Paterson Inquiry

Debate between Jonathan Ashworth and Nadine Dorries

Tuesday 4th February 2020 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Minister for advance sight of her statement. I welcome her apology on behalf of the Government and the national health service. I agree that the issues raised in this report are, as she says, shocking, serious and harrowing. Our thoughts are naturally with all the innocent victims of Ian Paterson. As the Minister rightly acknowledged, today is indeed World Cancer Day. We all know that a cancer diagnosis is frightening. When we hand ourselves, or a loved one, over to the care of a medical professional, we are literally trusting them with our lives. For that trust to be callously betrayed for financial gain is unforgivable, and indeed, as it has been found, criminal. I associate myself with the Minister’s remarks in paying tribute to all the patients—all the victims—for their bravery in speaking out. I thank all those who have represented them, including the various legal firms such as Thompsons, and thank Bishop Graham for putting together this report.

The findings from the inquiry were published at 12 noon today, so the House will want time to fully digest and reflect on the recommendations. However, I think we all agree that while we cannot undo the awful harm that Paterson’s criminal action has caused to so many, lessons must be learned and changes made so that something so heinous does not happen again. This report must not remain on a shelf to be forgotten, because it is clear that this was not just the action of one rogue lone surgeon; systemic organisational failures were at fault as well.

Fundamentally, it is time that we addressed the question of safety in private healthcare providers and the way in which clinicians are able to operate in private providers with little oversight. Paterson worked under the so-called practising privileges model, effectively as a self-employed contractor whereby people get a fee on top of their NHS salary for each funded NHS operation carried out in the private sector. Moreover, private hospitals would often, and still often, incentivise referrals from consultants by giving them, for example, shares in those private hospitals. This model creates financial incentives to distort clinical decision making and can lead to over-treatment, as we saw in the Paterson case. Indeed, as the Minister said, earlier this month something similar happened at Spire Healthcare when it was forced to recall hundreds of patients amid concerns over operations carried out by another surgeon.

The inquiry makes a number of recommendations and it is right that we reflect on them, but what is clear is that we need full transparency and accountability. I hope the Government mandate health bodies to quickly implement many of these recommendations. The fight that patients had to go through for compensation is, quite frankly, shameful. Surely it is time that private hospitals employed surgeons directly and required them to be fully liable for their actions. In that way, we would resolve the liability loophole.

About a third of all private hospital income now comes from the NHS for hip replacements, hernia procedures, cataract procedures and so on. Yet safety standards in the private sector leave much to be desired. Unlike in an NHS hospital where there are multi-disciplinary teams on standby to deal with potential complications post-op, in the private sector, post-operative care for patients is often left in the hands of a single junior doctor—a resident medical officer often working many hours, 24/7. In private hospitals there are few critical care facilities available if something goes wrong. Indeed, many patients are often referred back to an NHS hospital when complications occur. In 2018, the previous Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), wrote to the private hospital sector telling it to get its house in order on patient safety.

Patient safety must always be a priority. If this demands legislation to change the regulation of private hospitals, I hope the Minister can bring such legislation forward. We would work with her constructively to ensure that it finds its way on to the statute book. It is time to take these issues in the private sector seriously, and we will be happy to work with the Government on that front.

[Ms Dorries]

The hon. Gentleman raises many issues that we can agree on. I am not here to defend the private sector, but I would like to reiterate that women were affected both in the national health service and in the private sector. It does not take into consideration the suffering of those women in the NHS if we just focus on one particular area.

The CQC has had a duty with regard to the private sector since 2015. These cases took place between 1997 and 2011. In 2012, the CQC introduced the revalidation system for doctors, with responsible officers attached to each organisation and an appraisal process that consultants and doctors go through to assess their performance. That happened in 2012 and was introduced by the General Medical Council.

In 2014, we instructed the CQC to appraise the private sector in the same way and hold the private sector to the same standards as the NHS. As I said, I am not here to defend the private sector, but in the CQC examination it came out as good, and I believe that Spire scored 85%.

The hon. Gentleman is right—this is about patient safety and all providers raising their game. As I said, healthcare providers and healthcare professionals have a responsibility to speak out. The time that it took from complaints being made about Paterson to action being taken was too long. We need people in the NHS and the private sector to speak up, to listen and to act more quickly. That is one issue we want to take forward. I will take all his points on board. There is much we agree on. As I said, I am not here to defend the private sector, but women in the NHS suffered as well.