- 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
After years on the front line of motor industry politics, John Hall, a former Jaguar Land Rover director, was looking forward to a peaceful retirement of long-distance cycling and golf.
That changed when the 66-year-old father of three from Solihull received the shattering news that he had prostate cancer.
This also meant he faced possible lifelong incontinence and the end of his sex life as a result of the treatment itself.
A series of tests and biopsies led to a ten-hour operation to remove his prostate and simultaneously perform a hernia repair, which the surgeon assured him was also needed.
This was followed by an anxious and unexpected 24 hours in intensive care —and a further five years of worry, during which he had regular follow-ups to check the cancer had not returned.
His cancer odyssey has cost Freedom Health, John’s private health insurer, tens of thousands of pounds.
But in July 2014, almost five years after the November 2009 operation to remove his prostate, John was told by a different consultant urologist that the results of tests on his prostate showed he didn’t have cancer at all, need not have had his prostate gland removed — and hadn’t needed a non-existent hernia repaired.
John, understandably, is furious. He is just one of at least 66 people, many of whom were treated privately, who believe they were misdiagnosed or underwent unnecessary surgery or treatment at the hands of the same surgeon, Manu Nair.
And their story is the tip of a much bigger iceberg in private hospital care, experts suggest.
SURGEONS MAY BE SUBSTANDARD
The general assumption is that going private means getting the best and fastest care. But while this will be true for many, there is growing concern about patients being at risk of needless treatment or botched surgery in the private sector.
The NHS is far from immune, but the private sector seems to face particular problems with lack of scrutiny over what surgeons are doing.
‘Doctors working in private hospitals earn more if they do more treatment,’ says Brian Toft, visiting professor of patient safety at Brighton and Sussex Medical School. ‘They are not subject to the same monitoring and scrutiny as in the NHS. And private hospitals don’t have to monitor trends [in botched or needless operations] to detect substandard surgeons.’
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 warned that risks to patient safety ‘remain widespread’.
The report said NHS patients should be made aware of these risk factors before they are referred for treatment in private hospitals.
‘NHS hospitals have regular multi-disciplinary team reviews of patient care, but there is no requirement for anything similar in private hospitals,’ says Linda Millband, a lawyer representing 500 patients who were given unnecessary breast surgery. ‘Private hospitals consider themselves above the law and above the standards followed by the NHS.’
Not only that, says Professor Toft, but ‘if doctors started asking for extra safety provisions in private hospitals, it wouldn’t be long before they lost their admitting rights’.
And with the NHS increasingly farming out work to private hospitals — healthcare analyst LaingBuisson says a record 557,200 NHS patients were treated in private hospitals last year to cut waiting lists, almost 60,000 more than the year before — it is an issue that cannot be regarded as ‘just’ a private healthcare matter.
The complaints against Mr Nair echo concerns about unnecessary or unsuitable private operations involving other surgeons, with some (but not Mr Nair) currently under investigation by police.
Mr Nair, a qualified specialist urological surgeon, became well-known nationally through his regular appearances on the Channel 4 television programme Embarrassing Bodies.
However, as well as 66 legal complaints about his practice, the General Medical Council has imposed eight conditions on his medical practice, which mean he is only allowed to work under supervision within the NHS and it has suspended him from private practice.
WORRYING RISE IN COMPLAINTS
Suhaib Sait, 54, who until last year practised at Fawkham Manor private hospital in Longfield, Kent, is being investigated by police and the BMI hospital group over claims he performed unnecessary operations on fee-paying and NHS patients at the hospital. The procedures being investigated include arthroscopy (keyhole surgery on joints).
Fawkham Manor suspended Mr Sait, who denies the allegations, in June 2016 (he continues to work as an NHS consultant).
One of the private patients pursuing a legal complaint against him is Dorothy Whitehead, 69, from Swanley in Kent, who was given a replacement knee joint by Mr Sait in 2013.
She says the procedure was botched — her former partner describes her as ‘walking like a penguin’ — and a review by another specialist indicated that the joint had been misaligned. A third surgeon has told her the operation may have been unnecessary in the first place.
Last week Mrs Whitehead, who said she was devastated by the three years of misery she had suffered, was recovering from a new knee operation.
Her solicitor, Nick Haley, told Good Health complaints about substandard private care are increasing: ‘We are dealing with a worryingly high number of cases which involve surgeons recommending inappropriate surgery or not properly advising patients of their options. Such surgery has left many of these patients with long-term problems.’
PATIENTS NOT COMPENSATED
Another, related issue is compensation for patients treated in private hospitals if things go wrong.
While surgeons in the NHS are covered by the NHS Litigation Authority, in the private sector it is the surgeons who currently bear financial responsibility if things go wrong. They are legally required to take out their own cover, but in some cases have operated without this.
About £10 million was paid from public funds to compensate 250 NHS patients in a recent case of botched surgery, but many private patients involved may never be compensated.
Judy Conduit is one of them. The former administrator for the Environment Agency, from Olton, West Midlands, was 47 when she was seen in May 2000 at the Spire Parkway private hospital in Solihull.
The surgeon removed lumps from both her breasts, saying they were caused by a condition called Dercum’s disease.
He later removed both breasts entirely, reconstructing the area with flaps of tissue from Judy’s back, in a series of operations that caused repeated infections and complications.
‘It was only in 2012, after they started reviewing all his cases, that I found out I’d never had Dercum’s disease and none of the operations were necessary,’ she told Good Health. ‘To find out I went through all that pain for nothing just beggars belief.
‘I have been left with a huge livid scar up to an inch wide that goes right round my body and still hurts.
‘I lost my femininity, my self-confidence, my job.’
IS IT SAFER IN THE NHS?
Judy, now 64, is pinning her hopes on a civil case to be heard in October, which will determine to what extent Spire can be held liable. ‘The majority of the NHS patients have been compensated, but the private ones have so far had nothing at all,’ she says.
Spire Healthcare, which has 38 hospitals and is one of Britain’s biggest private providers, is hoping the Medical Defence Union (MDU), which insures doctors, will meet the claims.
‘We would be concerned at any failure by the MDU to stand behind their member, and we would urge them to ensure that cover is available for patient claims,’ a spokesman said.
Lawyer Linda Millband, of Thompsons Solicitors, is calling instead for a ‘non-negotiable duty of care’ for private hospitals. ‘They must take responsibility for medical negligence or criminal acts that take place on their premises, as NHS hospitals do,’ she says. ‘They shouldn’t be able to say doctors are just contractors using their rooms.’
Lawyer Nick Haley, of Penningtons solicitors, who is investigating several claims against Mr Sait, told us: ‘Patients should be entitled to appropriate compensation if there is negligence in their care that causes them injury, and this entitlement should be protected whether their treatment is in the NHS or private.’
Last month, 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.
This, however, would not prevent needless surgery being performed.
‘That patients treated in private hospitals don’t have the same level of protection as patients in the NHS is a big problem,’ says Professor Toft.
‘We can only start to tackle this problem when private hospitals are required to provide the same quality of audited information to the Care Quality Commission.’
Professor Toft’s 2015 think-tank report surveyed 15 private hospitals and found a pattern of incomplete or unsystematic reporting of patient safety issues that would flag up substandard surgeons.
It also found that the vast majority of private hospitals receive substantial chunks of their business from the NHS, with some treating only NHS patients through contracts with the Health Service.
‘People think they will get better treatment in the private sector but that’s not our experience at all,’ said Peter Walsh, of the charity Action against Medical Accidents.
‘It may be better in terms of the hotel environment, but as far as having any kind of invasive treatment is concerned, you are better off in the NHS with a whole back-up of healthcare professionals and intensive care if things go wrong. And there is better regulation for safety, and audit to guard against unnecessary procedures.
‘There is new legislation making it illegal for NHS bodies to supply misleading safety data to regulators. But despite our lobbying, they decided to exclude private care from that.’
‘These cases are absolutely shocking,’ said Laura Ralfe, a solicitor at Irwin Mitchell who is dealing with 66 complaints against Mr Nair.
‘The only glimmer of light is that now a lot of private hospitals have started reporting their surgeons, it will bring about a much-needed change in regulation.’
Mr Nair and Mr Sait declined the opportunity to respond.
THE NHS BY NUMBERS
530,000 – The number of surgical procedures carried out on NHS patients in the private sector in 2016
34 per cent – The proportion of all NHS-funded hip and knee replacements now being carried out in private hospitals according to healthcare consultancy Candesic
£54 – How much more it costs on average to treat an NHS patient at a private hospital, compared with the cost for the same treatment in the NHS £8.7 billion Amount the NHS paid the private sector for services last year
28 per cent – Proportion of private hospitals’ income that is derived from treating NHS patients (2014 figures)