It sounds like an upgrade. But being sent to a private clinic by the NHS can end in tears
23:58 GMT, 3 December 2012
You can but envy the NHS patients sent for treatment at private hospitals, with their plush surroundings, crisply uniformed staff and attention to customer care.
In fact it’s a ‘privilege’ enjoyed by thousands of patients.
Thanks to the Government’s increasing use of private contractors, many more NHS patients are being sent for private surgery, with the health service picking up the bill.
Private firms now see nearly one in ten patients who have suffered trauma such as a broken limb or need orthopaedic treatment
But as Celia Collett discovered, this system can go badly wrong.
Mrs Collett, a mother of three from Plympton, near Plymouth, was 54 when she suffered serious burns in a surgical accident while undergoing a hip replacement as an NHS patient in a private hospital.
Then a few weeks after the surgery, her new hip became agonisingly dislocated and had to be wrenched back into place.
Then it dislocated again.
Mrs Collett had been sent to the Haslar Hospital in Portsmouth, under a contract agreed between the NHS and Netcare, a South African health company.
Netcare had brought teams of surgeons over from South Africa to operate in Britain.
When she came round from the surgery, she was shocked to be told she’d suffered a third-degree burn to her foot, which was scorched almost to the bone.
‘When I woke up, the surgeon was there to say they’d had a bit of an accident. My foot was covered in bandages about six inches deep,’ she recalls.
The hospital assured her that the wound — caused by surgical equipment — was superficial and would heal in ten days.
But in fact she had to have it dressed three times daily for three months until finally a surgeon recommended a skin graft.
‘I have ended up with a nasty scar on my foot which will never heal fully,’ she says.
But worse was to come. She was also in constant pain from her hip replacement.
Many more NHS patients are being sent for private surgery, with the health service picking up the bill
Within two months, it dislocated twice.
Mrs Collett says a GP told her the prosthesis in her leg was too short and was also loose because insufficient cement had been used to fix it.
‘They made a catastrophe of my operation,’ she says.
At this point, one might expect the NHS to step in, organise remedial surgery and arrange compensation. But the health service washed its hands of the problem.
Instead, Mrs Collett had to fight for help. When she approached Netcare, it agreed to undertake further surgery on her hip — but asked her to pay a whopping 14,000.
So she employed a specialist lawyer — Laurence Vick, a leading medical negligence advocate. Mrs Collett’s case was settled out of court and she accepted substantial damages.
Six months after her operation Mrs Collett had further surgery, this time performed by an NHS surgeon at a private hospital paid for by Netcare.
She is now able to walk without pain but the damage to her foot means she cannot wear close-fitting shoes.
‘The skin is so fragile where it was burnt that it just rubs off,’ she says.
Mrs Collett has subsequently been contacted by five other hip patients who learnt of her legal battle.
They, too, said they had received faulty hip operations around the same time as her, under the same NHS-private contract, and went on to sue.
Netcare blamed a single rogue surgeon who had since been excluded from operating. It called the problem ‘an isolated incident’.
Laurence Vick says one of the most worrying aspects of the case is that NHS hospital bosses believed they had no legal responsibility for Mrs Collett — they thought they had passed it to Netcare.
The Healthcare Commission, a government watchdog, later demanded to examine all the evidence about Mrs Collett’s case to ensure that it did not happen again.
That was in December 2006. But since then, nothing has been done to address the serious and disturbing questions raised by this case, according to Vick and an array of leading healthcare experts.
At present, there are no umbrella systems in place to monitor the quality of care across private hospitals.
Each of them can effectively operate as a separate entity.
And the potential for problems is growing fast, as more NHS patients are funnelled into private hospitals.
The authoritative Institute for Fiscal Studies says private firms now carry out 17 per cent of hip replacements and hernia repairs, and 6 per cent of gall bladder removals in England.
In addition, they now see nearly one in ten patients who have suffered trauma such as a broken limb or need orthopaedic treatment.
In all, more than 195 independent treatment centres are doing this work in England alone, treating around 35,000 NHS patients, according to the health service’s figures.
Recent cases have highlighted how the ‘premium quality’ care provided by the private sector can fall woefully short of what NHS patients should expect.
For example, in September, a private hospital surgeon, John Fraser, was branded ‘cavalier or reckless’ by the doctors’ disciplinary body, the General Medical Council.
It found he’d subjected two patients to a series of failings when they went under the knife at the Spire Washington Hospital in Tyne and Wear.
On one, Mr Fraser carried out a full knee replacement even though independent medical opinion said the patient did not need the op.
Mr Fraser, while free to return to work, must do so under supervision, and with a personal development plan to improve his communication and record-keeping.
Meanwhile in August, a senior consultant at one of Britain’s leading private hospitals was charged with manslaughter after a 65-year-old patient, Joseph Hughes, died following a routine op.
Such cases may be isolated — or they may be the tip of a private iceberg.
We cannot tell.
No Government health watchdog monitors misconduct in the private sector.
The General Medical Council admits that it, too, has not been watching this situation.
‘We don’t have figures on the number of doctors who have appeared before the conduct committee in connection with private work,’ said a spokeswoman.
‘It is something that we are planning to record more accurately going forward.’
And when things do go wrong, NHS patients in private care may find that they have no one to sue — either because the company has inadequate insurance, or because the company has legally ‘disappeared’.
That’s what happened two weeks ago, when the Harley Medical Centre cosmetic surgery chain went into administration to avoid having to make a possible multi-million-pound legal pay out to 1,700 British women who suffered serious pain and distress after being fitted with defective PIP breast implants.
In a coup of legal conjuring, it has transferred its doctors and clinics to a new company to allow it to continue performing cosmetic treatments — but without the threat of legal action by the damaged women.
Daniel Yea, from Maitland Communications, acting for the company and the administrators, said: ‘It’s the same directors, surgeons, premises and website, but under a different holding company.’
He added: ‘The liabilities resulting from the class action die with the previous company.
'Women scheduled to have PIPs removed by Harley Medical will still have that done.
'The only difference is that legal claims against Harley Medical Centre will no longer be able to take place.’
According to Vick, this danger has long been known about — but even as the Government forges ahead with increasing numbers of private-NHS contracts, it has not been addressed properly.
This leaves patients facing huge problems seeking redress when things go wrong.
The charity Action for Victims of Medical Accidents wants to see a change in the law so that a single complaints authority covers both private and NHS patients.
‘Any NHS patient treated in the private sector should be guaranteed the same approach to clinical negligence as if they were treated by an NHS Trust,’ says chief executive Peter Walsh.
The NHS safety watchdogs were supposed to be producing answers six years ago.
Now the time is fast approaching when it will tragically be too late.