House of Commons Select Committee Report
Report of the Independent Inquiry into the Issues raised by Paterson
Inequality between NHS/Private Patients re complaints with NHS patients having far better protection
This House of Commons Select Committee Report (page173) will tell you there is an "inequity between patients treated in the NHS, who have a right to escalate a complaint to the Ombudsman for independent investigation, and private patients treated in the independent sector, who do not have this right. Moreover, private patients appear to be unaware that they do not have this level of protection." Page 173
This means you cannot raise a complaint to the Parliamentary and Health Service Ombudsman. Your only option is to sue the Consultant which you must funded privately, as Private "For Profit" Hospitals are not liable for their doctors. Your medical insurer will then add their costs into your claim! The way the system works Consultants rent rooms from the private hospitals almost like serviced offices. There is a complete lack of protection for private patients
I can tell you from my personal experience AXA are aware of this and have so far taken no action to protect their members. If something goes wrong they will NOT HELP even when given reports by the voluntary regulator of the private healthcare system (Independent Sector Complaints Adjudication Service (ISCAS) stating many breaches of their code of conduct.
The government has told all private hospitals to "voluntarily" sign up or they will eventually make regulation. However, the BMI were signed up, they just do not have to listen, comment, or reply to ISCAS. The CQC are meant to enforce but as the paragraph below will show the House of Commons Select Committee Report did not believe it was effective and has not been in my experience to date.
Regulatory system
"In 2018/19, the Care Quality Commission, the General Medical Council and the Nursing and Midwifery Council, had a total annual budget of over £435m per year, and between them employed over 5,200 people. In addition to this, the Professional Standards Authority for Health and Social Care employed a further 40 people with an annual budget of £4m, raised by fees paid by the regulatory bodies it oversees.
Despite the scale of the regulatory system, it does not come together effectively to keep patients safe. We also heard that it is not accessible or understood by patients. We do not believe that the creation of additional regulatory bodies is the answer to this.
We recommend that the Government should ensure that the current system of regulation and the collaboration of the regulators serves patient safety as the top priority, given the ineffectiveness of the system identified in this Inquiry." Page 221
This involves lack of protection for private patients and the NHS. The House of Commons Select Committee Report was published in 2020. My personal experience is nothing has changed. ISCAS told the BMI to reread chapters 4 (Safety and Quality of Care) and 5 (Responding when things go wrong). AXA know this and have told me it is not their job to make the system safer, not even for their members, as there is no legislation making them. It is the job of the regulatory authorities despite knowing they have been found to be ineffective. The Financial Conduct Authority welcomed AXA involvement and stated it was a "commercial decision" if they chose not to.
Clinical indemnity
"Medical defence organisations cover the costs of claims and damages awarded to patients. However, they are not subject to financial conduct regulation, and the indemnity cover they provide is discretionary
We recommend that the Government should, as a matter of urgency, reform the current regulation of indemnity products for healthcare professionals, in light of the serious shortcomings identified by the Inquiry, and introduce a nationwide safety net to ensure patients are not disadvantaged." page 220
I have raised this with my MP and she agrees Medical Indemnity should be a regulated insurance. Right now it is like car insurance and can be made null and void if the doctor breaches their terms and conditions giving a lack of protection for private patients
Corporate Accountability
"We heard that many patients......did not feel that the hospitals took responsibility for what had happened. In the NHS, consultants are employees and the NHS hospital is responsible for their management, and accepts liability when things go wrong. The situation is very different in the independent sector where most consultants are self-employed. Their engagement through practising privileges is an arrangement recognised by CQC. However, this recognition does not appear to have resolved questions of hospitals’ or providers’ legal liability for the actions of consultants.
We recommend that the Government addresses, as a matter of urgency, this gap in responsibility and liability.
We also heard that patients felt that they did not receive any meaningful apology from the hospitals. We understand that apologising was conflated with admitting legal liability. Despite the historical guidance on being open and saying sorry and, more recently, the statutory Duty of Candour, we were provided with no evidence to show how boards accept and implement accountability for apologising.
We recommend that when things go wrong, boards should apologise at the earliest stage of investigation and not hold back from doing so for fear of the consequences in relation to their liability." Pages 221-222
In my personal experience the BMI wrote two lines of an email that was not worth the virtual paper it was written on. They did not respond to their regulator's letter to their CEO. They use the same firm of solicitors as AXA. The CQC REFUSED to enforce Statutory Duty of Candour - Regulation 20, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 https://www.legislation.gov.uk/uksi/2014/2936/regulation/20/made in my case, despite it being implemented for cases just like mine where the hospital has still not explained everything. Their regulator called them "obfuscatory." They claim to have improved and changed but have never even tried to put things right with me, instead they have lied and told me to sue them.
Despite the House of Commons Select Committee Report calling for change, AXA has refused to insist the system becomes safer or to protect their members better. How can AXA not want to know they have made changes, so their members are safe, within the largest independent private hospital group in the country? The BMI appear to believe they should be able to act with impunity, and unfortunately, unless a company bigger than them (that pays them an awful lot of money eg AXA) or the government tell them to improve, I fear nothing will change. The BMI's CEO has never even bothered responding to their regulator, ISCAS, over a letter they wrote about my case, which any normal person would be contrite over. She did not bother to confirm the BMI's commitment to patient safety which they asked her personally to do. I will say, AXA's CEO, did respond directly to me which I do think indicates the seriousness of my case.