34LEGAL MEDICOMAGAZINESponsored by:References 1 Patients rated ASA 3 (having a severe systemic illness) or less.2 http://content.digital.nhs.uk/media/23516/Hospital-admissions- from-non-NHS-hospitals/xls/9895_admissions_from_non_NHS_hospitals.xlsx3 Patients rated ASA 3 (having a severe systemic illness) or less.4 Centre for Health and the Public Interest – Patient Safety in Private Hospitals – the known and the unknown risks, Table 3 2014 https://chpi.org.uk/wp-content/uploads/2014/08/CHPI-PatientSafety-Aug2014.pdf5 Verita Independent review of the governance arrangements at Spire Parkway and Little Aston hospitals in light of concerns raised about the surgical practice of Mr Ian Paterson http://www.verita.net/wp-content/uploads/2016/04/Independent-review-of-the-governance-arrangements-at-Spire-Parkway-and-Little-Aston-hospitals-Spire-Healthcare-March-2014.pdf6 Centre for Health and the Public Interest – Patient Safety in Private Hospitals – the known and the unknown risks. 2014 https://chpi.org.uk/wp-content/uploads/2014/08/CHPI-PatientSafety-Aug2014.pdf7 See Section 2 Interpretation http://www.legislation.gov.uk/ukdsi/2009/9780111487006/regulation/28 Care Quality Commission: Guidance for providers on meeting the regulations Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) (as amended) Care Quality Commission (Registration) Regulations 2009 (Part 4) (as amended) http://www.cqc.org.uk/sites/default/files/20150210_guidance_for_providers_on_meeting_the_regulations_final_01.pdf9 CQC Spire Parkway Hospital Inspection report – date 2012 http://www.cqc.org.uk/sites/default/files/old_reports/1-102643305_Spire_Healthcare_Limited_1-129798341_Spire_Parkway_Hospital_20121127.pdfany relevant checks. They must have a procedure for ongoing monitoring of staff to make sure they remain able to meet the requirements, and they must have appropriate arrangements in place to deal with staff who are no longer fit to carry out the duties required of them.’8 On a prima facie reading these regulations clearly apply to private hospitals which grant practising privileges to consultants to perform surgery on their premises and hence make the hospitals responsible for overseeing and monitoring their work. However it is unclear whether these regulations have been enforced: the CQC carried out inspections of the two private hospitals where Paterson worked 18 months after he had been suspended by the NHS, but the inspection reports make no mention of any attempts by the inspectors to discover whether the hospitals had in place procedures for monitoring the work of the consultants who practised in them. Instead the CQC’s focus at that time was solely on the other healthcare staff who were directly employed by the hospital such as ward nurses and theatre staff.9 Despite the content of these regulations, the current difficulty experienced by patients in seeking redress for the harm caused by Ian Paterson shows that liability for what goes on within private hospitals remains a contested matter. Unless it is resolved to the satisfaction of the victims, a change in the law will be necessary to make private hospitals fully accountable for all surgery which takes place on their premises. Without this there is no guarantee that patients receiving care in private hospitals will be safe and that a similar tragedy will not occur somewhere else.