Intended for healthcare professionals


Independent sector treatment centres: evidence so far

BMJ 2008; 336 doi: (Published 21 February 2008) Cite this as: BMJ 2008;336:421
  1. Allyson M Pollock, professor of international public health policy,
  2. Sylvia Godden, senior research fellow
  1. 1Centre for International Public Health, University of Edinburgh, Edinburgh EH8 9AG
  1. Correspondence to: A M Pollock allyson.pollock{at}
  • 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.

History of the independent sector treatment centre market

The initiative was presented as …

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