At the current rate of progress, the contracts look likely to cover fewer than 300,000 patients a year, even if those still under negotiation are eventually signed.

A review of the private sector’s role is set to be undertaken by Alan Johnson, health secretary, amid speculation he might cancel perhaps the bulk of the second wave of contracts that have yet to be signed for further independent surgical treatment centres (ISTCs).

Some senior NHS figures believe he will press ahead with the right of patients to choose any hospital, public or private, prepared to treat patients at the NHS price. The remaining contracts for diagnostics – scans, X-rays and endoscopies – that are needed for the NHS to hit its target of a maximum 18- week wait for treatment also look set to be confirmed.

These contracts, however, are less contentious than those for the direct treatment of NHS patients. Cancellation of the latter would be a gesture towards the health service unions at a time when some parts of the NHS are arguing that their extra capacity is not needed.

Such a policy, however, would raise questions about whether a long-term role will remain for private hospital operators in treating NHS patients.

Only 170,000 patients a year are being treated under the first wave of independent centres, not the 250,000 originally intended. Talks about a second wave, also intended to treat 250,000 patients, are bogged down.

Six of the original 20-plus schemes have been cancelled and only six contracts have so far been signed. With the deals taking longer to complete than the first wave, two of the remaining 12 had yet even to appoint preferred bidders, said the Department of Health.

Few in the private sector expect the deals to cover more than 130,000 patients – perhaps 300,000 once the first wave is added in. Reaction to the steady shrinkage of the centrally procured treatment centres varies across the private sector.

Richard Jones, commercial director of Bupa Hospitals who chairs the NHS Partners Network, which represents the private providers, said: “It is clear that the second wave of ISTCs is not going to be on the scale of the original procurement.” But that gap, he said, could be filled by the growing right of patients to choose to have their operation in private facilities.

Adrian Bull, managing director of Carillion Health, which saw one of its big schemes cancelled last month, said: “It is very important that the government does not allow serial cancellation of these schemes to undermine the confidence of the private sector in future investment in NHS work.”

David Mobbs, Nuffield’s chief executive, said he remained “excited” about the increasing right of patients to choose.

From:
http://www.ft.com/cms/s/a692477a-29c6-11dc-a530-000b5df10621.html