Ministers must not duck the challenge from the Paterson inquiry

It is time private hospitals, which make millions every year treating NHS patients, were forced to improve, writes Shaun Lintern

The Ian Paterson scandal lays bare the need to act on patient safety risks in private hospitals (Getty)

Another scandal. Another inquiry. Many readers of Tuesday’s Paterson inquiry report will find familiar themes – dysfunctional cultures, poor management, an environment of silence and looking the other way – all themes we’ve seen before in other healthcare disasters.

But the Paterson inquiry matters because it was not solely an NHS scandal, and the dangers revealed by the horrifying actions of one rogue surgeon have exposed the everyday risks that exist in the UK’s private healthcare system.

There have been a series of deaths and warnings in recent years to private hospital companies. In 2018 the then health secretary Jeremy Hunt warned the sector to get its house in order following the death of Peter O’Donnell, who died in 2017 and led to a coroner warning about the lack of responsibility private hospitals have for the consultants they use.

In many ways the report by retired Bishop of Norwich, the Right Reverend Graham James, was disappointing. It repeated much of what we know about how Ian Paterson harmed more than a thousand women over two decades. But it very clearly spelled out how private patients are disadvantaged.

Many private patients may not realise most private hospitals lack intensive care if they suffer serious complications which could see them shipped back into the nearest NHS A&E department. If something goes wrong there is every chance the hospital will deny any liability, because doctors work as independent contractors. In some cases there is no right of appeal for complaints.

It is a thoroughly unsatisfactory position, and in setting it out so clearly the inquiry team have challenged the government to act. It has frustratingly left the government much room for manoeuvre on specifics, but ministers would be making a grave mistake if they choose not to grasp this nettle.

It is time private hospitals, which make millions of pounds every year treating NHS patients, are forced to improve and take responsibility for what happens under their roof. Some are already taking steps to clean up their act and there is the hint of recognition that the landscape is changing.

But the government cannot rely on piecemeal sector-led progress. It must legislate to clearly set out who is liable for care, how patients can easily seek redress when things go wrong, and what the consequences are for companies and staff who fail to adhere to existing standards.

The NHS spends millions directly funding private hospitals to deliver care for NHS patients. It can only be right that the government and the NHS demand those same patients are provided with a level of safety they rightly expect.

None of this absolves the NHS of its own need to improve safety. Far too much avoidable harm is done every day in the NHS. The Paterson scandal lays bare the culture of denial and “wilful blindness” of some managers to not want to see problems or share information.

Ministers must avoid developing their own “wilful blindness” to safety risks in the private sector. To do so would be a betrayal of the taxpayer whose money is filling the coffers of private hospital shareholders.