Derbyshire village wins court battle

BMJ 2006; 333 doi: (Published 31 August 2006) Cite this as: BMJ 2006;333:461
  1. Sophie Arie
  1. London

    Residents of a former mining village in Derbyshire have won their battle for a greater say in whether a private company should be allowed to take over their local general practice.

    The Appeal Court ruled that North Eastern Derbyshire Primary Care Trust had not consulted the residents of Langwith village before awarding United-Health Europe the contract to provide GP services there and in the nearby village of Creswell.

    In June the High Court judge Mr Justice Collins had ruled that although the consultation process may not have been adequate the company would probably have won the contract anyway (BMJ 2006;332: 1469).

    But last week Lord Justice May and Lord Justice Keene overturned that ruling.

    “Probability is not enough. The simple fact is that the PCT [primary care trust] had a duty to consult, and they did not properly perform it,” said Lord Justice May.

    He said that if consultation had taken place the trust “might well have been negotiating with another bidder.”

    The trust will now have to carry out a proper consultation process with the local patients' forum.

    Pam Smith, 67, the local pensioner who had challenged the trust's decision, hailed the decision as a victory for “people power” against the government policy of allowing private companies to provide healthcare services at the level of general practice.

    She said, “It was a real case of David and Goliath. I feel like I'm on a high. I would love to be a fly on [the health secretary] Patricia Hewitt's wall now. She keeps saying patients have a choice; well, we've made our choice. UnitedHealth would only have taken profits. We will keep our NHS public, not private—that's what makes Britain unique.”

    Ms Smith and many other residents had hoped that a local doctor, Elizabeth Barrett, would take over the struggling surgery, arguing that UnitedHealth Europe, which is a subsidiary of one of the largest healthcare management companies in the United States, lacked the necessary understanding of the impoverished former mining community to provide the care it needs.

    Dr Barrett's tender did not even make the primary care trust's shortlist, and on 23 December 2005 the trust announced that it had given the company “preferred provider” status.

    Although no evidence was shown that the tendering process had been unfair, Ms Smith's complaint was that her views and those of other residents who shared her concerns were ignored.

    Richard Stein, the lawyer representing Ms Smith, said he hoped the case would guarantee that primary care trusts elsewhere in the country that are eager to contract private companies to provide primary care services made sure they listened to local concerns first.

    UnitedHealth Europe did not confirm whether it would bid again to run the surgery in the new round of tendering. But the company, which is also interested in another Derbyshire surgery, in Normanton, reiterated its wish to find ways to provide primary care in the region.

    “We believe that we can make a significant contribution in the region to reducing health inequalities,” said Richard Smith, chief executive of the company and former editor of the BMJ.

    A Department of Health spokesperson would not comment on the ruling, other than to say that the ruling had “no wider implications for the NHS or for government plans to introduce new providers in primary care.”

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