A very expensive way to die

REVEALED: Top private hospital is to be sued over tycoon's death as committee of MPs prepares to release damning report

AS ONE of Britain's wealthiest men, Sir Michael Caine could afford the best, so unsurprisingly he chose to have his bowel cancer treated in London's most exclusive private hospital.

The King Edward VII Hospital for Officers is used to caring for the rich and famous. The Queen Mother is treated there, as are numerous foreign royals.

Sir Michael, the former chief executive and chairman of Booker, the major food and agriculture business, was worth at least pounds 30m.

But the decision to go private, according to his wife, Baroness Emma Nicholson, cost him his life, for she is convinced that he would still be alive if he had been treated in an NHS hospital.

Sir Michael suffered a heart attack on the evening of 7 February. It lasted at least 15 minutes, during which time a tube, used to help him breathe, malfunctioned.

He suffered massive brain damage and never regained consciousness. The only doctor on site was a GP drafted in for the weekend, who had one week's experience in intensive-care duties.

The dying patient, the guiding spirit of the Booker Prize for fiction for nearly 25 years, was later moved to the NHS St Thomas's Hospital, where he died on 20 March.

Baroness Nicholson is determined to pursue the King Edward VII Hospital through the courts. She is convinced that negligence, strongly denied by the hospital, cost her husband his life. And she is not alone in believing that much private health care is inferior to that available on the NHS.

On Wednesday the influential House of Commons Select Committee on Health will issue a long-awaited report on the regulation of private health care. The Independent on Sunday has learnt that the highly critical report identifies key areas that need urgent attention, as well as ``huge gaps'' in existing regulations.

The committee's conclusions include:

Condemnation of doctors suspended by the NHS who continue to work in the private sector.

Criticism of private hospitals that fail to provide 24-hour cover.

The need for a statutory complaints procedure for the private sector.

Graham Maloney, of Yarm, Cleveland, who belongs to the pressure group Action for the Proper Regulation of Private Hospitals (Aprop), which was formed last year by disaffected private hospital patients, said: "The private sector in this country is sold as the Rolls-Royce of health care, yet in many areas the wheels are coming off. It's business first, medical care second in many cases."

In November 1993 his wife Christine, 47, died of cancer after a series of blunders by a doctor working for a private hospital.

Mr Maloney had to lay his wife out himself because there were no hospital staff available at the Nuffield Hospital on Teesside. He then had to fight for four and a half years before he managed to see a critical health report by the local authority on the way his wife was treated.

His story was one of many given to the select committee by Aprop members, who are campaigning for tougher legislation. At present the sector operates under the Registered Homes Act 1984, which was designed for nursing homes, not hospitals. Doctors suspended from the NHS are at present free to work in the private sector.

David Hinchcliffe, the Labour MP who chairs the select committee, said: "It doesn't make sense that doctors who have been suspended can continue to practise in the private sector. It is clearly an area where there is a huge gap in existing regulations."

Committee members interviewed alleged victims of the surgeon Christopher Ingoldby, who is facing 60 lawsuits following operations. Two families are suing after relatives died because of stomach and bowel operations by the surgeon, who continues to practise his lucrative private health work.

The select committee also learnt about Rodney Ledward, a gynaecologist struck off the medical register after he was accused of injuring 400 women in private and NHS hospitals, and it took evidence about Richard Neale, a consultant gynaecologist and obstetrician who allegedly left some patients disabled. Mr Neale continued with his private work after he had been suspended from an NHS hospital, and it emerged that he had already been struck off the medical register in Canada after a pregnant patient died.

The General Medical Council (GMC) admits that a date has yet to be fixed for Mr Neale to appear before it.

The issue has been taken up by William Hague, the Conservative leader, who has several of Mr Neale's patients in his Richmond constituency. In a letter to Mr Hague, the GMC said it first became aware of complaints about Mr Neale in February 1998. However, according to a BBC Panorama investigation, Mr Neale was brought to the attention of the GMC in 1986.

Most of the 220 private hospitals in the UK are owned by Bupa, Nuffield and the General Healthcare Group. Of the pounds 13bn turnover in the private healthcare industry, the share of the private acute hospital, including private facilities in public hospitals, amounts to pounds 2.3bn.

Baroness Nicholson claims that nurses at the King Edward VII repeatedly refused to call consultants and doctors, even though she believed her husband was in distress and pain. She believed that, shortly after his operation, a tube inserted into his throat to help him breathe had been removed and wrongly re-inserted, leading to the 15-minute-long cardiac arrest and brain damage.

She claims that after his surgery he was moved to an NHS hospital because the King Edward VII "could not cope" with such a complex condition. After the transfer, she said, King Edward VII staff repeatedly sought his return. "I wonder whether the King Edward VII was seeking Michael's return for financial reasons," she added.

Yesterday, Colin Harrisson, chief executive of the King Edward VII Hospital, said: "In concert with a lot of other hospitals, I fully support government regulation of the independent sector. It should be regulated in the same way as the NHS and it has our full support.

"Whether Emma Nicholson decides to sue the hospital is a matter for her. I would remind everyone that the coroner recorded a verdict of misadventure.

"It's up to Baroness Nicholson to do what she wants to do, but our side of the case has not come out yet and it didn't come out at the inquest. If she does decide to sue us it will be resisted most vigorously and comprehensively."

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