This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at http://www.theguardian.com/commentisfree/2014/aug/15/nhs-privatisation-failing-patients-warnings

The article has changed 2 times. There is an RSS feed of changes available.

Version 0 Version 1
NHS privatisation keeps on failing patients – despite a decade of warnings NHS privatisation keeps on failing patients – despite a decade of warnings
(3 days later)
We have learned this week that the NHS is footing the bill for dozens of people left damaged by eye operations provided by private healthcare operations. This comes as no surprise to those of us who have been following the disastrous implications of the privatisation of public health services.We have learned this week that the NHS is footing the bill for dozens of people left damaged by eye operations provided by private healthcare operations. This comes as no surprise to those of us who have been following the disastrous implications of the privatisation of public health services.
Since 2003, government policy in England has been to divert more than £5bn of scarce NHS funds to the for-profit private sector under a policy known as the independent sector treatment centre programme (ISTC). Doctors have been warning about how catastrophic the policy is for the NHS, for quality of care and above all for the safety of patients. For the private sector and their shareholders it is a dream scenario: the NHS trains and educates the junior doctors and nurses at taxpayer expense who, together with NHS consultants, may then moonlight in the private sector; the taxpayer underwrites the risks and costs of care allowing the private sector to cherrypick the profitable patients, ie the healthy ones with no complications; and the NHS takes back the risks when things go wrong as the private sector doesn’t have the intensive care facilities.Since 2003, government policy in England has been to divert more than £5bn of scarce NHS funds to the for-profit private sector under a policy known as the independent sector treatment centre programme (ISTC). Doctors have been warning about how catastrophic the policy is for the NHS, for quality of care and above all for the safety of patients. For the private sector and their shareholders it is a dream scenario: the NHS trains and educates the junior doctors and nurses at taxpayer expense who, together with NHS consultants, may then moonlight in the private sector; the taxpayer underwrites the risks and costs of care allowing the private sector to cherrypick the profitable patients, ie the healthy ones with no complications; and the NHS takes back the risks when things go wrong as the private sector doesn’t have the intensive care facilities.
The NHS also takes on the legal liability when patients sue the facility. The private sector quite simply offloads the revisions, readmissions, emergency treatments and clinical follow-up and law suits to the NHS and the taxpayer. And to crown it all the private sector has a poor record of doing the work it is contracted to do, with the NHS paying for work that the private sector has not performed.The NHS also takes on the legal liability when patients sue the facility. The private sector quite simply offloads the revisions, readmissions, emergency treatments and clinical follow-up and law suits to the NHS and the taxpayer. And to crown it all the private sector has a poor record of doing the work it is contracted to do, with the NHS paying for work that the private sector has not performed.
However, the multimillion-pound contracts which have been awarded to companies such as Care UK and Ramsey Health Care UK are confidential and rarely audited. There is a great deal of evidence that the NHS is paying for work regardless of whether it is done or not: with one contract, Netcare did not perform nearly 40% of the work it had been contracted to do, receiving £35.1m for patients it never treated. And as for safety, Netcare’s medical director Dr Dinesh Verma resigned (after only six months in October 2004), having “repeatedly raised concerns about on-call cover, continuity of care and access to complete outcome data for audit”, as reported by Hospital Doctor.However, the multimillion-pound contracts which have been awarded to companies such as Care UK and Ramsey Health Care UK are confidential and rarely audited. There is a great deal of evidence that the NHS is paying for work regardless of whether it is done or not: with one contract, Netcare did not perform nearly 40% of the work it had been contracted to do, receiving £35.1m for patients it never treated. And as for safety, Netcare’s medical director Dr Dinesh Verma resigned (after only six months in October 2004), having “repeatedly raised concerns about on-call cover, continuity of care and access to complete outcome data for audit”, as reported by Hospital Doctor.
The diversion of scarce funds out of the NHS destabilises NHS services. This leads to service closure and staff redundancies, undermining the training of juniors and quality of care, and erodes access for all patients. This in turn fuels waiting lists and public discontent. The Royal Colleges and Medical Associations have been sounding the alarm bells about the policy since 2006, when Bernard Ribeiro, president of the Royal College of Surgeons of England, told the Health Select Committee: “ISTCs have had a negative effect on existing NHS facilities. ISTCs are leaving NHS facilities under-utilised with a concurrent deleterious effect on fragile NHS Trust financial balances.”The diversion of scarce funds out of the NHS destabilises NHS services. This leads to service closure and staff redundancies, undermining the training of juniors and quality of care, and erodes access for all patients. This in turn fuels waiting lists and public discontent. The Royal Colleges and Medical Associations have been sounding the alarm bells about the policy since 2006, when Bernard Ribeiro, president of the Royal College of Surgeons of England, told the Health Select Committee: “ISTCs have had a negative effect on existing NHS facilities. ISTCs are leaving NHS facilities under-utilised with a concurrent deleterious effect on fragile NHS Trust financial balances.”
The Royal College of Ophthalmologists also told the government back in 2006 that it had evidence of outdated practices with adverse results for patients. They warned that ISTC procedures by overseas visiting teams have had to be raised to UK standards, and that there was also a complete lack of training in any ophthalmic ISTC. The programmes had limited training responsibilities and only accepted the “simplest cases”. The Royal College of Ophthalmologists also told the government back in 2006 that it had evidence of outdated practices with adverse results for patients. They warned that ISTC procedures by overseas visiting teams have had to be raised to UK standards, and that there was also a complete lack of training in any ophthalmic ISTC. The programmes had limited training responsibilities and only accepted the “simplest cases”.
The Royal College ended by saying the diversion of funds away from NHS hospital eye services to ISTCs is threatening the provision of comprehensive ophthalmic care for whole communities – emergency care for injuries or retinal detachments, and the management of chronic blinding conditions such as diabetic retinopathy, glaucoma, macular degeneration, children’s eye problems and so on.The Royal College ended by saying the diversion of funds away from NHS hospital eye services to ISTCs is threatening the provision of comprehensive ophthalmic care for whole communities – emergency care for injuries or retinal detachments, and the management of chronic blinding conditions such as diabetic retinopathy, glaucoma, macular degeneration, children’s eye problems and so on.
Some NHS eye units are contracting (instead of replacing ophthalmologists who retire) and may become unviable, requiring patients – mainly children, the elderly and visually impaired people – to travel further for care. The local hospital is also accommodating patients who suffer adverse incidents at the ISTCs, often requiring months of ongoing care, and sometimes further surgery to prevent blindness.Some NHS eye units are contracting (instead of replacing ophthalmologists who retire) and may become unviable, requiring patients – mainly children, the elderly and visually impaired people – to travel further for care. The local hospital is also accommodating patients who suffer adverse incidents at the ISTCs, often requiring months of ongoing care, and sometimes further surgery to prevent blindness.
The Royal College of Surgeons has been equally damning: “Imbalances are occurring with destabilisation of existing NHS facilities. There has been no evidence of innovative technical advance in the ISTCs established in the First Wave programme. Primary Care Trusts have expended significant sums of public money in the advance purchase of surgical procedures which have not been taken up. There is clear evidence from a number of areas that triaging arrangements has diverted patients into ISTCs leaving existing NHS facilities under-utilised with a concurrent deleterious effect on fragile NHS Trust financial balances. There is also evidence to show that training of surgeons in adjacent NHS hospitals has suffered.”The Royal College of Surgeons has been equally damning: “Imbalances are occurring with destabilisation of existing NHS facilities. There has been no evidence of innovative technical advance in the ISTCs established in the First Wave programme. Primary Care Trusts have expended significant sums of public money in the advance purchase of surgical procedures which have not been taken up. There is clear evidence from a number of areas that triaging arrangements has diverted patients into ISTCs leaving existing NHS facilities under-utilised with a concurrent deleterious effect on fragile NHS Trust financial balances. There is also evidence to show that training of surgeons in adjacent NHS hospitals has suffered.”
The British Orthopaedic Association states categorically that private sector ISTCs have had an adverse effect on NHS services in their areas.The British Orthopaedic Association states categorically that private sector ISTCs have had an adverse effect on NHS services in their areas.
For more than a decade governments have been warned repeatedly by medical professional bodies throughout the land of the disastrous effects of its policies of marketisation of NHS care. There are now a number of high-profile deaths in the private sector where the NHS has had to pay out compensation to the families, rather than expose the truth about the policy. So much for the government’s new requirement of a duty of candour.For more than a decade governments have been warned repeatedly by medical professional bodies throughout the land of the disastrous effects of its policies of marketisation of NHS care. There are now a number of high-profile deaths in the private sector where the NHS has had to pay out compensation to the families, rather than expose the truth about the policy. So much for the government’s new requirement of a duty of candour.