This Week

The chair of a Scottish trust at the centre of a row over the amputation of healthy limbs has expressed 'great surprise and concern' that the board was not consulted by senior managers.

But Ian Mullen, chair of Forth Valley Acute trust, said he would not rule out similar operations - as long as the patients concerned were local and it was 'clinically appropriate'.

Two operations were carried out privately at Falkirk Royal Hospital on patients suffering from a psychological disorder. The first, on an English patient, took place in 1997; the second, on a German patient, in April.

The surgeon concerned - Robert Smith - consulted the trust's former medical director, Douglas Harper, and the Medical Defence Union in both cases before 'making a judgment based on clinical evidence'. No disciplinary action will be taken.

The decision not to consult the board was taken by the then chief executive, Margaret Duffy, who told HSJ she had only been in post for four months at the time of the first operation. She said she took the advice of the former medical director - ' a very experienced and nationally respected consultant surgeon' - that it was justified on clinical grounds.

But Mr Mullen said it was a matter 'of great concern that these individuals did not think the board would wish to be informed of these operations'.

A third operation - on a US patient - was vetoed by current chief executive Jim Currie. All such operations will now be referred to the ethics committee of the trust.

The Scottish Executive is now investigating trusts' procedures for staff to consult their boards.