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Surgeons led by Professor Nigel Heaton at King's are paid about £20,000 for every kidney transplant performed on private Greek and Cypriot patients.

One of Britain's leading hospitals is giving NHS livers to private Greek and Cypriot patients – even though there is a waiting list of 400 Britons in desperate need of donor organs.

Health service watchdogs have now launched an inquiry into transplants at King's College Hospital in London, after the scandal was discovered by a Mail on Sunday investigation.

Surgeons led by Professor Nigel Heaton, who attracted controversy over his decision to give a transplant to alcoholic football star George Best, are paid about £20,000 for each operation they carry out.

The hospital has struck a deal with the Greek and Cypriot governments to treat the patients privately. Senior medical sources have revealed that King's earns around £85,000 per operation, from which the surgeon's fee is deducted.

Prof Heaton, 53, who makes the final decision on which patients he operates on, has earned up to £100,000 from five such operations in the past year on top of his NHS salary of between £150,000 and £200,000.

Prof Heaton was criticised six years ago when he gave George Best a transplant, even though the footballer ignored warnings that his continued drinking was destroying his health. Best died from multiple organ failure three years after the operation.

At the time, Prof Heaton defended his decision, saying: 'I don't think it is fair to ask whether he should have had a transplant because we judge every patient individually. As doctors, we can take responsibilities only so far.'

The situation at King's is causing deep concern within the medical profession and among patients.

Ingrid Shillito, a director of the British Liver Trust charity, said: 'The sad truth is there aren't enough livers donated to give seriously ill people a second chance of life.

'Liver transplant centres have to make tough choices about which patients get the few livers that are available, whose need is greatest and who will benefit most.

'It would be very wrong for financial matters to influence these difficult decisions, for patients to buy their way to the top of the list.'
King's has admitted that many of its Greek patients come from the Laiko Hospital in Athens, one of the biggest in the country. The Greek health service, including its transplant service, is seriously underfunded.

NHS Blood and Transplant (NHSBT), the health authority in charge of transplant services, decided to refer the King's situation to health watchdogs following a board meeting on Thursday.

In a statement, it said: 'The board was presented with information about the unusually high number of non-UK EU residents who received liver transplants at King's College Hospital NHS Foundation Trust between 2003 and 2007.

'A high proportion of the liver transplants performed [there] on non-UK EU residents were undertaken on a private basis. NHSBT has an overarching statutory responsibility to ensure the integrity of organ donation.

'The board is concerned that public confidence in the use of organs donated in the UK for transplantation may be significantly undermined if disproportionate numbers of non-UK patients are being treated at a single centre, especially where this treatment is taking place on a private basis.

'Based on the information presented, the board therefore took the decision to refer the matter to the Healthcare Commission.'

Prof Heaton, who lives in a £1million detached house in Beckenham, Kent, declined to comment on the controversy.

A statement from the hospital said: 'Under European law, citizens of the European Union are entitled to treatment under the NHS, and King's carries out liver transplants on a small number of patients referred by EU member countries. The costs for these operations are met through our block contract with the Department of Health.

'The Greek and Cypriot governments have chosen to pay for treatment provided to Greek and Cypriot patients outside this block contract arrangement. As a result, King's receives payment directly from Greece and Cyprus for all Greek and Cypriot patients treated here.

'Although these patients are effectively treated privately, they have the same rights as any NHS patient under European law.

'King's surgeons receive no fees for liver transplants carried out either on UK patients or those from the EU who are entitled to NHS treatment.

'In line with practice across the UK, the surgeons do receive additional fees for treatment for private patients. This includes those from Greece and Cyprus, whose governments have chosen for them to be treated in this way.'

The statement added that income from such operations went into the general hospital budget and was not used specifically to improve transplant services.

The Department of Health said: 'The transplantation of donated livers into non-UK EU residents who qualify for NHS treatment is lawful. This is guided by European law which effectively regards such patients as having equal access to the NHS.

'Decisions over accepting a patient on to the transplant waiting list and allocating an available liver rest with the individual transplant centre. They must always give priority to those waiting on the national list of super-urgent patients.

'We recognise that this is a complex area and will work with NHS Blood and Transplant and the transplant community to provide further clarification.'

The chairman of the Healthcare Commission, the watchdog investigating King's, is Sir Ian Kennedy, the distinguished academic who conducted the public inquiry into the children's heart surgery scandal at Bristol Royal Infirmary in the Eighties and Nineties.