Transparency/Accountability in the Private Sector

In the news this week there have been warnings of cancellations of operations on the NHS as a result of COVID-19. It would appear that this is to help the NHS cope with potential rising numbers of coronavirus cases this winter.

Many routine surgeries were cancelled or postponed earlier in the year because of the pandemic. The impact of the pandemic has also been keenly felt by oncology services, with worrying reports of cancer patients experiencing delays in treatment. It is predicted by the Lancet Oncology Journal that these delays will inevitably result in unnecessary deaths from cancer, which is a tragic outcome. NHS hospitals across the country are now facing a backlog and it could be possible that ongoing delays see more patients considering whether they are able to go private. With the ongoing strain on the NHS as a result of the COVID crisis, there is the potential for more services to be outsourced to the private sector.

Recently, stories surrounding orthopaedic surgeon Derek McMinn have made headlines, reporting that patient bones had allegedly been stored without full consent or licence over the last few decades. It is understood that many of his patients were seen at the private BMI hospital in Edgbaston. These accounts also bring to mind the fairly recent scandal involving breast surgeon Ian Paterson, who subjected many patients to unnecessary surgeries and exposed some of the gaps in protection for private sector patients.

How Easy Is It for Patients with Legitimate Claims to Receive Compensation?

Generally, doctors who work at private hospitals are not “employees” of that hospital in the way they usually would be if they worked for an NHS trust. Doctors working at private hospitals must therefore have their own individual indemnity insurance. This can sometimes make it more difficult for patients with legitimate claims to receive adequate compensation, which was one of the issues faced by Ian Paterson’s patients. Cases are, of course, fact-specific but the private hospital itself is not always accountable if things go wrong. This is in contrast with care within the NHS when it is the relevant NHS trust, which is accountable.

What Are ‘Never Events’?

Last month the Private Healthcare Information Network (PHIN) published data on serious patient safety incidents in private acute care from 2019. This appears to be the first time a comprehensive dataset of “Never Events” involving private patients has been published in the UK. Never Events are defined by the NHS as patient safety incidents that are “wholly preventable”. The data published by PHIN refers to 21 Never Events being reported in a private setting and include instances such as wrong site surgery and wrong implants/prostheses being used.

The publication of the above information is interesting as this type of information is something that is already monitored in the NHS on a regular basis. The NHS has routinely published this information as part of an open and transparent approach to patient safety and so that lessons can be learned where things go wrong (whether this culture is, in fact, always adopted is a subject for a different day).

It is important to note that the PHIN data indicates that data was submitted from only 287 out of 595 private provided sites. This would indicate there is still some way to go in terms of improving transparency within the private sector. However, hopefully this is still a step in the right direction and patients will now have access to more information to enable them to make better informed decisions about treatment.

With increased transparency, it is hoped that this will also lead to better protection for patients in the private sector and greater consistency across the board with regard to accountability in healthcare generally.