Most patients assume that “the hospital” is legally responsible if something goes wrong. In UK private ophthalmology, primary responsibility usually sits with the operating surgeon, and the framework that establishes this is well defined.
The Surgeon’s Duty of Care
The operating surgeon carries the central duty of care for the surgical decision, the operation itself, and the immediate management of complications. The General Medical Council’s Good Medical Practice sets out the standard against which clinical conduct is judged in the United Kingdom: the consultant is responsible for adequate consent, for the appropriateness of the procedure, for surgical competence, and for ensuring that postoperative care is delivered safely.¹ This framework applies equally to NHS and private practice and is the default reference point in most clinical negligence claims.
The Supreme Court’s decision in Montgomery v Lanarkshire Health Board reinforced this further by establishing that the duty of the surgeon includes informing the patient of any material risk that a reasonable person in the patient’s position would consider significant.² Failure to communicate complication risk in a manner the patient can understand is itself actionable. The decision shifted the legal centre of gravity decisively toward the operating clinician’s communication responsibility.
Where The Hospital Carries Responsibility
Hospitals carry attributable responsibility in narrower scenarios, clear-cut sterilisation failures, equipment contamination, or systemic infection-control breaches. Even endophthalmitis, the most serious post-cataract infection, is most often distributed across surgical technique, prophylactic protocol, theatre environment, and patient factors rather than attributed to a single source.³ Where a documented system failure is identified, the hospital is implicated; in routine clinical attribution, responsibility usually remains with the operating team.
The medico-legal reality, then, is that the most commonly imagined scenario, “I had surgery at a private hospital, so they are responsible”, is not how the framework operates. Patients seeking transparency about responsibility should ask explicitly who carries the duty of care for each phase of their pathway, and obtain that answer in writing before consent.
Who This Is Not For
This page is not legal advice. Patients with active complaints or potential negligence claims should seek qualified legal counsel. It is also not a guide to NHS-delivered care, in which responsibility is structured around hospital trust governance and is materially different.
Clinical Takeaway
In UK private ophthalmology, the operating surgeon usually carries the primary duty of care. Hospitals are accountable for environmental and systemic failures, not for the surgical decision itself.
References
- General Medical Council. Good medical practice. London: General Medical Council; 2024.
- Montgomery v Lanarkshire Health Board UKSC 11. Supreme Court of the United Kingdom; 2015.
- Endophthalmitis Study Group, European Society of Cataract & Refractive Surgeons. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33(6):978-988.
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