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NHS paid private firms £500m to ‘ease backlog’. Fewer patients got seen

The health service saw 6.6% fewer people in 2022 than 2019, despite lucrative contracts to fix wait lists

Adam Bychawski
12 April 2023, 10.00pm

The £500m handed to private firms last year could have funded an 8% uplift in wages for junior doctors, who are striking this week over pay


Ben Stansall/AFP via Getty Images

The government handed almost half a billion pounds to private healthcare companies to fix the NHS backlog last year, yet is still struggling to treat any more patients than it was, openDemocracy can reveal.

Experts say the figure is just scratching the surface, with NHS bosses in England having been given the green light to spend up to £10bn on private health companies as part of the government’s plan to reduce the record number of patients waiting for care.

The biggest beneficiary of the outsourcing has been the Australian healthcare multinational Ramsay, which received £134m to offer non-emergency care to NHS patients between 2021 and 2022.

Spire Healthcare, which operates 38 private hospitals formerly owned by Bupa, has been handed a further £108m over the same period. Circle, which is owned by Centene, one of the biggest US healthcare corporations, was paid £50m.

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A further 30 private companies, which also include the Nuffield Trust and Specsavers, have been paid £195m in total as part of a contract aimed at boosting the number of patients the NHS treats in England between 2021 and 2022.

The data was obtained by openDemocracy through a Freedom of Information request to all 42 NHS Integrated Care Boards, which are responsible for spending and managing NHS budgets regionally in England. Only 23 responded to openDemocracy’s request, meaning the total cost could be significantly higher.

Health and social care secretary Steve Barclay announced in December the launch of a new taskforce to find ways to “maximise” the NHS’s use of private hospitals. Members of the taskforce include a private healthcare lobbyist and Circle’s chief medical officer.

The government is reportedly considering forcing the NHS to give more contracts to private companies, after the taskforce found “barriers” to maximising their use, according to a leaked document obtained by the Times. OpenDemocracy understands that the leak was accurate.

Despite the NHS being given the go-ahead to increase the involvement of private companies in providing care, the number of patients being treated overall has not yet recovered to pre-pandemic levels.

Between January and November 2022, the NHS treated 6.6% fewer patients from elective care waiting lists than it did over the same period in 2019, according to an analysis by the Institute of Fiscal Studies.

The think tank said in February that the NHS was “clearly lagging” behind its target to increase the number of people it is treating to around 30% above pre-pandemic levels by 2024/25.

Minsters’ push for further NHS spending in the private sector comes as junior doctors take industrial action over pay.

Members of the British Medical Association (BMA), the union which represents doctors in the UK, began a four-day strike on Monday. Junior doctors are asking for a 35% pay rise to reverse 15 years of below-inflation wage increases.

The BMA calculates that the net cost of the pay rise for the government would be £1.03bn – a tenth of the potential spending on private healthcare companies. Even the £500m spent last year could have funded an 8% uplift in junior doctor wages for the year in question.

The union warned last year that the government’s plan risks “embedding a longer-term trend of outsourcing NHS contracts and funding to independent sector providers in England, rather than sustainably increase NHS capacity”.

David Hare, the chief executive of IHPN, told openDemocracy: “We think that the independent sector can make a bigger contribution to tackling the NHS’ record waiting lists and that’s why we have been working on the prime minister’s elective recovery taskforce, launched in December 2022 to look at this issue.

“We’d like to see the NHS make better use of the independent sector, for example through informing patients about their right to choose a provider for their treatment, which might include independent providers.”

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