Helen Puttick

Why not say all surgeons who wish to undertake private practice have to participate in a national audit?

I HAVE been following the twists and turns of the medical tribunal into the performance of spinal surgeon Colin Campbell Mainds for many months now. Given the stops and starts all those anxious about the outcome have endured since last autumn at least four words published by the tribunal panel last week should have come as a relief: “That concludes this case.”

The trouble is that, for many patients, the hearing which found Mr Mainds failed in his care of nine patients is only the beginning. When The Herald broke the story I began receiving phone calls and emails from other people unhappy with the outcome of treatment provided by Mr Mainds – more than I remember a headline prompting before. One patient Scott Holt, dates from 1997.

Other newspapers have now started reporting calls from unhappy patients too. Including some people who have rang me anonymously and the nine people who gave evidence at the hearing, I put the number close to 30. Apparently the GMC now has fresh complaints about Mr Mainds to consider, so the case feels far from over.

But there are other loose ends too. The circumstances in which Mr Mainds worked were unusual. From 2005 he was not employed by the NHS. I am told it is normal for orthopaedic surgeons including spinal specialists in NHS hospitals to be part of a team and to have agreed a performance monitoring system – such as regularly presenting results to each other.

Outside individual hospitals there are national audits in which surgeons can participate, one for hip and knee replacements, for example, which looks at rates of revision operations for all participants.

I have long been impressed by the willingness of some parts of the medical community to scrutinise how patients were looked after to see if there could be improvements and this is growing. A system for reviewing spinal surgery is new. It seems this kind of submission of results to flag potential areas of concern as well as good practice from which all can learn is a sensible approach.

What sort of audit did Mr Mainds participate in? We can’t be sure. A letter from January 2009, seen by The Herald, said Ross Hall did not hold individual consultant’s practice audit results or patient-reported outcome data on spinal surgery.

I have been impressed by the willingness to scrutinise to see if there could be improvements

Things may well have changed at the hospital. I hope so, not only because some of the witnesses at the tribunal were operated on by Mr Mainds at Ross Hall that year, but also because in 2013 that situation sounds dated. Why not, in the wake of the Mainds tribunal, say that all surgeons who wish to undertake private practice have to participate in a form of national audit covering their speciality? Why aren’t private providers boasting that this is what all their staff do and providing patients with their results?

When the NHS sends patients to private hospitals, as it does to Ross Hall, it needs to be able to tell them it knows safety nets are equally good if not better. Can it do that in the wake of the Mainds case?

There is a lot of excellent care by excellent surgeons in the NHS and independent sectors, but I dread another story about a consultant somewhere in the UK who worked entirely outside of the NHS.