Profit-driven firms are squeezing traditional GPs out of running family doctor services because of rules that NHS bosses and ministers both believe harm patient care, the Observer can reveal.
Doctors, MPs and campaigners have hit out at the “creeping privatisation” of general practice, with private companies being handed contracts ahead of groups of GPs.
They are demanding the repeal of parts of the coalition government’s controversial Health and Social Care Act 2012, so that NHS clinical commissioning groups (CCGs) are no longer forced to tender for any contract worth more than £615,000.
Critics say the trend makes a mockery of declarations by ministers and the NHS England chief executive, Simon Stevens, to seek closer collaboration between different parts of the service and reduce the role of private healthcare firms. Privately, NHS bosses say that their hands are tied, the law is “nonsense” and they have to allow for-profit firms to bid or risk facing legal challenge. Since 2016 Virgin Care has sued the NHS in Surrey as well as Lancashire county council amid disputes about contracts for services it failed to win.
Hartlepool & Stockton Health, a not-for-profit GP collective that provides appointments at three Teesside surgeries, is a case in point. Despite high patient satisfaction scores and offering 25,000 extra appointments a year outside usual surgery hours, it could lose out to profit-driven companies. Several private firms, including IntraHealth, have expressed interest after it issued a tender worth up to £1.1m a year for the extended-hours service from 2019-21.
Dr Paul Williams, a local Labour MP who helped to set up the collective in 2015 and still practises as a GP, said: “The law is creating unnecessary privatisation that isn’t working in the interests of patients. This is a ridiculous fragmentation of services, at a time when the rhetoric from government and NHS leaders has all been about integration.”
Doctors’ leaders are demanding an end to outsourcing. “These services should be managed and run by local GPs working together. It is these doctors, who provide care to the same patients from within the community, that are best placed to control how the service works best,” said Richard Vautrey, chair of the British Medical Association’s GPs committee.
Other CCGs intending to invite bids for evening and weekend GP sessions include Bassetlaw in Nottinghamshire, Watford and Three Rivers in Hertfordshire. North Lincolnshire CCG has also invited expressions of interest in extended-access consultations at an urgent treatment centre based in Scunthorpe general hospital worth £25m-£35m.Private firms such as AT Medics have already won contracts for out-of-hours sessions. Last year, it secured a £1.5m, two-year contract from Camden CCG in north London; it does the same in other boroughs in the capital.“The government is saying one thing – collaboration – but the reality is that competition prevails. How can it be better to have a private company running general pracice for an hour and a half each day than having it run collectively by local GPs?” asked Williams.
All 195 CCGs in England were required to have arranged extended-hours GP appointments for 100% of their population by 1 October. Such appointments were the centrepiece of David Cameron’s coalition government’s plans to turn the NHS into a 24/7 service.