Intended for healthcare professionals


Clinical governance and the role of NHS boards: learning lessons from the case of Ian Paterson

BMJ 2017; 357 doi: (Published 02 May 2017) Cite this as: BMJ 2017;357:j2138
  1. Kieran Walshe, professor of health policy and management,
  2. Naomi Chambers, professor of healthcare management
  1. 1Alliance Manchester Business School, University of Manchester, UK
  2. Correspondence to: K Walshe

Medicine’s enduring professional “club” culture must be eradicated

Last week, surgeon Ian Paterson was found guilty of 17 counts of wounding with intent to cause grievous bodily harm, in relation to 10 patients who had needless surgery at the Spire hospitals in the Midlands.1 These cases were just a sample of a larger number of patients he had harmed while working in the NHS and privately. The Heart of England NHS Foundation Trust (HEFT) has already spent almost £18m (€21m; $23m) on 265 claims for compensation; solicitors are bringing a civil class action on behalf of a further 350 women against both Spire Healthcare and the NHS; and it is thought there could be hundreds of other victims.2 Paterson did breast surgery on over 4400 women at HEFT during his time there, including 1207 mastectomies, and an unknown number of procedures in the private sector.3

In 2013 the trust published the report from an inquiry it commissioned from Sir Ian Kennedy.4 It sets out how problems with Paterson’s clinical performance were …

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