Reply: Care Quality Commission (CQC) reports

I think when you mentioned that you had been contacted by people thinking this to be a breakthrough in regulation you hit the nail on the head. The problem is that these initiatives make the situation worse, not better, by virtue of the fact they only serve to further cloud the underlying issues and create the illusion of regulation. What is more troubling to me is that the problem of regulation, or lack thereof, seems endemic through the entire private medical industry. BUPA, for example, is regulated by the Financial Conduct Authority despite the fact they offer medical advice to patients. If you complain to them about treatment, your complaint will, if you go so far (as I have) be decided upon by an ombudsman who will evaluate the complaint on the basis of whether any insurance contract has been broken, not whether the medical advice was right or proper. The MHRA will oversee the suitability of a lens to be implanted, not whether the lens is actually any good (and in fact they don't even do this, they take the word of a notified body working with the manufacturers in another European country under the CE scheme). As for refractive surgery clinics themselves, regulating them as the CQC purports now to be seems to be an exercise of walking in, counting the scanners and walking out again. You have already highlighted the ineffectual regulation of surgeons by the GMC; the extraordinary discrepancy between the number of refractive surgeons who are being sanctioned by the GMC (zero, I think) as opposed to the number of cases of litigation being brought against refractive surgeons (hundreds at least) makes a mockery of this so-called protection of standards and patients. We know the RCO is effectively powerless and at the mercy of the industry. And as for the root of the problem; we have seen how companies such as Optical Express hide behind a web of shell companies and frequently avoid litigation by passing both profits and losses between them and winding trading entities up. The directors of such companies seem prepared to go to practically any length in order to shuffle their ill-gotten gains around. And all the time the government play into the hands of the individuals behind this sub-standard industry by making the mistake of assuming positive intent.
The only effective form of regulation in this industry would be to force accountability upon named individuals. It isn't good enough for a surgeon to be allowed to abdicate responsibility for guaranteeing informed consent, it isn't good enough for the owner of a group to avoid culpability by dissolving companies. The government need to wake up to the fact that they are being played and out-played here, and act to actually get in the game.

When I read this announcement from Jeremy Hunt earlier today I thought it pointless to comment because I don’t think it has any value in relation to refractive eye surgery.
www.theguardian.com/society/2016/aug/21/...P=Share_iOSApp_Other

However, after being contacted by a few excited people who mistakenly understood it to be some kind of breakthrough in regard to regulation, I will comment...

• The Department of Health said: "Shining a light on poor care in this manner is an essential part of developing an open and honest learning culture, where mistakes are acted upon and prevented from reoccurring."

If only! The government is fully aware of the high numbers of patients damaged by the high street industry yet choose to do nothing, repeatedly claiming that the clinics/surgeons are regulated by the GMC, CQC and RCOphth - they are NOT!

• "Since the PIP breast implant scandal in 2012, we have made good progress raising the standards of care in the cosmetics industry so patients can feel confident they are getting the best care from professionals with the right qualifications.”

I have no idea whether or not anything has changed in the cosmetics industry, but what about the refractive eye surgery industry?

• "Up to 100 cosmetic surgery clinics will be given transparent ratings that will give potential users a simple guide to the quality of the clinics in their area. There will be four ratings: outstanding, good, requires improvement or inadequate.”

The CQC will rate a clinic’s facilities - NOT the surgeons! Also, it’s wrong to include refractive surgery under the cosmetic umbrella as it minimises the seriousness of eye surgery.

Only government regulation can make the difference so desperately needed to stop this scandalous industry acting as they do!

Meanwhile, perhaps Jeremy Hunt would like to come and hang out with the fairies at the bottom of my garden, while I wait to see how many excuses the new health minister (Nicola Blackwood) will give to avoid meeting me before the next general election!

The RCOphth logo removed from the MediDate site following my emailing the College just a few hours ago...

Original story here: www.facebook.com/OERML

The CQC logo should be gone tomorrow, while I have still to put in my complaint to the ASA.

However, already unimpressed with the CQC, this message has added to my concerns

'On 3 May 2016, at 16:35, Kerswell, Nick wrote:

Dear Sasha

Thank you for this. I have passed this onto a colleague who assures me she will contact the organisation to ask them to remove the logo … as well as the misinformation that the laser eye sector is unregulated and that people are receiving poor quality laser eye surgery.

Thanks
Nick Kerswell
Head of Regional Engagement
Care Quality Commission'

I replied...

'Hi Nick,

Re 'as well as the misinformation that the laser eye sector is unregulated and that people are receiving poor quality laser eye surgery.’

The latter part of that is possibly the only truth on the site, posted after speaking with me in March!

The eye sector IS unregulated and tens of thousands of people have received far worse than poor quality surgery - significantly high numbers in litigation after being left with irreparably damaged vision.

This is why John McDonnell and I have been campaigning for government regulation since 2012!

According to a letter from Ben Gummer, the CQC made ‘minimal changes to its core service framework’ following evaluation of this pilot: www.cqc.org.uk/location/1-386212981

With respect, the CQC are out of their depth in this area with no idea of what’s actually going on.

Best wishes,
Sasha'

It seems I should have gone to Optimax in Maidstone if this CQC report is to be taken seriously!
www.cqc.org.uk/location/1-386212981

Me to CQC
Sent: 13 April 2016 11:48
To: enquiries@cqc.org.uk
Subject: Laser eye surgery clinics...
Importance: High

Dear CCQ…

According to health minister Ben Gummer (to Theresa Villiers), the CQC undertook two pilot inspections of single specialty services and non-hospital acute services in 2015.

Mr Gummer wrote that a laser eye surgery provider was included in the first pilot between April and June 2015 and that the report is available on the CQC website by searching ‘laser eye clinics’. Also according to Mr Gummer, following evaluation of the pilot, the CQC made minimal changes to its core service framework.

However, I am unable to find this information, as were the CQC customer services.

I would therefore appreciate your help.

Many thanks,
Sasha Rodoy

CQC to me
20 Apr 2016, at 12:09, Terri Salt wrote:

Hello Mr Rodoy,

This has landed in my inbox as one of the inspection managers who was on the pilot for the laser eye services inspections. We went to Optimax Maidstone and the published report can be found at www.cqc.org.uk/location/1-386212981 If you search the website put Optimax in as the service name and Maidstone as the location. I have copied in Zoe Nixon, as she is the lead inspector for the service and will be your point of contact with CQC.

Please come back to me if I can be of further assistance

Best wishes

Terri
Terri Salt
Inspection Manager (Hospitals)

Excerpts from the report
• Staff ensured that patients and those close to them received adequate psychological support.
I am aware that a number of damaged patients received, or were offered, post op psychological counselling paid by Optimax. If anyone was offered this before surgery please post details.

• This report describes our judgement of the quality of care at this hospital. It is based on a combination of what we found when we inspected and a review of all information available to CQC in including information given to us from patients, the public and other organisations.
Which 'other organisations', why didn't the CQC speak to me? Are they incredibly gullible or guilty of something more?

Report signed off by Sir Mike Richards (Page 2)

I will be calling Zoe Nixon

Care Quality Commission (CQC) hierarchy... 'nuff said

• Sir Mike Richards - Chief Inspector of Hospitals
(Line Manager David Behan)
www.cqc.org.uk/content/professor-sir-mike-richards

• David Behan - Chief Executive
(Line Manager Michael Mire)
www.cqc.org.uk/content/david-behan-cbe

• Michael Mire - Interim Chair
www.cqc.org.uk/content/michael-mire

"Michael (Mire) is on the board of Aviva plc, where he is a non-executive director and a member of the Risk and Governance Committees, and is a Senior Advisor to Lazard, the investment bank.”
www.cqc.org.uk/sites/default/files/20150...l_mire_doI_05_15.pdf

I actually heard back from the CQC a week or so ago, after a bit of telephone tag, we finally spoke.

I would like to say that, they seem have an genuine interest in "how they conduct operations" at Liverpool 1 and will be contacting Optical Express following my concerns for a response.

I suggest affected OE patients unhappy with the advice received from their optometrist, in particular those with existing dry eye conditions who were then treated, then DO contact CQC via any of the options below.