The importance of patient safety is repeatedly drummed into everyone who works in the NHS. Whether or not standards of patient safety are always maintained in our underfunded, under staffed hospitals is a moot point, but no one underestimates its critical role in delivering medical care.
By contrast, the CQC's first inspection report into 206 private, acute hospitals makes for sobering reading. The good news is that, overall, 70% of hospitals were rated good or outstanding – but the remaining 30% were rated as requiring improvement, with governance, clinical audits, and safety being singled out for particular attention.
Lack of oversight
Although there is much in the report to applaud about the services provided by private hospitals, the concerns raised about governance contained unwelcome echoes of the criticism levied at the Spire Parkway hospital in Solihull and its failure to oversee the work of the former breast surgeon, Ian Paterson. References to 'lack of oversight of practising privileges', and an unwillingness to challenge consultants, serve as a reminder that old-fashioned perceptions about surgeons being above scrutiny still persist. Even worse, the inspectors encountered Medical Advisory Committees (responsible for overseeing consultants' work) which were not checking if consultants had the requisite experience in the procedures they were undertaking; nor were they carrying out risk assessments on new or innovative procedures.
Lax attitude to patient safety
Unsurprisingly, the report also highlighted concerns around safety and incident reporting, suggesting that lack of control over the quality of the work practised by consultants was leading to an ostrich mentality among hospital management. References to 'informal practices and consultant behaviour' should have every alarm bell on the premises ringing. Over the past two or three years I have highlighted the unsafe (and, in the case of Ian Paterson, criminal) practices of several consultants up and down the country and their rather cavalier attitude to patient safety. Despite everything that is being done within the NHS to counter concerns over patient safety, it is clear that the message is simply not getting through to the management boards of some private hospitals.
With the NHS in its current state, private hospitals will continue to perform a valuable service for many patients seeking elective surgery and other non-complex procedures. However, to treat consultants as if they are on a pedestal, and allow them to get away with behaviour that discourages other medical staff from querying what they are doing, is unacceptable.
No consultant should be above scrutiny
The one bright point is that the CQC has been impressed by the speed with which the hospitals have responded to its findings by taking appropriate action. As I have pointed out on numerous occasions, if other industries, whose existence depends on accuracy and precision, treated quality control in the way that some private hospitals have, as shown by the report, there would be a public outcry and they would go out of business. Why some hospitals still think they can turn a blind eye to poor consultant behaviour with impunity is beyond me. Patient safety must be every hospital's mantra, private or NHS, and management must acknowledge that no consultant is above scrutiny.
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