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February 4th 2020

Medical Negligence

Care of 11,000 patients to be reviewed as inquiry into ‘rogue’ breast surgeon highlights widespread NHS failings

Paul Cain

Paul Cain

Senior Solicitor, Clinical Negligence and Head of CICA

Care of 11,000 patients to be reviewed as inquiry into ‘rogue’ breast surgeon highlights widespread NHS failings

Having supported some victims of ‘rogue’ breast surgeon Ian Paterson in legal proceedings I have to say that the findings of an independent inquiry into how and why he wasn’t stopped from performing unnecessary surgery on patients makes for deeply disturbing reading.

Having supported some victims of ‘rogue’ breast surgeon Ian Paterson in legal proceedings I have to say that the findings of an independent inquiry into how and why he wasn’t stopped from performing unnecessary surgery on patients makes for deeply disturbing reading.

Paterson left male and female patients significantly deformed after telling them they were at risk from cancer when they were healthy, ‘exaggerating and inventing’ risks of tumours and carrying out surgery patients didn’t need so he could earn extra money.

Some later discovered years later that they did not have cancer and when he was eventually jailed for 20 years in 2017, he was labelled a ‘rogue’ surgeon and presented as someone who had acted entirely alone.

Yet today, the Rt Rev Graham James, who chaired the inquiry, said that had been far from the case.

He said it was not a ‘story of a rogue surgeon’ but one of ‘a healthcare system which proved itself dysfunctional at almost every level’ across the Heart of England NHS Foundation Trust as and Spire Parkway and Little Aston.

Between 1998 and 2011 Paterson treated 6,617 patients at Spire and 4,077 had a surgical procedure or operation, of whom 2,399 had some form of breast surgery. At the NHS at the Heart of England Foundation Trust, Paterson had 4,424 breast patients in the same period.

Over this time he was able to avoid scrutiny and carry out unnecessary operations on patients, resulting in the call today for the surgery of 11,000 patients to now be reassessed.

It is the latest huge patient recall scandal and sadly, these are findings I could have predicted.

In my work, I see far too many cases where it is all too easy for health trusts to point the finger of blame in the direction of one individual, knowing all too well the problems run much deeper and have largely been ignored or not thoroughly challenged or investigated.

The more I spoke to people involved and the more I learned about this case, the more I questioned how a surgeon could get away with this for so long. I wondered whether there had been any other health professionals involved.

Now we are in a position where we know one of Paterson’s colleagues has been referred to police and five more to health watchdogs by the inquiry.

Patients believed others knew what was happening and ‘turned a blind eye’

Patients, who had already been compensated and therefore had nothing to gain financially, but were just telling it as it was, painted a shocking picture of healthcare professionals who appeared to know what was happening but ‘turned a blind eye’, or appeared not to be concerned by what they saw.

A third of those who gave their opinions to the inquiry said they believed other individuals working there will have been aware of what was happening at the Heart of England NHS Trust and Spire, and that they had a responsibility to raise concerns.

“We witnessed a strong belief from patients treated at Spire, and their relatives, that the breast care nurse who worked with Paterson there must have known of his malpractice and aided him in this,” the report says.

This is quite astonishing.

Anyone who has had a loved one diagnosed and treated for any form of cancer – even if the patient themselves or their family members consider themselves fairly well informed or educated generally in their daily lives – will tell you how important the input of the specialist nurses is.

They are able to explain next steps, what can be expected, and act as the contact, not just at the time of treatment, but for years after. They are the human face of the treatment that is being faced and in a very important position of trust.

To find out that a nurse or nurses at the Spire were in effect breaching that trust and simply ignoring malpractice that was causing physical and psychological injury reveals the real state of mind of the surgeon and those assisting him.

The report says there appeared to be a culture from the top of avoiding problems by managing them as isolated incidents, with a lack of critical thinking about what the real issues were.

It was convenient for Paterson to be characterised as a unique rogue by those who worked with him and those in charge – but devastating for patients who suffered so badly, and their loved ones.

The inquiry came to the conclusion that ‘it would be unwise to dismiss him as a one-off’

One of the recommendations from the review is that when a hospital investigates a healthcare professional’s behaviour, if there is a perceived risk to patient safety, the healthcare professional is suspended and this is communicated to any other providers for whom they work.

It seems incredulous that it takes a matter like this for a policy like this to be introduced, and sadly, like other large healthcare scandals, it has come far too late for so many.

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