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April 23rd 2018

Hospital Negligence

Lack of checks on doctors and surgeons in private hospitals is a major patient safety concern

Paul Cain

Paul Cain

Senior Solicitor, Clinical Negligence and Head of CICA

Lack of checks on doctors and surgeons in private hospitals is a major patient safety concern

It has been somewhat worrying to see the Care Quality Commission (CQC) express its concerns over a lack of checks and monitoring of doctors and surgeons operating in many private hospitals.

It has been somewhat worrying to see the Care Quality Commission (CQC) express its concerns over a lack of checks and monitoring of doctors and surgeons operating in many private hospitals.

In any walk of life or profession, close monitoring of performance is needed to ensure standards remain high and that procedures to ensure patient safety are always followed.

A failure to do so often leads to a drop in performance levels, and more importantly mistakes not being challenged and lessons not being learned.

As an independent regulator of all health and social care services in England, the CQC monitors, inspects and regulates hospitals, care homes, GP surgeries, dental practices and other care services to make sure they meet fundamental standards of quality and safety.

Now, its chief inspector of hospitals, Professor Ted Baker, has described the approach to consultants by many private hospitals as old-fashioned, reliant on informal systems and people knowing each other.

In essence, it is not driven by a focus on patient care and protection.

“Too often, safety was viewed as the responsibility of individual clinicians, rather than a corporate responsibility supported by formal governance processes,” he said.

These are worrying observations, and such an environment where independent assessment and monitoring is overlooked is certainly not conducive to maintaining high standards and ensuring any areas of concern are noted, reflected upon and addressed.

It is perhaps fair to say that most people who choose private health treatment or surgery will often do so as they feel they will receive a greater standard of care opposed to the NHS.

They’d perhaps also expect to find more stringent checks and monitoring in place of doctors and surgeons, and greater scrutiny of their work. This does not appear to always be the case.

Loose controls are a ‘significant concern’ with poor practices not challenged

The CQC says loose controls around private consultants is a “real danger” with regards to poor practices not being picked up or challenged.

It says it has “significant concern” that checks are not being made in some hospitals to ensure doctors and surgeons are only undertaking treatments they are qualified to do, or carrying them out in a safe way.

Having represented a number of patients of rogue breast surgeon Ian Paterson, and having seen the harm he caused to lives, I find this particularly shocking, and it raises serious questions as to whether private hospitals would be alert should a similar situation now occur.

We questioned how and why he was able to go undetected for so long. There simply can’t have been enough checks, or enough monitoring of his work and decisions, as he carried out botched operations on patients and was not suspended from his position until eight years after concerns were first raised – a quite incredible amount of time.

He was eventually found guilty of 17 counts of wounding patients with intent and jailed for 20 years.

His trial heard he had wildly exaggerated his patients’ cancer symptoms, leading them to have several needless operations which left them scarred for life physically and emotionally.

Many of his victims could have been spared had the right systems been in place and followed.

On a positive side, it is pleasing to hear that hospitals have been quick to respond where failings have been found by the CQC.

But the facts are that it should never reach that stage, as if hospitals are not able to assess, monitor and manage the doctors and surgeons they use themselves, how can patients have complete confidence and trust in them?

Dr Howard Freeman, of the NHS Partners Network, which represents private providers, said providing safe and high-quality care was a “top priority”, whilst The Royal College of Surgeons has said there is “no room for complacency”.

Sadly, this CQC report suggests complacency has been a problem, and that providing safe and high-quality care has not always been the priority. That is a completely unacceptable situation.

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