Category Archives: Diet & Fitness

Working in healthcare over Christmas and new year? Tell us your stories

This Christmas and new year, millions of healthcare professionals across the world will turn up to work as normal.

While treating people at their most vulnerable can be difficult and sad, working over the festive period can also be uplifting. Hospital wards are decked with tinsel and Christmas trees, choirs sing carols and there’s an abundance of chocolates. Meanwhile, staff might help deliver babies, save someone’s life or simply be there for a person in need.

Are you a healthcare professional who has worked at Christmas and/or new year? We want to hear about it. What have been your memorable moments? What’s the atmosphere like? How did you feel working over the festive season? Have you witnessed or been part of any Christmas or new year miracles? What is different about working at this time?

Please fill in the form below and tell us about your experiences of working at Christmas. A selection of responses will be used in our reporting. You can remain anonymous if you wish.

Have you been rejected by insurers because of mental health problems?

If you have a mental health condition it can be harder to get insurance and in some circumstances you have to pay more.

However, this should only be the case if the insurer can provide evidence that you are at a higher risk of making a claim and if the information they used to access your application was applied in a reasonable way.

Earlier this year travel insurance companies were accused of discriminating against people with mental health problems after a young woman was refused cover when she revealed that she had bipolar disorder.

What are your experiences?

We want to know whether other people feel they have been discriminated in this way. Have you found it harder to get any kind of insurance – travel, health, life – even though there is no evidence you are higher risk? Do you feel you were unfairly treated? Does the current system work for those with mental health problems? Share your views, experiences and stories and we will use a selection in our reporting.

  • Your responses are secure as the form is encrypted and only the Guardian has access to your contributions. We will do our best to keep you anonymous.
  • If you’re having trouble using the form, click here

Portugal shows the way ahead on drugs policy | Letters

The driving force behind Portugal’s capacity to rescue itself from the throes of an opioid crisis is an emphasis on personalised care that galvanises the community and functions conterminously with the decriminalisation of all substances (The big fix: Portugal’s truce on drugs, 5 December). Crucially, Portugal’s radical policy has gone some way to eradicate the taboo on drug misuse. This cultural shift highlights the very tangible affects of ostracising users from the local community, be it through labelling them with derogatory language – “junkie” or “smackhead” etc – or by deeming them antisocial criminals.

As the UK sinks further into its opioid epidemic, the necessity of radically reforming its legal, political and sociocultural policies on drugs is pushed further to the fore. This means shifting the emphasis from criminalisation to healthcare, increasing public spending on health services, and encouraging communal support for drug users.
Yasmin Batliwala
Chair, WDP drug and alcohol charity

Congratulations on your long read on Portugal’s drugs policy. This should be required reading for policymakers who have refused to base drug and addiction policy on evidence. A young man I know has been to prison 11 times in the last three years. On each occasion the offences have been directly linked to drug and alcohol addiction. The young man is homeless and leaves prison, without meaningful support, to life on the street and a seemingly inevitable return to prison.

At the very least the government should be consulting evidence, and recognising that the justice system is failing addicts and the taxpayer.
Ian McCauley
Reading, Berkshire

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Portugal shows the way ahead on drugs policy | Letters

The driving force behind Portugal’s capacity to rescue itself from the throes of an opioid crisis is an emphasis on personalised care that galvanises the community and functions conterminously with the decriminalisation of all substances (The big fix: Portugal’s truce on drugs, 5 December). Crucially, Portugal’s radical policy has gone some way to eradicate the taboo on drug misuse. This cultural shift highlights the very tangible affects of ostracising users from the local community, be it through labelling them with derogatory language – “junkie” or “smackhead” etc – or by deeming them antisocial criminals.

As the UK sinks further into its opioid epidemic, the necessity of radically reforming its legal, political and sociocultural policies on drugs is pushed further to the fore. This means shifting the emphasis from criminalisation to healthcare, increasing public spending on health services, and encouraging communal support for drug users.
Yasmin Batliwala
Chair, WDP drug and alcohol charity

Congratulations on your long read on Portugal’s drugs policy. This should be required reading for policymakers who have refused to base drug and addiction policy on evidence. A young man I know has been to prison 11 times in the last three years. On each occasion the offences have been directly linked to drug and alcohol addiction. The young man is homeless and leaves prison, without meaningful support, to life on the street and a seemingly inevitable return to prison.

At the very least the government should be consulting evidence, and recognising that the justice system is failing addicts and the taxpayer.
Ian McCauley
Reading, Berkshire

Join the debate – email guardian.letters@theguardian.com

Read more Guardian letters – click here to visit gu.com/letters

Brain drain: our default responses to flu | Daniel Glaser

I’ve been laid up with flu and as I return to full cognitive function, I’ve been pondering the neuroscience. A fever’s tweak to your temperature regulation circuits triggers not only shivering, but also indirect loops. ‘Feeling’ cold can make you turn up the thermostat, grab blankets and take to your bed.

It’s not clear whether it’s the bug or your defences that are in control, but using your body as a laboratory, it’s fascinating to wait for the paracetamol to work. When it hits you suddenly start sweating and kick off the covers as your hypothalamus catches on to the actual temperature of your body.

Researchers have been looking at external signs, too. Evidence suggests the walking patterns, sweat and facial expression of sufferers can reflect their infection before even they are aware of it. This may help others to steer clear.

Internet activity is a promising avenue, too. The ‘Google flu trends’ project is currently suspended, in public at least, pending improvements. But within the rich mine of subconscious information we reveal through our searches, we perhaps find the earliest traces of infection. Keep well, everyone.

Dr Daniel Glaser is director of Science Gallery at King’s College London

Scientists trace 2002 Sars virus to colony of cave-dwelling bats in China

Scientists have pinpointed a population of virus-infected bats, which they have linked to the mysterious outbreak of Sars disease 15 years ago. Hundreds died as the virus spread around the globe but its source was never traced.

Now, after years of searching across China, where the disease first emerged, researchers reported a few days ago that they had found a remote cave in Yunnan province, which is home to horseshoe bats that carry a strain of a particular virus known as a coronavirus. This strain has all the genetic building blocks of the type that triggered the global outbreak of Sars in 2002.

“This will certainly not be the only cave that contains bats infected with these strains of virus, but it is really important that we have found the first one,” said Sars expert Jeremy Farrar, director of the Wellcome Trust. “Samples from these bats will make it much easier to develop a vaccine for the disease and help us be prepared for another outbreak.”

Severe acute respiratory syndrome (Sars) first appeared in November 2002 in southern China and spread around the world – often carried by airline travellers – and eventually killed more than 750 people in 37 countries. It was contained by placing patients in quarantine. The outbreak ended in 2004 and the disease has never resurfaced.

But scientists have always feared that Sars could reappear. Hence the efforts of Chinese scientists – led by Shi Zheng-Li and Cui Jie of the Wuhan Institute of Virology, China – to trace the source of the outbreak. Scientists initially suspected that civet cats, sold in markets in China, were the source of the virus but later turned their attention to bats, which they realised were the prime source of the virus. Civets were merely an intermediary.

In their study – published in the journal Public Library of Science Pathogens – the Wuhan team reveals that by sequencing the genomes of the different strains of the virus found in horseshoe bats in the cave they found these contained all the genetic pieces that make up the version of Sars virus that caused the 2002 outbreak.

These strains often mix and could have produced a strain that caused the Sars outbreak. “This was a really heroic effort by the team of scientists involved,” said Farrar.

“Finding these caves and getting sample from bats inside them would have been very hard and dangerous work. However it was definitely worth it. Sars is a horrible disease and extremely dangerous.

“There is no effective treatment and no vaccine. It was only contained the last time because it was possible to quarantine people while they were still infectious. Now we have a chance to create vaccines and treatments.”

In their paper, the Chinese team warn that another deadly outbreak of Sars could emerge at any time. As they point out, the cave where they discovered their strain is only a kilometre from the nearest village. The risk of people becoming infected is a definite possibility, they stress.

“However, this is good news overall,” saidd Farrar. “We now have something concrete to work on, and I applaud the openness of these Chinese scientists in sharing their work and – I hope – these virus strains.”

Alarm over restraint of NHS mental health patients

Patients in mental health units were physically restrained by staff more than 80,000 times last year in Britain, including 10,000 who were held face down or given injections to subdue them, new NHS figures show.

Girls and young women under the age of 20 were the most likely to be restrained, each being subjected 30 times a year on average to techniques that can involve a group of staff combining to tackle a patient who is being aggressive or violent.

Black people were three times more likely to be restrained than white people, according to the first comprehensive NHS data on the use in England of such techniques, which have provoked controversy for many years.

Mental health campaigners fear that the use of such force can cause patients physical harm or revive painful memories of the trauma that many have suffered in childhood.

The figures, published by the NHS Digital statistical agency, show that the 80,000 uses of restraint in 2016-17 included patients being subjected to “prone” restraint – being held face down – 10,000 times, and patients being controlled by “non-prone” physical force 43,000 times. Chemical restraint was used on another 8,600 occasions.

The findings have prompted fresh concern among mental health experts that too many patients are still being restrained, despite moves by the government and NHS in recent years to reduce the incidence.

“It is troubling to see how prevalent the most severe, and dangerous, kinds of restraint are in the mental health system,” said Brian Dow, director of external affairs at the charity Rethink Mental Illness. Prone restraint, he warned, “can be terrifying and badly damage someone’s recovery”.

NHS Digital’s figures were published in the recent annual mental health bulletin detailing activity and treatment in NHS mental health units in England. They show that:

■ Black people were more than three times more likely to be restrained than white people.

■ Prone restraint, which guidance says should be used only in life-threatening situations, is used on fewer women than men, but is used on the former more often; women are physically subdued multiple times.

■ Mechanical means of restraint were used 1,200 times, seclusion on 7,700 occasions and segregation 700 times.

Katharine Sacks-Jones, the director of Agenda, an alliance of 70 organisations working with women and girls who are at risk, said: “It’s completely unacceptable that so many women and girls are being restrained over and over again.

“The picture for girls and young women is particularly alarming, with those under 20 subjected to restrictive practices nearly 30 times each on average, the majority of these being incidents of physical and face-down restraint.

“More than half of women who have mental health problems have experienced abuse, so not only is restraint frightening and humiliating, it also risks retraumatising them.”

In its annual report in July, the Care Quality Commission, which regulates NHS care in England, said its inspectors had found unwarranted and wide-ranging variation between units in terms of how often staff used restraint. Wards with low rates had staff who had been trained to handle difficult behaviour and de-escalate challenging situations.

But, the CQC added, mental health wards dealing with acutely unwell patients are high-risk environments where patients can regularly be violent towards staff or fellow patients. The number of times restraint techniques are used has risen from 781 per 100,000 bed days in 2013-14 to 954 per 100,000 bed days last year. However, use of face-down restraint has fallen, from 231 incidents per 100,000 bed days in 2014-15 to 199 incidents per 100,000 bed days in 2015-16.

The Department of Health said that its guidance, issued in 2014, stressed that restraint should be used only if other means of dealing with difficult situations were unlikely to succeed.

“Physical restraint should only be used as a last resort and our guidance to the NHS is clear on this – anything less is unacceptable,” a spokeswoman said. “Every patient with mental health issues deserves to be treated and cared for in a safe environment. We are working actively with the CQC to ensure the use of restraint is minimised.”

The bulletin also reveals that almost one in 20 people in England received NHS help last year for mental health problems.

A total of 2,637,916 people – 4.8% of the population – were in contact with secondary mental health, learning disabilities and autism services at some point. Of these, 556,790 were under 18.

In addition, 101,589 (3.9%) of those 2.6 million patients ended up in hospital receiving treatment.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

US prisoner gouged out eyes after jail denied mental health care, lawsuit says

A mentally ill Colorado prisoner gouged his eyes out and became permanently blind after jail officials repeatedly denied him treatment for psychosis despite multiple suicide attempts, according to a lawsuit.

Ryan Partridge, 31, sued Boulder law enforcement officials on Thursday, alleging that while he was jailed for months for minor offenses that were later dismissed, officers ignored numerous acts of self mutilation and responded to delusional episodes by beating and tasing him. Officials also ignored a judge’s emergency order to get Partridge psychiatric treatment, leaving him alone in his cell where he “plucked out his own eyeballs”, the suit said.

His case appears to be a particularly gruesome example of the way Americans with mental illness struggle to get help, and can end up in jails and prisons that punish them with cruel treatment and refuse to provide medical services.

“I hope that things will change, not just for people with mental disorders, but for the people in disciplinary,” Partridge said by phone, explaining how solitary confinement and other punishments exacerbated his mental illness. “Getting tased and beaten, all that is stressful. What can be worse than that is the delusion that arises in isolation.”

Boulder County sheriff’s officials called the allegations “untrue and incomplete” in a statement, but did not comment on any specific claims.


Getting tased and beaten, all that is stressful. What can be worse than that is the delusion that arises in isolation

Ryan Partridge

Partridge began suffering from schizophrenia in his late 20s, and his parents were repeatedly forced to call the police due to violent outbursts, the suit said. The Boulder native was in and out of jail for minor offenses related to mental illness – all misdemeanors, such as loitering, trespassing and mischief – and at one point, he was homeless, Lane said.

Jail records show that Partridge was experiencing psychosis in early 2016 when he reported that he was going to gouge out his eyes and banged his head into a toilet, leaving him bloodied and with broken teeth, according to the lawsuit.

Although Partridge told a mental-health worker that he had suicidal thoughts and officials were aware of his psychosis, deputies repeatedly responded to him with violence, the suit said. One deputy allegedly punched and tased him and sent him to a “secure disciplinary cell” in March of 2016.

Although a judge ordered that he should be sent to a state mental hospital, Partridge remained at the jail and was again punched and tased when he ignored orders, according to the complaint. When two deputies later saw Partridge attempting to gouge out his eyes, they put him in a “restraint chair”, placed a “spit sock” over his head and tased him, the suit said.

Ryan Partridge with his mother Shelley five years ago.


Ryan Partridge with his mother Shelley five years ago. Photograph: Courtesy of family

After a brief stay at a community hospital, he was sent back to jail, where he was suffering from increasingly intense paranoia.

On 1 November 2016, during a psychotic episode, Partridge attempted suicide by climbing to the top of a second-floor railing in the jail and jumping head first to the ground, smashing his head on a table and cement floor and suffering broken vertebra, the suit said. He tried to jump again from the same railing a month later before guards stopped him.

One deputy began mockingly referring to him as “Parachute Partridge”, the suit said.

Despite the suicide attempts and injuries, a mental health worker and a sergeant concluded he was “not a risk to himself and that the jump was merely an attention-seeking behavior”, his lawyers wrote.

Partridge said in an interview that spending so much time alone, unable to talk to his parents or attorneys, was deeply harmful to his mental state: “It’s just very difficult psychologically … That led to more delusional thinking.”

As his mental health deteriorated toward “severe insanity”, the jail ignored a court’s emergency order and his parents’ pleas to hospitalize him, the lawsuit said.

“I’ll never forget the feeling of literally knowing my son is being abused and tortured and I can’t do anything to stop it,” his father Richard Partridge said by phone.

He ultimately gouged his eyes out with his fingers in December, and when deputies discovered him in his cell with his eyes swollen shut and blood on his hands, they proceeded to try and handcuff him before slamming him to the ground and tasing him, the suit alleged. Eventually, he was taken to a hospital and released from jail.

Commander Mike Wagner of the Boulder sheriff’s office said the department can’t comment on pending litigation or an inmate’s health, but said some of the claims were false, adding in a statement, “We are aware of the very difficult circumstances surrounding Mr Partridge’s time in-custody at the Boulder County jail. Our mental health professionals, deputies, and staff faced very difficult situations involving Mr Partridge, and went above and beyond in trying to assist him during his time in-custody.”

Partridge’s attorney David Lane said he hoped the lawsuit sparked national reforms: “We want to send a message to jails and prisons across this country that deliberate indifference to the mental health needs of inmates will be so costly. … Tasing and beating does not count as rendering aid or assistance to someone suffering from a psychotic break.”

Richard Partridge said the public needed to understand that schizophrenia is a disability and argued that the government should not incarcerate people for mental illness: “You can take a sane person, and if you treat them inhumanely, they can take out their eyes as well.”

The former inmate is now living with his family, and he said his mental health has dramatically improved. The damage to his eyes, however, was so severe that no surgery could bring his vision back, according to doctors.

He said he is slowly adjusting to blindness: “It’s a different form of solitude. I feel alone even when I’m around people.”

Contact the author: sam.levin@theguardian.com

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

US prisoner gouged out eyes after jail denied mental health care, lawsuit says

A mentally ill Colorado prisoner gouged his eyes out and became permanently blind after jail officials repeatedly denied him treatment for psychosis despite multiple suicide attempts, according to a lawsuit.

Ryan Partridge, 31, sued Boulder law enforcement officials on Thursday, alleging that while he was jailed for months for minor offenses that were later dismissed, officers ignored numerous acts of self mutilation and responded to delusional episodes by beating and tasing him. Officials also ignored a judge’s emergency order to get Partridge psychiatric treatment, leaving him alone in his cell where he “plucked out his own eyeballs”, the suit said.

His case appears to be a particularly gruesome example of the way Americans with mental illness struggle to get help, and can end up in jails and prisons that punish them with cruel treatment and refuse to provide medical services.

“I hope that things will change, not just for people with mental disorders, but for the people in disciplinary,” Partridge said by phone, explaining how solitary confinement and other punishments exacerbated his mental illness. “Getting tased and beaten, all that is stressful. What can be worse than that is the delusion that arises in isolation.”

Boulder County sheriff’s officials called the allegations “untrue and incomplete” in a statement, but did not comment on any specific claims.


Getting tased and beaten, all that is stressful. What can be worse than that is the delusion that arises in isolation

Ryan Partridge

Partridge began suffering from schizophrenia in his late 20s, and his parents were repeatedly forced to call the police due to violent outbursts, the suit said. The Boulder native was in and out of jail for minor offenses related to mental illness – all misdemeanors, such as loitering, trespassing and mischief – and at one point, he was homeless, Lane said.

Jail records show that Partridge was experiencing psychosis in early 2016 when he reported that he was going to gouge out his eyes and banged his head into a toilet, leaving him bloodied and with broken teeth, according to the lawsuit.

Although Partridge told a mental-health worker that he had suicidal thoughts and officials were aware of his psychosis, deputies repeatedly responded to him with violence, the suit said. One deputy allegedly punched and tased him and sent him to a “secure disciplinary cell” in March of 2016.

Although a judge ordered that he should be sent to a state mental hospital, Partridge remained at the jail and was again punched and tased when he ignored orders, according to the complaint. When two deputies later saw Partridge attempting to gouge out his eyes, they put him in a “restraint chair”, placed a “spit sock” over his head and tased him, the suit said.

Ryan Partridge with his mother Shelley five years ago.


Ryan Partridge with his mother Shelley five years ago. Photograph: Courtesy of family

After a brief stay at a community hospital, he was sent back to jail, where he was suffering from increasingly intense paranoia.

On 1 November 2016, during a psychotic episode, Partridge attempted suicide by climbing to the top of a second-floor railing in the jail and jumping head first to the ground, smashing his head on a table and cement floor and suffering broken vertebra, the suit said. He tried to jump again from the same railing a month later before guards stopped him.

One deputy began mockingly referring to him as “Parachute Partridge”, the suit said.

Despite the suicide attempts and injuries, a mental health worker and a sergeant concluded he was “not a risk to himself and that the jump was merely an attention-seeking behavior”, his lawyers wrote.

Partridge said in an interview that spending so much time alone, unable to talk to his parents or attorneys, was deeply harmful to his mental state: “It’s just very difficult psychologically … That led to more delusional thinking.”

As his mental health deteriorated toward “severe insanity”, the jail ignored a court’s emergency order and his parents’ pleas to hospitalize him, the lawsuit said.

“I’ll never forget the feeling of literally knowing my son is being abused and tortured and I can’t do anything to stop it,” his father Richard Partridge said by phone.

He ultimately gouged his eyes out with his fingers in December, and when deputies discovered him in his cell with his eyes swollen shut and blood on his hands, they proceeded to try and handcuff him before slamming him to the ground and tasing him, the suit alleged. Eventually, he was taken to a hospital and released from jail.

Commander Mike Wagner of the Boulder sheriff’s office said the department can’t comment on pending litigation or an inmate’s health, but said some of the claims were false, adding in a statement, “We are aware of the very difficult circumstances surrounding Mr Partridge’s time in-custody at the Boulder County jail. Our mental health professionals, deputies, and staff faced very difficult situations involving Mr Partridge, and went above and beyond in trying to assist him during his time in-custody.”

Partridge’s attorney David Lane said he hoped the lawsuit sparked national reforms: “We want to send a message to jails and prisons across this country that deliberate indifference to the mental health needs of inmates will be so costly. … Tasing and beating does not count as rendering aid or assistance to someone suffering from a psychotic break.”

Richard Partridge said the public needed to understand that schizophrenia is a disability and argued that the government should not incarcerate people for mental illness: “You can take a sane person, and if you treat them inhumanely, they can take out their eyes as well.”

The former inmate is now living with his family, and he said his mental health has dramatically improved. The damage to his eyes, however, was so severe that no surgery could bring his vision back, according to doctors.

He said he is slowly adjusting to blindness: “It’s a different form of solitude. I feel alone even when I’m around people.”

Contact the author: sam.levin@theguardian.com

  • In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Inquiry announced into case of rogue surgeon Ian Paterson

The government will launch an independent national inquiry into the actions of the rogue surgeon Ian Paterson, who was sentenced to 20 years in jail in August after carrying out needless surgery on patients who were left traumatised and scarred.

The inquiry will begin in January and report in the summer of 2019, and will be chaired by the Right Rev Graham James, the bishop of Norwich.

Paterson, a consultant breast surgeon at the Heart of England NHS foundation trust (HEFT) who practised privately at Spire Parkway and Spire Little Aston, was found guilty in April of 17 counts of wounding patients with intent.

The NHS has paid out almost £10m in compensation to more than 250 patients, and Spire healthcare agreed in September to settle a further 750 cases.

The government said the scope of the investigation would include the independent sector, and it would examine whether the Care Quality Commission’s inspection regime needed to be strengthened.

The health minister Philip Dunne said he was determined that lessons would be learned so that similar problems could be avoided in both the NHS and the private sector.

Concerns were raised about Paterson as far back as 2003 but, despite several internal and external investigations and complaints from patients, GPs and other surgeons, the General Medical Council did not suspend him until 2011.

Dunne said: “Ian Paterson’s malpractice sent shockwaves across the health system due to the seriousness and extent of his crimes. I believe an independent, non-statutory inquiry, overseen by Bishop Graham James, is the right way forward to ensure that all aspects of this case are brought to light and lessons learned so we can better protect patients in the future.”

Lawyers for Paterson’s victims said they were disappointed that the inquiry would not be statutory and would not have the power to force people to give evidence under oath or give binding recommendations.

“We have previously expressed doubt in the current government’s political commitment to take on and tackle failings of the private health sector that were so vividly exposed in this terrible case,” said Tom Jones, the head of policy at Thompsons Solicitors, which represented about 500 victims. “Our concerns are reinforced by the potential for this inquiry to kick the can down the road and whose recommendations will not be binding.”

Kashmir Uppal, of Access Legal, said the inquiry was a “positive step” but victims were disappointed and concerned. “The government has said patients’ interests will be put at the heart of this inquiry and so it must take place in public and fully expose the failings that allowed Ian Paterson to continue practising in the private sector long after concerns were raised about him.”

James, the inquiry chair, said serious questions remained unanswered. “It is vital that the inquiry be informed by the concerns of former patients of Ian Paterson and their representatives,” he said. “The interests of all patients, whether they seek treatment in the NHS or the private sector, should be at the heart of this inquiry.”

The government said the inquiry would consider oversight of care in the private sector, the sharing of complaints between private hospitals and the NHS, the role of private health insurers, and arrangements for medical indemnity cover for clinicians in the private sector.

One of Paterson’s former patients, Sarah Jane Downey, said she was pleased the inquiry would report quickly, but she shared the concerns of other victims. “It worries me that the inquiry won’t have the ability to compel witnesses. We know there were people who aided and abetted Paterson and they need to answer questions,” she said. “It is a worry that it could be toothless.”

Spire Healthcare, which runs Parkway and Little Aston hospitals, where Paterson practised, initially argued that as Paterson was not technically its employee, it was not responsible for his actions.

In September, it agreed to settle all claims against it relating to Paterson, paying £27.2m into a £37m fund, with the balance funded by Paterson’s insurers and the Heart of England trust.