-
Why do we need German surgeons to operate the new diagnostic treatment
centres (NHS to hire German surgeons, February 22)? We have well-trained
staff who are presently underemployed due to massive bed-blocking problems.
This is the reason why elective surgery is grinding to a halt in the
UK. Guardian
letters Friday March 1, 2002
-
A network of fast-track surgery units being set up to clear NHS waiting
lists will also be allowed to treat private patients in a U-turn that
yesterday infuriated Labour MPs. Gaby Hinsliff, chief political
correspondent
Sunday December 22, 2002 The Observer
-
Private health companies are to be invited to compete for multi-million
pound contracts to run fast-track surgeries designed to meet government
promises to cut waiting lists. James Meikle, health correspondent
Monday December 23, 2002 The Guardian
-
Guide: the new surgery centres. The government hopes that standalone
'surgery factories' or diagnostic and treatment centres (DTCs) will help cut
waiting times in some of the specialties where waiting is longest. This
guide explains where they will be located and how many extra operations are
expected each year
Patrick Butler Monday December 23, 2002
-
The government is inviting bids from private health companies to build and
run 11 new NHS diagnostic and treatment centres in England in an attempt to
bring down waiting times in routine specialties such as orthopaedics and
cataracts.
Patrick Butler Monday December 23, 2002
- An American private healthcare firm will launch the first of a new wave of
'surgery factories' in Britain next month under radical plans to slash NHS
waiting lists. Gaby Hinsliff, chief political correspondent
Sunday July 27, 2003 The Observer
- Consultants protest as top eye hospital told to transfer patients to private
sector treatment centre. Michael White, political editor
Friday
September 5, 2003 The Guardian
- Ministers have given the green light for private hospital corporations from
the US and Canada to poach NHS doctors and nurses to staff 30 fast-track
treatment centres that are to be set up in England under a scheme hatched in
Downing Street. John Carvel, social affairs editor
Wednesday September 10, 2003 The Guardian
- The government has agreed to pay US hospital corporations at a premium rate
to operate on patients from the NHS waiting list in a network of fast-track
treatment centres in England to be announced tomorrow by John Reid, the health
secretary. John Carvel, social affairs editor
Thursday September 11, 2003 The Guardian
- Off-centre policy. Leader
Thursday September 11, 2003 The Guardian
- No, it's not privatisation. John Reid
Friday
September 12, 2003 The Guardian
- The government will today deal a body blow to Britain's leading private
healthcare companies by shutting them out of a £2bn programme to develop 27
fast-track treatment centres to operate on patients from the NHS waiting list.
John Carvel, social affairs editor
Friday
September 12, 2003 The Guardian
- Where the treatment centres will be. The health secretary, John Reid, today
announced details of the government's controversial programme of privately run
fast-track diagnostic and treatment centres, and a number of new mobile
ophthalmology units. This guide explains where they will be.
Friday September 12, 2003 [South-west peninsula (Mercury Health Ltd),
Lincolnshire (Mercury Health Ltd), Horton hospital, north Oxford (Mercury Health
Ltd), North-east Yorks (Mercury Health Ltd), Southampton (Mercury Health Ltd),
Northumberland (Mercury Health Ltd), East Berkshire (Slough, Bracknell,
Maidenhead and Windsor/Ascot) (Mercury Health Ltd), Didcot, Oxfordshire (Mercury
Health Ltd), Ashford, Surrey (Mercury Health Ltd), Maidstone (Care UK Afrox),
Barlborough Links, Nottinghamshire (Care UK Afrox), Derriford, Plymouth (Care UK
Afrox), Chase Farm, Barnet, London (Anglo Canadian), King George hospital,
Redbridge (Anglo Canadian), Royal National throat nose and ear hospital, Kings
Cross, London (Anglo Canadian), Bradford (Nations Healthcare), Burton (Nations
Healthcare), Daventry (Birkdale Clinic), Trafford, Greater Manchester (Netcare
UK), Royal National Orthopaedic Hospital, Stanmore (New York Presbyterian),
Shepton Mallet, Somerset (New York Presbyterian).
Two mobile units will offer ophthalmology services in the following areas:
Cheshire and Merseyside (Netcare UK), Cumbria and Lancashire (Netcare UK),
Horton, Oxfordshire (Netcare UK), Wycombe, Bucks (Netcare UK), North Tyneside
(Netcare UK), South-west Oxfordshire (Netcare UK), North-west peninsula (Netcare
UK), Dorset/Somerset (Netcare UK), Kent/Medway (Netcare UK), Hants and Isle of
Wight (Netcare UK), Surrey and Sussex (Netcare UK), Thames Valley (Netcare UK)]
- Is the government's programme of privately-run fast-track treatment centres
a bad idea? Tash Shifrin
Friday September 12, 2003
- The health secretary, John Reid, today announced details of the
government's controversial programme of privately run fast-track diagnostic
and treatment centres.
Tash Shifrin Friday September 12, 2003
- John Reid, the health secretary, yesterday stoked the fire of a revolt at
the Labour party conference against the government's health service reforms when
he gave seven private healthcare corporations a £2bn foothold in the market for
treating NHS patients. John Carvel, social affairs editor
Saturday September 13, 2003 The Guardian
- Wasting money, and lives. Tony Blair said back in May that he wanted to
open the whole NHS to outside competition. Now, it seems, his ministers want
to go one step further and prop up foreign healthcare corporations at the
expense of NHS doctors and nurses (No, it's not privatisation, September 12).
So much for the government's pledge to invest in the NHS. Letters
Monday September 15, 2003 The Guardian
- Q&A. Treatment centres John Carvel
Wednesday September 17, 2003 The Guardian
- An NHS trust [South West
Oxfordshire PCT] yesterday delivered a slap in the face to John Reid, the
health secretary, when it threw out his plan to use foreign healthcare
corporations to operate on patients from the NHS waiting list. John Carvel,
social affairs editor
Friday November 28, 2003 The Guardian
- A South African healthcare company involved in government reforms has been
reported to health inspectors after three patients developed serious
complications undergoing eye surgery last year. James Meikle, health
correspondent
Wednesday December 24, 2003 The Guardian
- The health secretary, John Reid, has announced that contract negotiations
have been completed for two mobile cataract surgery units as part of the
government's controversial programme of private sector-run treatment
centres.Tash Shifrin
Monday January 12, 2004
- Jarvis, the company at the centre of the Potters Bar rail crash inquiry,
yesterday gained a foothold in the market for treating NHS patients in
fast-track surgery centres. John Carvel, social affairs editor
Saturday January 17, 2004 The Guardian
- Government plans to use private healthcare firms to treat patients from
the NHS waiting list were in disarray last night after ministers axed the
preferred bidder for a chain of fast-track surgery centres. The Department of
Health said it "deselected" Anglo-Canadian, a consortium based in Calgary,
Alberta, because it could not offer value for money on a proposed contract to
carry out 30,000 operations a year at three London hospitals. John Carvel
Social affairs editor
Friday April 16, 2004 The Guardian The government has struck a groundbreaking deal with two of Britain's
independent hospital chains to carry out 25,000 orthopaedic operations on
patients from the NHS waiting list in England at a cost to taxpayers which
slashes the normal private sector rate. John Reid, the health secretary, will
today announce block contracts with Nuffield Hospitals and another UK company
to provide hip and knee replacements at 40 of their operating centres across
England. There will be no charge to patients. John Carvel, social affairs
editor
Wednesday April 21, 2004 The Guardian
[similar to ISTCs]
- Patients could be subjected to inferior and sometimes "botched" operations
under government plans to employ overseas doctors to cut waiting lists, NHS
surgeons have warned. The Department of Health's decision to employ overseas
doctors in special private treatment centres could compromise patient care and
squander NHS resources, according to a group of 43 orthopaedic surgeons from
the West Country.
Thursday May 13, 2004
- The Department of Health used bully-boy tactics to force local NHS trusts
to sign contracts with foreign healthcare corporations for treatment centres
they did not need, according to the chairman of a primary care trust (PCT) who
lost his job for resisting the scheme. John Carvel, social affairs editor
Tuesday June 1, 2004 The Guardian
- The number of NHS patients being treated by the private sector will double
to 500,000 a year during a third Labour term, Tony Blair disclosed yesterday. In
a departure that caught the Department of Health by surprise, he promised a
second wave of independent treatment centres to operate on patients from the NHS
waiting list. This would increase the proportion of NHS patients being treated
in the private sector to 10%, he said in his speech to the Institute for Public
Policy Research. John Carvel, social affairs editor
Tuesday October 12, 2004 The Guardian
- John Reid, the health secretary, ran into a storm of protest yesterday from
doctors and NHS managers when he promised to contract out thousands more
operations to private treatment centres in an effort to cut waiting lists. The
British Medical Association said the scheme was destabilising the NHS by
stealing work from its established surgical teams. John Carvel, social affairs
editor
Saturday January 8, 2005 The Guardian
- John Reid, the health secretary, is facing a groundswell of opposition from
NHS trust chiefs in England about plans to contract out up to 15% of
non-emergency operations and diagnostic tests. A survey of more than 100 trust
chief executives found 73% thought the scheme was not good value for money and
37% said it was being enforced by "bullying" from the Department of Health. John
Carvel, social affairs editor
Thursday
January 20, 2005 The Guardian
- Q&A: diagnostic and treatment centres. NHS acute trusts and primary care
trusts have criticised the growing network of privately-run independent
treatment centres which the government has brought in to help drive down waiting
lists. So is another flagship government health policy in jeopardy? Debbie
Andalo reports.
Wednesday January 26, 2005
- A hospital set up three years ago to help cut NHS waiting lists has run up a
multi-million debt because of lack of demand from cash-strapped health trusts,
it has emerged. Ravenscourt Park hospital, a west
London NHS specialist centre
for hip and knee operations, is expected to incur losses of £37m by 2010 because
of high running costs and the low numbers of patients being referred to its
services. Hélène Mulholland
Monday
February 14, 2005
- Britain's general surgeons accuse the government today of betraying the
principles of the NHS by spending billions on contracting out standard
operations to the private sector, leaving NHS hospitals ill-equipped to handle
the harder cases. John Carvel and Heather Tomlinson
Thursday
April 21, 2005 The Guardian
- A multi-million-pound government deal with a private company, aimed at
clearing up the long waits for diagnostic scans for the NHS has backfired,
leaving some patients waiting up to a year and a half for a scan. Jo Revill,
health editor
Sunday
April 24, 2005 The Observer
- The NHS is to more than double its use of the private sector to operate on
patients on waiting lists in England, the health secretary Patricia Hewitt will
reveal today, in a speech signalling unremitting health service reform. John
Carvel Social affairs editor
Friday May 13, 2005 The Guardian
- The government's rushed timing for signing the second wave of NHS contracts
to double the involvement of the private sector is unadulterated cynicism
(Report, May 13). The Labour manifesto gave only vague generalities on this key
topic and the Blair-Milburn electioneering rapidly dropped the boast of yet more Blairite reform of public services when it became clear that what was meant was
unwanted privatisation. Letters
Saturday
May 14, 2005 The Guardian
- Patricia Hewitt, the health secretary, promised today to phase out the
sweeteners enjoyed by private sector health corporations treating patients from
the NHS waiting list. In an article in the Guardian, she acknowledged the
current contracts for independent treatment centres in England gave the private
sector an unfair advantage in competition with NHS hospitals. John Carvel,
social affairs editor
Saturday
July 2, 2005
- Private sector bidders for contracts worth £3bn to diagnose and treat NHS
patients are being wooed with the prospect of a permanent place in England's
healthcare market. The deal was advertised in the official journal of the EU
soon after Patricia Hewitt took over as health secretary at the start of Tony
Blair's third term. Companies expressing an interest in bidding were sent more
than 200 pages of documents setting out what would be expected of them. The
confidential documents, dated September 8, show that the primary purpose of the
contracts would be to help create a "sustainable" market in the provision of
elective care to NHS patients and encourage competition between NHS and private
providers. Some private companies will be given an opportunity to take over NHS
buildings and equipment. John Carvel, social affairs editor
Thursday September 22, 2005 The Guardian
- Private units could trigger collapse of
Brighton NHS Trust As Health
Secretary Patricia Hewitt gets to her feet to give her speech to Labour
conference delegates today, her policies are causing havoc in hospital services
just down the road from the conference hall. A controversial scheme to buy in
operations from new private sector Treatment Centres is due to slice off 85% of
the orthopaedic caseload from the Brighton & Sussex Hospital, and instead
purchase £18m of NHS treatment a year from a newly-created private unit. This
will leave the NHS with only the most costly and complex cases and emergency
work. Keep
Our NHS Public 28 September 2005
- Do not be beguiled by the health secretary's assertions that the second wave
of treatment centres currently under negotiation will restrict the
private
sector to a 10% share of elective care or just 1% of NHS expenditure. It would
be a mistake to infer that this would be the limit of private sector
involvement. Leader
Monday
October 3, 2005 The Guardian
- 'Faults' of NHS provider.
Channel 4 News has uncovered serious failings in a private healthcare
provider that has been awarded an NHS contract. Published: 7 Dec 2005 By:
Victoria MacDonald
- Hewitt: expansion of IS-TCs will continue. In her LSE speech yesterday,
Patricia Hewitt said: "I know that the second wave of independent sector
procurement is controversial, but I also know that the only way to achieve the
18 week target will be to achieve an enormous increase in diagnostic capacity
both in the NHS and independent sector. We won't abolish waiting lists without
it." She said "the next 24 months will determine what kind of NHS we will have
for the next 20 years", arguing that "Reform is the solution, not the problem.
"We need to march on with reform because society, economy and the world keeps on
changing and the NHS needs to change with it. If we are to convince the public
to keep supporting a tax-funded system, free at the point of need, then the NHS
has to provide not just a greater quantity of healthcare but greater quality
too." She also launched the publication of 'Reform of the NHS in England: Update
and Next Steps', a handbook on how to implement the reforms outlined in
Commissioning a Patient-led NHS.
Department of Health 14 December 2005
- A French surgeon employed by private provider Capio put UK patients at risk,
according to a report to the GMC. The report recommends that the Healthcare
Commission investigate Capio after seven joint replacement operations in which
standards of surgery were poor and joints were at risk of early failure. The
report concludes that the surgeon had been put in an "impossible position" by
Capio, who "employed a doctor with a poor grasp of English, no training or
understanding of the implants that he was expected to use and no understanding
of independent consultant practice in the UK." The surgeon says that Capio did
not supply all X-rays and notes relating to the cases.
Hospital Doctor 15 December 2005
- An IS-TC in Greater Manchester run by South African company Netcare has lost
the health economy nearly £2m in its first six months, according to a
confidential report by
Greater Manchester surgical centre's contract management
board. 14 PCTs have paid £1.9m to Netcare for operations that were not carried
out, as patients opted for traditional NHS care. The IS-TC performed fewer than
4,000 of 6,000 contracted operations, yet under the contract Netcare have been
paid for the full amount. The biggest loser has been Ashton, Leigh and Wigan
PCT, which paid nearly £500,000 for an anticipated 688 procedures, of which only
67 were performed. Ashton finance director David Wharfe admitted the situation
"does not represent value for money." Health Service Journal 15 December
2005
- IS-TCs harm the NHS and risk compromising patient care, according to a
British Medical Association survey. A poll of 177 clinical directors in England
found 68% felt IS-TCs "destabilised" local services. In contrast NHS treatment
centres were thought to be better integrated with hospitals, with half of
respondents believing they had a positive impact on services compared with none
for private centres. Respondents said IS-TCs cherry-pick simple operations,
meaning a loss of income for the local NHS and low staff morale. Training could
be harmed if junior doctors were not given experience with minor surgery. Two
thirds of respondents were aware of cases where NHS trusts had to deal with
complications arising out of surgery in an IS-TC, and doctors reported examples
in
Oxfordshire and
Nottinghamshire where NHS facilities were idle because
patients had to be channelled to private treatment centres.
BBC News 15 December
2005
- Patients are 25% more likely to develop post-operative complications after
being treated in one of the new privately run independent sector treatment
centres than in their NHS equivalents, clinical directors claimed in a BMA
survey.
Public Finance 16 December 2005
- NHS to be sued
over Netcare procedures. Ten patients plan to sue the NHS over botched
orthopaedic surgery at IS-TCs run by South African health provider Netcare,
according to legal firm Michelmores. The news follows a spate of bad media
coverage for Netcare, including a Channel 4 News investigation that highlighted
examples of poor clinical performance, resulting in complications that patients
had to have corrected in the NHS.
Summary by
Keep our NHS Public
of
Business Day 12 January 2006
- Private clinic
claims it is not liable for failings. A company that runs an IS-TC is
seeking to appeal against a court ruling holding it legally liable if treatment
goes wrong. Frances Johnson sued the Birkdale Clinic in
West Yorkshire over a
cataract operation that encountered complications.
Summary by
Keep our NHS Public
of British
Medical Journal 13 January 2006
- Independent
treatment centres will have to provide training. Patricia Hewitt has
attempted to placate concerns that IS-TCs harm doctor training by depriving
junior doctors of simple procedures with which to hone their skills. Speaking to
the NHS Confederation, she said: "We will continue to respond to legitimate
concerns - for instance, to ensure that training for junior doctors is provided
in independent treatment centres and more generally to provide a level playing
field for different providers within the NHS family."
Summary by
Keep our NHS Public
of British
Medical Journal 20 January 2006
- Primary care
opened up to commercial operators. The health white paper will announce six
pilot schemes to open up the primary care market to companies such as United
Health and Care UK. The projects will be centrally procured "to get economies of
scale and to tempt new providers with significant capital backing". PCTs will
then decide which services they want, including services in high streets and
supermarkets, nurse-led practices and diagnostic centres that combine health and
social care. The pilots will operate in
London,
Liverpool,
Bradford,
Plymouth
and
Ribble Valley, with ten more areas lined-up. Hewitt will also launch a
"social enterprise unit" to aid professionals in setting up not-for-profit
businesses. The FT says: "This is aimed, over time, at creating a purchaser/
provider split under which PCTs will chiefly purchase from a growing
range of independent providers." Department of Health sources say the shift from
hospitals to community care will move 5% of activity out of hospitals over a
decade, about £2.5bn a year. This would force reconfiguration and in some cases
closures. Meanwhile the increase in payment for treatments will only be 1.5%
next year. This below inflation rise is intended to save £3bn in order to
eliminate trusts' structural deficits and overspends and increase efficiency. It
has been described by John Appleby, Kings Fund chief economist, as "very
challenging if not impossible".
Summary by Keep our NHS Public
of Financial Times 28 January 2006
- Can privatisation
help our health service? At the new Shepton Mallet diagnostic and treatment
centre, owned and run by private company New York Presbyterian Healthcare
System, the cost of every operation is 20% more than the NHS tarfiff.
Summary by Keep our NHS Public
of BBC Online 30
January 2006
- Adams takes chief
task at Netcare. Netcare, the south African company that runs a number of
independent sector treatment centres, has appointed a British chief executive in
what it calls a demonstration of its long-term commitment to NHS provision. Mark
Adams was formerly the director of AXA PPP healthcare and managing director of
Denplan. The FT says Netcare is looking to expand into primary care and family
doctor services. Summary by Keep our NHS Public
of Financial Times 14
February 2006
- Transfusion
needed after IS-TC hip op. Maurice Cardew, 79, from Helston,
Cornwall,
needed an emergency blood transfusion after being discharged just three days
after a hip operation at the privately-run Peninsula NHS Treatment Centre in
Plymouth. He then had to spend a week at the Royal Cornwall Hospital. An
orthopaedic surgeon who saw Mr Cardew at there said his early discharge was
"shocking". He knew of three operations carried out at the Peninsula centre from
which major complications had arisen. Maurice Cardew started losing large
quantities of blood on the drive home from the treatment centre. The Peninsula
Centre said policies on discharging patients have been revised. Summary by Keep our NHS Public
of BBC
Online 21 February 2006
- Healthcare
marketing drive targets GPs. South African company Netcare, which operates
independent sector treatment centres, is to market its services to doctors.
Summary by Keep our NHS Public
of Financial Times 21 February 2006
- Consultant groups
may win contracts. The contracts for the new round of treatment centres will
make it possible for groups of consultants as well as private companies to
provide a wide range of treatments to NHS patients. Confidential government
documents suggest consultant groups are more likely to be successful in bidding
for the new 'extended choice contracts' than for the previous two waves of
independent sector treatment centre deals. The new contracts, due to be signed
by July this year and worth as much as £200m annually, do not ask bidders to
provide millions of pounds in performance security and cover a wider range of
procedures. The additionality principles preventing employment of NHS staff
without trusts' permission have been dropped. While the DoH has yet to issue a
complete list of procedures covered, it has so far only excluded cosmetic
surgery, clinically urgent procedures, maternity and abortion services. Existing
IS-TCs are protected by geographical exclusions where they are already offering
treatment. Successful bidders will be guaranteed inclusion in 'choice menus'
offered to patients under Choose and Book. The DoH will this time not be
guaranteeing patient numbers or income. Contracts will terminate by 31 March
2008, despite previous expectations of three-year deals. Summary by Keep our NHS Public
of Hospital Doctor 23 February 2006
- Britain's botched
operations. A BBC investigation has uncovered an alarmingly high number of
botched operations by foreign surgeons working in private treatment centres for
the NHS. One confidential health authority audit of 70 operations at a private
hospital found "serious concerns" about 67% of them. David Dandy, vice-president
of the Royal College of Surgeons, said: "In 40 years experience, I have never
come across quite so many operations needing to be repeated in such a short
time." For example, of 18 operations carried out by Arpad Illyes from Hungary,
12 were found by an independent surgeon to be poor. For another doctor, Roland
Istria, of 15 operations, nine were found to be poor - a failure rate of 66%.
The average NHS failure rate in the field is 2%. There is concern about
statistics, most of which the government will not release due to commercial
confidentiality. In the case of one botched hip operation, because corrective
surgery was later carried out by the NHS the procedure was recorded as an
overall success.
Summary by
Keep our NHS Public
of BBC Online
8 March 2006
- High cost of
private care firms adds to hospitals' cash crisis. Private companies
brought into the NHS to increase capacity are costing the government millions
of pounds more than it has admitted, adding to the huge financial pressures on
the NHS. Health authority board meeting documents obtained by Channel 4 News
suggest that some companies are receiving up to 27% above the tariff for
procedures. Details have also emerged of multimillion-pound "residual value"
packages - agreed sums to be paid to the private companies for their
facilities should their five-year contracts not be renewed. Some companies may
be receiving up to £25 million more than the NHS would for a similar service.
According to the documents, productivity in independent sector treatment
centres has been questionable. In South Yorkshire and Trent alone, 7,000
operations were paid for but only 5,400 were actually carried out, according
to analysis of contracts between Partnership Health Group and 19 local PCTs.
Summary by
Keep our NHS Public
of
Times 8 March 2006
- Exclusive (including video clip): We reveal how new privately run treatment
centres were paid millions for operations never carried out.
Channel 4 News 8 March 2006
- NHS hospitals are having to repair the damage done during botched operations
on people who have been sent to private centres for hip and knee replacements to
cut waiting lists, it is revealed today. Independent sector treatment centres
(ISTCs) have been set up around the country using mainly surgeons from overseas
to take the pressure off major NHS hospitals by fast-tracking the easiest cases.
But Angus Wallace, professor of orthopaedic and accident surgery at
Nottingham
University, writes in the British Medical Journal that "the number of patients
we are seeing with problems resulting from poor surgery - incorrectly inserted
prostheses, technical errors and infected joint replacements - is too great."
Many overseas surgeons, he says, "have been asked to carry out joint replacement
operations that they have never seen or done before". Many of the centres have
contracts to buy just one type of artificial joint - but sometimes it is one
that the surgeon has no experience in using. "It is quite clear that this has
occurred with inadequate training of both the surgeons and the operating theatre
staff and as a consequence there have been several serious errors - joint
replacements put in without bone cement when bone cement was essential for that
joint replacement, the use of the incorrect size heads (ball) for a hip joint
replacement, etc," he writes. Sarah Boseley, health editor
Friday
March 10, 2006 The Guardian
- MPs hear how
Labour's reforms are undermining the NHS. Royal
Cornwall Hospital Trust -
which is to axe 300 jobs because of a £8.1 million funding shortfall - is losing
£6m of its income next year because of the government's use of privately-run
treatment centres. It will perform 6,000 fewer operations next year with the
patients being switched to ISTCs.
Summary by
Keep our NHS Public
of
Telegraph
10 March 2006
- My life has been
wrecked by op blunders of foreign doctor hired to cut NHS lists. A
Bristol
grandmother has accused a foreign surgeon at a Nuffield ISTC of ruining her life
by botching her operation. Elaine Cowan suffered agony for a year and cannot
return to work after her hip operation went badly wrong.
Summary by
Keep our NHS Public
of Western Daily Press 10 March 2006
- Wards closing "as
cash goes private". Bernard Ribeiro, president of the Royal College of
Surgeons of England, has said hospital wards across
Greater Manchester are
closing because a private clinic is attracting funds from the NHS. At the same
time as Trafford Acute Trust last week announced that two 26-bed wards will shut
at Altrincham General, millions of pounds of public money is being channelled
into the private Greater Manchester Surgical Centre in Trafford, a 48-bed unit
run by Netcare and staffed with South African surgeons. Ribeiro said that in the
first six months of this year, £2 million had been diverted away from Trafford
to fund treatments at the private clinic.
Summary by
Keep our NHS Public
of
Manchester Evening News 13 March 2006
- In your report (NHS forced to fix bungled private sector hip replacement
operations, March 10) you say independent sector treatment centres (ISTCs) have
been set up to take pressure off NHS hospitals. In practice, government policy
is forcing services out of the NHS into the private sector, in a move that
threatens NHS hospitals across the country. Letters
Wednesday
March 15, 2006 The Guardian
- ITCs threaten
clinical training, admits DoH. Bob Ricketts, the Department of Health's head
of access, policy development and capacity, has admitted that doctors' training
is being put at risk by the government's introduction of independent treatment
centres. He told the Commons health select committee this was the "biggest
issue" to do with the policy. But he said that it would be the job of the SHA to
monitor training.
Summary by
Keep our NHS Public
of Health Service Journal 17 March 2006
- Costs soar as eye
ops go to private firm. Eye operations at a new private treatment centre
funded by the taxpayer are costing almost seven times more than they would be on
the NHS. Every cataract operation at the Mercury Healthcare ISTC at St Mary's
Hospital,
Portsmouth, has so far cost a staggering £5,590 compared to the standard NHS
price of £847. The public has so far paid £335,412 for 60 cataract operations at
the private-sector centre since it opened on December 19 last year - the same
number would cost just £50,820 at an NHS hospital. Mercury Healthcare has an
£84m five-year contract with local PCTs. As part of the deal Mercury should
carry out 1,650 cataract operations a year, although it gets paid whether GPs
refer patients there or not. The government also pays out an extra 20% to
compensate Mercury for setting up the £10m centre. By March Mercury should have
performed 330 cataract operations. The actual number was just 60.
Summary by
Keep our NHS Public
of
Portsmouth News 18 March 2006
- Independent
sector treatment centres: experience and spin. Simon Kelley writes: "The
government argument that independent centres provide value for money in elective
surgery is unconvincing because it considers 'spot purchasing' costs of 'waiting
list initiatives' rather than the costs of planned NHS care. Procurement may
drain the NHS of funds that might otherwise be invested in comprehensive care in
NHS hospitals."
Summary by
Keep our NHS Public
of
British Medical Journal 31 March 2006
- Row over
hospital waiting times claim. A hospital manager has accused health bosses
of falsely telling patients there are long waiting times at an NHS hospital to
influence them to choose to have treatment at an ISTC. In 2004
Worcestershire's three PCTs signed a £26m contract with a Canadian firm -
tying them into a deal which would see 9,000 hip, bone and knee operations
performed privately at the Kidderminster Independent Treatment Centre. Health
watchdogs expressed concern, saying the PCTs could find it difficult to refer
enough patients to the company, in which case they would incur huge fines.
Now, Jo Harper, general manager in surgical specialities at the Alexandra
Hospital in Redditch, claims chiefs at Redditch and Bromsgrove PCT are telling
patients they will have to wait six months for surgery at the Alex, so instead
should be treated at Kidderminster. She says that the wait at the Alex is
actually four months, and that it was particularly concerning as health chiefs
were proposing to axe a host of services at the Alex in a bid
to save £20m. The PCT
denies lying.
Summary by
Keep our NHS Public
of Birmingham Mail 4 April 2006
- Hewitt walks
tightrope with 'rebalancing' act. In a letter to the FT, Alex Nunns of
Keep our NHS Public
writes:
"Patricia Hewitt refers to the loss of thousands of NHS jobs as a 'rebalancing
of staff', made necessary by new technology and better ways of treating
patients at home. Why, then, are NHS managers citing market reforms as the
reason for cuts ? Mrs Hewitt says
the current reforms are 'part of the solution, not part of the problem'. But
the
County Durham and Darlington hospitals trust recently announced that 700
staff are to be 'rebalanced' because of the payment by results system and the
effects of contracted private treatment centres."
Summary by
Keep our NHS Public
of
Financial Times 4 April 2006
- Audit shows ISTC
failures. More damning evidence of poor quality patient care in independent
sector treatment centres has emerged in the face of Government denials that such
evidence exists. An audit comparing NHS primary joint replacements at North
Bristol NHS Trust and the private Cheltenham Nuffield Hospital in 2004-05
showed re-operation rates were ten times higher at the latter. Mr Gordon
Bannister, an NHS consultant at Avon Orthopaedic Centre (AOC), compared 1,754
joint replacement operations at the AOC with 137 in the Cheltenham Nuffield. The
Nuffield's re-operation rate for knee replacements was ten per cent, compared
with the NHS' one per cent. For hips it was 12 per cent, with 0.7 per cent in
the NHS. German surgeon Mr Matthias Honl, who treated NHS patients in
Cheltenham, said he had to steal instruments from another hospital, as those at
the Nuffield were inappropriate. Meanwhile Prof Angus Wallace, of Nottingham's
Queens Medical Centre says during two weeks in March he saw 15 orthopaedic
patients from
Barlborough ISTC, run by Partnership Health Group, with problems due to poor
surgery and inappropriate discharge. 'One resulted in a near death from renal
failure,' he wrote to Health Minister Jane Kennedy.
Summary by
Keep our NHS Public
of Hospital
Doctor 21 April 2006
- Firm to set up
practices. South African company Netcare, one of the leading
independent sector treatment centre providers, has
unveiled plans for a major move into providing GP services. Mark Adams, UK chief
executive officer of Netcare, said: "It's not about delivering health care as it
was. We want to get as big as we can in primary and secondary care. It may be
all we do is administration, reception, scheduling patients, support staff,
dispensing, with GPs working on their own with bureaucracy taken away from them.
Equally we could have clusters of salaried doctors." Netcare has already won
contracts to run commuter walk-in centres at King's Cross, London, and in Leeds,
and is currently bidding for six APMS contracts.
Summary by
Keep our NHS Public
of Pulse 21 April 2006
- PCTs re-route
referrals to independent sector. GP referrals are being re-routed to
independent sector treatment centres behind the backs of GPs. Referral
management centres in at least three LMC areas are phoning "significant" numbers
of patients and pressurising them to switch from referral at an NHS trust, where
they expect to see a certain consultant, to independent sector treatment
centres. GPC chair Dr Hamish Meldrum said the practice was unacceptable, and
rode roughshod over patient choice. Somerset LMC is instructing GPs to attach a
disclaimer to any referral that is made directly to a named consultant, warning
that "any medical, legal or process complaint arising out of a diversion of this
referral will be the responsibility of the chief executive of the PCT
authorising this action". Dr Terry McCormack, a GP in Whitby, north Yorkshire,
confirmed patients were experiencing pressure to use the independent sector
treatment centre. He said: "It pulls the rug from under local hospitals' feet."
Summary by
Keep our NHS Public
of Pulse 21 April 2006
- The air of crisis surrounding the government's NHS reforms grew yesterday
when health workers and nurses warned of
industrial action in protest at threatened job cuts to tackle
NHS deficits. Health
secretary Patricia Hewitt's strong defence of the NHS reform programme,
including the use of the
private sector, drew scorn from the health conference of the public sector
union Unison in Gateshead. The anger was directed at both job cuts and the
spread of the private sector into the NHS through the
private finance initiative
and independent treatment centres. Patrick Wintour and
Martin Wainwright
Tuesday April 25, 2006 The Guardian
- Netcare-led team
to acquire General Healthcare Group. General Healthcare Group, one of the
UK's biggest private healthcare businesses, is set to be acquired for £2.3bn by
a buyout team led by South African company Netcare. The deal is the largest
healthcare transaction to date in Europe. The FT says: "The sale will be the
latest in a series of deals in the healthcare sector, which is attractive to
private equity because of increased government spending… Last year, healthcare
deals in the UK by private equity companies totalled £4.5bn, up from £1.5bn in
2004."
Summary by
Keep our NHS Public
of Financial Times 25 April 2006 [Private
Sector Involvement, Independent Sector Treatment
Centres]
- 'Twin-track'
strategy remains to reap NHS work. Netcare's acquisition of General
Healthcare Group - marrying South Africa's largest healthcare provider with the
UK's biggest private hospital business - has put a new face on the government's
drive to use the private
sector for healthcare. So far Netcare has won about 10% of what is roughly a
£500m-a-year market for NHS waiting list operations. General Healthcare, by
contrast, whose private hospitals operate as the BMI group, failed to win any of
the first wave of independent treatment centres,
although it has since won a small supplemental contract. It has been following a
"twin-track" strategy. It is trying to build and maintain its private patient
side, funded chiefly through private medical insurance and patients who pay out
of their own pocket. At the same time, it has created a new trading entity,
Amicus, to bid for NHS work. Mark Adams, chief executive of Netcare UK, says the
plan for the merged company was to have "in effect two businesses" - broadly
reflecting BMI's strategy. One would supply the NHS, while the other would
concentrate on private work. The NHS work provides a lucrative market that
within a few years will be worth well over £5bn annually as the NHS buys a mix
of waiting list operations, diagnostics, mental health and, soon, primary care
services from the independent sector.
Summary by
Keep our NHS Public
of
Financial Times 26 April 2006
- Health staff unite on NHS funding. A coalition of bodies representing 1m
health professionals, managers, nurses and patients have united to call for a
"free, fair and tax-funded" NHS. Twelve
bodies, including health unions, royal colleges and patient groups, say tax is
the best way to fund the NHS, and that a move to a social insurance system, as
advocated by Doctors for Reform, would increase costs and red tape and see the
most needy paying the most. Dr Gill Morgan, chief executive of the NHS
Confederation, said: "We believe a social insurance system would be a step back
not forward." Dave Prentis, general secretary of public sector union Unison,
said: "Need, not the size of your wallet or the small print of your health
insurance policy, must be the criteria for healthcare across the UK." Meanwhile
Patricia Hewitt told MPs on the health select committee that hospital managers
should stop complaining about the impact of privately-run but state-funded
independent sector treatment centres.
Summary by
Keep our NHS Public
of BBC
Online 27 April 2006
- Treatment centre
programme in disarray as contracts axed. The DoH has been forced to scrap a
large swathe of its second-wave independent treatment centre programme nearly a
year after it invited private sector organisations to bid for the lucrative
contracts. Seven of the 24 local schemes have been axed, with the rest being
delayed by up to a year. Those axed include two of the most high profile
schemes, in
South Yorkshire. The climbdown came after the DoH was forced to acknowledge
claims by SHAs and PCTs that more elective capacity was not needed in their
regions. Companies bidding for the work received letters from the DoH's
commercial directorate saying: "It has become clear for a variety of reasons
that the detailed make-up of the schemes needs to be reviewed and that these
schemes will not go ahead as part of the phase-two procurement programme. We are
currently exploring options to replace the capacity of these schemes." The DoH
has told private providers
that the monetary value of the schemes - £550m worth of work per year - will
still be guaranteed. Meanwhile the other 17 remaining schemes have been delayed
for up to a year. NHS Confederation policy director Nigel Edwards said: "What is
becoming increasingly clear is that the level of surgical elective capacity is
enough, if not too much. The problem is now one of patient flow rather than
capacity, and there has been a growing anxiety that too much capacity had been
procured and this has become a big issue." The second part of the wave two
contract, known as the 'extended choice network', under which the DoH was set to
buy elective services on top of the initial national schemes, has also been
delayed indefinitely. However, the diagnostic element of the second wave is
unaffected. The cancelled projects are:
County Durham and Tees Valley - multi-specialty treatment centre;
Birmingham and the Black Country - Birmingham City treatment centre to be
housed on site at Sandwell and West Birmingham Hospitals trust;
South Yorkshire - cardiology treatment centre;
South Yorkshire - general surgery treatment centre;
South West Peninsula - multi-specialty mobile unit;
West Yorkshire - plastic surgery unit;
West Yorkshire - multi-specialty treatment centre.
Summary by
Keep our NHS Public
of Health Service Journal 27 April 2006
- ITCs to face
clinical audit over care quality concerns. An
independent audit to review
the clinical quality of independent treatment centres
with NHS contracts is to be launched by the Department of Health, in an attempt
to head off criticism from orthopaedic and ophthalmic surgeons about the quality
of operations at the centres. The audit will be carried out by the Healthcare
Commission in partnership with the medical royal colleges. A DoH spokesperson
said: "As well as assessing the delivery of care in the centres, the review will
assess views and concerns from the medical royal colleges, clinical specialist
associations and other groups who have an interest in the programme."
Summary by
Keep our NHS Public
of Health Service Journal 27 April 2006
-
South Yorks lobbying killed off proposals. Managers in South Yorkshire
say heavy lobbying about unneeded and destabilising independent sector capacity
led to the cancellation of two independent treatment
centres proposed for the area. The £200m general surgery centre based in
Sheffield and a £40m cardiology centre for Rotherham and Barnsley foundation
trust were two of the seven ITCs axed. South Yorkshire SHA is now in discussions
with the DoH to procure £11m worth of primary and community care services
instead. In September last year the SHA was ordered by the DoH to find £18m
worth of extra work for the second-wave procurement after its original plans
assumed the region needed just £3.2m in private provision. Senior managers in
the five foundation trusts - which form the country's first foundation
'community' - were understood to be 'very concerned' that the DoH's proposals
could jeopardise their business plans. One chief executive said he was concerned
the DoH would "try to replace the scrapped scheme with
additional capacity in other
types of services across the region, which would not be needed either".
Summary by
Keep our NHS Public
of Health Service Journal 27 April 2006
- MPs call for more
scrutiny of DoH contracts. The DoH faces pressure to open up its procurement
arrangements following concerns that its £4.6bn programme for
private treatment centres does not offer good value
for money. The calls were made by the Commons health select committee, which
accused Patricia Hewitt of being overly secretive about information the
department claims is "commercially sensitive". The committee has been unable to
conclude its investigations, as the DoH has refused to release the methodology
used to evaluate contract bidders, nor the full business cases of the 13 so-far
successful bidders. Committee chair Kevin Barron told Hewitt that the DoH's
reluctance to release the documents was "preventing us from properly
scrutinising the procurements". Concerns over the costs of the ISTC programme
stem from the premium paid for operations and the guaranteed revenues given to
contractors. Whereas the DoH claims that the centres are paid, on average, only
11.2% above the NHS tariff
for the elective treatments they perform, the committee has been told that it is
nearer 30%, once the less complicated case mixes of ISTCs is taken into account.
Those concerns relate to the first wave of ISTCs. A much larger procurement
process was launched in 2005. It follows a revised value for money guidance set
out in a review of the first wave, which the DoH has also refused to show the
committee. However, a briefing document released to Public Finance under the
Freedom of Information Act confirms that the DoH assumes that all successful
bidders will continue to receive revenue guarantees.
Summary by
Keep our NHS Public
of
Public Finance 28 April 2006
- NHS eye to eye.
In a letter to the Times Nick Astbury of the Royal College of Ophthalmologists
writes: "When a false statistic gets into the body politic it is very hard to
remove it. Your leading article (April 25) states that 'independent cataract
centres have been treating around eight times more patients than the average NHS
unit'. This was first uttered by the previous health secretary, John Reid, in
January 2005. It wasn't the whole truth then and it is not the whole truth now.
The figure was based on a comparison of cataract operations carried out in
independent sector treatment centres (ISTCs) with a mix of more complex
procedures performed in the NHS. Where cataract-only lists are run in the NHS
the number of operations achieved is similar. It is misleading to compare ISTCs,
which have received massive investment to perform single procedures, with NHS
providers who deliver a total ophthalmic service and also train our future
surgeons."
Summary by
Keep our NHS Public
of
Times 28 April 2006
- ISTC capacity is
surplus to requirements. The DoH's £2.5bn 'wave two' independent sector
treatment centre programme is in turmoil, with ten out of 24 schemes in doubt.
The DoH admitted last week that seven schemes would not go forward in their
present form. These were part of a 'second tranche' of schemes. It has now
emerged that the DoH had received no bid responses on three of 12 schemes in an
earlier tranche. Failure to respond is a good indication schemes will be
scrapped. With 21 ISTCs already open and a further 11 due in 2006-07, doctors
are questioning whether too much elective capacity has been procured. Dr Paul
Miller, BMA seniors committee chairman, said: "Capacity is not the problem any
longer. The problem is funding the capacity we've got." In 2005, Bob Ricketts,
DoH head of access and capacity, presented information showing that only
one-third of the 24 schemes were designed to meet local "capacity needs". The
rest were procured to improve "plurality and choice" and to provide a national
chain of orthopaedic centres. Meanwhile, Patricia Hewitt has come under fire for
refusing, in her evidence to the health committee's ISTC inquiry, to reveal the
methodology behind selection of firms to run the centres. Committee chairman
Kevin Barron asked: "How can we expect to make a proper assessment . . . of the
decision to spend public money on ISTCs if we are denied the methodology of how
this is being done ?"
Summary by
Keep our NHS Public
of
Hospital Doctor 5 May 2006
- NHS managers are offering "bribes" to GPs to persuade them to send patients
to a private treatment centre instead of local NHS hospitals, it emerged last
night. The unorthodox payments came to light in the primary care trust covering
the Leigh constituency of the health minister, Andy Burnham. An investigation by
Hospital Doctor magazine found GPs in the area were being paid £30 for every
patient sent to
Greater Manchester surgical centre, a private unit run by the South African
operator Netcare. John Carvel, social affairs editor
Thursday
May 11, 2006 The Guardian
- GPs are offered
£30 'bribe' for private centre referral. GPs are being offered a
£30-per-patient 'bung' to refer patients to an underused independent sector
treatment centre run by Netcare. Figures from
Ashton, Leigh and Wigan PCT showed only 243 patients had been treated at the
centre up to February this year, compared with an expected level of 711. Earlier
figures from September last year show the PCT had paid out almost £500,000 to
that point for operations not carried out. A spokeswoman for the General Medical
Council said it was "concerned the standards may have been breached".
Summary by
Keep our NHS Public
of Pulse 12 May 2006
- The Department of Health does not support
any payment being made to GPs as an "inducement" to refer patients to any
particular provider (GPs offered payments to send patients private, May 11), nor
has it seen any evidence that this has occurred. GPs do receive payment for
pre-operative work, but this is payment for additional work done. If the patient
chooses to go to the
Greater Manchester Surgical Centre, they may need
some preparatory tests, such as blood tests etc. Traditionally, this would
involve one or more hospital outpatient appointments. But for some procedures it
is now possible for these to be carried out by a GP who has had extra training.
This benefits patients as it can be undertaken more quickly and conveniently,
and frees up hospital consultants' time. We understand that the PCT approved a
payment of £30 a patient in recognition of the extra work needed. We have
reiterated that any payments to GPs must be for services not for any other
reason. Norman Warner Minister of state for NHS Reform. Letter Guardian 19 May
2006
- Primary care - Jitters as new providers fear marriage of inconvenience.
HSJ says: "UnitedHealth Europe, which became well-known in the UK for its
Evercare case-management model, was recently successful in convincing PCT
managers in
Derby that it was the best
contractor to take over two GP practices. However, it fell foul of a group
of well-organised local patients, parish councillors and local GPs and its
selection by North Derbyshire PCT as preferred bidder is currently subject to a
judicial review." UHE has also been accused of using the sheer size of its
wallet to win APMS tenders. The company's detractors say it is treating such
contracts as "loss leaders" to get its foot in the door. This, claim critics,
calls into question their commitment to local services. UHE UK managing director
Dr Richard Smith is unapologetic: "We've got to make a beginning, as you have to
with any business. We do not expect to lose money on the contracts we have but
you've got to create plans and respond to the costs." Many potential alternative
providers are starting to lose patience at the mounting costs associated with
bidding for APMS contracts. The national APMS procurement pilot run and funded
by the Department of Health commercial directorate was launched last year. It
appears to be backfiring. One large bidder, Clinovia, which provides community
health equipment and services, has pulled out of the bidding process for one of
the six pilot contracts on offer because of costs. Companies have spent over
£100,000 so far on the tendering process. Richard Smith says the pilot has
provided many lessons ahead of the much bigger programme to procure 30 APMS
providers on behalf of PCTs with under-doctored areas in the summer: "There has
got to be a realistic tendering process. The government worked out how to do ITC
contracts, but now they have got to come up with an appropriate process for APMS."
There is still a perceived lack of clarity about how the commissioner/
provider split will be policed in budget-holding practices - meaning that
there have been calls from some quarters for an independent local market
manager. Choice and contestability require a wide range of services. If large
companies find it easier to enter the market than smaller ones, plurality will
not be taking place. There are concerns that smaller providers would be unlikely
to survive against the likes of UHE and Pfizer.
Birmingham and the Black Country SHA long-term conditions programme director
Paul Murbach has been working on an intensive project over the last year to test
ways in which SHAs can manage and police burgeoning new markets. The SHA has two
out-of-hospital contracts with the independent sector - one with UHE to provide
'risk stratification data', and one with Pfizer Health Solutions for self-care
support for people with heart conditions. Murbach says he has had early
experience of dealing with a "potential conflict management" issue when UHE
decided to bid for the APMS contract in Derby. "That raised issues for us
because our GPs were concerned UHE would have an advantage because they have
access to commissioning-support data through their data contract with us."
Murbach says they were able to reassure GPs that the SHA could sue UHE for
breach of contract if evidence was found of any abuse of its privileged access
to data. Meanwhile John Proctor, managing director of Pfizer Health Solutions
UK, says NHS assumptions about the profit-motivated intentions of the
independent sector have been aggravated by government meddling: "We need to
challenge assumptions in the NHS about the independent sector, but it's
difficult when people feel they've had it forced on them, such as in areas with
independent treatment centres, where people feel the
capacity has just been placed and they're then forced to commission from it."
Summary by
Keep our NHS Public
of Health Service Journal 18 May 2006
- Health boss opens treatment unit. A new diagnostic and treatment
centre run by Mercury Health has been officially opened. St Mary's NHS Treatment
Centre in
Hampshire has a minor injuries unit, a walk-in centre for Portsmouth
patients and provides day-surgery procedures. The ISTC expects to deal with
about 50,000 patients a year.
Summary by
Keep our NHS Public
of BBC
Online 19 May 2006
- GPs advised to reject 'bungs'. Medical defence bodies, LMCs and GP
leaders have strongly advised GPs to reject 'enhanced payments' on offer to
refer patients to independent sector treatment centres. The advice came in the
wake of
Ashton, Leigh and Wigan PCT's offer of £30 per patient for GPs to refer
patients to Greater Manchester Surgical Centre, which
is run by the South African firm Netcare. Despite the GMC saying it was
'concerned' GPs would be breaking Good Medical Practice guidelines if they
accepted the offer, the PCT has refused to scrap it.
Summary by
Keep our NHS Public
of Pulse 19 May 2006
- Hospital at risk as patients sent away. Key departments at the
University Hospital of North
Staffordshire will be put at risk of closure or downgrading by a decision
to farm thousands of patients out to a private centre in Burton, according to
senior doctors. Nurses' leaders called the transfer "a slap in the face" for
the hospital staff already under threat of redundancy because the hospital's
debts. Executives from the PCTs defended the move which involves switching
£1.5m from the hospital to the Burton diagnostic and
treatment centre. They say it was necessary because the Hartshill hospital
is downsizing services and so the PCTs had to look elsewhere for capacity to
treat their patients. Hospital bosses argue, however, that they are planning
to downsize only because PCTs are sending in fewer patients for treatment.
Summary by
Keep our NHS Public
of Stoke Sentinel 26 May 2006
- NHS still pays for axed operations. South West Oxfordshire PCT is
still footing the bill for a privately-run mobile eye unit which has withdrawn
its service from south Oxfordshire due to a lack of patients, despite being
previously assured that it would not have to cover the costs. The cataract
operation clinic, run by South African firm Netcare, no longer makes regular
visits to Wantage, even though the PCT is still paying part of the £2m four-year
contract forced on it by Government ministers. The Government announced in 2003
that the mobile unit would travel around the UK to reduce a backlog of patients
waiting longer than three months for cataract operations. South West Oxfordshire
PCT board members turned down plans for Netcare to visit its area, fearing it
would not be used and would impact on Oxford Eye Hospital, where there were few
delays. Chairman Martin Avis later resigned when the board was forced to
reconsider its decision, on the understanding that Thames Valley Health
Authority would underwrite the contract if patients failed to use the service.
Speaking about Netcare's withdrawal from Wantage, he said: "There was a clear
agreement that the PCT would not be liable for any shortfall. It was absolutely
not to be paid by the PCTs if patients did not use it." But now Thames Valley
Health Authority has said: "We had been working with the Department of Health to
underwrite the contract but that money wasn't forthcoming. The PCT is aware that
it's our expectation they will bear the cost." The eye clinic was contracted to
do 400 operations in Wantage every year, at an annual cost of about £500,000.
Last year, only 160 were done. The 240 excess procedures were sold to other
health authorities at a discounted rate, leaving SW Oxfordshire PCT with a
wasted £150,000 bill. If the PCT fails to sell Netcare's next two years'
operations to other health authorities, it will incur further costs of £1m. Lib
Dem MP Dr Evan Harris said: "This is yet more evidence that this was a
preposterous white elephant imposed by Government on Oxfordshire."
Summary by
Keep our NHS Public
of
Oxford Mail 27 May 2006
-
'Fee was not
inducement'. Health minister Lord Warner has approved a PCT's £30 per
patient payment to GPs for referring to an independent
sector treatment centre. In a letter to the Guardian, Lord Warner said
Ashton Leigh and Wigan PCT's payment to GPs for referring to Greater
Manchester Surgical Centre, was not an "inducement" but for additional screening
of patients.
Summary by
Keep our NHS Public
of Pulse 2 June 2006
- Government reforms will 'destroy
the NHS'. Speaking to the annual BMA consultants' conference, Paul
Miller, chairman of the consultants' committee, said: "This has been the NHS's
best year ever ... for management consultants ... for losing staff ... for
wasting money." He estimated that
private management
consultants were costing around £3bn a year and used the work of private
managers in Department of Health-appointed "turnaround teams" sent into 18
trusts with financial
difficulties as examples of wasted money. This included £700,000 paid to
management consultants for three months' work at Surrey
and Sussex trust, despite the fact it still finished the last financial year
with "an operating deficit of £28m and an accumulated deficit of over £57m".The
multi-billion pound contracts awarded to independent sector treatment centres
were also a waste of money, Dr Miller said. Calling for a moratorium on any
other private treatment contracts, he said Oxfordshire primary care trust had
been made to pay £500,000 a year for the next four years to a
private eye clinic despite there being no shortage of
NHS capacity to do the work. He said only 160 of the 400 operations planned in
the contract annually were carried out last year. This was unnecessarily
inflating local NHS debt, which stands at around £82m. Dr Miller also criticised
the PFI, highlighting
£130m wasted on three deals: the abandoned
Paddington PFI scheme, which cost £14.9m; the delayed Barts PFI scheme,
which cost an extra £35m; and the
Norfolk and Norwich PFI, under which the NHS missed out on £82m when the
private contractors refinanced the deal. "If you had made this up, you would be
laughed at," Dr Miller said. "If you were the one who did make this up, you
should be ashamed. If you continue to make it happen, you will destroy the NHS.
This is not the way to run our NHS… It is hard to avoid the conclusion that we
are working in a service which is being broken by policies which do not work;
devised by officials who have resigned; implemented by managers who don't
believe [in the NHS]; and
patients without a say." His speech, which got a standing ovation, was
echoed by criticism of the government made by delegates. A member of the BMA's
consultants committee, Dr Anna Athow, said the government had allowed the NHS to
get into the current financial crisis in order to ration services and push more
resources and patients into the private sector.
Summary by
Keep our NHS Public
of
Guardian 7 June 2006
- Free NHS of politics, says top doctor. Dr Paul Miller, chairman of
the British Medical Association consultants' committee, has said an independent
body should run the health service because the Government's health policies have
failed. He said there had been "shocking incompetence" at the top and "something
is going badly wrong". Miller accused the Government of wasting money on
expensive PFI schemes,
independent sector treatment centres and unnecessary
private management
consultants. He said: "Care is suffering, jobs are disappearing, patients and
staff are paying the price. If a patient gets worse instead of better with
treatment, then it's time to figure out whether the diagnosis or the treatment
is wrong. Something is going very badly wrong with these health policies. It is
time to call a halt, examine what is not working and why." The deficits, he
said, "are caused by bad policies and shocking incompetence inflicted on the
whole service from the top, from Whitehall". He called for the Government to
stop reorganising the NHS,
stop interfering in the local planning of services, and stop using external
management consultants to tell NHS doctors and managers how to run their
services, which he said was costing £1bn a year "without any clear benefit".
Summary by
Keep our NHS Public
of
Telegraph 7 June 2006
- PCT forced to pay £120K for 'nothing'. A strategic health authority
that promised to underwrite a controversial contract in order to get it signed
has reneged on the agreement. As a result the PCT forced into the deal
will have to pay a
private company £120,000 for doing nothing.
Thames Valley SHA promised in 2003 to underwrite the financial risk of an
ISTC contract with Netcare to provide mobile units doing cataract operations.
South West Oxfordshire PCT initially refused to sign the deal, arguing it was
not needed. Under pressure from the SHA and the DoH, it agreed to sign - but
only after it was given the guarantee. The mobile unit no longer visits south
west Oxfordshire, as so few patients chose it. But the SHA is now refusing to
bear the costs, leaving the PCT with an annual bill of £60,000 for the next two
years. Martin Avis, who was PCT chairman in 2003 and whose contract was not
renewed as a result of the ISTC furore, said: "This is
outrageous. An absolute assurance, verbally and in writing, was given to the PCT
that there would be no financial risk to it." Jane Hanna, who was non-executive
director of the PCT in 2003, told the Commons Health Committee earlier this year
that she had resigned "after experiencing other decisions where the PCT was
required to rubberstamp national policy but required to present decisions as
local decisions".
Summary by
Keep our NHS Public
of
Hospital Doctor 8 June 2006
-
Trust goes it alone on private bid. A
London trust is snubbing bidders under the DoH's independent sector
treatment centre scheme in favour of setting up its own deal with the private
sector. Bidders hoping for contracts in South West London under the DoH's second
wave of ISTCs asked to use Kingston Hospital NHS Trust
facilities in their schemes. They wanted to use the Kingston site as either a
'hub' or 'satellite', centre but the trust executive has recommended refusing
such requests. In a bid to become a
foundation trust, the hospital wants to set up its own private sector
partnership. If Kingston's plan is successful it will compete with the DoH's
ISTC for elective work.
Summary by
Keep our NHS Public
of
Hospital Doctor 8 June 2006
- ISTC chaos ignored. The Government is
ignoring local concerns over the national ISTC programme as evidence emerges of
more schemes being scrapped or put on hold. At least eight of 24 schemes in the
£2.5bn wave two ISTC procurement have now been dropped and another put on hold
after commissioners said they were not needed. But the DoH is not only insisting
that
Norfolk, Suffolk and Cambridge SHA spends £38m on a elective surgical ISTC,
it has also rejected its proposals for case-mix of patients treated there. A
recent report by Cambridge City and South Cambridgeshire PCTs said the DoH had
"modelled that we need this capacity" without factoring new NHS capacity into
the model. It said "there will be high risk to local providers because the aim
is for the [ISTC] to fill up first". The PCTs are also under pressure to buy
more scans under the national diagnostics procurement. Most of the commissioned
scans would substitute for work done in the NHS rather than supplement it, the
report says.
Essex SHA has been ordered to spend £45m on independent sector schemes,
despite the collapse of two ISTC projects in 2005. A paper presented to
Colchester PCT's board in January said the SHA had "identified a number of
concerns" with this but the scheme was going ahead anyway. A surgical scheme for
Leicestershire, Northamptonshire and Rutland SHA has been halted. The SHA
said that a PFI project
to upgrade three hospitals and an ISTC could lead to over-capacity. The SHA is
negotiating to leave the national private diagnostics procurement. The DoH has
allowed the scrapping of a surgical ISTC in
York, which already has a surgical treatment centre, at Clifton Park.
Birmingham City Hospital's ISTC had been dropped and it has been reported
elsewhere that a further six schemes have been abandoned. These are:
County Durham & Tees Valley,
South Yorkshire (both cardiology and general surgery),
South West Peninsula, and
West Yorkshire (both plastics and multi-specialty centres). Dr Paul Miller,
chairman of the BMA's seniors' committee, said: "There's clear evidence that
wave one schemes are surplus to requirements - spare capacity is being hawked
around like soft fruit at the end of market day. Rather than imposing wave two
schemes where they are not wanted the DoH should stop now. It should not sign
another contract before it has reviewed the whole policy."
Summary by
Keep our NHS Public
of
Hospital Doctor 8 June 2006
- Hewitt warns overspending NHS. Overspending NHS trusts that are
"concentrated in the healthiest and wealthiest areas" will have to take
responsibility and not rely on being bailed out by the rest of the NHS according
to Patricia Hewitt. Addressing an Amicus conference in Scarborough, the health
secretary said that although trusts in the black will be asked to help their
neighbours this year, they will get the money back with interest starting with
the poorest areas. Hewitt also admitted that times would be particularly hard
for acute trusts as attempts are made to drastically reduce the number of visits
made to hospital by those taken seriously ill. Hewitt's comments come as more
Yorkshire health workers are set to lose their jobs and Scarborough hospital
faces the threat of a new private non-urgent surgery
clinic in York.
Summary by
Keep our NHS Public
of
Yorkshire Post 13 June 2006
- Union in plea over NHS jobs. Union leaders in
Derby have launched a campaign against
NHS cuts to fight bed
losses, redundancies and
privatisation. The campaign run by Unison is also calling for the government
to plug the gap in the area's NHS finances. Andy Belfield, Unison's regional
head of health said: "Private companies are being given
contracts where they are guaranteed payment, even if they don't perform one
single operation," and stated a campaign message of "Enough is enough".
Summary by
Keep our NHS Public
of Derby Evening Telegraph 19 June 2006
- The chairwoman of an NHS trust is set to attack Government health reforms
which, she claims, threaten the future of the service. Debbie Abrahams, chair of
Rochdale Primary Care trust, will tell a protest rally in Manchester she is
speaking out before the health service reaches "the point of no return". She
will say: "I believe passionately in the NHS. For me it is not just about how we
organise and provide health care, it reflects and represents the values of our
society." And she will continue: "During my period as chair of Rochdale PCT, I
have seen a steady stream of national policies introduced -
Foundation Trusts,
Choice,
Independent Treatment Centres and now
Commissioning a Patient led NHS - which threaten these values and the future
of a NHS that is equitable and free at the point of need."
Press
Association Saturday June 24, 2006 10:03 AM
- Sick of health reforms. Doctors are expected to call on their trade
union to oppose key health reforms such as
private funding for hospitals
and the contracting out of
GP practices. At its annual conference in Belfast, the British Medical
Association will be urged to join ranks with the anti-private sector group, Keep
Our NHS Public. The group is made up of MPs, doctors, trade unions and patients
opposed the involvement of the private sector in the NHS. It is against PFI
hospitals, companies running GP practices and private
clinics providing minor NHS treatment such as cataract surgery. Many doctors
believe the policies are
destabilising the NHS and are partly responsible its £500m-plus debt.
Summary by
Keep our NHS Public
of Sky
News 26 June 2006
- "Supermarket" reforms are tearing the NHS apart. Angry doctors at the
BMA's ARM have attacked NHS reforms, which they say are
breaking apart the NHS.
They also criticised their own leaders for not doing enough to stop it. A
multitude of speakers criticised the government on a raft of reforms. They
condemned patient choice as a sham
and accused the new independent treatment centres of
creaming off the easy cases, leaving difficult ones for the NHS. They had
particular bile for recently proposed funding changes, criticising
payment by results under
which hospitals only get money for each patient they treat, as well as
expressing complete opposition to plans to allow
private companies to
commission health services on behalf of patients. James Johnson, Chairman of the
BMA, questioned whether the US "supermarket" model of healthcare works in a
system where "more 'customers' do not mean more profits". He also argued that
payment by results created "perverse incentives to keep patients in hospital".
He pointed out that it would not take "a financial wizard" to realise that if a
private company ran hospitals as well as commissioning services then it would
"add up to a licence to print money". He said that at the BMA's instigation, the
Government had agreed to a health summit next week. Dr Chaand Nagpaul attacked
the squandering of record
investment in the NHS and accused the government of "misappropriating
billions away from patients' care". Voicing the concerns of many he stated that
"now we have the madness of instituting a market in the NHS, with all the
wastage in bureaucracy and transaction costs." Summary by
Keep our NHS Public
of Telegraph
27 June 2006
- Private GPs surgery plan for Merseyside.
Merseyside's first
privately run GP surgery will be one more "nail in the coffin" of the NHS as
we know it, critics have warned. Health managers are vetting tenders from
companies to run a new general practice in South Sefton that will treat around
4,000 patients in the Maghull area. It will be the first in the North West to be
run by an independent firm under a new scheme accused of privatising the
"frontline of the NHS" by the back door. The revelation has angered campaign
group Keep Our NHS Public, which warned putting the focus on profit would turn
patients into "commodities". Alex Scott-Samuel, senior lecturer in public health
at the University of Liverpool and part of Keep Our NHS Public's Merseyside
branch, said: "I'm deeply concerned about the damage this is doing to the NHS
through introducing the private sector initially into hospital services and now
into primary care. This is one more nail in the coffin of front line care.
Firstly companies are doing this work primarily to make a profit, secondly they
have no experience of primary care. Not only will it draw doctors and financial
resources away from the NHS, it will inevitably be a poorer quality of care that
is provided. It's also about changing the whole quality of the NHS from being
part of the Welfare State providing services that we all feel part of, to
reducing people and their health to commodities. It's the commercialisation of
the welfare state and it's carrying on the damage that the Thatcher government
started." Other doctors warned encouraging private firms into the GP market
would lead to the "fragmentation of the NHS". Care UK has already come in for
some heavy criticism from Keep Our NHS Public chairman and lecturer at Edinburgh
University, Allyson Pollock. She accused the company of having "very little
experience" of providing direct services for patients. It is not known if Care
UK or United Health Europe have tendered for the Sefton contract. The names of
all companies involved are being kept under wraps. Keep Our NHS Public's
national spokesman, John Lister, referred to a deal for Canadian-owned
Interhealth Care Services to operate a £146m orthopaedic
Independent Sector Treatment Centre, in Runcorn. He said: "The private
sector are coming in and they are picking and choosing what areas they want to
go into. They don't want anything messy like emergency care, they want fast
admissions, treatment and discharge like a factory production line. Initially,
it appears it's a great way to increase capacity, but in the end all it is doing
is taking capacity away from the NHS. Gradually it means the private sector is
going to have quite a large controlling stake in the NHS and you lose the focus
on patient care being the driving force."
Summary by
Keep our NHS Public
of Liverpool Daily Post 28 June 2006
- Vote to curb private sector in the NHS. Doctors voted resoundingly
against any further involvement of the
private sector in NHS
health care and sent a strong message to the Government that its reforms were
not working. They have singled out the independent sector
treatment centres, the decision to allow a private company to provide
general practitioner services in
Derbyshire, a Government plan to let private companies commission health
services for local patients and private management consultants. Yesterday they
agreed that "the BMA actively opposes the Government plans and restates its core
beliefs in the NHS". Summary by
Keep our NHS Public
of Telegraph
29 June 2006
- GPs in 'bung' victory. GPs are claiming a 'pyrrhic victory' after a
PCT scrapped a controversial scheme to pay them for referring to an
independent sector treatment centre. Ashton, Leigh and
Wigan PCT has ditched the £30 per patient 'enhanced payment' to send more
patients to the underused
Greater Manchester Surgical Centre. It was widely condemned by GPs as a
'bung'. Summary by
Keep our NHS Public
of Pulse 30 June 2006
-
Conference attacks referral centres. Doctors have criticised
referral management centres
for sending patients for inappropriate treatment to
independent sector treatment centres far from their home. At their annual
conference in Belfast, BMA representatives backed motions that condemned the use
of referral management centres, saying they made a nonsense of
patient choice, and called for a
restoration of GPs' right to refer patients to a named specialist. Summary by
Keep our NHS Public
of British
Medical Journal 30 June 2006
- Bupa preferred in health deal. Bupa Hospitals has been given
preferred provider status for one of the second wave of
Independent Sector Treatment Centres. It will be contracted to provide 6,000
surgical procedures in
Cheshire and Merseyside on top of the recent contract it secured to provide
similar services in the north-east. Summary by
Keep our NHS Public
of Financial
Times 3 July 2006
- The five specialist
orthopaedic hospitals in England may have to abandon complex surgery on hips and
bones because of a bizarre twist in the government's rules to turn the NHS into
a competitive market, chief executives warned last night. In a private briefing
paper for MPs, they said patients are set to become the victims of the health
secretary Patricia Hewitt's new system of
payment by results. They
observed that much routine orthopaedic surgery is being diverted into private
sector treatment centres, leaving the five NHS centres
of excellence to concentrate on more highly skilled work. However, they said the
national price list for every type of operation did not recognise the extra
costs of more difficult work. The five hospitals are: the Royal National
Orthopaedic hospital at Stanmore,
Middlesex; the Nuffield Orthopaedic centre in
Oxford; Robert Jones and Agnes Hunt hospital in Oswestry,
Shropshire; Royal Orthopaedic hospital in
Birmingham; and Wrightington hospital in
Wigan. John Carvel, social affairs editor
Thursday
July 6, 2006 The Guardian
-
Specialist trusts
lobby ministers for change in tariff. Britain's five specialist orthopaedic
hospitals say they could be forced to cancel operations and cut services unless
the government adjusts the
payment by results tariff. A briefing paper provided to MPs by the hospitals
says: "The NHS's current financial situation is making financial balance a
non-negotiable requirement and if the national tariff is not amended to
recognise complex cases some trusts will have no way of avoiding serious
financial loss. This situation could result in trusts being forced to end
provision of vital specialist services: ones that are not available in normal
acute trusts."
London Royal National Orthopaedic Hospital chief executive Andrew Woodhead
said the tariff system as it stood would mean his trust lost £5m a year: "We
would be faced with a position where the only way to balance the books was to
stop doing operations that lose us money. We could not continue to operate with
a £5m loss of income." Robert Jones and Agnes Hunt Orthopaedic Hospital chief
executive Jackie Daniel said the projected losses were hampering specialist
trusts' efforts to gain foundation status. Some service cuts may have to take
place before 2008 to convince regulator Monitor that the organisation is ready
to become a foundation trust.
Wrightington, Wigan and Leigh chief executive Sheena Cuminsky blamed
independent treatment centres for taking less complex
patients: "The more this happens, the more complex cases are left for us which
are higher than tariff." Summary by
Keep our NHS Public
of Health
Service Journal 6 July 2006
- Herts and minds: £100m hole that could defeat protesters. West
Hertfordshire Hospitals trust and East and North Hertfordshire trust are
launching consultations on the centralisation of some of their services. With
the local health economy more than
£100m overspent the
talk is of reconfiguration. Both trusts have ambitious plans for centralised
facilities funded through the
private finance initiative. But the affordability of those projects is in
doubt. Both trusts are in deficit and are cutting posts. But PFI projects come
with a substantial yearly payment - about 10 % of the cost - that trusts have to
meet out of income. Both trusts will also lose some income to
privately run surgical centres which will be set up at
Hemel Hempstead Hospital and at the Lister in Stevenage. These will carry out
much of the elective treatment formerly done by the trusts - and will limit
their ability to benefit from patient
choice. Some staff and £15m of work will be transferred to the surgical
centre.
Summary by
Keep our NHS Public
of Health
Service Journal 6 July 2006
-
Trust faces bill
for dropped PFI deal. A
£167m scheme to centralise a hospital trust's services on one site has been
dropped at a likely cost of £10m.
Essex Rivers Healthcare trust made because the decision because the opening
of a new independent treatment centre would have made
it unaffordable and because the plans did not align with the government's desire
to move more services into the community. Now the private finance initiative
partners want as much as £10m in recompense for the costs they have incurred on
the project. It is thought likely that the DoH will agree to meet at least some
of the company's costs, to calm the commercial sector's nerves over the future
of PFI. Chief executive of Essex Rivers Healthcare, Peter Murphy, said four
factors had influenced the decision: the white paper on care outside hospitals;
payment by results; plans for an independent treatment centre in Essex which is
expected to take 20% of the trust's elective income - £7.8m in 2008-09; a
strategy for patients with chronic conditions to visit hospital less. Summary by
Keep our NHS Public
of Health
Service Journal 6 July 2006
-
Trust to shed 80 jobs as Bupa moves in. A National Health Service trust
that is to be the site of an independent treatment centre
run by Bupa has announced up to 80 job
cuts as part of a drive
to cut its workforce by 250, or 10%.
Southport and Ormskirk NHS Trust has announced 33 compulsory redundancies
and says that it may need 50 more as it tries to save £14m over the next two
years to cope with a financial deficit. Summary by
Keep our NHS Public
of Financial Times 8 July 2006
-
Privately run NHS surgery opens. The Midlands' first privately run
surgery unit is to open in Burton-on-Trent this week. The opening of The
Midlands Treatment Centre at Queen's Hospital in
Burton-on-Trent comes as 1,000 staff at North
Staffordshire's hospitals are being laid off to claw back a £15m
debt. The ISTC will
perform minor surgery using NHS staff. As part of the deal primary care trusts
will pay towards the unit whether they send patients there or not. Stoke-
on-Trent PCT will contribute £1.5m. Last month, the University Hospital of North
Staffordshire NHS Trust said it wanted to stop using four operating theatres,
freeing them up for use by private firms and operations from other NHS trusts. Summary by
Keep our NHS Public
of BBC
Online 10 July 2006
-
Patient choice agenda attacked.
Hospital departments will be under threat from the increasing prevalence of
independent sector treatment centres (ISTCs) according
a leading health professional. Professor John Yudkin, director of the
International Health and Medical Education Centre at University College London,
said that the choice agenda was creating big problems with dubious benefits. He
pointed out that ISTC's work can often be substandard and leave the NHS to pick
up the pieces. He also warned that as ISTCs take over more and more simple
procedures such as hip replacements and cataracts, their provision under the NHS
will disappear. He accused the government of deliberately using the impression
that a high proportion of consultants care only about private work to justify
the push for ISTCs. He added that his concerns were shared by others at a recent
meeting of the Royal College of Physicians. Summary by
Keep our NHS Public
of Chester Chronicle 11 July 2006
-
Parry: We are not proud of 83 job losses. Staff at
Southport and Ormskirk hospitals have been thrown on the scrap-heap, union
leaders claimed after it was announced 83 jobs face the axe. In total, 33 posts
have been made compulsory redundant in a bid to save money, and bosses at the
debt-ridden Southport
and Ormskirk NHS Trust have also revealed that a further 50 posts will follow
over the coming months. Staff affected have also been told they cannot apply for
new positions at the controversial soon-to-be-open
Independent Sector Treatment Centre (ISTC), run by private health providers,
BUPA, announced last week. The news comes after a vacancy freeze and the
opportunity of applying for voluntary early retirement or voluntary redundancy
came into operation to save money. However, hospital chiefs say although this
saved £750k, more needed to be done to achieve the overall total of £2.5m on
staff savings. Summary by
Keep our NHS Public
of Sefton
& West Lancashire Champion 13 July 2006
-
Fury as 'anti-competitive' £30m contract awarded. South African-owned
private healthcare company Netcare looks set to win a £30m-a-year contract to
provide clinical assessment services across
Manchester, even though it owns and runs the Greater Manchester surgical
centre. Netcare will be awarded preferred bidder status for the integrated
clinical assessment and treatment services (ICATS) contract by the end of July.
However, NHS sources close to the discussions have raised concerns over whether
this is anti-competitive. If Netcare wins the five-year deal, the company will,
controversially, be able to assess patients for surgery and then refer them to
its own surgical centre for treatment. In January, private providers were
invited to bid for the work to provide ICATS in general surgery,
musculoskeletal, ear, nose and throat, gynaecology and urology services. A
source close to the talks said the DoH's decision to award the contract to
Netcare was "ludicrous". "By doing this, Netcare will be able to sew up the
market, assessing patients to see if they need acute treatment and then advising
and referring those patients for treatment at its own surgical centre." Sources
close to the DoH said that in response to local concerns, the ICATS contract
would be split and shared with another private provider, Partnership Health
Group, in partnership with Alliance Medical. Both companies will have preferred
bidder status by the end of the month. Last year, Netcare's Greater Manchester
surgical centre was found to have lost the local health economy nearly £2m in
its first six months. A confidential report revealed that the 14 PCTs
commissioning from the centre had had to shell out £1.9m to Netcare, even though
the centre was being underused by patients. ICATS contracts form part of the
second stage of the DoH's independent treatment centre procurement programme for
elective services. Summary by
Keep our NHS Public
of Health
Service Journal 20 July 2006
-
The
government's £5bn drive to set up private health clinics could be adding to the
financial problems in the NHS, and there is no evidence they provide better
treatment, a committee of MPs warned today. In a damning report the health
select committee said ministerial pressure on the NHS to set up so-called
independent sector treatment centres (ISTCs) could lead to "unpopular hospital
closures". It reported "real concerns" in the NHS that the expansion of the
centres would "destabilise local NHS trusts, especially those with financial
deficits". The committee said the impact of the £5bn programme "would clearly
affect the viability of many existing NHS providers over the next five years and
possibly beyond". But it added that it was difficult to assess the extent of
impact because the Department of Health refused to disclose its own analysis of
the scheme to the committee.
Matt Weaver and agencies
Tuesday July 25, 2006 Guardian Unlimited
- MPs attack treatment centre program. MPs have challenged the
government's determination to press ahead with a second wave of privately run
surgical treatment centres for National Health Service patients. The independent
treatment centre programme, with contracts worth a total of about £5bn, "could
clearly affect the viability of many existing NHS providers over the next five
years and possibly beyond", the Commons health committee warned. A second phase,
involving an extra 17 centres, might lead to whole hospitals closing, it said.
Yet the health department "has failed to provide the evidence" that the benefits
from the first wave had been greater than if the work had been done within the
NHS. The committee did say that the 29 schemes in the first phase had increased
patient choice, and the threat of the competition they created "may have had a
significant effect on the NHS", even if the additional capacity they added had
been "tiny". But the evidence for a beneficial effect from increased competition
was largely anecdotal. It was "almost impossible to assess" whether the centres,
paid above the standard NHS price for treatment and given guaranteed volumes of
patients, "have . . . proved good value for money". In part that was
because the Department of Health refused to release figures on grounds of
commercial confidentiality, the MPs said, as they called on the National Audit
Office to conduct a study and question whether the second wave of centres should
go ahead. "The decision to maintain the commitment to spend £550m a year despite
changing circumstances" and evidence that the NHS might have too much capacity
in some parts of the country, had not been explained, MPs said. It was
"difficult to as-sess the rationale behind it". Kevin Barron, the committee's
chairman, said: "There is clearly an ideological issue about the use of the
independent sector." Unison said the report's "damning conclusions" showed the
ISTC experiment should be ended. Summary by
Keep our NHS Public
of Financial
Times 25 July 2006
- 'They did not repair my hernia'. MPs say they are not convinced about
the benefits of a network of private clinics set up to carry out minor surgery
for the NHS. But they said there was no evidence to suggest standards of care
were lower compared to the NHS. Andy Walker, a former anaesthetic consultant,
from Burnham-on-Sea, Somerset, wanted to go to north Somerset's
Weston General Hospital when he was told he needed surgery for a hernia. But
instead he was directed to the nearby Shepton Mallet
Independent Sector Treatment Centre by the local primary care trust. "I went
for the pre-op assessment and that all went well. I was seen by a youngish
Polish surgeon and Slovakian anaethetist and they both seemed very competent.
But when I went in for the operation, I saw different staff. It did not strike
me as good continuity of care." He said during the operation he was asked to
cough, adding the doctor was "having trouble finding the hernia". After the
operation, he developed urinary retention. However, as the centre did not have a
pharmacy on site his wife had to drive to the nearest chemist to pick up the
drugs. He also said the doctor was unable to fill the prescription out in
English and had to turn to him and the senior nurse for help. Worse still, Andy
Walker soon realised that the hernia had not been repaired. He went back to his
GP and was told he needed another operation, but this time he insisted on going
to the Weston General Hospital where the problem was eventually cured. It
transpired that the private clinic had treated a small hernia instead of dealing
with the major one. Andy Walker said he was concerned over the standards of care
being provided. The private treatment centre, run by the US-backed UK Specialist
Hospitals Ltd, did not have the back up facilities on site if there were
complications, such as the need for blood transfusion.
Summary by
Keep our NHS Public
of BBC
Online 26 July 2006
- MPs find no evide
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