National inquiry into private health practices launched to prevent repeat ‘shocking’ malpractice like jailed breast cancer surgeon Ian Paterson

Inquiry will judge whether Care Quality Commission needs tougher inspection powers for private sector

Alex Matthews-King

Health Correspondent

Thursday 07 December 2017 11:27 GMT

Surgeon Paterson was jailed for 20 years after being found guilty on 17 counts of wounding with intent (PA)

The Government has announced an independent national inquiry into the private health sector and insurance providers to prevent a repeat of the “shocking” malpractice by surgeon Ian Paterson.

The Department of Health has expanded the scope of the inquiry into Paterson, a consultant breast surgeon who was jailed for carrying out unnecessary operations on patients, after meeting with victims families and being warned of “broader issues” in private healthcare.

Health Secretary Jeremy Hunt had initially pledged a “comprehensive and focused inquiry” into the specific failings around Paterson’s case.

Its expanded remit will also look at:

Who has overall responsibility for assuring the quality and safety of care in the private sector, including ensuring regular vetting of care standards;
Information sharing and the reporting of any concerns between the private sector and the NHS;
The role of insurers of independent sector healthcare providers, including how it shares the information it holds on the scope and volume of private doctors’ work, and the adequacy of any medical negligence cover;
And whether health sector regulator the Care Quality Commission needs tougher inspection powers to enforce this.

Paterson was found guilty of 17 counts of wounding with intent in May this year, after falsely telling his victims they required surgery for breast cancer, or performing incomplete mastectomies that saw the cancer return.

He was initially sentenced to 15 years but this was extended to 20 after a judge ruled this was “unduly lenient”.

Around 750 women and men who were treated by the surgeon will receive a portion of a £37m settlement fund set up by the Government in September.

The inquiry will not have statutory power, which means it will not be able to compel witnesses to give evidence. But the Department of Health said it was focused instead on learning lessons swiftly.

It will be led by the Rt Reverend Graham James, Bishop of Norwich, who said that the grievous harm inflected by Paterson gave rise to serious questions that “remain unanswered”.

“It is vital that the Inquiry be informed by the concerns of former patients of Ian Paterson and their representatives,” Mr James said. “The interests of all patients, whether they seek treatment in the NHS or the private sector, should be at the heart of this inquiry and I will do my very best in the interest of those affected and the public.”

Paterson was appointed as a consultant at Solihull Hospital in 1998, which became part of the Heart of England NHS Foundation Trust (HEFT). He also carried out surgery at private hospitals owned by Bupa from 1993 and then Spire Healthcare from 2007 onwards.

Both the NHS and Spire suspended Paterson in 2011 and he was struck off the medical register this year.

Reviews already completed by Spire, in 2014, and HEFT, in 2013, identified issues with data sharing between the private and NHS sector after questions were raised about a consultant.

They also found a need for private hospitals to submit data regarding activity and outcome to national and regional databases.

Philip Dunne, health minister, said: “Ian Paterson’s malpractice sent shockwaves across the health system due to the seriousness and extent of his crimes, and I am determined to make sure lessons are learnt from this so that it never happens again in the independent sector or the NHS.

Everyone the Government blames for the NHS crisis – except themselves

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1/6Everyone the Government blames for the NHS crisis – except themselves

Everyone the Government blames for the NHS crisis – except themselves

The elderly

“We acknowledge that there are pressures on the health service, there are always extra pressures on the NHS in the winter, but we have the added pressures of the ageing population and the growing complex needs of the population,” Theresa May has said. Waits of over 12 hours in A&E among elderly people have more than doubled in two years, according to figures from NHS Digital.

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Everyone the Government blames for the NHS crisis – except themselves

Patients going to A&E instead of seeing their GPs

Jeremy Hunt has called for a “honest discussion with the public about the purpose of A&E departments”, saying that around a third of A&E patients were in hospital unnecessarily. Mr Hunt told Radio 4’s Today programme the NHS now had more doctors, nurses and funding than ever, but explained what he called “very serious problems at some hospitals” by suggesting pressures were increasing in part because people are going to A&Es when they should not. He urged patients to visit their GP for non-emergency illnesses, outlined plans to release time for family doctors to support urgent care work, and said the NHS will soon be able to deliver seven-day access to a GP from 8am to 8pm. But doctors struggling amid a GP recruitment crisis said Mr Hunt’s plans were unrealistic and demanded the Government commit to investing in all areas of the overstretched health service.

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Everyone the Government blames for the NHS crisis – except themselves

Simon Stevens, head of NHS England

Reports that “key members” of Ms May’s team used internal meetings to accuse Simon Stevens, head of NHS England, of being unenthusiastic and unresponsive have been rejected by Downing Street. Mr Stevens had allegedly rejected claims made by Ms May that the NHS had been given more funding than required.

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Everyone the Government blames for the NHS crisis – except themselves

Previous health policy, not funding

In an interview with Sky News’s Sophy Ridge, Ms May acknowledged the NHS faced pressures but said it was a problem that had been “ducked by government over the years”. She refuted the claim that hospitals were tackling a “humanitarian crisis” and said health funding was at record levels. “We asked the NHS a while back to set out what it needed over the next five years in terms of its plan for the future and the funding that it would need,” said the Prime Minister. “They did that, we gave them that funding, in fact we gave them more funding than they required… Funding is now at record levels for the NHS, more money has been going in.” But doctors accused Ms May of being “in denial” about how the lack of additional funding provided for health and social care were behind a spiralling crisis in NHS hospitals.

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Everyone the Government blames for the NHS crisis – except themselves

Target to treat all A&E patients within four hours

Mr Hunt was accused of watering down the flagship target to treat all A&E patients within four hours. The Health Secretary told MPs the promise – introduced by Tony Blair’s government in 2000 – should only be for “those who actually need it”. Amid jeers in the Commons, Mr Hunt said only four other countries pledged to treat all patients within a similar timeframe and all had “less stringent” rules. But Ms May has now said the Government will stand by the four-hour target for A&E, which says 95 per cent of patients must be dealt with within that time frame.

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Everyone the Government blames for the NHS crisis – except themselves

No one

Mr Hunt was accused of “hiding” from the public eye following news of the Red Cross’s comments and didn’t make an official statement for two days. He was also filmed refusing to answer questions from journalists who pursued him down the street yesterday to ask whether he planned to scrap the four-hour A&E waiting time target. Sky News reporter Beth Rigby pressed the Health Secretary on his position on the matter, saying “the public will want to know, Mr Hunt”. “Sorry Beth, I’ve answered questions about this already,” replied Mr Hunt. “But you didn’t answer questions on this. You said it was over-interpreted in the House of Commons and you didn’t want to water it down. Is that what you’re saying?” said Ms Rigby. “It’s very difficult, because how are we going to explain to the public what your intention is, when you change your position and then won’t answer the question, Mr Hunt”. But the Health Secretary maintained his silence until he reached his car and got in.

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“I believe an independent, non-statutory inquiry, overseen by Bishop Graham James, is the right way forward to ensure that all aspects of this case are brought to light and lessons learned so we can better protect patients in the future.”

Responding to news of the inquiry, Professor Derek Alderson, president of the Royal College of Surgeons (RCS), said: “Ian Paterson abused the trust placed in him by patients. He performed unproven and unacceptable operations on many women.

“What is also clear is that he was often working in isolation. Teamwork and shared decision making is now standard practice in healthcare but there is more that can be done to correct poor practice in both the NHS and private sectors.

“It is right that the Government now moves forward with a review of the many issues raised by his criminal behaviour.”

It added that the RCS has also begun work to improve the collection and publication of data from private providers which, at present, are “minimal”.

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