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London’s doctors may fear privatisation by large corporations but in Scotland it may be happening already.
Though, in England, partners join together as a firm, in Scotland they create a legal person distinct from the partners of whom it is composed (1). Health Boards contract with Partnerships which must include a GP but may comprise other members (who may be Limited Companies with separate legal identities) so they don't know to whom they are doling out vast sums of NHS money.
There is no legal obligation for a partnership to declare its constitution or its accounts and so there is no impediment to a large firm such as Centene entering a partnership with one or more GPs and investment and profits being sorted out in an undisclosed partnership agreement.
Though individual doctors are regulated by the GMC Responsible Officers in Scotland who are often also Medical Directors of the NHS contracting authorities “there are no regulatory inspections of General Medical Practices in Scotland” (2). In England NHS General Practices are subject to a minimum 5-yearly inspection regime by the CQC and private practices in Scotland are similarly subject to inspection by Health Improvement Scotland.
While privatisation is resisted in London it may well be well underway in Scotland where “Cross-Cover” between branches of the same organisations allows care to be devolved from centralised qualified GPs to local nurses and Health Care Assistants without fear of being found out.
The Scottish model is attractive to well-heeled corporations who may take a particular view of the conflict between patient care and corporate profit and be comforted by the lack of regulatory inspection.
There is no public evidence that General Practices in Scotland have been privatised but, because of the unique circumstances, there is no way of demonstrating that they haven’t!
1. Partnership Act 1890 S 4 (a)
2. NHS Lothian FOI response 4891 dated 13 Jan 2021
Competing interests:
I have been a whistleblower about regulatory inadequacy in General Practice in Scotland.
I am a former member of BMA Council.
I am not opposed to private sector involvement in publicly provided healthcare but have concerns that contracting authorities have acted naively in the past, particularly around awarding PFI contracts and lucrative General Practice Contracts.
Scotland is (over)ripe for Corporate Takeover of General Practice
Dear Editor,
London’s doctors may fear privatisation by large corporations but in Scotland it may be happening already.
Though, in England, partners join together as a firm, in Scotland they create a legal person distinct from the partners of whom it is composed (1). Health Boards contract with Partnerships which must include a GP but may comprise other members (who may be Limited Companies with separate legal identities) so they don't know to whom they are doling out vast sums of NHS money.
There is no legal obligation for a partnership to declare its constitution or its accounts and so there is no impediment to a large firm such as Centene entering a partnership with one or more GPs and investment and profits being sorted out in an undisclosed partnership agreement.
Though individual doctors are regulated by the GMC Responsible Officers in Scotland who are often also Medical Directors of the NHS contracting authorities “there are no regulatory inspections of General Medical Practices in Scotland” (2). In England NHS General Practices are subject to a minimum 5-yearly inspection regime by the CQC and private practices in Scotland are similarly subject to inspection by Health Improvement Scotland.
While privatisation is resisted in London it may well be well underway in Scotland where “Cross-Cover” between branches of the same organisations allows care to be devolved from centralised qualified GPs to local nurses and Health Care Assistants without fear of being found out.
The Scottish model is attractive to well-heeled corporations who may take a particular view of the conflict between patient care and corporate profit and be comforted by the lack of regulatory inspection.
There is no public evidence that General Practices in Scotland have been privatised but, because of the unique circumstances, there is no way of demonstrating that they haven’t!
1. Partnership Act 1890 S 4 (a)
2. NHS Lothian FOI response 4891 dated 13 Jan 2021
Competing interests: I have been a whistleblower about regulatory inadequacy in General Practice in Scotland. I am a former member of BMA Council. I am not opposed to private sector involvement in publicly provided healthcare but have concerns that contracting authorities have acted naively in the past, particularly around awarding PFI contracts and lucrative General Practice Contracts.