Cataract concerns are probed by Channel 4

Fresh concern that the Government's efforts to cut NHS waiting lists by using private cataract surgery contractors has led to increased complication rates were broadcast this week.

Channel 4 News (August 15) questioned whether the safeguards of overseas private providers were robust enough, and investigated the UK work of Netcare, a South African cataract surgery provider.

Following the broadcast the Healthcare Commission told optician that it is to reassess Netcare's record-keeping following an earlier review of the Johannesburg Securities Exchange listed business. Netcare, which has now won an £85m contract with Trafford Hospital over five years, is one of the largest healthcare groups in South Africa.

The C4 investigation centred on Netcare's 2002 work for Morecambe Bay NHS Trust when, the report alleged, three patients contracted endophthalmitis within the first two weeks of the South African firm's Operation Cataract programme starting.

One patient had to have his right eye removed after a five-week battle to save it, and the item also claimed that eye surgeons were surprised that such a cluster of problem cases did not halt the programme immediately as would be the case within the NHS.

A paper published by Eye Journal found that Netcare's rate of eye infection was three times more than that of the Health Service, and six times' higher than that of a neighbouring NHS cataract provider, the Bolton Eye Unit healthcare provider.

'But what astonished experts was Netcare's response that the difficulties were caused by a patient's throat infection, and in another patient's case, poor personal hygiene,' said C4 News health correspondent Victoria Macdonald.

She told viewers that C4 News had obtained a leaked report from the National Patient Safety Agency for the DoH which stated a more significant reason for the problem was that Netcare 'has failed to clean the eyes before surgery with iodine, standard practice in the NHS for over 10 years'.

MacDonald said the report stated that the overseas team 'was unaware of the UK standard practice. At least three patients have been rendered blind because of the error'.

In addition, former UK medical director for Netcare, Dr Dinesh Verma, alleged that initially he did not have access to 250 patient records he requested. When he did gain access to 21 cases he discovered four of them contained letters to GPs telling them their patients were fine when in fact complications had taken place.

Netcare denied Dr Verma's version of events was correct and told C4 the company 'was not unhappy to accept his resignation'.

The business told C4 that its 'current rate of infection match the best in the world and the comparison in the Eye research is invalid'.

The company responded to the claims regarding iodine by stating its use was not in universal UK guidelines in 2002, and there was no intentional apportionment of blame towards the patients, and apologised to them.

The South African company backed its comments to the TV news show by stating that it had improved sight of 13,000 patients, and that patient satisfaction ratings currently ran at more than 80 per cent.