Independent sector treatment centres: evidence so far

doi:10.1136/bmj.39470.505556.80

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Allyson M Pollock, professor of international public health policy,
Sylvia Godden, senior research fellow

¹Centre for International Public Health, University of Edinburgh, Edinburgh EH8 9AG

Correspondence to: A M Pollock allyson.pollock{at}ed.ac.uk

Accepted 3 January 2008

The government plans to continue using NHS funds to contract with commercial healthcare providers in the second phase of the independent sector treatment centre programme, but Allyson M Pollock and Sylvia Godden argue that no good evidence is available to support this policy

Summary points

Using NHS funds to deliver NHS clinical services via the private sector lacks evidence and has not been evaluated
Data to support government claims that independent sector treatment centres offer high productivity, high quality health care, or value for money are lacking
Such centres are meant to provide extra capacity and staff, but 23 000 NHS beds in England have closed and many NHS clinical staff have transferred to the private sector since their introduction
Patients’, lawyers’, and professional bodies’ concerns over quality and safety are being ignored by government

The policy of the Department of Health in England is to use NHS funds to contract with for-profit multinational healthcare corporations to deliver clinical services. One controversial aspect of this policy is the independent sector treatment centre programme, which over the course of two phases (waves) will provide elective surgery and other services at a total cost of over £5bn (€6.7bn; $9.7bn). The announcement by the secretary of state for health, Alan Johnson—that new contracts will be determined by local commissioners but second phase schemes will go ahead if they are value for money—makes a review of the evidence to support the policy timely.1 2 3 This article assesses the programme in terms of the objectives set by the Department of Health4—that these centres should provide:

High productivity
High quality health care
An increase in the number of medical professionals working in England (staff will come from overseas or be additional to the existing NHS workforce)
Good value for money.