Independent inquiry into Mr Ian Paterson, Breast Surgeon

Tuesday 4th February 2020

An independent inquiry, led by the Bishop of Norwich the Rt Revd Graham James, has reported on the issues raised by the treatment and care from the jailed Breast Surgeon, Ian Paterson.

What did Paterson do?

Paterson was jailed for 20 years after being found guilty of wounding with intent. He had been carrying out botched operations and unnecessary procedures on hundreds of patients across the West Midlands, over more than a decade.

Many of the patients either had cancer, or were falsely told that they had cancer by Paterson. He also carried out a ‘cleavage sparing’ mastectomy in some cases, leaving behind breast tissue which meant that the disease could come back. In other cases, he carried out unnecessary procedures which patients did not need, apparently for financial reasons within the private sector, where he would be paid more for more complex or detailed surgeries.

What does the inquiry say?

The report has made a number of recommendations as a result of speaking with many of those involved. Some of the recommendations are:

● Increased information for patients on doctors’ performances, and better communication of their treatment/conditions to each patient.

● Better compliance from private hospitals with MDT meetings; MDT (multi-disciplinary team) meetings allow for doctors of different specialisms to meet and discuss patients’ cases.

● More information about how patients can complain about their treatment, and who they can appeal to if they’re unhappy with how their complaint has been handled.

● A complete and improved recall of Paterson’s patients. Despite the efforts already made, the inquiry found that a third of patients they spoke to had not been recalled.

● A safety net for indemnity products for private doctors, to ensure that patients are not left stranded without legal recourse if an indemnity provider withdraws cover, as the MDU did with Paterson.

● Earlier and more transparent complaints responses; specifically, that organisations apologise as soon as possible, without thinking about defending any legal action when considering making an apology.

● An overhaul of the system of regulating patient safety, with the Government called on to ensure that patient safety is served as the top priority in the future.

Will the recommendations work?

● Many of the recommendations are sensible and welcome. The issues identified are, sadly, not new. They are the same issues which have been spoken about on too many occasions in the past, and have been left unanswered for too long. You will find it easy to find historical blogs and comments on these issues from the legal sector, as we see the same mistakes repeated again and again:

● A lack of dedication to patient safety. Whether it be a lack of resources, a lack of commitment, or a lack of communication, more needs to be done to improve patient safety in both the NHS and the private sector. Patient Safety Champions, raised by the Society of Clinical Injury Lawyers in its response to calls for reform of the law surrounding medical negligence, should be installed as a matter of urgency.

● A fear of admitting a mistake. The report quotes a patient as saying: ‘I was also told I could have a meeting with representatives from the trust which I did…The attitude at that point seemed to be one of trying to ensure I did not take anything further and to protect themselves.’ A culture within the healthcare sector of ‘defend, deny, delay’ has grown, and needs to be stopped at its root.

● A lack of accountability when something does go wrong. In the vast majority of the time, the doctors and nurses in the UK treat their patients to an excellent standard. In the minority of cases where something goes wrong, it’s only right for patients to be able to put right those wrongs, through the legal system where necessary. The difference in accountability between the NHS and the private sector needs to be resolved.

The patient accounts in the inquiry have a common theme: many have been left without a proper explanation of what went on, and how Paterson may have affected their health. The report quotes a Consultant involved in part of the recall of Paterson’s patients; that Consultant estimates that less than 1% of Paterson’s 11,000 patients were treated appropriately. The inquiry refers to how many of those working in the healthcare system believe that a similar thing could happen again today. Nobody has grasped the nettle. We can only hope that this inquiry is the first step towards change.

Joseph Norton, Waldrons Solicitors