NHS pays out millions to patients of surgeon convicted of needless breast operations

The NHS has been forced to pay out almost £10m in compensation to more than 250 patients of a rogue surgeon found guilty of carrying out needless breast operations on patients who were left traumatised and scarred.

Consultant surgeon Ian Stuart Paterson, 59, was convicted on 20 counts of wounding with intent and unlawful wounding against nine women and one man on Friday. But he could have more than 1,000 more victims, among them hundreds of private patients who may never be compensated for botched and needless operations.

Paterson had denied the charges, which related to procedures he carried out between 1997 and 2011. The jury at Nottingham crown court had heard claims that the surgeon – who saw hundreds of patients a year – carried out the operations for “obscure motives”, which may have included a desire to “earn extra money”.

He denied misrepresenting patients’ test results to dupe insurers into paying for surgery, but other former patients have told the Guardian that the surgeon exaggerated or simply invented the risk of cancer and – in some cases – claimed payments for more expensive procedures that those he had carried out.

Paterson was employed by Heart of England NHS trust in 1998 – despite having been previously suspended from the Good Hope hospital in Birmingham – and also practised at privately run Spire Healthcare hospitals in the Midlands over a 13-year period.

The NHS has so far paid out around £9.5m, settling 256 cases, with 25 outstanding, the Guardian has learned. But hundreds of Paterson’s private patients may never see a penny after Paterson’s insurance company – the Medical Defence Union (MDU) – said their cover was “discretionary” and had been withdrawn. Paterson had a limited separate insurance policy of £10m, which solicitors say will not nearly cover the compensation and costs of all private patients.

Spire Healthcare, which runs the Parkway and Little Aston hospitals where Paterson treated private patients, have settled some cases but argue that as Paterson was not technically their employee, they are not responsible for his actions. The company would not divulge any details about compensation.

Sarah Jane Downing, who set up a petition, demanding compensation for Paterson’s private victims, said she had been left “shocked and appalled” at the lack of redress.

Sarah Jane Downing. Photograph: Teri Pengilley for the Guardian

“Many of these people chose private healthcare because they bought into those promises in the glossy brochures. And now we have realised that those promises are not worth the paper they are printed on. It’s utterly devastating.”

At a recent coffee morning for former Paterson patients, many described the consultant’s “brilliant” bedside manner. “He was so lovely, I thought I was so lucky – I thought I was being looked after,” said Elaine Diskin, who had eight operations by Paterson over as many years.

Her husband, Mike, also had a deep respect for the surgeon – so much so that when he had a pain in his chest, he went to him and did not hesitate when the surgeon said he suspected lipoma and that they “had to get it out”.

“Sinister was the word he used,” Diskin said. “I had no reason to doubt him because he was looking after Elaine so well.”

They trusted Paterson so much they also recommended his care to a friend, who went on to have a lump removed. “We used to joke that we’d paid for his skiing holidays,” said Elaine Diskin.

After the Diskins were recalled for a review of their treatment in 2012 they discovered that at least seven of the eight operations Paterson had done on Elaine – along with both performed on her husband and their friend – were unnecessary.

A civil case with seven “test” cases – which will determine to what extent Spire can be held liable for Paterson’s work in their hospitals – is scheduled to be heard in October, but looks likely to be delayed. The outcome will affect all the private patients who have brought civil claims – and who fear they may get nothing.

Solicitors familiar with the case say Spire has made a handful of payments – the largest about £150,000 – to former patients in the private sector which include unnecessary removal of lumps and the received“cleavage-sparing mastectomies”, a controversial operation that left breast tissue behind after the removal of cancerous cells.

Concerns about Paterson were raised as far back as 2003. But despite several internal and external investigations and complaints from patients, GPs and other surgeons he was only suspended by the General Medical Council in 2011. “In every profession you get rogue operators – but there are checks and balances to stop terrible things happening,” said Mike Diskin. “Why were there not in this case, or why were they ignored?”

Timeline

1998: Paterson is hired as a consultant surgeon at the Heart of England NHS trust, despite being previously suspended from the Good Hope hospital, and also sees private patients at Spire Healthcare hospitals Little Aston and Parkway.

2003: Paterson is investigated because of concerns about “cleavage-sparing mastectomies”. Recommendations are not followed through.

2007: Breast surgeon Hemant Ingle is appointed and with others raises concerns. Further investigations are carried out and Paterson is told to stop performing “cleavage-sparing mastectomies”. Mark Goldman, chief executive of the Heart of England NHS trust, informs Spire that the trust is investigating Paterson.

2008: Two GPs complain about Paterson’s treatment of a patient, saying he gave misleading information about pathology reports, over-treated patients and disregarded the multidisciplinary team meeting process. Another report is critical.

2009: A Spire Parkway patient makes a formal complaint about Paterson. No action is taken. Heart of England NHS trust recalls 12 patients who have had “cleavage-sparing mastectomies”. West Midlands Cancer Intelligence Unit submits two further reports.

2010: The General Medical Council (GMC) tells Spire Parkway executives about a complaint from an NHS patient. .

2011: Parkway were informed Paterson had carried out a “cleavage-sparing mastectomy” in 2009 after being told to stop in January 2008. A month later the GMC informed Spire about another patient complaint. A total recall of all Paterson’s patients begins.

Paterson is suspended by the NHS in May 2011 but continues to perform breast surgery for Spire until 31 May and general surgery until 8 June 2011. He is paid until November 2012.

NHS pays out millions to patients of surgeon convicted of needless breast operations

Sam is a convicted paedophile … and a teenage girl

Sam* is a paedophile. Sam’s offence was a serious one – threatening a young boy and forcibly kissing and touching him. Sam was found guilty of this offence, and has a past history of offending including assaults, theft and drug use.

Sam is not in prison. Sam is in hospital. Sam was sent to hospital because the court took the view that the degree of mental illness that Sam had, in the form of schizophrenia and post-traumatic stress disorder, was so severe that Sam would not be safe in a custodial setting.

Sam is a teenage girl. Her history of contact with social services began before she was born. Her mother also had mental health problems, and was using heroin throughout her pregnancy. Sam never knew her mother who abandoned her soon after the birth. Instead, Sam was looked after by her father who was part of a paedophile ring. Sam suffered chronic abuse and still lives with the physical side effects.

The paedophile ring was subsequently exposed by the police, her father went to prison and Sam spent most of her childhood with a relative, who failed to protect her from a series of physically and at times sexually abusive partners. Social, health and education services all raised concerns that she was often inappropriately dressed for the weather, looked undernourished and had bruises that were hard to explain, but the family frequently relocated when people came knocking at the door. She had few friends, and when she did go to school she often sat quietly on her own in the corner so that she could see who was around her.

She began self-harming, took an overdose and attempted suicide. She has scars that will be visible for the rest of her life. She’s had psychotic episodes as a result of using a mixture of amphetamines and ketamine. She continues to experience voices that tell her that she is worthless and should try to kill herself. On her worst nights, she relives her experiences at the hands of every abuser that has ever touched her – they’re holding her down, and nobody ever comes to make it stop.

Sam’s story is not the worst I’ve come across. Sam is not simply defined by her behaviour. She is a frightened, fragmented and traumatised little girl who finds praise terrifying, because in the past it was so often associated with abuse of her trust. We’re working with her and with the other girls on my ward, to try to begin the process of healing. She doesn’t understand why we are trying, but she knows that we are, and that we will never give up on her, even when she begs us to. We are very conscious of her risks to others, but the most pressing need is to stop her from killing herself.

Sam is already surprising us with her shy sense of humour and resilience despite her background. When she gets frightened or feels insecure, she carries around a stuffed toy that carries stains and holes in the same manner and frequency that Sam carries her scars.

I’m a child and adolescent forensic psychiatrist and I have worked in a secure adolescent service for six and a half years. I understand why the general public and the media tend to have binary definitions of people – when awful things happen, it helps us to make sense of it. We have a reason, an explanation – they’re “evil”, born bad, they have wonky genetics, they’re “not like us”. We’re right – Sam is not like us. She didn’t have the same childhood, the same opportunities or the same care. She never had anyone to tell her that things would be OK, or to rescue her when she was in pain and thought she would die. She never had anyone to help her understand that she can be whoever she wants to be, that she doesn’t have to replicate the same cycle, or that relationships with other people can be safe. She never had anyone to share her hopes and dreams with. She never had anyone that she could trust.

It is my great privilege to work alongside our clinical team in trying to help people like Sam. When young people begin to trust us and reach out for the first time, my faith in the human spirit surpasses anything I ever thought possible. By day, I love my job with a passion, I work hard to help my patients recover from extreme trauma and illness, and I would never want to do anything else – by night, I dare to dream of a better world for the next Sam that is born.

*Sam is a composite of this psychiatrist’s experiences of patient care

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

Sam is a convicted paedophile … and a teenage girl