The news yesterday that NHS England had extended the contract of Capita to continue to provide support services to primary care was met with horror by many GPs.
In extending the contract, NHS England is basically rewarding ‘failure’, as the BMA put it, and a private company that is taking funding out of the NHS is being held to less account than GPs.
Over the past seven years, Primary Care Support England – the service Capita is contracted to run – has been failing to provide GPs with the support they need. GPs have been left waiting until it’s too late for their pension statements, practices have failed to get patient records transferred in time, GPs have been unable to get on the performers list and any attempt to get in touch with a PCSE adviser has required half a day spare and a lot of patience. The very fact that a trial has been set up to escalate queries when they have gone beyond the 40-day mark suggests these past seven years haven’t been a roaring success.
This shows the folly of the idea that the private sector is more efficient for the NHS. Efficiency for private company firms means delivering to the specs of the contract in the most cost-effective way. I don’t feel that Capita have actually delivered on the contract (and the National Audit Office agreed) yet NHS England is seemingly pleased with their work.
Contrast this with their attitude to GPs, where they demand face-to-face access, which GPs are both doing already and isn’t even written into the contract; where GPs have also to contend with more regulators like the CQC and the GMC; and where contracts are so ambiguous as to leave GPs unaware as to whether they have to physically be in the premises or not on Saturdays. Yet GPs routinely provide services beyond their contract.
So what if Capita were a GP practice? We would see NHS England slapping monthly contract breach notices, we’d see weekly press releases about how Capita need to start responding to their customers within three months, and we would see at least two regulators removing their registration within the year.
Maybe NHS England will start to apply the same principles to GP practices that they apply to Capita now. So the next Daily Mail headline screaming about how terrible GP access is will hopefully be met with a statement from NHS England: ‘We are delighted to announce a pilot so that any patient calling for 40 days continuously will be able to call a dedicated number (which also won’t be answered).’