Private hospital not liable in contract for consultants under “all-inclusive” treatment package.

In the recent case of Bartolomucci (Respondent) v Circle Health Group Limited(Appellant) [2025] EWHC 529 (KB), the High Court ruled that the Defendant (a private healthcare provider) could not be held responsible in contract for the actions of independent consultants working within their facilities. This significant ruling confirms that even with an “all in package” arrangement with a hospital, which includes consultant fees, the contractual document was clear that the hospital was not providing or responsible for the individual consultant’s services. It highlights the importance of entities having clear contracts in place with patients when collecting fees and for clinicians to have their own individual indemnity. 

Summary of facts 

In 2015, the Claimant (nineteen at the time) underwent hip resurfacing surgery at The Edgbaston Hospital (part of the Circle Health Group, formerly known as BMI Healthcare),during which he suffered a catastrophic brain injury due to a prolonged period of very low blood pressure under anaesthesia. The Claimant alleged that the negligent anaesthetic care was the primary cause for his brain injury.  

The orthopaedic surgeon, denied any breach of duty while the consultant anaesthetist, Dr Prasanna, had voluntarily erased himself from the GMC register and was reportedly working abroad, making it difficult to pursue a claim against him. 

The Claimant filed a Part 8 claim seeking a declaration on the scope of Circle Health Group Limited’s contractual obligations, rather than a claim for tortious liability.

Key Issues  

The key issues in the case were: 

1. Liability of the Private Hospital - the question was whether the Defendant could be held liable for the injury sustained by the Claimant, which occurred during a medical procedure carried out by private consultants.  
2. Scope of the Hospital’s Contractual Obligations - the Claimant sought a declaration regarding the scope of the contractual obligations owed by the hospital. The Claimant argued that the Defendant’s responsibility extended to the anaesthetic and surgical services provided by the consultants, whereas the Defendant argued that they were only liable for its own services, such as nursing, accommodation, and surgical facilities. 
   
3. Consultants' Independent Liability - a related issue was whether the consultants were personally liable for the Claimant's injury, particularly given that one of the consultants (the anaesthetist) had voluntarily erased himself from the GMC register and was working abroad, making it difficult to bring legal proceedings against him.  
4. Nature of the Relationship between the Claimant and the Consultants -the Claimant contended that no direct contract existed between him and either of the two consultants, whereas the hospital argued that the Claimant had a direct contractual relationship with the consultants for their services. 

Decision 

The High Court ruled that the Defendant was not contractually liable for the actions of the consultants involved in the Claimant’s surgery despite a fee package that included the hospital’s fees and those of the consultants. 

It was argued by the Claimant that acceptance of the Defendant’s offer to provide a fixed price package of services included the fee for the provision of services of the Consultants. However, the Court found that on proper interpretation of the Contract, commercial common sense was very important and therefore determined that the fixed price package set out in the contract did not include an acceptance of contractual responsibility by the Defendant for the provision of surgical services by the Consultants.  

The High Court found that as the Consultants were directly providing the Claimant with their services, a contractual relationship existed between them. Furthermore, a legal remedy was still available to the Claimant as he could pursue a claim directly against either of the private consultants in respect of any alleged breach of duty in the performance of the surgery.  

The Claimant is seeking permission to appeal. 

What this case means? 

The decision in Bartolomucci highlights the importance of the need for clear contractual documentation for private patients. While practising privileges may set out the need for the consultant to have their own cover, this is not a document seen by the patient, whereas the contract is. A private hospital may be liable for nursing and medical care by non-consultant staff, but liability for clinical negligence matters will usually rest with the individual consultants unless specifically stated in the contract.  

Key provisions such as the wording here in the contract with the patient case stating “All consultants are self-employed and provide their services directly to the client” will protect the entity against any separate non-tortious claim as it makes clear the consultant does not work for the entity but provides their services independently. 

How Capsticks can help 

Capsticks aims to be the firm of choice for private health providers and their insurers, advising on all aspects of indemnity, insurance coverage and claims. 

If you have any queries around what's discussed in this article, and the impact this may have on any insurance policies you are involved in, please speak to Majid Hassan, Ed Mellor Sarah Bryant, or Pallabi Shakya to find out more about how Capsticks can help.