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The case of rogue breast surgeon Ian Paterson

Breast surgeon Ian Paterson was jailed in 2017 for wounding patients with intent. His career spanned 14 years in both the NHS and private practice for the Spire Healthcare group of hospitals.

He was found guilty of criminal charges against nine women and one man and there were many more victims. In total, he treated about 11,000 patients. He subjected hundreds of patients to unnecessary surgery. In most cases these patients suffered removal of their breasts despite having no signs of breast cancer or surgery using an inappropriate technique that left them highly at risk of their cancer spreading or returning.

Spire and the NHS Trust involved undertook a review and recalled patients Paterson had treated to let them know what had happened and to investigate whether the treatment was correct. This was competed in 2017 but the process was woefully inadequate.

In 2017, there was legal settlement of £37m, involving 40 different law firms. The defendants jointly established the Ian Paterson (Liability to Private Patients) Compensation Fund. Of the £37m, Spire contributed £27.2m. At the settlement hearing in October 2017, Justice Whipple set aside a proportion of the fund to compensate any former private patient yet to bring a legitimate claim, but the claims needed to be made before 30 October 2018.

As part of the deal, the 40 law firms involved are effectively barred from bringing any new claims against Spire Healthcare for 20 years, in the belief that at the time of the deal, most of the affected patients had been identified. However, in 2018, additional patients contacted the Inquiry who had not received any communication from Spire about their care.

The Government called an Independent Inquiry. The Inquiry heard that Paterson himself was involved in some of the discussions relating to the earliest recall of patients, thereby jeopardising its independence. A large number of patients were never recalled.

A report from the Independent Inquiry was published in February 2020. This uncovered the magnitude of people affected at the hands of Paterson. The report highlighted the devastation he caused the victims. The opening statement by The Rt Reverend Graham James, Chair to the Inquiry, said:

  • They were initially let down by a consultant surgeon who performed inappropriate or unnecessary procedures and operations.
  • They were then let down both by an NHS trust and an independent healthcare provider who failed to supervise him appropriately and did not respond correctly to well-evidenced complaints about his practice.
  • Once action was finally taken, patients were again let down by wholly inadequate recall procedures in both the NHS and the private sector. The recall of patients did not put their safety and care first, which led many of them to consider the Heart of England NHS Foundation Trust and Spire were primarily concerned for their own reputation.
  • Patients were further let down when they complained to regulators and believed themselves frequently treated with disdain.
  • They then felt let down by the Medical Defence Union which used its discretion to avoid giving compensation to Paterson patients once it was clear his malpractice was criminal. Only by taking their cases to sympathetic lawyers did some patients find themselves heard. By that stage many others found their exhaustion was too great and their sense of rejection so complete that they scarcely had the emotional or physical strength to fight any further.

Reverend James warned: "It is wishful thinking that this could not happen again." The Inquiry found that Paterson "exploited patients’ fear of waiting for treatment and their fear of having cancer." The report heavily criticised Spire for its failure to reach affected patients and for trying to protect its reputation rather than the interests of patients.

Spire Healthcare launched a mass recall of 5,500 former patients, with independent clinicians reviewing their medical records. Some patients are now being told for the first time that they, too, received inappropriate care. Those lawyers who signed up to the deal would have believed that the recall process had been undertaken properly and thoroughly.

Fundamentally, we believe that patients should have full access to justice and be able to choose their own solicitor. Because it did not enter into agreement with Spire, Fieldfisher is not bound by the 2017 settlement.

Find out more about cancer misdiagnosis claims and surgery negligence claims, or read through our medical negligence case studies

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