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Surgeons call for review of private sector transparency and safety standards

17 May 2017

Following Ian Paterson’s abhorrent actions, the President and Vice-Presidents of the Royal College of Surgeons (RCS) have issued an open letter today (Wednesday 17 May) reassuring the public that rogue doctors should now be caught by modern rules governing medical practice. However, they warn there is no room for complacency and the RCS today calls for a review by the next Government of how safety standards and transparency can improve, particularly in the private sector.

In the letter, they welcome the Secretary of State for Health’s suggestion that an inquiry be conducted by the next Government to understand how Ian Paterson was able to practise for so long. They say the review “should build on the findings of Sir Ian Kennedy’s report as well as the independent review of the governance arrangements at Spire Parkway and Little Aston hospitals and assess what action has been taken following those reviews.” The RCS Council will also review the Paterson case and judgment, in particular to understand why doctors were unable to spot or unwilling to challenge Ian Paterson’s malpractice.  

The surgeons also call for ‘An equal focus on patient safety in both the private and public sectors’, warning in particular that there is poorer public availability of patient safety and clinical data from private hospitals.  They say:

  • A review should be carried out by the next Government into how safety standards and data transparency can improve in the private sector and not just the NHS.
  • The private sector should be expected to report similar patient safety data as the NHS. This should include data on unexpected deaths, never events, and serious injuries.
  • The private sector should be better at taking part in clinical audits – this could become a condition of all NHS and private organisations’ registration with the Care Quality Commission.
  • Cosmetic surgery, which happens almost entirely in the private sector, needs to be better regulated. The RCS is calling for legislation to enable the General Medical Council to annotate the medical register with details of which surgeons are qualified to undertake cosmetic surgery.

The RCS is not suggesting there is evidence of less safe care in the private sector compared with the NHS, but that it is less transparent on reporting safety incidents.

Miss Clare Marx, President of the Royal College of Surgeons, said:

“Ian Paterson wilfully abused the trust placed in him by patients at their most vulnerable. His actions and behaviour were appalling and we must do everything in our power to prevent such a violation being repeated.

“It is important to remember that the overwhelming majority of doctors work with diligence and commitment, often under great pressure, motivated to understand and meet the needs of their patients as best they can. Modern day medical practice – which includes annual appraisals as part of revalidation and rules around team decision-making and patient consent – means rogue doctors are more likely to be identified at an early stage and remedial action initiated.

“That said, there are still a number of areas which require urgent improvements to protect patients from harm. Robust regulation remains an important way of protecting the public.

“Patient safety initiatives have tended to concentrate on the NHS but we also need a strong focus on the private sector, particularly in the collection and publication of patient safety data in private hospitals. We are therefore calling for a review of the sector to look at how safety standards and data transparency can improve. Similarly, regulation is not keeping pace with the booming industry of cosmetic surgery, which also largely takes place in the private sector.

“We continue to call for the General Medical Council to be given powers to annotate the medical register with details of which surgeons are qualified to undertake cosmetic surgery.”

At the end of April, the Nottingham crown court found surgeon Ian Paterson guilty of seventeen counts of wounding with intent, and three of unlawful wounding, after carrying out unnecessary operations. The RCS condemned Paterson’s actions as those of ‘an individual who abused the trust put in him by patients.’


Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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