The Freedom of Information Act has helped expose massive NHS overpayment to private healthcare companies, an article in the BMJ reports.1 The case came to light after a doctor joined forces with academics to release the financial details of a contract for an independent sector treatment centre between an NHS trust and a private healthcare company in Scotland.

Researchers at the Centre for International Public Health Policy at Edinburgh University discovered a possible overpayment of more than £4m (€4.4m; $6m) to the company in the contract’s first year. When they applied the Scottish findings to the whole independent sector treatment centre (ISTC) programme in England, they concluded more than a billion pounds may have been overpaid.

The case highlights how the Freedom of Information Act has great potential to promote transparency and accountability. However, it also shows the obstacles facing those using the legislation. John Evans, a retired consultant clinical biochemist, made his freedom of information request after the contract between NHS Tayside and Netcare Healthcare (UK) was signed in November 2006. NHS Tayside turned down his request, saying disclosure would prejudice the company’s financial interests.

With advice from Edinburgh University academics, Dr Evans made a public interest appeal to the Scottish Information Commissioner in January 2008. NHS Tayside finally published the contract’s financial details in June 2008, just before the commissioner was due to make an official ruling.

“It’s very important that public interest takes precedence over commercial interest. As far as I’m aware, this is the first time such a result has applied to a private medicine ISTC contract,” said Dr Evans, who documented his investigation into the Scottish case …