SENIOR doctors believed the former chief executive of a Westcountry hospital trust was ousted because of "resentment and tension" over controversial plans to centralise specialist cancer services, a tribunal was told.

The Royal Cornwall Hospitals Trust (RCHT) and the Strategic Health Authority (SHA), which oversees healthcare in the region, have always said that John Watkinson was dismissed because of concerns over his performance and behaviour in a previous post and in Cornwall.

Dominic Byrne, who stepped down as medical director of RCHT in protest at the circumstances of Mr Watkinson's departure, yesterday told a tribunal that many health professionals believed the "real reason" was a difference of opinion over proposals to centralise treatment for upper gastro-intestinal (GI) cancer services in Plymouth.

It came as Peter Davies, former chairman of the RCHT, told the hearing that sacking a chief executive who was improving performance and relations within the trust was "tantamount to committing suicide".

Yesterday, the tribunal panel asked Mr Byrne, who is still a consultant at RCHT, the "real reason" for pressure on Mr Watkinson after a negative report came to light which criticised his performance in his former post in Bromley Hospital Trust, in Kent.

Mr Byrne said: "The widely held conclusion was that the unwelcome differences in upper-GI cancer had caused resentment and tension in the trust, and that somebody had to go to allow the process to run more smoothly.

"All the passion and power presented behind those issues fit with that being the reason. Circumstances played out very conveniently that everything came together in a timely manner."

He told the tribunal that the board of directors at RCHT had felt "under pressure" from the SHA to suspend Mr Watkinson, to make way for the report which has been criticised as "one- sided", and resulted in dismissal. "It was expected by the SHA, and if we didn't agree to it, it was highly unlikely that anyone would still be there," he said.

Mr Byrne resigned as medical director, because clinicians did not support the suspension. He said they had sought assurances that the problems at Bromley were not recurring at Cornwall, and said finance director, Joe Teape, told consultants that there were no major financial issues at the trust.

Mr Byrne said Mr Watkinson had begun to turn around damaged relations between "disengaged" clinicians and hospital administration. He said 120 doctors had gathered to support Mr Watkinson, an outcome he called "remarkable".

Yesterday, Mr Davies, who resigned as RCHT chairman after non-executive directors refused to sign up to an agreement over upper GI, revealed Sir Ian Carruthers, chief executive of the South West Strategic Health Authority, said Mr Watkinson "promised, but did not deliver". Mr Davies did not agree, and told the tribunal Sir Ian thought Mr Watkinson was "rocking the boat" over upper-GI transfer.

A month later, he and Mr Watkinson were summoned to a "very unpleasant meeting" in Taunton, which they felt was a "set up". Sir Ian told them he was "appalled" by the public outcry in Cornwall. "We were told quite clearly that we had to agree a joint statement with the PCT," he said.

He said: "We were being pushed very hard in a direction where we knew the public of Cornwall would be very angry, and a move that wasn't based on clear, clinical and proven evidence we could present to the public." But he said a later review provided the evidence needed. He believes it would have won support if it had been carried out earlier.

Mr Watkinson was invited to take a "special leave of absence" in September 2008, and was later sacked.

The tribunal continues on Monday.