Revealed: fears at private hospital operations raised years before surgeon was reported

He queried the safety nets in place to monitor the success of operations on patients sent to Ross Hall by the NHS to meet waiting-times targets, seeking reassurance they were as robust as those in the health service.

Former patients of Mainds tell of problems following back surgery

His letter ended: "Given the concerns of patient safety, an early response would be helpful."

Details of the correspondence have emerged in the wake of a recent GMC tribunal hearing which found surgeon Colin Campbell Mainds botched spinal operations on patients sent to Ross Hall to meet waiting-times guarantees around 2009.

Following the tribunal, six new patients or their relatives have contacted The Herald saying they are unhappy about outcomes of surgery carried out by Mr Mainds. These patients were treated by Mr Mainds both in NHS hospitals and at Ross Hall, with the operations dating back to 1995.

Among those to come forward are Scott Holt, 48, who said he has been bedridden for the past 15 years and Alistair McLennan, who says he is paralysed below the knee in one leg.

It has also emerged a letter was sent to Ross Hall expressing concern about Mr Mainds's standards of care one year before he was suspended.

Now a Glasgow legal firm has revealed it is pursuing four cases against the surgeon.

Solicitor David Bell said: "A common feature is the speedy and summary nature of the consultations and the dismissive way in which clients were spoken to. In particular, the risk and potential consequences of the potential treatments were fairly vaguely mentioned to them.

"Certainly, in two of the cases there was no mention of alternative procedures and treatments. That is something that has caused a lot of concern to my clients."

The surgeon, 56, was employed for a time by NHS Greater Glasgow, but stopped working for the NHS completely in 2005. By 2009 he worked at Ross Hall full-time and admitted at the hearing to working seven days a week.

In September 2008, a retired doctor whose relative had been treated by Mr Mainds at Ross Hall wrote to the hospital expressing concern about

aspects of the care provided by the consultant. The doctor, who does not wish to be named, told Ross Hall he intended to report Mr Mainds to the GMC.

The letter says: "Since (my relative's) unsuccessful surgery, as a member of the medical profession, I have heard some concerns expressed by other patients and indeed doctors concerning Mr Mainds. These may well be unsubstantiated and simply idle gossip, but as you may realise they do raise concerns in my mind. I would therefore respectfully ask you to provide me with Mr Mainds most recent surgical audit results so that I can seek my own reassurance that all is well."

The doctor received a response from Adrian Fawcett, then chief executive officer of BMI Healthcare.

In his reply, Mr Fawcett said the hospital did not hold individual consultant's practice audit results or patient-reported outcome data on spinal surgery. He added: "I do not believe that Mr Mainds failed in his duty of care to provide follow-up care."

In a statement BMI said: "BMI Healthcare does not employ consultants; instead, consultants working in our hospitals do so as independent, self-employed practitioners. Consultants wishing to work in our hospitals are required to apply for 'practising privileges' and these are granted if they are able to demonstrate they hold the right qualifications and have the appropriate skills and experience.

"It should be noted that all surgery inevitably carries inherent risks, and complications do not invariably indicate failures by the consultant involved."

It added: "Where there are concerns, they are investigated and we will, if the circumstances require, withdraw a consultant's practising privileges and/or report them to the standards committee of their professional body."