Paterson Inquiry

Debate between Philippa Whitford and Nadine Dorries

Tuesday 4th February 2020 Commons Chamber

[Ms Dorries]

My hon. Friend is right; Rahman has been suspended. He is not practising at the Spire group. However, he is still in a non-patient facing role at the trust, and we are querying that.

My hon. Friend is right to say that this has been harrowing, and many women were affected. I do not think I can give him a guarantee that this would never happen again, because for that to happen we would have to have somebody reviewing every single appointment, operation and case that any doctor undertook. We have a process in place now that was not in place then. The CQC was not inspecting the private sector then, and it was not inspecting the NHS robustly enough. That has now changed. We also have the revalidation system, brought in by the General Medical Council in 2012 after Paterson. It is really important to point out that Paterson is in jail and has been for some time. This inquiry came after Paterson had gone to jail, and the purpose of the inquiry is learning, so that we can look at the recommendations and improve our service to patients in both the NHS and the private sector as a result.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Having been a breast cancer surgeon for 33 years, I find this case heartbreaking, and I can only apologise on behalf of the profession. The hon. Member for Leicester South (Jonathan Ashworth) highlighted that the way in which women were treated after the event and the fact that they had to fight for help and compensation added insult to injury.

As the Minister said, this was not a failure of processes not existing; it was a failure of processes that were not enforced. This scandal went on for 14 years, which highlights a failure to listen to people who raised concerns early on and the fact that there was a power differential between Paterson and people who were raising concerns. It should have been striking that his rate of surgery was so much higher among his private patients than his NHS patients. His practice was not being looked at within NHS quality audits, which might have shown that up. What will the Government do to ensure that all units are taking part in national audits, which faded away over the last decade, and in Getting it Right First Time, so that units cannot just opt out? Will that be rolled out to the independent sector, to ensure that units take part in national audits?

Breast cancer is a multidisciplinary team specialty, but we have to do a 360° appraisal only every five years. To me, that is the most telling and most important part of appraisal, and the Government should look at that part of appraisal being made more frequent and, again, being extended to private hospitals.

The Health Service Safety Investigations Body is currently envisaged as working only in NHS hospitals and for NHS patients treated in independent hospitals. Surely the Government recognise that the Bill legislating for that will need to be amended, to ensure that the HSSIB can investigate across the piece.

Once again, we come back to whistleblowers who have raised concerns, have not been listened to and have been suffering detriment, and an opportunity to stop Paterson many years earlier has been missed. What reforms are the Government planning genuinely to support whistleblowers? I am presenting a private Member’s Bill tomorrow, because we need a root-and-branch reform of how whistleblowers are treated.

[Ms Dorries]

The hon. Lady raises a wide range of issues, which I will try to go through. First, I reassure her that, at the time Paterson was practising, the CQC was not investigating or assessing the private sector; that was introduced in 2015. Whistleblowing was in an entirely different place from where it is now. We now have 500 lanyard-wearing national guardians across the NHS, and we encourage people to raise their concerns with those national guardians, the guardians to listen and the trust to act quickly on the concerns raised. I think it is fair to say, that since 2012, when the CQC introduced revalidation, a number of regulatory processes have been put in place. There was shockingly little at the time that Paterson was practising. The system is now much more robust—and yet, I completely take her point; much more still needs to be done.

We are learning the lessons from Getting it Right First Time. In fact, that is a subject of discussion within the Department. We are looking at how the lessons have been applied and what we can learn.

The hon. Lady is right about revalidation and 365° appraisal every five years. As she will know, the CQC is an independent body. It introduced revalidation and appraisal. Our job is now to ask the CQC to make that system more robust and look at how to improve it, because that is an important part of the equation, ensuring that something like this does not happen again. I say here and now at the Dispatch Box that I would like the CQC, as a matter of urgency, to look at how it can make that system more robust and effective, so that we can quickly identify doctors—not those like the hon. Lady—who are not up to standard, who are outliers and who should not be practising.

We will look at the hon. Lady’s point about the HSSIB. I do not think that there is a role for the HSSIB in the private sector. The private sector is a matter of personal choice. It is our job to ensure that healthcare reaches the same standard across the board, whether it is in the private sector or the NHS. The CQC does that, and that is how we hold the private sector to account. Then it is down to patients to make the choice about where they wish to be treated; that is their independent choice. That is a matter of consent, which is something else we need to look at—how do conversations about consent take place? Does the patient have the capacity to take in the information being given to them? Are they making an informed choice? Do they have enough information about the surgeon they are seeing to make the right choice? Those are the issues we need to focus on.