Concerns over skin cancer care gap after man's death

Some private skin cancer patients could receive "inferior care" compared to those in the NHS, a coroner has warned after a man's death.

Gary Starbuck, 81, from Cranleigh in Surrey, died in August 2021 after being treated for skin cancer, which later spread to his lungs and neck.

An inquest in December 2025 raised concerns of a gap where high-risk skin cancer patients may miss being referred to specialist teams if treated privately, rather than in the NHS.

In a Prevention of Future Deaths report released on Monday, coroner Darren Stewart said: "Patients treated privately are at risk of receiving inferior care to those treated under the NHS, often within the same physical hospital setting."

The inquest into Starbuck's death heard how he had spent time living in Australia and had previously been diagnosed with hairy-cell leukaemia in 2006.

Between 2011 and 2018, he had multiple skin lesions removed, including a carcinoma on his right ear in January 2017 and January 2018.

When further attempts to remove the carcinoma were unsuccessful, Starbuck received radiotherapy treatment which appeared to have cured the tumour, but it returned in May 2020 and metastasised.

Starbuck was initially treated privately, before having his care transferred to the NHS.

In his report, the coroner said guidelines stated that patients with high risk squamous cell carcinoma should be referred to a specialist team, which should have occurred after the skin cancer was removed.

The guidance from the National Institute for Health and Care (Nice) is treated as mandatory in the NHS, but use of the guidance privately was "less clear", the coroner added.

"The consequence is that patients treated privately are at risk of receiving inferior care to those treated under the NHS, often within the same physical hospital setting," he added.

The report has been sent to the Care Quality Commission (CQC) and Royal College of Surgeons, who must reply by 3 June setting out what they intend to do to prevent future deaths.

A spokesperson for the Royal College of Surgeons said it recognised the coroner had raised concern about standards for patients treated privately, adding: "It is absolutely vital that private providers and the wider healthcare sector learn from the coroner's findings to help ensure safe, high quality care for all patients."

The CQC has also been approached for comment.

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