Butcher surgeon Ian Paterson in outburst at hearing for 50 of his patients who died

Jailed Ian Paterson raised his voice at coroner Judge Richard Foster claiming he had been pre-judged ahead of the inquest into 50 of his patients who had died after he treated them

A rogue breast surgeon jailed for 20 years had an outburst during a coroner's hearing, ahead of 11-month long inquest into the deaths of more than 50 of his patients.

Ian Paterson, who subjected more than 1,000 patients to unnecessary and damaging operations over 14 years, raised his voice and made demands as he insisted his preparations for the case were being hampered by his prison sentence. In the forthright torrent he also claimed coroner Judge Richard Foster had pre-judged him and moaned that he was being denied access to a laptop that contained files he claimed to need for the inquest. He also said he wanted to be transferred to an open prison.

Paterson's outburst - which was witnessed by and upset one of his victims - came at proceedings which took place on June 14 but can now be revealed by the Mirror ahead of the full inquests which are due to get under way on October 7.

At the time, Paterson told the pre-inquest review hearing: "I do think there’s been a conflation between the current sentence I’m serving and what’s happening in your court. I need an infrastructure that you have, that I don’t have. There’s clearly a negligible - there isn’t a level playing field here. It’s all you and your apparatus against me with no access, no representation and no funding. That doesn’t seem like a fair representation of the British legal system to me."

Addressing Paterson, the judge reminded him that despite being on a video link he was in a court hearing and Paterson should bear in mind the press and public were present. He told Paterson: "Whether or not any or all of those deaths are what are called in the coronial law process an unnatural death is a matter for me to decide and I sit there to decide that and I am also the investigator and not just the tribunal."

In 2017, Paterson was found guilty of 17 counts of wounding people with intent and three counts of unlawful wounding. Now a joint inquest is being held for more than 50 of his patients that died after the were treated by him. He left male and female patients significantly deformed, with one looking like a "car crash victim" after telling them they were at risk from cancer when they were healthy.

The full inquest is due to get underway in October and the earlier hearing at Aylesbury Crown Court was to decide how he would be able to participate. The judge has now ruled that he can participate in proceedings at Birmingham Coroner's Court via video-link from HMP Wymot in Preston, Lancashire.

Ahead of October's hearing one of his victims who survived her ordeal told the Mirror she was concerned Paterson's presence will put victims' families through a similar trauma as experienced during his trial in 2017. Sarah Jane Downing has said the coroner needs to put the victims' families "front and centre" and not allow Paterson to cause any more distress and trauma.

Paterson, then a consultant, was employed by the Heart of England NHS Foundation Trust and practised in the independent sector at Spire Parkway and Spire Little Aston, all in Birmingham between 1997 and 2011. He thought he was a pioneer and performed unregulated "cleavage-sparing" mastectomies, leaving cancerous tissue behind, which led to the recurrence of the disease in many patients.

He advised numerous patients that they had pre-cancerous lumps, leading to unnecessary surgeries that caused both physical and mental scarring. He also carried out unnecessary surgery for various veins, hernias and several other medical procedures. After his trial, a review was carried out and in 2020 recommendations were made to prevent surgeons being able to carry out unregulated and unnecessary operations, but those have still not been implemented.

Linda Millband, head of group claims at Thompsons Solicitors, has represented hundreds of patients to bring claims for compensation after they were treated by Paterson, as well as six families who are involved in the coroner’s investigation.

Speaking following the pre-inquest review hearing she welcomed the coroner’s ongoing commitment to ensure that all the facts are "fully, fairly and fearlessly investigated" in each case.

She said: “Whilst Paterson has already been jailed for his despicable actions, there are still countless unanswered questions with regards his conduct, as well as the actions of the various NHS Trusts and private clinics where he worked. The upcoming inquests will play a vital role in investigating the concerns raised by thousands of patients, and dozens of grieving families. It is these victims who must always remain the focal point of these proceedings.”