Who’s driving your ambulance?

4 July 2012

Private contracts in public sector healthcare: where does accountability lie?

The delivery of healthcare services to vulnerable people is always under scrutiny, especially when things go wrong and a patient suffers as a result of negligent treatment.

But what happens when a patient is injured by a service that has been sub-contracted out to a private company?

We recently acted for the family of an elderly lady, who had been in hospital for three months following a stroke, and  sustained serious injuries whilst being transferred in an ambulance from an NHS hospital to a nursing home.

Unknown to the family or the patient, the NHS hospital had a contract with a third party ambulance company to provide non-emergency patient transport.  This service was run and administered from within the hospital's transport department. It was this third party ambulance company which was going to transfer the patient to the nursing home.  They did not, however, reach their destination. The driver failed to strap her into the wheelchair. As a result, during the course of the journey, she fell out of the chair and sustained spinous fractures to her neck vertebrae together with cuts and bruises to her face and body.

She was extremely traumatised by the accident and had to be readmitted to hospital. She died less than 3 weeks later.

The family were outraged to discover that the NHS hospital refused to accept liability for this accident. It appears that in this case the NHS was all too willing to side-step its duty of care by pointing the finger of blame at the private ambulance company and leaving the patient’s family to liaise with it and its insurers.

So, where does the NHS’s duty of care to its patients stop? Should it stop when it has chosen to contract out a service which would ordinarily be run by the hospital?

As more private sector companies secure lucrative contracts for NHS services, an uneasy alliance has formed which, as here, appears to be failing vulnerable patients.

In this case, we settled the claim against the private ambulance company. The family are considering taking the matter further with the Health Service Ombudsman.

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