We are so used to the attacks on the NHS from the Daily Mail that we forget that it can be merciless to private medicine too. A critical article by Lois Rogers for the Mail’s on-line edition on June 12th provoked the Association of Independent Healthcare Organisations (AIHO) to respond.
Rogers’ attack begins with the story of a man (a Director of a high-end car company) who underwent surgical removal of the prostate (no small procedure) in a private hospital, only to be told years later that the surgery had not been necessary. According to the Mail’s journalist he is just one of at least 66 people, many of whom were treated privately, who believe they were misdiagnosed or underwent unnecessary surgery at the hands of the same surgeon, Manu Nair.
EXPOSED: How the NHS is paying millions to private surgeons for operations that we may not need – and could even HARM us
The quality of care received by NHS patients in private hospitals is under review
Insiders fear countless people are paying for needless, expensive operations
There’s also been a sharp rise in complaints from unhappy or worried patients
Those treated in private hospitals are often not compensated if things go wrong
By Lois Rogers for The Daily Mail Published: 22:06, 12 June 2017 | Updated: 13:57, 14 June 2017
This story is the tip of a much bigger iceberg in private hospital care, Rogers asserts, citing a number of experts who express concern about patients being at risk of needless treatment or botched surgery in the private sector. Whilst the NHS is far from immune, says the Mail story, the private sector seems to face particular problems with lack of scrutiny of what surgeons are doing.
Doctors working in private hospitals earn more if they do more treatment, and so have a financial incentive to be interventionist, even ‘gung ho’, about operations. They are not subject to the same monitoring and scrutiny as in the NHS, according to Brian Toft, visiting professor of patient safety at Brighton and Sussex Medical School. And private hospitals don’t have to monitor outcome trends to detect substandard surgeons either, he claimed. According to the Mail’s story, the Royal College of Surgeons published an open letter to the Government calling for private hospitals to be required to disclose data on botched operations, so rogue surgeons can be identified.
Professor Toft is joint author of a 2015 report, ‘How safe are NHS patients in private hospitals?’, published by the Centre for Health and the Public Interest think-tank, which the Mail journalist reported as saying that risks to patient safety ‘remain widespread’.
The report argued that NHS patients should be made aware of these risks before being treated in private hospitals. Linda Millband, a lawyer representing 500 patients who underwent unnecessary breast surgery, said to the Mail: ‘NHS hospitals have regular multi-disciplinary team reviews of patient care, but there is no requirement for anything similar in private hospitals. Private hospitals consider themselves above the law and above the standards followed by the NHS.’ The article then goes on to mention by name NHS consultants who have been accused of over-treating patients in the private sector. Read more at: http://www.dailymail.co.uk/health/article-4597524/EXPOSED-NHS-pays-millions-private-surgeons.html#ixzz4l1HcaqS)
While surgeons in the NHS are covered by the NHS Litigation Authority, in the private sector it is the surgeons themselves who bear financial responsibility if things go wrong. They are legally required to arrange their own insurance cover, but in some cases have operated without this, says the Mail. About £10 million was paid from public funds to compensate 250 NHS patients in a recent case of botched surgery, but Rogers believes that many private patients who have undergone unnecessary surgery may never be compensated.
Unsurprisingly the AIHO was not pleased by these claims and responded sharply, pointing out that surgeons in the private sector are all responsible to the General Medical Council, mostly work for the NHS (where they are scrutinised), and work privately in hospitals that are inspected by the Care Quality Commission.
The AIHO insists that the ‘independent’ (private) sector is actively working with NHS England and other relevant bodies to bring the level of reporting of surgery in line with the NHS’s own. Independent hospitals are already required to provide detailed data on every private episode of care, and they are beginning to publish performance measures for 149 common procedures at over 250 hospitals. That is just a beginning, says the AIHO, but it is of immediate benefit to patients, and is better than anything that has existed before. More will soon follow, according to the AIHO, including measures of consultant performance in 2018.
The AIHO says “failings of a handful of rogue surgeons does not represent the high quality and compassionate care delivered day in and day out by the independent sector as a whole”.
This spat matters. Treating NHS patients is big business for private hospitals. 530,000 surgical procedures were carried out on NHS patients in the private sector in 2016. A third of all NHS-funded hip and knee replacements are now being carried out in private hospitals. The NHS paid the private sector £8.7 billion for services last year, amounting to 28 per cent of private hospitals’ income. The private hospital sector constitutes a source of spare surgical capacity for the NHS, which is obliged to ensure that private hospitals are inspected and judged as closely and critically as NHS hospitals. Private hospitals are in effect in the NHS’s public domain (as distinct from the state-run public sector) when they do NHS work. They are, then, like GPs, dentists, pharmacists and other contractees to the NHS, and they have to perform according to NHS rules. That is why the Mail sees them as fair game for the critical journalist.
Steve Iliffe 26/6/17