Personal Injury, Serious Injury & Clinical Negligence

Ou est la docteur? – the perils of health tourism

The South Kent Care Commission Group (“the CCG”) has announced a deal with Centre Hospitalier de Calais (“Centre Hospitalier”) under which the French hospital will provide surgery to NHS patients in a bid to cut down waiting times. For many Kent residents it can be quicker and easier to travel to Calais than London and the CCG plans to take full advantage of its geographical position. But what does this mean for patients?

The CCG and Martin Treclat, General Manager for Centre Hospitalier, are keen to reassure patients that the quality of care will equal that to hospitals back home in Kent. Hazel Carpenter, Chief Accountable Officer for the South Kent CCG said “We carried out a careful assessment of the services they offer and are visiting sites”, whilst the investment from the French side includes providing English lessons to around 70 nurses to ensure that patients can communicate with their care givers.

Not all patients will have the option of travelling to France for faster treatment. The proposal applies only to general surgery, gynaecology, cataract surgery, pain management and orthopaedics. Patients will be able to access the scheme through their GP, who will presumably make the request via the CCG.

But matters are not quite as straightforward as the CCG make out. Contracting overseas and private health providers to perform NHS services has for a long time been under scrutiny, and for good reason:

Cost

Any patient undergoing treatment in Calais will be required to fund their own travel. The CCG has not released details as to where pre and post operative assessments will be carried out, but if this is to be in France, this could mean 3 return trips to France at the expense of the patient.

One also has to question the value for money to the NHS in contracting out this treatment. Centre Hospitalier will not have tendered for the contract if it was not financially beneficial, and whilst no details have been released as to how much the NHS will pay per patient, you would expect the NHS to be shouting from the rooftops if this project offered a cost saving. Who is really winning out of this deal?

Quality of Care

There is nothing to suggest that the quality of the surgery and care in France is substandard compared with the NHS. However, the CCG has not announced what post operative follow up will be available to patients, where this will be given or what will happen if something goes wrong. If a complication arises when the patient is back in the UK, will the Kent hospitals have capacity to treat this unexpected patient or will they be required to travel to France to obtain the follow up treatment they need?

Centre Hospitalier De Calais have themselves said that whilst they would offer follow up consultations, it is a long way to travel for a 10 minute appointment.

There is also no current plan as to how patient’s medical records will become available to French doctors or indeed how they will be transferred back in the event that the patient needs urgent care in the UK. The benefit of cutting waiting times will be undone if patients turn up to an outpatient appointment and their records are the other side of the Channel.

Complications

The announcement is not clear if both major and minor surgery is going to be performed in France. If major operations are to be carried out, patients may be put at risk by having to arrange their own transport back from France. Patients are discharged from hospital when they are medically fit, but this does not necessarily mean that they should be taking a long ferry or train journey. The nature of such journey increases the risk of complications such as infection, damage to wounds and general fatigue.

Hospitals in England have a duty to ensure that their patients have appropriate transportation to their home, but under this agreement, that responsibility is passed to the patient and once they are discharged by French doctors, Calais are no longer responsible for the wellbeing of that patient. The patient is in limbo, with reliance upon no healthcare professional, whilst crossing the channel.

Responsibility

Outsourcing NHS services has come under scrutiny due to its ongoing use as a method of limiting the NHS liability for failings and negligent treatment. Whilst a patient’s treatment would be funded by the NHS, there is scope to argue that as treatment will be performed by French doctors, at a French hospital which operates as a private institution, the NHS would not be responsible for any claims if the treatment goes wrong.

Patients then have the added difficulties associated with a cross border legal dispute in a country where clinical negligence laws may not be as favourable to patients as those in the UK.

Clarke Willmott has been instructed in a number of clinical negligence cases this year alone whereby Claimants have suffered harm as a result of private outsourcing, and where the NHS is trying to rely on the actions of others to avoid liability for any claim arising.

So, the CCG may be offering a route to faster treatment, but is it a case of “good things come to those who wait?” With the first patients expected to board the ferry in December 2015 it will be a year before we know if this proposal is effective, but patients should think carefully before placing themselves outside of the hands of the NHS.

If you or anyone you know has been affected by negligent treatment whilst in hospital, speak to one of our specialist medical negligence lawyers on 0800 316 8892.