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Private sector and NHS must meet the same standards of care

13 Oct 2017

Professor Derek Alderson, President of the Royal College of Surgeons

On Monday night (16 October) BBC Panorama will broadcast an important investigation into standards in the private sector.

Like many, I was absolutely appalled by the behaviour of breast surgeon Ian Paterson. He was a rogue surgeon who misled and abused patients, potentially for his own financial gain. As both the Sir Ian Kennedy and Verita reports into his actions made clear, there are important lessons that needed to be learned by the NHS and private organisations he worked in, and indeed professional bodies including our own. In particular it is unclear why his senior clinical and managerial colleagues did not do more to question his practice and disregarded the concerns raised by patients.

The vast majority of surgeons in this country perform surgery to an incredibly high standard in both the NHS and the private sector, putting the care of patients first and foremost. Nevertheless, we need to continue to strive to assure the public that we have done our best to make sure that gaps in the system do not create the potential for other rogue doctors to harm patients.

Following the Mid-Staffordshire scandal, there have been a large number of initiatives in the NHS to improve patient safety. Yet the same focus from government and healthcare leaders has not happened in the private sector. Paterson’s actions served as a reminder that this sector needs as much focus on safety as the NHS. In its annual state of care report published earlier this month, the CQC said that it was now planning to consider ‘how well private hospital governance systems monitor consultants’ practising privileges to ensure they are working within the agreed scope of practice to protect patients effectively’ as well as ‘how well providers ensure effective multidisciplinary meetings take place.’

We also believe there is a need to improve the collection and publication of data, especially patient safety and clinical audit data. There is an appetite to drive this. The Private Healthcare Information Network is already taking some steps to improve data publication and it will shortly be collecting consultant outcomes’ data in the private sector. We encourage RCS members to support this initiative and work to improve it as it matures. Over the coming months, the Royal College of Surgeons also plans to work with private health organisations to encourage the collection and publication of further information so we understand the outcomes and safety of the private sector in better detail.

The NHS is not without fault, but Monday night’s Panorama programme will provide an important nudge to all of us not to forget about the need to drive standards in the private sector too.

We owe it to the victims of Ian Paterson and other rogue doctors who have behaved badly to ensure the same high standards of care and governance apply regardless of where a patient is treated.

The programme will be broadcast on Monday 16 October at 20:30 on BBC One. 

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