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Independent providers ‘deeply disappointed’ at health bill changes

By Susan McNulty

The chief executive officer of one of the leading private providers in the UK has said many in the independent sector are ‘deeply disappointed' at the changes announced to the health bill.

Professor Jill Watts, CEO of Ramsay Health Care UK, told a breakfast event at the King's Fund today that the danger was that parts of the NHS would now turn its back on competition.

‘Over recent years, with the opening up of the NHS, many independent providers have invested significantly to integrate their services into the NHS and many are deeply disappointed I think, at the pulling back and the overall tone of the changes that have been announced.'

At the same event, David Worskett director of the NHS Confederation's partners network, said the fineprint of the changes to the bill announced yesterday, meant any qualified provider only applied now to those services that have a national or local tariff. Mr Worskett, said: ‘As my colleague Nigel Edwards, (NHS Confederation, director of policy) says, for much of community services we don't know what good looks like, never mind construct a tariff for it.'

Professor Watts, voted ‘most influencing leader' in last year's Health Investor Power 50 awards, added: ‘The traction that the political hysteria surrounding the NHS reforms has gathered has been quite amazing considering that much of it has been based on myths and misleading facts.

‘When you consider that the total services delivered by the independent sector still represents less than 5 per cent of a PCT's budget, then we're a long way away from that slippery slide into privatisation of the treasured NHS.

‘And even if it's the case that we double this in the next five years, we're only talking about 10 per cent of the budget.

‘It would be nice to take politics out of health based on fact but I don't think that's likely to happen in my lifetime.'

Ramsay operates 22 acute hospitals in the UK and was awarded the largest public sector contract in health in 2004 to treat 95,000 NHS patients.

Addressing claims the private sector would ‘cherry pick', Professor Watts said Ramsay would like to take on services such as maternity but that PCTs prevented them from doing this.

‘Our experience overseas in France, Indonesia and Australia actually sees us providing a full range of services from open heart surgery, maternity and emergency services. We're actively involved in training and researching in those countries and in fact the only service I can think that we don't provide is major transplants.

‘The reality is it's the PCTs who are restricting patient choice in an effort to protect local trusts' services.'

Lord Victor Adebowale, who sat on the Government's listening exercise panel, said competition had become incorrectly blurred with privatisation. ‘During the course of the listening exercise, my perception was that the competition debate was often confused with privatisation.

‘The two things had become conflated in people's minds.

‘To compete meant to privatise and in fact the two things are very different.'

He called for an appropriate ‘context' for competition as it could deliver both positives and negatives.

‘ Where the main source of funding in that market is the public purse, which it most certainly is in the NHS, I don't think it's unreasonable to expect the players in that market to show how their company, how their services aren't just taking out from that market by creating profit for shareholders.'

He added where public money was being applied the public had a right to know how operators were ‘adding value' to a service.

Professor Nick Bosanquet, professor of health policy at Imperial College London, said: ‘Commissioners have to ask service by service "can we within the funding constraints – that by the way are going to go on forever – deliver better services without more partnership with the private sector?".

‘I was on the strategy group for cancer services. You can't provide more home-based chemotherapy, without using outside suppliers like Health Care at Home. The NHS does not have the staff to develop that service, or the expertise or the will to do it. Secondly, radiotherapy. If you run a service, which gives state-of-the-art therapy , high utilisation, local access, plenty of new equipment, you're going to need to get into partnership with the private sector because the NHS does not have the funds to do these things. Let's look at the patient interest service by service.'