Private clinics on NHS ‘not offering value for money’
There is no evidence to suggest that private clinics given NHS contracts to deal with routine elective surgery are providing value for money, MPs have warned.
The health select committee says independent sector treatment centres (ISTCs) have increased patient choice but warns they have not made any major contribution to bringing down waiting times and their job could be done by other NHS providers.
It also expresses “real concerns” that the expansion of the ISTC programme – at a planned cost of more than £5 billion in total – could “destabilise” NHS trusts in the area by taking away a huge amount of their funding.
However, health minister Lord Warner defended the treatment centres, saying they provided a good standard of care, improved patient choice, had driven down prices and were also providing competition to get NHS trusts to “raise their game”.
The first ISTC was opened in 1999, and three years later the government announced a roll-out of more than 20 such clinics, starting with areas where extra capacity was most needed in routine elective care such as hip replacements.
They were intended to increase capacity to cut waiting lists, bring down prices, increase patient choice and stimulate innovation in other NHS organisations by providing competition.
Today the committee accepts that waiting lists have fallen since ISTCs were introduced, but says it is “unclear” whether this was caused by the centres’ additional capacity rather than the major investment in the health service over that period.
It also acknowledges that most treatment centres engage in good practice and innovative techniques, but says such techniques are also evident in the NHS treatment centres. There was nothing to say the private clinics were more efficient.
Meanwhile, it notes “well-founded” concerns among clinicians about the way the ISTCs are integrated with the rest of the health service, particularly in their failure to train junior doctors despite taking away a significant chunk of the work they should be doing.
And it warns the government’s attempts to persuade private firms to set up the treatment centres, by guaranteeing them an income regardless of their work load, gives them a “significant advantage” over other NHS providers.
The committee accepts that in the second phase of the ISTC programme, announced last year, the government has addressed some of these problems, such as introducing a new requirement for them to train doctors.
But it concludes: “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.All these options would more readily secure integration and may be cheaper.”
In response, Lord Warner said more that 260,000 patients had benefited from faster access to treatment from the programme, and were generally satisfied with the standards of care they received.
However, he added: “It is still relatively early days in the programme, but we agree that greater integration with the NHS is essential so that the full benefits of this programme can be realised.”
