Just how bad does a private doctor have to be before he gets struck off
When William Brown went for a routine operation at a private hospital, he had high expectations of the treatment and aftercare he would receive.
Little did he imagine that he would emerge so seriously ill that he would never walk independently again, and that he’d be in need of 24-hour care.
William, then 74 and still working as a ship’s captain, had fallen victim to a disturbing pattern of medical malpractice where doctors who harm patients in private hospitals ultimately go unpunished.
A life devastated: William Brown, pictured with his wife Jean, was left an invalid after minor bowel surgery at a private hospital
One MP has alleged that the true scale of the problem is being covered up and is demanding it be debated in Parliament.
Worryingly, the problem is apparently being made worse by the lenient approach the doctors’ watchdog takes towards incompetent medics.
William Brown was oblivious to all this when he was booked in for minor bowel surgery in 2004. Mr Brown, from Bishop Middleham, Co Durham, had been diagnosed with colon polyps. These growths have the potential to become cancerous, so he was advised to have them removed for further examination.
Convinced that a private operation would be better than the NHS, Mr Brown decided to have the operation in London. The bill would be met by his family health insurance policy.
His wife Jean, now 70, a nursery headteacher, recalls having serious qualms about his decision.
‘I did not want him to go privately,’ she says. ‘My daughter, who is a nursing sister, agreed with me. She says that with an operation you should go to the NHS, because they have the proper emergency back-up.
‘Afterwards, the doctors told us the operation had been very successful,’ recalls Jean. ‘But when my husband was in the recovery unit a few hours after the operation, he told the anaesthetist he thought he was having a stroke because he had no feeling in his left arm or left leg.
“How can private hospitals happily employ doctors who have serious question marks put on their records’
‘He repeated this on three occasions. William had suffered a mini-stroke three months earlier, with similar symptoms, and this was in his notes. But the anaesthetist refused to believe him or take any action. In fact, he asked me several times why William kept complaining.’
It is well established that the sooner you treat a stroke, the better.
‘The doctor should have arranged to get him treated with aspirin and given emergency care as soon as possible,’ says Mrs Brown. ‘If he’d been treated within three hours, he might have survived quite symptom-free. But the hospital did not decide that he’d suffered a stroke until seven days later, when he was finally given proper neurological tests.’
Tests on the polyps showed that they were benign — but Mr Brown left the hospital an invalid.
‘His quality of life just ceased,’ says Jean. ‘It has been very hard for him to go from how he was to how he is. He can still talk and he has not lost his mind, but he used to be very active and now that’s gone. He needs two carers each day and 24-hour care.’
Mr Brown’s case is one of a number that have raised fears over the safety of doctors working in private hospitals.
Precise figures are not available: there is a dearth of research into the issue, despite the fact that the UK private healthcare sector is worth around 4 billion, with many people going private because of dissatisfaction with the NHS.
There is no national body overseeing complaints against private hospitals, and no standard complaints procedure. Many are dealt with individually by the hospitals.
However, Dr Iain Barclay, deputy medical director of the Medical Protection Society, said last year that there had been a 40 per cent rise in the cost of clinical negligence claims against private doctors and GPs over a 12-month period.
Hush money: Many mistakes by private doctors aren”t being made public because the patients are paid off, according to a Tory MP
The Browns complained to the General Medical Council — the official body that regulates doctors’ training and practice — and the anaesthetist, Dr Ronald Cohen, was brought before a disciplinary panel on 14 counts of misconduct, including failing to keep proper notes of the operation.
He was found guilty of all counts and suspended from practising for nine months. He was also told his work would have to be supervised after his suspension had ended.
But Dr Cohen took his case to the High Court and his suspension was quashed. A warning was placed on his registration about the regulator’s findings, but he was free to practise at another private hospital.
This he did. And four years later, in 2009, he was back before the GMC over complaints from a woman who’d had an epidural at the private Portland Hospital and been left in severe pain.
Again, Dr Cohen was found to have taken no proper notes of the operation. The ruling was again that he should be suspended and conditions be put on his registration to practise. Dr Cohen decided to resign before this could come into effect.
All this has left Jean Brown very angry. ‘How effective can the GMC be when its judgments can be overturned’ she asks. ‘And how can private hospitals happily employ doctors who have serious question marks put on their records’
Lee Scott, the Conservative MP for Ilford North, is convinced there is a particular problem with medics working in private hospitals. He believes that some hospitals are deliberately covering this up.
“People harmed by private hospital blunders were then pressured to sign non-disclosure agreements as part of compensation deals”
His concerns follow the death of Carmel Bloom, the sister of one of his constituents. The MP is campaigning for official investigations into Ms Bloom’s case to be re-opened.
Ms Bloom, of Woodford Green, Essex, was a healthy woman who died aged 54 from post-operative complications after routine surgery to remove a kidney stone at the Bupa-run Roding Hospital in Ilford in 2002. The hospital is no longer owned by the private health firm.
Ms Bloom developed septicaemia and suffered multiple organ failure. She was transferred to an NHS hospital but died there ten days after her surgery.
Two doctors involved in her operation were confronted with a catalogue of alleged failings at a hearing by the GMC in February last year.
‘Between them, they pleaded to, or were found guilty of, 79 charges, including one where the doctor’s conduct was so serious it increased the risk of Carmel suffering cardiac arrest, brain damage and death,’ says Mr Scott.
The regulator, however, ruled that the failings did not amount to professional misconduct as they were not sufficiently grave.
However Ms Bloom’s brother, Bernard, has discovered a long list of anomalies about the case, including the fact that important X-rays are missing from her hospital file.
He has also uncovered new evidence, including a transcript of a 999 call from Roding Hospital (previously described as ‘lost’), which appears to contradict evidence given to the GMC.
Mr Scott says his investigations into private hospital doctors indicate that the problems do not stop here.
‘Many such incidents are being covered up by “hush money”,’ he alleges. ‘A number of constituents have come to me saying they’ve been harmed by private hospital blunders and were then pressured to sign non-disclosure agreements as part of the compensation deals offered to them.’
Furthermore, he says, private hospitals can ‘hide’ their failings by transferring patients with post-operative difficulties to NHS hospitals.
‘Very few post-op patients die in private hospitals in these kinds of cases,’ he says. ‘They’re transferred as emergencies to NHS hospitals. Then, if they die, it is not recorded as a private hospital death.
‘Some of these people go in for something minor, but they die. Why I don’t think we always get the proper answers.’
Guy Forster, a clinical negligence solicitor at Irwin Mitchell, the UK’s largest medical negligence law firm, says another issue is that some private hospitals lack emergency back-up for when routine surgery goes wrong.
‘I have had to deal with a number of cases like this recently,’ he says. ‘Often, private hospitals do not have the facilities to cope. Not all have intensive care beds, for example, even though they are doing pretty major surgery.
‘I would urge all managers of private hospitals to address this kind of problem urgently.’
Similar disquiet has been voiced by the parents of Louise Field, a 27-year-old trainee accountant and keen sportswoman who died after a private hospital operation to cure excessive sweating of her hands went terribly wrong.
During the procedure in 2002, medics at a BUPA hospital in Harpenden, Hertfordshire, mistakenly punctured one of Louise’s lungs. The hospital is no longer owned by BUPA. She suffered a catastrophic lack of oxygen and was left irreparably brain damaged.
“We have been left very bitter by everything that has happened. It has completely shaken our faith in the medical profession”
Her parents, Pat and Phillip Green, had to make the decision to turn off her life support machine two days later.
They then fought an eight-year legal battle to see the doctors responsible face charges.
At a GMC hearing last year, it was alleged that when Louise was rushed to an NHS hospital, the private hospital’s anaesthetist failed to let staff there know she might have neurological problems caused by a lack of oxygen. He was also accused of failing to inform them about drugs he had administered to her.
The surgeon admitted making inaccurate records after the operation and was criticised for ‘significant departures from good medical practice’, yet he was exonerated. The anaesthetist, Dr Wasfy Yanny, was simply required to undertake that he would not conduct any similar procedures again.
After the decision, Louise’s mother said: ‘We have been left very bitter by everything that has happened. It has completely shaken our faith in the medical profession.’
Mr Scott believes that the GMC can be excessively lenient in cases where things go wrong through bad doctoring. ‘Is the GMC there to protect patients, or is it a union to protect doctors I think it is the latter,’ he says.
The regulator did recently strike off one private hospital doctor. Surgeon Chinh Nguyen was found to have punctured a patient’s heart during an operation to treat back pain at the BMI Garden Hospital in Hendon, North London.
The patient, Satwant Vohra, 55, had to be transferred to an NHS hospital for emergency surgery but she died the following morning.
Disturbing, Chinh Nguyen had only just returned from a period of restricted duty and retraining after a number of bungled operations. At the time he was operating on Ms Vohra, he was also on bail awaiting trial for laundering 2.3 million in drug money. He was subsequently found guilty and jailed for five years.
However, it seems as if the death of Ms Vohra would not have been enough alone to end Nguyen’s doctoring days.
In its summing up, the GMC said: ‘The panel regards the criminal offence for which you were convicted of such a serious nature that a period of suspension would be insufficient.’
In response to allegations of private doctors being treated too leniently, the GMC said it endeavours to keep all doctors to the same high standards. A spokeswoman added: ‘The way we keep data on complaints does not record whether they were working in a private or an NHS hospital.’
Some might say that Lee Scott MP is being alarmist with his allegations of widescale private hospital malpractice and cover-ups. But this last, most disturbing case must surely make any reasonable person wonder: how bad does a dodgy private doctor have to be before they are finally brought to book
Please note that the period to which Dr Barclay’s quote refers is 2008/09. The Medical Protection Society has confirmed that there was no increase in claims costs for private consultants between 2009/10.