NHS   (Click to enlarge: opens in new window)

Heather Rawling, Leicester Socialist Party

It is shocking that a doctor, breast surgeon Ian Paterson, subjected more than 1,000 patients, mainly women, to unnecessary and damaging operations over 14 years.

We need full funding and public ownership of the entire health sector. But we must also fight for democratic workers’ control and management to replace unaccountable leaders and the culture of secrecy.

Most of Paterson’s victims were women who had found a lump in their breast or who had already been diagnosed with breast cancer. He cruelly exaggerated the risks to persuade them to have surgery, sometimes several operations.

It’s hard to imagine the worry and stress they and their families experienced, as well as being subjected to needless operations and damage to their bodies.

An independent inquiry showed that his victims were lied to, deceived and exploited. The bishop who chaired the inquiry reported: “The scale of what happened; the length of time this malpractice went on; the terrible legacy for so many families: it is difficult to exaggerate the damage done, including to trust in medical organisations and clinicians.”

Paterson was convicted in 2017, and is serving a 20-year jail sentence for wounding with intent. But that cannot be the end of the matter.

It is worrying that Paterson was able to continue abusing the trust and damaging the bodies of mainly women for so long between 1997 and 2011. It raises the questions, why wasn’t he found out, why wasn’t he stopped? What safeguards are in place to protect patients from rogue doctors and other medical practitioners?

Paterson treated patients both through private practice and the NHS. The victims “were let down time and again,” by Paterson, by both private and public hospitals, and by healthcare regulators who did not take complaints seriously. How can such scandals be prevented in the future?

The NHS, publicly funded and mostly publicly owned, must be defended by the labour movement against attempts to further cut, privatise and undermine it.

Private healthcare increases the possibility of operations being ‘sold’ to patients in pursuit of profits. In the US, healthy women are persuaded to have unnecessary and intrusive vaginal examinations that have no scientifically proved benefits.

And the NHS is hugely underfunded and at breaking point. Healthcare professionals are under enormous pressure, making it more likely for malpractice to be missed or improperly addressed.


Much of Paterson’s most extreme crimes took place in the private sector, which is less accountable than the NHS. Bringing private care into fully integrated public ownership would make it harder for rogue practitioners to slip between the cracks.

But it’s also clear that even if the NHS was adequately funded, this alone would not guarantee that patients couldn’t be abused in the future.

There needs to be democratic accountability. This must include elected representatives of patients, healthcare practitioners and support workers, and the wider community controlling the health service, including budgets, hiring, and other policy.

A vigorous campaign is needed to defend the NHS, spearheaded by the unions. The Trade Union Congress should lead it, but the unions organised in the NHS, and campaigning community organisations, must also fight for its future.