Intended for healthcare professionals

Feature Health White Paper

New kids on the block

BMJ 2010; 341 doi: (Published 24 August 2010) Cite this as: BMJ 2010;341:c4421
  1. Peter Davies, freelance journalist
  1. 1London
  1. petergdavies{at}

    Will opening up to “any willing provider” lead to the denationalisation of the NHS in England? And which groups are poised to make the most of these new opportunities? Peter Davies investigates

    In a pre-election “manifesto,” the UK’s largest private hospital company, General Healthcare Group, declared: “the time is right for the private healthcare sector to have a proper seat at the planning table.”1 It called for a “guaranteed proportion” of elective surgery to be transferred to the independent sector and suggested increasing its share of NHS activity from 5% to 15% during the next five years.

    That bullish approach is characteristic of a sector that has steadily expanded its role since the Labour government announced in 2002 that independent providers would become “a permanent feature of the new NHS landscape.”2 So they have. Once largely confined to secondary care, independents now have interests in primary care, diagnostic services, long term care, and outsourced “back office” services such as human resources, information technology, and accounting support. Latterly under Labour, a handful won approval to offer help with commissioning—an important bridgehead.

    Now the coalition government’s health white paper is opening NHS provision to “any willing provider” and, by handing general practitioners responsibility for commissioning, creating substantial potential for more outsourcing. One player in the market is Tribal Newchurch. Its director of business development, Kingsley Manning, predicted: “This white paper could amount to the denationalisation of healthcare services in England.”3

    Boom time?

    So amid the economic crisis, is it boom time for private healthcare companies? “I see relatively little prospect of many more acute elective providers coming in,” says David Furness of the Social Market Foundation, the left of centre think tank. “There’s no real appetite from the private sector to do that.” This is because it means shifting from its …

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