Comment: ‘The private piece of the Whipps puzzle’

Whipps columnist Mary Burnett on her fears of private sector encroachment

There’s an elephant in the room sitting alongside Whipps bosses as they discuss plans for the new hospital, and its name is the private sector. Private healthcare has become embedded in our NHS over the last decade and, although Barts insist they can cut down on beds due to improved hospital and community services, it seems to me squaring the circle of insufficient beds will leave them relying on the private sector even more.

This year, for the first time, more orthopaedic surgery – knees and hips – was carried out nationally by the private sector than the NHS. Only last June, the government was perfectly happy to promise £10 billion over 4 years to private healthcare to “increase capacity” for dealing with waiting lists, yet dragged its heels over how much it would give the NHS directly. And it’s only committed a paltry £2.7 billion for the redevelopment of eight hospitals, including ours.

On a local level, there’s evidence of a similar trend. How to spend the borough’s NHS budget – paying who for what health services – is a decision made by the Clinical Commissioning Group (CCG). At the start of 2020, our borough’s CCG was spending more than a tenth of its annual budget, or £55.75million, on “healthcare from non-NHS bodies”. More than it spent on GPs.

It’s argued that the private sector is a partner in providing health services and one we desperately need to tackle our awful waiting lists, especially post-Covid. But, as Stella Creasy MP recently wrote in the Guardian, waiting lists have been creeping up for years because of under investment in the NHS and a “conscious decision to divert funding to profit-making private healthcare companies”.

Taking a closer look at one of these companies – like BMI Healthcare, from which Barts bought more than £2.25m of health services in three years – can perhaps help us understand how we ended up here.

BMI is owned by Circle Health, a company that in 2019/20 earned over £240m, almost a third of its total income, from the NHS. It is also one of the companies awarded part of that £10bn government investment. Going further up the chain, Circle Health is itself a subsidiary of Centene Corporation, a huge US private healthcare firm. Centene has another UK subsidiary called Operose Health, which last February took over 67 GP practices across England with over half a million patients, including in Redbridge, Tower Hamlets and Newham. It was a highly controversial take-over and one that is currently being challenged in the High Court.

In Operose, we can see an example of the “revolving door” of powerful people moving between the NHS and the private sector, best placed to influence its increased use. At the time of the GP take-over, Samantha Jones was chief executive of Operose Health, having previously worked as director of NHS England’s “new care models” and chief executive of a couple of hospital trusts. Two months later, she was recruited to be Boris Johnson’s health advisor and has just been elevated to be his interim permanent secretary and chief operating officer.

I fear the growing role of the private sector is a key part of the planning for Whipps Cross, to be used instead of increasing NHS beds and services. I think it’s high time Barts and the North East London CCG started talking about this particular elephant in the room.

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