Four years, one fight: Standing with the Saints of St Helena

Written by Sophie Goddard, Senior Marketing Manager.

“If you only ever take on cases that don’t have any risk, you’re never going to change the legal landscape because you’re never going to be pushing boundaries and you’re never going to change the fabric of society.”

That is what Ruth Powell, Head of Clinical Negligence, said when asked why fighting for justice for the victims of the surgeon of St Helena matters.

For the past four years, Ruth and our team have been representing 145 people on St Helena who say they were harmed by treatment they received from Dr Sergio Villatoro Bran, the island’s only practising surgeon between 2016 and 2021. Some say they underwent procedures they did not need or properly consent to, while others were left with serious, long-term injuries as a result of negligent treatment.

In 2023, Bran pleaded guilty to five counts of unlawful wounding and received a suspended prison sentence and a lifetime ban on practising medicine on St Helena. He was, however, able to leave St Helena and continue practising elsewhere.

Concerns have also been raised by a number of patients about treatment provided by another surgeon who practised on the island at around the same time, Dr Carlos Soto. Some patients have subsequently raised allegations that aspects of the treatment they received were negligent. Dr Soto has not been criminally convicted in relation to these allegations.

For the people affected, known locally as Saints, that was not the end of the story. What began as a complex group of clinical negligence claims has developed into a much wider battle over access to justice. Since Hugh James became involved in November 2022, the team has travelled repeatedly to St Helena to investigate the claims and build relationships with those affected; seen Sergio prosecuted and convicted; worked towards a proposed compensation scheme; challenged new legislation affecting how the claims could be funded and pursued. A successful constitutional challenge removed that particular obstacle, but it did not resolve the underlying claims.

Four years on, the team is now looking to the UK courts in its continuing effort to secure a viable route through which the Saints’ cases can finally be heard. As Ruth says: “It’s one thing not winning a case but another thing being told that actually you can’t even bring it.”

Where is St Helena?

St Helena is a tiny British Overseas Territory in the South Atlantic, around 1,200 miles from the coast of Africa. Home to approximately 4,000 people, known as Saints, it is one of the most remote inhabited islands in the world.

As a British Overseas Territory, it is internally self-governing but has close ties to the UK, which retains responsibility for areas including defence, security and international relations, as well as providing significant financial support for essential public services.

Its extraordinary isolation shapes everyday life on the island, particularly when people need medical care. St Helena has just one hospital and access to specialist treatment and medical resources is inevitably limited by the island’s size and location. With the nearest major healthcare facilities thousands of miles away and limited transport links off the island, accessing specialist medical help can involve significant logistical challenges.

Until 2017, the only regular way to reach St Helena was by a five-day journey by sea. Even today, flights remain limited, illustrating just how isolated the island and its community can be.

For Ruth, travelling there changed her understanding of the cases and the impact on those affected.

“Going there just changes your whole perspective on the lives of Saints and therefore the impact that this surgeon and the actions of their government had and are still having on them.

“I’m not sure that anybody who works on this case could possibly do it with adequate understanding and empathy unless they have been there and seen it with their own eyes. It’s just such a different world. I don’t think you can imagine the impact of what happened until you’ve been there and have experienced the sense of distance, isolation and vulnerability.”

The journey so far

2016–2021 – Treatment on St Helena: Dr Sergio Villatoro Bran works as an orthopaedic surgeon on St Helena. Concerns emerge about the treatment of patients and the scale of potential harm.

November 2022 – Hugh James gets involved: We begin representing affected Saints, travelling repeatedly to the island to investigate their claims, meet clients and build trust.

September 2023 – Sergio is convicted: Sergio pleads guilty to five counts of unlawful wounding. He receives a suspended prison sentence and a lifetime ban on practising medicine on St Helena. The criminal case concludes, but the wider group of patients is still seeking civil redress.

September 2023 – Compensation scheme announced: The day after the sentencing, the St Helena Government announces plans for an independent compensation scheme, offering a potential route to redress for affected patients.

2023–2024 – Working towards compensation: We help shape the proposed scheme, but negotiations ultimately break down – leaving the Saints without that route to compensation.

July 2025 – A new legal hurdle: New legislation governing civil litigation costs raises concerns about the Saints’ ability to fund and pursue their claims. Hugh James launches a constitutional challenge.

May 2026 – Access to justice victory: St Helena Government amends the legislation before the substantive hearing, addressing the issues challenged. It is an important victory – but the underlying clinical negligence claims remain unresolved.

August 2026 – Turning to the UK courts: We prepare an application seeking to pursue the claims through the courts in England.

Today – The fight continues: Four years on, the Saints are still seeking a route through which their individual claims can be heard and determined.

Why we took on the challenge

The pursuit of justice for the Saints began long before we became involved. When the opportunity came to us through our Legal Network, the scale and complexity were already significant.

So why did we take it on?

“I think it goes back to our history of helping people like the miners, backing people who might otherwise struggle to be heard, backing the underdog and recognising that some issues are fundamentally important and they’re worth fighting for,” said Ruth. “And I do love that about Hugh James. I don’t actually think there are many firms who would have done this.”

Ruth has been travelling to St Helena to meet with her clients since 2023. Those visits have become a fundamental part of the team’s work, not only in understanding the circumstances behind the claims but in establishing relationships with people thousands of miles away.

“If we hadn’t gone, and we hadn’t gone as many times as we have, the clients wouldn’t have trusted or accepted us. We couldn’t have ever done it remotely. They needed to meet us; they needed to start to trust who we were and what we were doing.

“Every time we go, people say, ‘Thank you so much for coming back.’ I don’t think they’ve ever had anybody stick up for them, honestly, or be committed to them.”

When a clinical negligence case becomes an access to justice issue

One of the reasons these cases have continued for so long is that the challenge has extended beyond establishing what happened to individual patients.

St Helena’s position as an internally self-governing British Overseas Territory means that it has its own legal system. The Saints cannot simply pursue their cases through the courts of England and Wales in the same way as someone bringing a clinical negligence claim in the UK.

Following Sergio’s criminal conviction in 2023, a proposed compensation scheme appeared to offer a potential route to redress for the wider group of patients. Hugh James became closely involved in discussions about its development, but negotiations ultimately broke down without resolving the claims.

Further complexity followed in 2025 with the introduction of new legislation governing civil litigation costs on St Helena. Concerns about the impact of the changes on the Saints’ ability to fund and pursue their claims resulted in a constitutional challenge. St Helena Government subsequently amended the legislation before the substantive Judicial Review hearing.

It represented an important development for access to justice, but it still did not resolve the underlying clinical negligence claims.

Four years on, the question of how and where the Saints can have their individual cases heard therefore remains at the heart of the case.

Why does this case matter?

For Ruth, the significance of the case now extends well beyond the individual clinical negligence claims.

“It matters because fundamentally, it’s about society’s approach to vulnerable people. It’s about giving everybody a voice that can be heard. And it’s about ensuring that everybody has equal access to justice. That’s why it matters.”

“I don’t think you can really call yourself a lawyer unless you are prepared to take risks and you’re prepared to take the consequences of those risks not going your way.”

That willingness to continue despite the uncertainty has been tested repeatedly over the past four years.

What does success look like?

Hugh James is now seeking to establish whether the Saints can pursue their claims through the courts in England. After four years of legal, jurisdictional and practical challenges, however, success is about more than the outcome of any one claim.

“Justice for them is just having a fair crack at the whip,” said Ruth. “It’s that they all want the opportunity to have their cases investigated and to have access to a system that can adjudicate their cases.”

There is also the potential for the impact of these cases to extend beyond compensation for those currently affected.

“The long-term benefit I would want is that they have some sort of equality before the law, that they are empowered to challenge things when they go wrong and they’re empowered to follow it through.

“I would want for their healthcare system to be improved and for their access to justice and their ability to assert themselves and challenge to be better.”

Whatever the next stage brings, Ruth remains clear about her commitment to the Saints she represents.

“This sounds cheesy, but truthfully I’d want them to know that I am not ever going to give up. Until I am told that I’m at the end of the road, definitively, I am not going to give up.”

Hear the full story

Ruth has recently been involved with ‘The Surgeon of St Helena’ – an investigative podcast series hosted by journalist Luke Jones and produced by the award-winning team at Audio Always for the Always True Crime network.

The series explores what happened on St Helena, the experiences of those affected and the continuing fight for justice. Ruth features throughout the series, sharing her experience of representing the Saints and the legal battle that has followed.

A note before listening: the podcast deals with difficult and distressing subject matter. Some episodes include discussions of sexual assault and abuse, as well as accounts of medical trauma and the physical and emotional harm experienced by patients. Please take care when listening.

Listen to The Surgeon of St Helena podcast on Spotify. (Also available on other podcasting platforms).