The British Government has announced further plans for its independent inquiry into disgraced breast surgeon Ian Paterson, which will look at any broader lessons that can be learnt about private healthcare.
The inquiry will be chaired by the Right Reverend Graham James, Bishop of Norwich.
It will examine the circumstances and practices surrounding Paterson’s malpractice and look at how this can improve care locally and the independent healthcare sector across the country to ensure private patients have the safeguards they expect.
Paterson - a consultant breast surgeon who was employed by the Heart of England NHS Foundation Trust (HEFT) - intentionally wounded his patients by exaggerating or inventing cancer risks and claimed payments for more expensive procedures.
Paterson, who had practising privileges in the independent sector at both Spire Parkway and Spire Little Aston in Birmingham, was found guilty of 17 counts of wounding patients with intent in April and jailed for 20 years.
The details released on Thursday follow a pledge by Health Secretary Jeremy Hunt to hold a "comprehensive and focused inquiry" into Paterson’s wrongdoing.
Following this, and Health Minister Philip Dunne’s meeting with victims and their families, the initial scope of the investigation has been widened in recognition of their feedback that broader issues about care in the independent sector needed attention.
This includes whether any further action is needed to strengthen the Care Quality Commission’s (CQC) inspection regime in relation to the private sector.
Mr Dunne said: "Ian Paterson’s malpractice sent shockwaves across the health system due to the seriousness and extent of his crimes, and I am determined to make sure lessons are learnt from this so that it never happens again in the independent sector or the NHS.
"I believe an independent, non-statutory inquiry, overseen by Bishop Graham James, is the right way forward to ensure that all aspects of this case are brought to light and lessons learned so we can better protect patients in the future."
The Right Revd James said: "The actions of Ian Paterson and the grievous harm he inflicted on patients are deeply concerning, and they have given rise to some serious questions which remain unanswered.
"It is vital that the inquiry be informed by the concerns of former patients of Ian Paterson and their representatives.
"The interests of all patients, whether they seek treatment in the NHS or the private sector, should be at the heart of this Inquiry and I will do my very best in the interest of those affected and the public."
Tracey Smith, who was operated on by Paterson in 2010, said she was pleased at the announcement.
She said: "We’re happy that we seem to be finally getting somewhere after five years.
"We’ve kept on the fight also for the ladies that didn’t make it past treatment by Paterson, and their families, to get answers as to why he was allowed to continue after red flags were raised.
"He was allowed to continue when it was clearly shown on his CV he was only a vascular surgeon.
"Why was he doing breast surgery?"
The mother-of-one said she wanted other people to be held to account, "and the dysfunctional system under which he was allowed to work scrutinised".
"Our GPs could not access notes from the private sector," she added.
"If the GP was allowed access to our pathology and scans it would have shown most patients were non-cancerous and none of our surgeries were actually needed.
"Ladies with Grade One and Grade Two cancers were being over-treated."
Asked about how she felt about the women who had not survived since treatment by Paterson, Mrs Smith said she felt "choked up".
She added: "I feel quite emotional when I talk about the ladies that didn’t make it past Paterson’s treatment.
"There were many missed opportunities to stop him because they knew he was performing cleavage sparing mastectomies, and leaving ladies at risk of secondary cancers.
"But now we’re moving forward and will finally be allowed to answer those questions for the families.
"I do feel choked up, because we had a lady two weeks ago who has died.
"It is relentless and it just goes on and on.
"We will continue to speak up for those families and victims who are not here to speak for themselves."
The inquiry, which is expected to take 18 months, will be informed by Paterson’s victims and their families, and will look at the work he did under the NHS as well as the private sector.
It is likely to examine the responsibility for the quality of care in the independent sector, along with the appraisal and ensuring validation of staff in the independent sector and the safety of multi-disciplinary working.
It will also look at information sharing, reporting of activity and raising concerns between the independent sector and the NHS, and is expected to consider whether GPs should have access to the notes of privately treated patients.
The role of insurers of independent-sector healthcare providers will also be scrutinised, including how data it holds about the scope and volume of work carried out by doctors is shared with the sector, and arrangements for medical indemnity cover for clinicians in the independent sector.
The inquiry will be formally established in January 2018 and expected to report in summer 2019.
The terms of reference and other arrangements relating to how it will be conducted are yet to be announced.
The Association of Independent Healthcare Organisations (AIHO) said it welcomed Thursday’s announcement.
Chief Executive Fiona Booth said: "The Government is right to emphasise the importance of patient safety. We look forward to making a constructive contribution to the inquiry.
"Patient safety is a priority for the independent sector. The independent sector delivers high-quality care to patients and is regulated by the Care Quality Commission to the same standards as the NHS.
"Consultant surgeons working both in the independent sector and the NHS are regulated by the General Medical Council and follow the same code of practice.
"The failings of an individual rogue surgeon such as Ian Paterson do not represent the high quality and compassionate care delivered day in and day out by the multi-disciplinary teams working in both independent sector or the NHS ."
Emma Doughty, a medical negligence lawyer from Slater and Gordon, which represented more than 100 of Paterson’s victims, said: "We and our clients are relieved that the sheer enormity of failings that led to Paterson being able to harm his victims for years has led to the inception of a much needed independent inquiry into the private sector.
"Having supported our clients’ fight for a review of patient safety and regulation in the private sector for over six years, we now hope that this inquiry will not only look into the roles of individuals in scandals, such as the Paterson case, but also how the institutions involved enabled this to go on for so long.
"It is fundamental that patient safety in the private sector must be protected."