his mother took him to have the procedure without his father being aware.

Consent for circumcising a child should be obtained from both parents, according to British Medical Association (BMA) guidance, which references the previous case involving Dr Mehat.

The boy's mother signed two disclaimer forms, claiming only she had parental responsibility and nobody else was involved in his care, but these were dated after the circumcision had already been carried out.

Although the boy has recovered from what happened, his father is worried he will have problems when he gets older.

"I've spoken to other people on online forums; not everybody wants to be circumcised," he said.

"It affects men, physically and mentally, especially when that decision isn't even a part of what you chose."

Bakersfield Medical Centre provides about 10 circumcisions a week, according to a Care Quality Commission report

The father complained to the General Medical Council (GMC), which investigated but closed the complaint "on the basis that there was no realistic prospect of proving that Dr Mehat's fitness to practise was impaired", according to a document seen by the BBC.

However, the father asked for that decision to be reviewed, and the GMC has now found it "may be materially flawed".

It means a new review is due to commence "for the protection of the public".

Dr Mehat said in a statement to the BBC: "We acknowledge the GMC's decision to revisit this case and will co-operate fully, once again, with their review of the facts.

"We believe the procedure was carried out correctly and with appropriate consent in place."

The GMC did not want to provide a comment, but a document seen by the BBC said: "I note that similar conduct by Dr Mehat has previously been determined to amount to serious misconduct. If it were found to have been repeated, this would be an aggravating factor."

The document also said: "Subsequent correspondence from Dr Mehat suggests that his understanding as to when an individual has parental responsibility may remain flawed and/or incomplete. This is despite the previous Tribunal's findings. Until formally resolved this may represent an ongoing risk to patients."

Why was the most recent boy circumcised?

The father found out his son had been circumcised when he was dropped off for a half-term break

The boy was taken to Bakersfield Medical Centre in Nottingham by his mother on 19 October 2022.

The boy's parents were married but separated, and the father did not know the procedure was going to be carried out.

Dr Mehat fitted the boy with a Plastibell device, which is used in child circumcision procedures.

The boy's father said the procedure was painful for his son.

"He was fully aware of what happened," said the boy's father.

"When he talked to me about it, he told me he felt everything, and the lidocaine injection [local anaesthetic] didn't actually work. He felt like he was getting electrocuted all over his body."

The father only found out about the circumcision a few days later, when his son was dropped off for a half-term break.

BMA guidance says circumcision should only be done if it is in the overall best interests of a child.

However, the father said he still did not know what discussions were had between Dr Mehat and the mother, to establish whether or not the procedure was in their son's best interests.

He said he and the mother had discussed circumcision when their son was a baby, but due to their disagreement, he was not circumcised then.

What were the complications with the circumcision?

The boy was taken to hospital after "complaining of acute penile pain" (stock photo)

The boy's father said his son "woke up screaming in agony" on 22 October 2022, and he took him to A&E at the Royal Derby Hospital.

The boy's emergency department attendance record confirms he was "complaining of acute penile pain in the night".

The boy then had emergency surgery to have the Plastibell device removed because, according to the record, it was "causing constriction". The boy then had the remnants of his foreskin surgically removed.

"The surgeon who performed the procedure explained that the device had been incorrectly sutured, causing it to migrate and cutting off the blood supply to the glans," said the father.

"There was also evidence of infection."

Although this is not in the records, the father said a nurse told him his son was at risk of losing his penis if the surgery had been delayed any longer.

What consent checks did Dr Mehat make?

The boy's mother signed two disclaimer forms, dated after the circumcision had been carried out

Dr Mehat told the GMC that the boy's mother brought his birth certificate to the GP practice on 19 October 2022 - the day of the circumcision.

The father was not named on the birth certificate, but the father still had parental responsibility for his son because he was married to the boy's mother.

On the same day, the boy's mother signed a "circumcision consent form", which stated: "I agree that I have parental responsibility for the patient. Also all those with parental responsibility are aware of the procedure described above to be carried out without any disagreement or disputes."

The boy's father said this was false because he also had parental responsibility and was not aware the procedure would be carried out.

Dr Mehat also got the mother to complete two disclaimer forms, which stated that the father "was not involved in the care of the child", and also that nobody other than her had "ever had parental responsibility for your son".

However, the BBC has seen copies of the disclaimer forms and they are dated 24 October 2022 and 8 December 2022 - which were after the circumcision had been carried out, and after the boy's father had complained to Dr Mehat on 21 October 2022.

The "expert" who originally looked at these forms for the GMC seemingly did not notice that they were completed after the boy was circumcised, and this is partly why a new review is going to be carried out.

What have police said?

The boy's father is worried his son will have problems when he is older due to being circumcised (stock photo)

The boy's father contacted Nottinghamshire Police after learning Dr Mehat had previously been arrested and investigated in relation to the baby he circumcised without his mother's consent.

He said police initially told him officers could not take the case further as they thought he did not have parental responsibility for his son - despite him providing a court order to the contrary.

He also said police told him there would be no further action due to "evidential difficulties", and said he had asked for clarification about this, but none had been provided to him.

In a statement to the BBC, a police spokesperson said: "Nottinghamshire Police investigated the matter and determined that there was no evidence to support the allegation that a crime had been committed."

The father believes police have not considered the evidence properly in relation to the forms signed by the mother, and the court order confirming he had parental responsibility.

The BBC put this to Nottinghamshire Police, but the force said it would not comment beyond its statement.

Was the GP practice safe?

A Care Quality Commission inspection rated the safety of services as "inadequate"

Bakersfield Medical Centre was inspected by the Care Quality Commission (CQC) in June 2022.

The practice was rated as "requires improvement" overall and the safety of services was rated as "inadequate".

The inspection evidence table noted: "No checks were made on child patients who attended the practice for a non-therapeutic male circumcision procedure to ensure that they were not subject to child safeguarding."

The report also said "appropriate standards of cleanliness and hygiene were not met".

The GMC did not consider this CQC report when it investigated Dr Mehat for the circumcision, but the report has since been provided to the GMC by the boy's father.

The GMC now considers the report to be "new information", and this is another reason why a new review is due to be carried out.