A former GP has gone on trial accused of sexually abusing nine male patients by carrying out unjustified genital examinations, a jury has heard.

Gregory Manson’s alleged conduct spanned almost 20 years and involved him touching men’s groins, testicles and penises while unchaperoned, without offering an explanation and when not wearing gloves.

Some of the patients, including teenage boys, were attending Cossington House Surgery in Canterbury for ailments such as knee sprain, back pain, coughs or colds at the time.

Others had concerns including a rash, indigestion, fatigue and depression.

While some later described Manson as being “friendly and thorough”, one was left feeling the doctor was “weird, outdated and old-fashioned” in his approach and another “embarrassed and violated.”

Jurors at Canterbury Crown Court were told today (Monday) that the accusations were first made in 2017 and led to an investigation involving police, the General Medical Council (GMC) and NHS England.

As well as his general practice work since 1994, the now 56-year-old also had roles at the time as a GP trainer and programme director of GP training, as well as a GP appraiser for the GMC.

Manson, of Tower Way, Canterbury, denies 18 offences of sexual assault and six of indecent assault, alleged to have occurred between October 1998 and September 2017.

At the start of his trial, prosecutor Jennifer Knight KC told the court: ”This case, in a nutshell, concerns occasions when Dr Manson performed unnecessary examinations of male patients’ genitals.

“He performed these examinations without offering a chaperone, without providing any proper explanation to the patients involved about why these examinations were taking place, and without wearing gloves.

“You will also hear that Dr Manson also failed to document in the patients’ records the fact that such genital examinations had taken place or what the findings of those examinations were.”

Ms Knight told the jury the issue to decide would be whether there was medical justification for his alleged conduct or whether it was sexually motivated.

“This is not a case where the prosecution suggests that every genital examination was without justification,” she explained.

“The prosecution case is that in taking his explanations into account, there were many examinations that were carried out that were in truth entirely unnecessary and his real motivation was a sexual one.

“He took frequent opportunities to examine patients’ genitals not because he needed to medically but because he wanted to.”

The court heard the police investigation began in July 2017 when a complainant attended Canterbury Police Station to report having been sexually assaulted by the GP.

His allegation was then referred to the GMC and onwards to NHS England, which conducted an exercise leading to other alleged victims being identified.

The doctor was first interviewed by police in February the following year. He stated that he had never acted in a sexually motivated way towards any patient and had never performed a medical examination of male genitalia without a proper medical justification.

When re-interviewed more than four years later in July 2022 and having been provided with the available medical records for each complainant, Manson provided a prepared statement in which he gave “some general assertions and explanations about his customary approach to examinations”, said Ms Knight, while maintaining he had never examined any patient for improper or sexual purposes.

“He said every examination he did was conducted for a justified medical reason,” the prosecutor added.

The jury was also told that an expert GP and forensic medicine professor had, for the purpose of the trial, provided reports in respect of the examinations performed on each complainant in this case.

The earliest alleged victim in time told police Manson was someone he found “empathetic and attentive and always listening” to what he told him.

But he recalled that during well over half the consultations he had with him, Manson performed an examination of his genitals.

Explaining the alleged offences, Ms Knight told the court: “He remembers that when that happened, Dr Manson would take him into a separate room next to his consultation room, tell him to get up onto the bed, and then tell him that he needed to examine his genitals.

“(The complainant) cannot remember the reasons he was given but he thinks it was usually to check whether he had swollen glands.

“Dr Manson would then ask him to pull down his trousers and boxer shorts and lie on the bed. Dr Manson would feel around his (the patient’s) groin area before holding and examining each testicle individually.

He doesn’t recall either a chaperone or his mother ever being present and simply remembers being alone with Dr Manson in the room next to his consulting room each time...

“He doesn’t remember the doctor wore gloves but thinks he probably would have washed his hands.

“He doesn’t recall either a chaperone or his mother ever being present and simply remembers being alone with Dr Manson in the room next to his consulting room each time.

“It seemed to him those examinations were being done professionally and he assumed they were required.

“But as he got older he became uncomfortable about these examinations and wondered if they should be so frequent.”

Some of those examinations occurred when the alleged victim was said to be presenting with a viral infection such as a cough or cold, added the prosecutor.

When the accusations were put to Manson in his second police interview, he said he did not think the notes were complete but recalled that such examinations of the groin and testicles would have been “necessary” for the ailment being investigated at the time.

The independent expert also concluded that there were occasions where an examination of the ano-genital region may have been “reasonable and justified”, although this should not always have included an examination of the testicles.

The second complainant told police that “whenever he went” to see the GP, whatever his complaint, he would always end up in a separate room having a genital examination and did not recall being given any explanation.

“He would examine each testicle individually and lift his penis up to examine it and look at it,” said Ms Knight.

“He remembers Dr Manson touching his penis on the majority of occasions that he examined his testicles.”

Again, the complainant could not recall being offered or having a chaperone in the room or the doctor wearing gloves.

He also told police that although he did not think at the time there was anything sexual in the GP’s actions, he did think it was “odd” if he had just gone to see him with a cough or cold.

Jurors heard none of his records detailed such examinations and Manson again described them as incomplete when interviewed.

However, he told police that he would carry out testicle examinations when conducting what was called a new patient check.

In the context of back pain, the GP also said the need to exclude “a very rare but serious condition” might include a genital examination.

However, the trial expert was said to have concluded that such repeated examination was not necessary and, if it had taken place, that it should be documented in the patient’s medical notes.

Another alleged victim told police he had visited the surgery for upper abdominal pain and, having been initially examined with his trousers lowered, Manson then pulled his underwear down and “moved his hands around, brushing against his testicles and penis.”

Again, there was no chaperone, he was not gloved and no explanation given.

During a follow-up appointment, he said the GP “just looked” at his exposed genitals rather than touched or examined them.

Manson told police any brushing against his genitals may have been “accidental” during an abdominal examination.

But he accepted that his notes were not “inadequate” and he had not included a genital examination in them.

The court heard similar allegations were made by six other male patients. One reported how the doctor had abused him after first checking the glands around his neck and armpits, before pulling down his boxer shorts and feeling around his genitals.

He reported the same intimate examination happening on multiple surgery visits.

Another was said to have been subjected to a genital examination for a rash on his legs. The patient was not given any explanation, said Ms Knight, but he assumed it was required and thought that Manson had behaved in a “professional manner.”

He did what (the complainant) describes as a ‘cough and cup’ test. He thought Dr Manson was weird, outdated, and old-fashioned...

One man said it was during a new patient appointment that he underwent a genital examination, having been told by Manson what he was doing but not why.

The prosecution expert concluded that most GPs would not conduct a genital examination as part of a new patient health check but, when carried out in justified circumstances for example in relation to testicular cancer, it would be necessary to explain to the patient why it was being conducted, to offer a chaperone and to record any findings in the notes.

Another complainant told police that having explained his symptoms and what was wrong, he was taken into an adjoining room and told to remove his clothes and pull his boxer shorts down.

“He thought that it seemed strange but he assumed that he was being thorough, and that Dr Manson wanted to give him a clean bill of health before taking him on (as a new patient),” said Ms Knight.

“He did what (the complainant) describes as a ‘cough and cup’ test. He thought Dr Manson was weird, outdated, and old fashioned.”

Another patient told police he had seen many doctors over the years for a specific health condition but only Manson had performed a physical examination.

He described feeling “upset, embarrassed and violated”, and how he was subjected to a similar examination on a second occasion, with the GP pulling his pants down, cupping his testicles in his hand and asking him to cough.

Manson later told police the examinations were conducted due to the patient’s appearance and expressed illness.

He also explained that it was his standard practice when examining testicles to also examine the penis.

The expert concluded however that it was “not normal practice” for a GP to fail to explain why a testicular examination was being conducted or fail to record it, added the prosecutor.

In outlining the defence case, Mark Harries KC told the jury there were three factual issues for the jury to decide - whether a genital examination took place, if so whether there might have been a medical justification for it, and crucially, whether his “medical diagnostic pathway” was the motivation.

Detailing how the doctor had “discharged his responsibilities in a genuine, professional and comprehensive” way and “absolutely refutes” the prosecution’s contention that he was “sexually motivated”, Mr Harries said: “Dr Manson’s position, his clear position, is that when a genital examination of some kind took place, it was always medically and clinically justified.

“He says a sexual purpose never entered his head. He was medically motivated, not sexually motivated.”

The trial continues and is expected to last up to four weeks.