Paying for private failure in England's NHS - again

The NHS is paying millions to a failed private Treatment Centre to escape a contract after a series of patient deaths - and the figures don't quite add up.

caroline m.jpg
Caroline Molloy
8 August 2013

Image: Wikicommons

The NHS has had to pay private healthcare company Clinicenta £53million to end a contract to run an NHS Treatment Centre in Stevenage, after a catalogue of clinical failings and an investigation into three patient deaths after routine surgery. The running of the centre has now been taken over by East and North Hertfordshire NHS Trust, it was announced this week.

It is the second time taxpayers have had to fork out to escape a failing Clinicenta contract with the NHS. In 2011 NHS London had to pay the company - a subsidiary of ex-Tarmac construction giant Carillion - £8million to terminate a similar contract following an investigation into a series of avoidable deaths.

The Clinicenta Surgicentre in Stevenage was opened in November 2011 on the site of the NHS Lister Hospital, to provide eye and joint operations along with trauma, gynaecological and general surgery.

The centre was dogged by reports of substandard care and management failings from the start. The Care Quality Commission found the centre had “insufficient staff to meet people’s needs”. According to local doctors, six patients lost their sight after Clinicenta failed to invite them for follow up checks. 8,500 patient records were lost. Up to half of patients were forced to wait more than the target maximum of 18 weeks. Last year East and North Hertfordshire CCG suspended all GP referrals, after the deaths of three patients following what should have been routine, low risk procedures. Following a third failed inspection, the Care Quality Commission began moves to revoke the centre’s licence in February this year.

At the time the deal was announced, the value of the Surgicentre was put at £31 million, with a further £122 million to be paid to Clinicenta over 5 years for carrying out operations. The centre had been due to carry out around half the NHS operations in the Hertfordshire area but the problems meant they never met the expected level of procedures.

Asked about the £53million that the NHS is now paying Clinicenta to escape the contract, a spokeswoman for East and North Hertfordshire NHS clinical commissioning group claimed “The vast majority of this relates to the value of the building and the equipment which will be retained by the NHS for use in delivering services to patients. We are contractually bound to pay for this even if the contract is not terminated and runs for its full term.”

The expensive collapse of this arrangement fuels mounting concerns about whether outsourced public sector contracts provide value for money and quality services. Last month G4S and Serco outsourcing giants were found to be over-charging for a variety of services. This week, a survey carried out for WeOwnIt found that 88% of people wanted an end to private sector contracts in the case of poor service provision.

Conservative MPs have pointed out that the Surgicentre was one of a wave of Independent Treatment Centres signed off by the last government. However this government too has a policy of cutting GP referrals to hospitals and pushing treatment out into 'the community', in other words to often privately run clinics and treatment centres. Such a policy is likely to come under increasing scrutiny, both in terms of value and patient safety.

Like most such smaller clinics, the Stevenage Surgicentre did not have an intensive care unit. Although an investigation found that the patients who had died had received adequate care, doubts remain about the wisdom of such a policy. At the Surgicentre, patients had been transferred from the nearby QEII hospital, and the hospital’s day surgery unit demolished and redeveloped into flats, despite fierce opposition from local residents.

The government also continues to pursue Private Finance Initiative schemes which tie the NHS into yet more expensive and hard to break contracts. Clinicenta’s parent company, Carillion, is a large player in the Private Finance Initiative scheme and in June they were selected as the ‘preferred bidder’ for a massive £425 million new PFI scheme at the Royal Liverpool hospital. 

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