The employers’ organisation cast the decision as a “pivotal test” of Gordon Stalinist Brown’s ability to deliver on his promise that National Health Service reform will go “wider and deeper”.

Seven deals remain to be decided out of the original 27 contracts for a second wave of independent surgical treatment centres (ISTCs). Eleven of these have been cancelled, with just nine definitely going ahead. Ministers have promised a decision on the remaining contracts next month.

“Whatever happens is going to send a signal not just about the ISTC programme but about the government’s broader commitment to long-term change in the NHS,” Neil Bentley, the CBI’s director of public services, said.

It will be a signal “not just to the private sector”, which runs the surgical centres and which the government now wants to enter the GP market, “but to the wider NHS about how committed the government is to its reform agenda”, Mr Bentley said.

In his New Year speech on health, the prime minister “mentioned choice 20 times and spoke about NHS reform going wider and deeper. So the decision on these ISTCs is a pivotal test of the government’s ability to deliver on what it says it wants to do,” he said.

The CBI remained “nervous” of whether all seven of the remaining deals would get the go-ahead.

Mr Bentley’s comments were made as the employers’ organisation published a review of the ISTC programme to date. It claims that the first wave of 26 centres and units, now operational, has had a real impact on the performance of the NHS.

Independent assessments from the NHS inspectorate and others show patient satisfaction remains higher in the ISTCs than in the rest of the NHS, with low infection rates, rapid access to services, high standards of cleanliness and, as far as they can be compared, low complication rates, the report says.

However, the NHS information centre said last week that ISTCs were still not reporting all the data required.

The CBI report acknowledges that, on average, only 84 per cent of the procedures contracted for are being taken up. Under the terms agreed for the first wave of treatment centres, the NHS pays for the procedure regardless of whether it is used.

But it blames the poor take-up on “flawed commissioning and procurement and local NHS resistance to ISTCs being introduced”.

Health ministers say that improvements to the performance of the NHS mean the cancelled centres are no longer needed and that change will be driven by the introduction from April of free patient choice of any hospital, whether public or private.

But the Department of Health’s latest figures show that less than half of patients are aware that they have a choice. And while ministers plan a campaign to raise awareness, along with measures to allow hospitals more freedom to advertise, Mr Bentley said “we need to see that in action.

Resistance to reform and the continued protection of traditional NHS provider interests means patient choice remains limited.”

The ISTCs, he claimed, are “an NHS success story” but the £2bn invested in them “is at risk of being wasted if the programme does not achieve sufficient size”.

The challenge ISTCs pose has encouraged NHS hospitals to become more productive and attractive to patients, the CBI argues.

http://www.ft.com/cms/s/0/a5d05aa0-d7f6-11dc-98f7-0000779fd2ac.html