Intended for healthcare professionals


Can GPs compete with big business?

BMJ 2006; 332 doi: (Published 18 May 2006) Cite this as: BMJ 2006;332:1172
  1. Sophie Arie
  1. London

    This week a decision by a primary care trust to award a contract for services to a private company is being challenged in the High Court. Sophie Arie explains why the trust's decision is ringing alarm bells

    In a scruffy corner of the village playing field, facing rows of small, red brick, terraced houses, the Langwith village surgery cares for about 2000 people, many of whom spent every day working bent double in cramped mine shafts, until the local pit was closed down in the 1980s.

    Embedded Image

    In the eye of the storm: the Langwith village surgery

    Credit: ALEX NUNNS

    Like the abandoned pits throughout Derbyshire, the surgery was once a thriving local point of reference and is now more of a blot on the landscape: a small, run down bungalow, with several windows boarded up after being smashed by local kids with nothing better to do.

    For the past few years a nurse has struggled to run the surgery, and complaints were growing about short opening hours and lack of postal prescription services. Last year, the local primary care trust (PCT) began searching for a new team that could salvage the troubled village surgery and its larger sister service four miles down the country lanes in Creswell.

    A well known local GP, Elizabeth Barrett, proposed setting up a small team to run the Langwith surgery. But when the tendering process was over, a very different kind of health service provider emerged victorious.

    United Health Europe (UHE) is a fledgling subsidiary of US based United Health Group, a giant multibillion dollar private US healthcare corporation and the biggest of its kind in the states. It trumped the local GP, winning top marks on most of the criteria set by the local PCT. Dr Barrett's bid did not even make the shortlist. …

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