MEDICO LEGAL M A G A Z I N E
ARE WE SAFE IN A PUBLIC-PRIVATE HEALTH SERVICE? Laurence Vick Legal Director at Enable Law Outsourcing medical treatment to private providers is common practice in many areas of the NHS, with private companies increasingly operating alongside NHS trusts. The result, in some places, is an NHS that is neither fully public nor fully private, leading to concerns over gaps in safety where the two sectors overlap. In this article Enable Law Legal Director Laurence Vick comments on the safety concerns over outsourcing by the NHS to often inadequately vetted private sector hospitals and shortcomings in the supervision and monitoring of those contracts when in progress. The Paterson scandal inevitably looms large over the private healthcare sector and serves as a reminder of the sometimes uneasy relationship between the NHS and private providers. Paterson had been employed by the Heart of England NHS Foundation Trust (HEFT) and had practising privileges at Spire's Solihull Parkway and Little Aston hospitals. Spire, BMI and other private companies carry out a significant amount of work for the NHS. The NHS is now contracting out a fifth of its total healthcare budget, equivalent to more than £20 billion a year. Spire’s NHS referrals nationally are reported to account for almost a third of its £926m annual
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revenues. Although nearly a quarter of their activity at the Solihull and Little Aston hospitals is funded by the NHS, none of Paterson’s surgery appears to have been outsourced by the NHS. Nearly half of the patients treated by BMI in their hospitals are NHS referrals. In her 29 January 2017 report for the Bureau of Investigative Journalism on the concerns over consultant orthopaedic surgeon Mohammed Suhaib Sait’s treatment of patients at the private Fawkham Manor BMI hospital, Melanie Newman noted the current lack of a national system for monitoring the care provided to NHS patients treated in the private sector. Regional NHS Clinical Commissioning Groups (CCGs) are responsible for handing out and overseeing contracts, but senior NHS sources quoted in the TBIJ article said that these bodies are overstretched, unable to carry out adequate checks and rarely carry out audits: ‘NHS commissioners are funding these treatments but don’t know which patients have had what done…they get a bill for a list of services and they pay it’ We may not be sliding into full-scale privatisation of our healthcare as many fear. After Circle’s unhappy experience running the Hinchingbrooke NHS hospital there must be a doubt over the private sector’s appetite for taking over and accepting the operating risk and
