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Newsletter 28 : 8 - HEALTHCARE, LIMITED

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Many healthcare professionals and patients are concerned at the growing presence in the NHS of private sector providers, which stand to profit from this role. Unions and campaigning groups have argued that the private sector tends to provide a more expensive and lower quality service, and that the core NHS values of equality and universality in healthcare are being compromised.[1] This article looks at some of the companies that might be gaining a growing role in providing our healthcare and benefiting from our taxes, and the links between government and business.

The government has been stepping up its programme of ‘reform’ in the NHS, in clinical as well as non-clinical sectors. More foundation hospitals and plans to transfer primary care staff to the private sector have been announced. A second round of the Independent Sector Treatment Centres (ISTCs) programme has awarded private companies contracts to operate NHS units. This has already damaged local health economies according to a British Medical Association (BMA) survey of clinical directors.[2] The current emphasis on 'choice' will see hospitals competing with each other for funding; the introduction of markets brings the risk that selection and differentiation in service will compromise NHS values.[3]

Government receptiveness to the private healthcare industry is probably helped by the flow of senior NHS/Department of Health (DoH) figures into the private sector, and vice versa. The current Health Secretary, Patricia Hewitt, is a former director of Andersen Consulting (now Accenture), which has gained from PFI contracts.[4] This is a good time for companies to promote private health care. In October 2005, six private healthcare companies conducted a national media campaign 'to champion the benefits of private healthcare.'[5] A DoH report has advised that the government should increase the role of private healthcare providers – not to solve a crisis in the NHS, but to prevent a potential collapse in the private healthcare sector market.[6]

Some companies involved in NHS clinical services:
  • Patients Choice Partners, a PFI consortium including construction company Carillion, Nestore Healthcare and South African hospital company Medi-clinic
  • InterHealth Jarvis, another consortium, made up of Canadian hospital company InterHealth Canada, with UK construction company Jarvis.[7]
  • BUPA is bidding to run diagnostic and treatment centres for the NHS.[8] In 2003, BUPA’s profits rose almost 20%, reportedly as a result of increasing treatment of NHS patients.[9] BUPA also plans to build and run a private oncology centre with Hammersmith NHS Trust.[10]
  • Netcare is a South African healthcare company that has signed contracts with the NHS[11]. It has NHS contracts for mobile cataract units.[12] In February 2005 the British Medical Association reported that another company, Healthmark Partners Inc, had claimed to have lost a contract to Netcare because of being 'too focused on quality of care.'[13]
  • Aspen Healthcare is owned by United Surgical Partners International, a US-based healthcare company which states on its website that it 'sees a great deal of opportunity in the United Kingdom.'[14]
  • Alliance Medical runs diagnostic services for the NHS, including in Birmingham[15] and Falkirk.[16] UNISON reported that services were giving patients sub-optimal care, losing the NHS money because of below-capacity uptake, and pressurising hospitals into using private sector treatments. When the contract was awarded, Alan Milburn, then Health Secretary, was a consultant for Alliance Medical’s parent company.[17]
  • MercuryHealth was awarded contracts in 2005 to build and operate ISTCs in southern England.[18] Centres have opened in November 2005 in Medway[19] and in December 2005 in Portsmouth.[20]
  • BMI Healthcare, a division of the General Hospitals Group, is providing procedures and consultations for the NHS, and is planning to expand its NHS work.[21] It says on its website that on sites it shares with the NHS, its hospitals benefit from the access to NHS resources gained by links with NHS hosts.[22]
  • CapioHealthcare UK has 'chosen to collaborate with public healthcare'.[23] In 2005 it was awarded contracts for nine ISTCs for the NHS, in Boston, Gainsborough, Kettering, Newcastle, Reading, Salisbury, Banbury, Bodmin, Milton Keynes and York.[24]
  • UnitedHealthcare, a US company, was awarded a contract for advising the DoH on the Evercare pilot scheme for keeping elderly patients out of hospital, despite academic research showing that in the US the scheme operates by focussing care on profitable patients.[25]
  • Boots has begun to move from eye tests into eye surgery performance, and was among companies bidding for NHS work.[26]

These companies make clear that they stand to benefit from an involvement in NHS services. Their involvement will fundamentally change the nature of the NHS.

For further information and to get involved, see:

UNISON - www.unison.org.uk

Keep Our NHS Public campaign - www.keepournhspublic.com/index.php

Allyson Pollock, NHS Plc, (Verso, London 2005)

References

[1] See, for example, UNISON (www.unison.org.uk) and Keep our NHS Public (www.keepournhspublic.com/index.php)

[2] BBC News, “private treatment centres warning” http://news.bbc.co.uk/1/hi/health/4528230.stm [viewed 01.01.2006]

[3] Refer to UNISON’s “Positively Public” campaign briefings, www.unison.org.uk/positivelypublic/pages_view.asp?did=2350#3 , and Allyson Pollock, “NHS Plc” (London, 2005) for more on the potential impacts of the growing role of market forces in the

[4] Allyson Pollock, NHS Plc

[5] BMI Healthcare, News, “Million pound boost for private healthcare,” 16.10.2005 www.bmihealthcare.co.uk/newsarticle.cfm?id=676 [viewed 29.12.2005]

[6] Hélène Mulholland, “Call for more private healthcare providers,” The Guardian 04.02.2005 www.guardian.co.uk/uk_news/story/0,,1406203,00.html [viewed 19.01.2006]

[7] Allyson Pollock, NHS Plc p.11

[8] Jo Revill, “Boom time for Bupa as private cover soars,” The Observer 16.03.2003 http://society.guardian.co.uk/privatehealthcare/story/0,8150,915817,00.html [viewed 19.01.2006]

[9] David Black “NHS Patients boost Bupa,” The Guardian 20.03.2003 http://society.guardian.co.uk/privatehealthcare/story/0,8150,918074,00.html [viewed 19.01.2006]

[10] UNISON Factsheet, Private sector in NHS Health care, August 2005 www.unison.org.uk/acrobat/B1992.pdf [viewed 19.01.2006]

[11] Allyson Pollock, NHS Plc p.12

[12] UNISON Factsheet, Private sector in NHS Health care, August 2005 www.unison.org.uk/acrobat/B1992.pdf [viewed 19.01.2006]

[13] Medical News Today Doubts cast over DoH care criteria for independent treatment centres, UK 04.02.2005 www.medicalnewstoday.com/medicalnews.php?newsid=19624&nfid=rssfeeds

[14] United Surgical Partners International website www.unitedsurgical.com/frames_whoweare.htm [viewed 19.01.2006]

[15] Alliance Medical Press room, ALLIANCE MEDICAL OPENS A NEW PET/CT FACILITY WITH THE UNIVERSITY HOSPITAL BIRMINGHAM, 04.07.2005 [viewed 19.01.2006] www.alliancemedical.co.uk/media_New_PETCT_Birmingham.htm

[16] Alliance Medical Press room, New standards and investment to cut waiting times in NHS 21.06.2005 www.alliancemedical.co.uk/media_Falkirk_Royal_Infirmary.htm [viewed 19.01.2006]

[17] UNISON Factsheet, Private sector in NHS Health care, August 2005 www.unison.org.uk/acrobat/B1992.pdf [viewed 19.01.2006]

[18] UNISON Factsheet, Private sector in NHS Health care, August 2005 www.unison.org.uk/acrobat/B1992.pdf [viewed 19.01.2006]

[19] Mercury Health, Minister opens Will Adams NHS Treatment Centre, www.mercuryhealth.co.uk/news.php?id=15http://www.mercuryhealth.co.uk/news.php?id=15 [viewed 19.01.2006]

[20] Mercury Health website, “Eve of opening preview of new NHS treatment centre in Portsmouth,” www.mercuryhealth.co.uk/news.php?id=16 [viewed 19.01.2006]

[21] UNISON Factsheet, Private sector in NHS Health care, August 2005 www.unison.org.uk/acrobat/B1992.pdf [viewed 19.01.2006] ; Allyson Pollock, NHS Plc p.11

[22] BMI Healthcare, “working with the public sector,” www.bmihealthcare.co.uk/workingwiththepublicsector.cfm [viewed 19.01.2006]

[23] Capio website, History and vision, www.capio.co.uk/aboutus/historyvis/ [viewed 19.01.2006]

[24] Capio website, www.capio-nhs.co.uk/ [viewed 19.01.2006]

[25] Allyson Pollock, NHS Plc p.14

[26] Allyson Pollock, NHS Plc p.11