Private health centres fall flat

Rob Ray interviews a leading health watchdog on the rollout of Independent Sector Treatment Centres, which have faced strong criticism as heralding the start of privatisation for the NHS.

Submitted by Rob Ray on November 24, 2006

A leading NHS watchdog has attacked the government’s excuses for continuing their flagship Independent Sector Treatment Centre (ISTC) programme, even in the face of criticism from their own health committee.

ISTCs are private-sector providers of operations which are currently being licensed by the government as an alternative to the NHS.

In an exclusive interview with Freedom, London Health Emergency group director John Lister explained that the government has missed crucial information, misrepresents what it does talk about and paints an inaccurate picture of ISTCs.

He said: “They seem to have substituted a lot of blather for real information. This figure that 80,000 procedures have been done for example underlines that they have had a really marginal effect compared to the six million operations done this year. It shows that virtually all the improvements to the NHS have been due to work within the system rather than by this very expensive process.”

John explained that even the operations that had been done were not an adequate test to justify expansion of the project, and added his own criticisms of the committee’s proposed solutions.

“They only use the most basic and easy cases, and while the Health Committee have not picked up on it the government haven’t said anything about this.

“The HSL favour giving them a training role. The patients have been chosen to have only the most minor conditions, unlike any other hospitals which have a varied role. I’m not sure what real benefits there would be in this – it baffles me. They seem to be encouraging people to move into the private sector and anything which encourages that I think is a backwards step.”

In its original report, the commons committee raised major questions over the financial viability of the plan, citing excessive costs for patchy service that was undermining core functions of the NHS itself.

Concerns were also raised at the prospect of Phase II, due to begin next year, introducing ISTCs to areas where there is no need for them and actively closing existing NHS sites to do so.

John agrees with this analysis, and remains unconvinced by the government’ rebuttal, fearing that they will simply ignore any pressure over placement from local government. He said: “The government say that ITCs will ‘only’ be 7.5% of patients by 2010 but it’s still a lot of people and a lot of money flowing out of the NHS, especially at the enhanced rates because they don’t say anywhere that they will impose the flat rates for operations. All the guarantees are with the private sector, all the risks with the NHS.

“Some parts of the NHS will escape it and others will lose out heavily, for example 85% of the orthopaedics work is going from Brighton Hospital, 15% of the toughest operations will be left but with budgets slashed.

“There will be five year contracts for the private sector but it’s entirely payment by results for the NHS, it’s a completely one-sided process and the government seems to be saying it’s deliberate.”

“In the government reply they are saying it will be done over the head of the local authorities. No one with influence will have any say at all. PCTs are being squeezed out of the picture.”

The report concluded: “We are not convinced that ISTCs provide better value for money than other options such as more NHS Treatment Centres, greater use of NHS facilities out–of–hours or partnership arrangements.”

Despite this damning phrase, John believes the government was given an easy ride. He concluded: “The committee missed tricks as well in the questions they have asked. We still don’t have half the information we should do.”