Renewing faith in doctors

By Robin Stride

Private doctors’ representatives are looking forward to ‘a restoration of confidence in the professional integrity of doctors throughout the sector’ in the wake of the Government’s support for recommendations arising from the Paterson inquiry.

The Federation of Independent Practitioner Organisations (FIPO) said rogue surgeon Ian Paterson betrayed the basic principles of medicine and had a devastating impact not only on the patients whose lives he ruined but also ‘on the medical profession as a whole’. 

Its comments were backed by the London Consultants’ Association, which said private specialists would be pleased to only practice with providers who have the correct assurances and governance in place.

Welcoming the Government’s long-awaited response to the remaining recommendations of the former Bishop of Norwich’s inquiry into his ‘reprehensible behaviour’, it said it was gratified that the majority of the ‘sensible’ recommendations had been accepted. 

As reported by Independent Practitioner Today in late December, there were 17 recommendations signalling some major changes for some consultants.  

Nine were accepted, five more in principle, one was not accepted and another is being kept under review (see ‘Doctors welcome Paterson response’).

Detailed analysis

In a detailed analysis of the recommendations, FIPO said the integration of practice data should allow for earlier identification of concerns, but this would need to be viewed within an independent professional goverance framework. 

A peripheral benefit would be to ease the data capture burden for doctors working at multiple sites.

It thought the matter of consent for surgery was less likely to be an issue in the private sector where the consultant would be getting the informed consent and performing the surgery, normally with a time gap for the patient to consider what they had been told. 

Regarding multidisciplinary team meetings, these were considered in many instances to be best practice, stated FIPO. 

However, the routine adoption of these meetings compliant with national standards throughout the sector would need professional monitoring to ensure that, as was the case with Paterson, this did not degenerate into a tick-box exercise.  

FIPO added: ‘However, these meetings are very resource- and time-intensive in terms of assembling the necessary skill sets to perform them. 

‘There is also the issue that currently neither the hospital providers nor the private medical insurers (PMIs) reimburse the doctors and other professionals involved for their time. Although some of the PMIs have done so in the past, they now refuse to do this.’ 

Complaint resolution

Regarding complaint resolution, FIPO said some private providers had for some years supported the Independent Sector Complaints Adjudication Service to allow for independent assessment of complaints when in-house procedures had failed to satisfy complainants. 

It added: ‘FIPO wholeheartedly supports universal adoption of ISCAS and its principles by providers but also believes that there  should be better independent processes for complaints made by doctors about remote clinical decision making by insurers about individual patients. 

‘Currently, the insurers are regulated by the Financial Conduct Authority and, since clinical decisions may be made on financial grounds, FIPO believes that there should be independent professional medical monitoring of such complaints. 

‘Recent cases have highlighted the need for a clear understanding of the responsibility and liability of both hospital providers and consultants. 

‘Hospitals will need to accept responsibility for the quality of care in their establishments. This may also require a change in the law in relation to indemnity insurance and the Government intends to report on this in 2022.

‘Overall, FIPO endorse the Government’s  measured response to the Inquiry’s recommendations. We hope that their implementation will improve patient safety and restore professional respect and trust for patients choosing to use the private sector.’