Intended for healthcare professionals

Feature Health White Paper

NHS franchise for sale

BMJ 2010; 341 doi: (Published 31 August 2010) Cite this as: BMJ 2010;341:c4584
  1. Sam Lister, health editor
  1. 1Times, London
  1. Sam.Lister{at}

    As the private sector gears up to take over its first entire NHS hospital, Sam Lister analyses this “touchpaper” moment for one of the government’s big ideas for the NHS

    When England’s health secretary, Andrew Lansley, was threading together the main themes for his radical vision for the NHS, a little district general hospital in Cambridgeshire cannot have failed to catch his eye. Hinchingbrooke is a 369 bed complex on the outskirts of Huntingdon, the Tory heartland constituency once held by former prime minister John Major. It is also less than 10 miles from Mr Lansley’s own seat, Cambridgeshire South, with both constituencies sharing similar demographics and demands on the health service. But more importantly, Hinchingbrooke is not only a cautionary tale of the pitfalls of poor management and financial overstretch in the NHS but the test case for the most far reaching (and potentially inflammable) of Mr Lansley’s big ideas.

    Presenting his white paper on 12 July, Mr Lansley told the House of Commons: “We will allow any willing provider to deliver services to NHS patients—provided that they deliver the high quality standards of care we expect from them.” The strategy of opening up the NHS to the private sector—which was promoted by former prime minister Tony Blair then buried by a succession of Labour health secretaries concerned by its electorally toxic message—was back centre stage. The policy seemed not to warrant much of a mention on the Tory campaign trail. But it is the one most likely to reshape, fundamentally, the way the NHS is run in future generations.

    Concerns have been raised by health professionals, unions, NHS ideologues, and traditionalists over what the Tory vision of “any willing provider” will mean. Many envisage that it will be a free-for-all for independent companies and that shareholder interests will …

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