‘Surgery’s Dirty Secrets’ up for Scottish BAFTA

People trust their lives in the hands of doctors on a daily basis but Liam McDougall’s recent documentary investigating NHS practice has uncovered that some of the time the tools they use are no better than the plastic prongs in a game of Operation.

Notably, the former Strathclyde student's Panorama investigation into one of the NHS' most unknown controversies, 'Surgery's Dirty Secrets', this year achieved a nomination for a Scottish BAFTA. McDougall, who did a postgraduate degree in Journalism at Glasgow Caledonian University, grew up with dreams of becoming an investigative journalist. He watched Panorama from an early age and remembers how it was the flagship programme for broadcasting investigative journalism. After starting out in a newsroom and then becoming the assistant editor of the Big Issue; Liam got his first taste of being at the helm of an investigation in 2006, as assistant producer of ‘Frontline Scotland’. 

The nomination for the Current Affairs award at the Scottish BAFTAs marked his first nomination as a director. When speaking to The Journal, McDougall expressed his gratitude for being considered, saying: “It’s a real honour, such a surprise.” However, he swiftly moves to a more serious topic; the documentary exposed a worrying lack of quality control in surgical instruments being used in the NHS, which could potentially mean life or death.

“The case came to light after our reporter, Samantha Poling, came across a study that had taken place in Sweden in the 90s, to source surgical instruments. We decided to see if there were similar checks in the UK and discovered that the majority of our surgical instruments came from Pakistan.”

He elaborates, saying that the majority of surgical instruments produced in Pakistan actually came from one city, Sialkot, and decided to travel to the country and find out more for himself. Constantly shadowed by a security detail, he and his team travelled to Sialkot and were shocked at what they discovered. After visiting the official suppliers’ factories, where a high level of quality is guaranteed, Liam discovered instruments being made in crude backwater workshops; and there were plenty of them.

“Reading a report is one thing, but actually seeing it was incredible- you have people sitting crossed legged, hunched over instruments - being paid a pittance” says McDougall. However the most shocking revelation was yet to come. It turned out that most of the instruments produced in these makeshift settings were being directly sold to the larger companies in Sialkot - where they could potentially then be sold on to the NHS. Secret filming during an interview with one of these companies revealed there was a widespread practice of rebranding sub-standard steel as high quality.

The BBC Director also speaks of how the NHS is apparently unaware of the issue. “We got in touch with Tom Brophy [dedicated technologist at St. Barts Hospital London], who really is the only person thoroughly checking instruments in the NHS.” What Brophy found was that instruments sent by suppliers like the ones in Sialkot to the NHS were not fit for purpose.

“Tom really held the key to the documentary and allowed people to see the impact this issue could have on them,” says McDougall. The health care professional identified faults that could pierce a surgeon’s glove or even leave shards of metal in patient’s bodies.

“It's extremely shocking, the NHS is such a huge organisation with a lot of issues to be aware of, but this is a very significant problem and is not on their radar”, says McDougall, stressing the seriousness of poor instrument quality.

However, he also seems keen to point out that his documentary “isn’t meant to put anyone off the NHS, because it is a world class health service. Instead I hope it helps implement a more robust checking system; already there have been very prominent NHS figures in talks about a better system.”

The NHS response to the documentary was testament to its impact. In Wales, a statement to Panorama stated that "The safety of all patients in Wales is of paramount importance. Procurement of goods and services used in the NHS in Wales is done on an all-Wales basis. We are aware of concerns regarding the quality of some reusable and single-use surgical instruments, having seen the report produced by Tom Brophy, the Head Technician at the Department of Clinical Physics at Barts and the London PCT. The trend data from this surveillance programme revealed instrument reject rates of 25 per cent.” A group was set up in Wales to review the arrangements concerning instrument checks in Welsh hospitals.

In Scotland, Health Secretary Nicola Sturgeon said that "National Services Scotland procure equipment on behalf of the NHS. All national contracts awarded by NHS Scotland have to meet specific terms and conditions and require that participants operate and apply ethical standards. These conditions apply to all parts of the supply chain. National procurement can and does request documentation that these standards are being adhered to and can take action if any company is found to be in breach."

The response was similar in Northern Ireland and England, with English Health Secretary Andrew Langley stating that the programme's findings would be investigated whilst Northern Ireland’s Business Trade Organisation demanded that all traders adhered to the Ethical Trade Initiative base code of conduct.

With 'Surgery's Dirty Secrets' provoking change across the NHS, and a prestigious Scottish BAFTA nomination under his belt, the future for Liam McDougall looks busy. He says he has found his niche and is content: “I’m in between a few projects now, but I’m still always on the lookout for strong investigations. I might not go back to Pakistan in a hurry, there were a few scary moments, but at the end of the day you have to be prepared to go to the source to get your story, wherever it is.”