A patient is unlikely to know where the instrument used in a serious operation comes from and whether it is safe to use.
And, according to the BBC programme Panorama, the surgeon operating on the patient might also be unlikely to know the answers to these questions.
As Claims Direct’s website stresses, the standard of healthcare in this country is usually high and the Panorama programme, which aired at the end of June 2011) did not suggest that surgeons were in any way responsible for faulty instruments.
But the investigation did point a finger of blame at the suppliers responsible for selling the instruments to the NHS and the health trusts which fail to carry out rigorous tests.
The year-long investigation revealed how two-thirds of the world’s surgical instruments are made in Sialkot in Pakistan.
Many of these instruments are stamped ‘made in Germany’ if the steel used comes from Germany; labelling which might seem misleading but is legitimate under EU law.
Panorama’s camera team shot footage of some of the sweat shops used to make the instruments. In the darkness it was hard to make out the cross-legged workers toiling away to make instruments which will be used under the bright lights of operating theatres many miles away.
The programme suggested that child labourers might be responsible for many of the instruments which adult western surgeons will use in life-or-death operations.
Back in England, Panorama interviewed Barts surgeon Paul Stroden as he scrubbed his hands under running water and said: “Everything that is handed to you needs to work. They are the tools of our trade.”
Mr Stroden’s employer is the only English hospital trust which employs a technologist (rather than merely a visual test) to check that the instruments it is supplied with comply with the regulatory board’s health standards.
Last line of defence
That man is Tom Brophy, the “the last line of defence” checking for factors such as whether instruments will cause dangerous micro-punctures in surgeons’ gloves.
He rejects one in five pieces of equipment presented to him and has seen used instruments coated in blood which suppliers have tried to pass off as new.
Some instruments he has rejected have been accepted by other trusts.
Panorama had another piece of work for Mr Brophy, asking him to check the 19 surgical instruments they had returned with from Pakistan; 12 failed his safety checks.
Understandably, no other medical professionals agreed to be interviewed on camera during the programme.
But three anonymous NHS surgeons agreed to their testimonies – voiced by actors - being used during the programme.
One said: “Sometimes you struggle with an arterial clamp and you know your patient is bleeding longer than they should because your instrument is not working.”
Another revealed: “You look at your glove which has been torn by the rough edge of an instrument and you think have I just cut that patient’s bowel with this?”
Asleep on the job?
Are Britain’s health authorities as Panorama suggests “asleep on the job”? Regulatory body the MRSA insists that “there is no evidence that non-compliant instruments are being supplied to the NHS”.
But the programme could provide a real wake-up call for those who think the existing safety regulations are stringent enough.