Monday 27 May 2019

, Stealing from the Public Purse - The Scandal of Prince Philip Hospital''s "Extra Benefits in Kind"

Wales is said to be infamous for wasting public money. The Assembly, the County Councils, The National Health Service, various UK and EU grant funding bodies often find their public money is not all spent as intended. A few weeks ago I was at an international women's day event and intended to talk about my own experience of being a female surgeon, a career cut short by the greed of my male colleagues.

I had explained that after spending most of my childhood and a university education in England I finally returned to Wales. I was about to tell the story about how I was forced out of my  Consultant job by a group  of greedy scumbag consultants who used  NHS facilities , hardware, drugs and investigations etc for their private patients for free, and must have pocketed quite a few grand on a regular basis .

 The management colluded with these men who presumably made a far bigger profit from their private patients than they would otherwise. In my time at Prince Philip Hospital senior female doctors were sometimes treated quite contemptuously and one other female consultant was also forced out of her job. This left only a single female consultant in the hospital. I'm sure things must be better now?

However, as I started to speak I recalled that an earlier speaker had told a moving story of her battle with breast cancer. She needed a special test not available on the NHS which cost a thousand pounds.
Don't worry, said the kindly consultant , I'll  pay for it for you, he said, provided you don't mention it to my wife!.

This was one of doctors on the scam that had ended my career and I was going to mention him. I couldn't help but speculate how much of that £1,000 had actually been filched from the public purse. The doctor himself had sought me out when the scandal broke to explain that he was not as much of a scumbag as the others. When he was doing purely cosmetic operations he insisted , he said, on paying for the breast implants

No great pain to him, of course, as the ladies improving the size of their boobs would have paid him the going rate for the job lot anyway. He would just have got free use of the theatre, drugs, anaesthetics, etc  and less of a "profit" at public expense. His level of morality was that he would not rob quite as much from the public purse when the patient  was having cosmetic work done by him  in an NHS hospital She would pay for the implants which he could have got for free. He told me he found he was not being invoiced for the £800 silicone implants by the hospital, and had insisted on being charged for them from then on.

A theatre nurse later told me that he occasionally used the weekend "on call" theatre, where staff awaiting emergencies,(who were  not paid anything extra at the time for the private work) assisted him Emergency cases were rare at weekends in Llanelli, with a relatively few cases per day, you could get away with fitting in a short operation usually. One day, she recalled, an emergency appendectomy case came in  during a boob job. The team were said to be under considerable pressure to get the lady "ofF the table" Luckily the sick patient did get their operation before the appendix burst, but the situation was very uncomfortable.
Prince Philip Hospital

My orthopaedic colleague forced me to go public on the scam when he not only substituted his own private patients ahead of his own NHS patients ,many of whom has waited a long time in pain, but started to discharge my patients awaiting operations,  to admit his own private patients. To my shame I knew it was going on but did not know the extent if it, The medical director explained that we needed to attract private work into the hospital to help pay the bills, he just didn't specify whose bills. I assumed the  the hospital was informed where patients were private and  charging fully for all their services. Far from it.

I find greed particularly disturbing in those with already healthy salaries and good, secure jobs. Those consultants who got carried away with their greed, and especially when they displaced urgent NHS patient cases to line their own pockets were particularly deplorable. The management were totally complicit and knew all of what was happening. I was only ignorant because I never did any private practice and was happy with my salary. I never asked for extra increments on my salary nor asked for free use of NHS  facilities, goods and services. Many of colleagues, it seems, did both.
So I decided not to mention Mr Simon Holt in my "inspirational speech" which became quite disjointed as I self censored more than half of it. It was not the occasion, celebrating women, to "out" him as one of the many parasites I worked with in the health service, especially in the presence of lady who thought so much of him,  I hope he is "being good" now.

 The Scam was said to be quite legal because the hospital management gave the NHS implants, beds and facilities away freely in order to keep the Surgeons and anaesthetists happy  For them it was a staff retention scheme, explained to me as "undeclared benefits in kind", I bet they were not taxed so possibly not as legal as they claimed.  The chief executive of the time was asked to resign, the chair was not reappointed, but no doctors were disciplined  after the misuse of NHS services was exposed.

Auditors would surely assume all medical implants eg hip replacements, purchased by a hospital would be used on NHS patients, and all theatre cases were NHS patients. In my day I found serious deception, where private patients were not declared and extensive theatre records, the operation log books, were "lost" before the Audit Commission arrived to check out the hospital. It was hard for the authorities to find out what had actually happened and how much had been lost to the NHS.

I'd like to think that these things don't happen any more, but I am suspicious that they may. Greedy people in authority can often find ways to line their pockets. Clever doctors did persuade the management that they really need an "extra something" to stay in such a god forsaken place as West Wales and if other surrounding Health Boards had similar incentives, as claimed, it did put the management in a difficult situation.

I even think the private patients were exploited in this scam, as they were surely overcharged for operations which the NHS and their taxes were subsidising?

When I was assessed by the GMC  (the then  medical director, Dr Peter Thomas reported me as incompetent when I declined  his offer to leave quietly) the GMC assessors agreed I needed some refresher training (I had been suspended for 3 years) and advised me to leave Wales to get it, the inference being that such scams were common here and surgeons and management  in England were far more moral.

 The truth of this. I never looked into.  My father who had moved to Wales to retire was dying, my mother was not coping well, my partner and I split up, and I had 4 children in local school, I wanted to stay.  It felt like the bandits, not the sheriff running you out of town. I was severely depressed for several years following the whole unpleasant experience but I have now recovered.

 I have stayed in Wales.

Several of my colleagues had promised me I would never work again, I didn't believe them but the Health Board  and my colleagues did refuse to give me any references. I did try to find refresher training work in the Welsh NHS but found myself essentially blacklisted. Whistle blowers usually do get their careers destroyed and I was no exception.

 Now, if well payed,valued and respected workers in the public sector need extra money from quiet  and management endorsed theft , especially when it may affect the quality of  care of patients on the waiting lists, what sort of example is that to our Nation?. Some time ago our local MP was criticised for claiming a modest kettle on her  MP expenses. Clearly a £1500 hip replacement implant  disappearing from a theatre shelf was much easier to hide!.

I would like to think that these practises are long gone. I left the NHS in 2005 and I would like to think that the Hywel Dda and other health boards are now squeaky clean and these scams are a thing of the past..

If you know differently, I would be happy to confidentially hear your stories.

Siân Caiach

Parc Farm House,
Trimsaran Road,
Llanelli SA15 4RD    01554 785046