Government urged to quicken health reform pace a year after rogue surgeon report

Ian Paterson is currently serving a 20-year-prison sentence after being found guilty of wounding patients by carrying out unnecessary surgery on men and women.

He subjected more than a 1,000 patients to risky procedures which they did not need.

The surgeon carried out unapproved “cleavage-sparing” mastectomies on patients leaving behind breast tissue and risking a return of cancer.

He carried out breast and general surgery, treating more than 11,000 patients in total.

Paterson was employed by Heart of England NHS Foundation Trust (HEFT) – since taken over by University Hospitals Birmingham NHS Trust (UHB) – but also had practising privileges in the independent sector at Spire Parkway, Solihull, and Spire Little Aston in Birmingham.

The independent Paterson Inquiry into the issues raised, published in February 2020, found that many of Glasgow-born Paterson’s patients were “lied to, deceived or exploited”, though the consultant maintains his innocence.

The inquiry led by Right Reverend Graham James, ex-bishop of Norwich, made 15 recommendations.

More than 13 months after the first anniversary of publication of the panel’s findings, Health Minister Nadine Dorries said five of those recommendations had been actioned by the NHS, private health provider Spire, and professional bodies.

She said the Government would respond to the remaining recommendations “during 2021”.

Victims of Paterson welcomed the update, but said the Government needed to get on with implementing all the report’s recommendations “to ensure safety and proper governance” for patients, in the NHS and private health sector.

Deborah Douglas, of Solihull Breast Friends, said without full implementation patient safety would remain “compromised”.

She said: “As far as patient safety and proper governance of healthcare providers goes, we’re still at threat of having another Paterson.

“I welcome the robust recall of patients, which was long overdue, but the rest of the recommendations around patient safety, need urgently to be built in.

“Before the end of this year, we want to see a road map from the Government as to how they’re going to implement the full raft of recommendations.”

Ms Dorries gave an update on the Government’s progress in implementing the inquiry’s findings in a ministerial statement, on Tuesday.

She said “effective action” had already been taken on five of the recommendations.

Ms Dorries said the bishop’s report had exposed the “terrible harms” that can happen “when the malpractice of a…rogue surgeon goes unchecked”.

The minister added that dealing with the unprecedented challenge of the Covid-19 pandemic had meant a delay in the Department for Health and Social Care’s work in tackling all of the report’s recommendations.

But she added that since publication of the independent inquiry’s findings, her team had “listened carefully” to victims, and were in “regular conversations” with main patient groups.

Ms Dorries said: “The immediate safety of patients has been our top priority and we have sought and received reassurance that the recalls of patients by University Hospitals Birmingham NHS Foundation Trust and Spire Healthcare have proceeded as quickly as possible.”

She added: “It is right that we have taken urgent action where we can, and we will respond in full to the inquiry during 2021.”

The bishop had recommended it be “standard practice” NHS and private consultants write to patients, setting out their condition and treatment, in simple terms, and copy the letter to the GP.

Ms Dorries said the department would “examine” how current guidance, published by the Academy of Medical Royal Colleges, “can be incorporated into the requirements of the NHS standard contract”.

Another recommendation had been the introduction of a short period of reflection into the patient consent procedure for surgery, which should then be monitored by the General Medical Council (GMC).

The Health Minister said revised GMC guidance on consent had come into effect in November 2020.

The bishop urged both the NHS trust and Spire to make sure all Paterson’s patients had been recalled.

Ms Dorries said that the UHB trust had contacted 4,394 patients between May and August 2020, receiving 355 replies from patients, who now had access to consult-led review of their care.

The minister added that by December 2020, Spire had contacted 5,500 patients and was “currently ensuring that those patients’ care has been fully reviewed”.

The bishop’s report had urged the Care Quality Commission (CQC) to assure compliance with guidance on multi-disciplinary team meetings (MDTs), “as a matter of urgency”.

Ms Dorries said questions for providers on MDTs were already included in CQC inspection frameworks, and that plans were in place for these to “become mandatory elements” of its inspectors’ assessments.