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Private companies increase GP presence

The private sector has established a small but significant bridgehead in general practice in England, but any “corporate takeover” of family doctor surgeries remains a long way off.

Primary care trusts have been commissioning some 260 “GP-led health centres”, or “polyclinics”, open 8am to 8pm, seven days a week – one in each primary care trust and a further 110 or so in areas short of doctors.

With just over 200 of the contracts awarded, 42 per cent have been won by partnerships of GPs, according to health department figures. Private sector companies have won 21 per cent, and consortia – usually a mix of GPs working with independent sector partners – have won 19 per cent.

The remainder have gone chiefly to third sector organisations, including social enterprise, with primary care trusts awarding 6 per cent of contracts to their own provider arms.

When the centres were announced, the British Medical Association ran a “save our surgeries” publicity campaign and petition, saying the labour government was seeking to privatise general practice and that many of the extra surgeries with longer opening hours were unnecessary.

The contract award figures show, however, that GPs locally have bid strongly to run them – even the practice in which Dr Hamish Meldrum, the BMA’s chairman of council is a partner, won one commission.

“How well family doctors and the private sector have done depends somewhat on how you want to look at the figures,” said Helen Parker, co-director of the Health Services Management Centre at Birmingham university.

If GPs working in consortia with independent sector partners are included in the total that are GP-run, family doctors have won 60 per cent of the contracts.

If, however, those consortia that include the independent sector are counted as privately run, private operators have a stake in 40 per cent. But even in this scenario, fewer than 100 of the 8,000 general practices in England will be run by the independent sector.

“This does not yet amount to a corporate takeover of general practice,” Ms Parker said.

Mark Britnell, the health department’s director-general of commissioning, said the outcome “is a good mix, and the fact that GPs have won a significant proportion of the contracts shows that the BMA was wrong to insist that this was bad for GPs”.

Mike Parish, chairman of the NHS Partners Network, which represents private providers, said it was broadly pleased with the outcome.

“It is a fantastic opportunity to build on the new relationships that have been established [with primary care trusts]”, he said. “We see these projects as the beginning rather than the end, or a one-off.”

Some £10bn of efficiency improvements would be needed over the next few years as NHS spending was squeezed, he said. Private sector investment could play a key part in moving services out of hospital to more convenient locations at lower cost.

From:
http://www.ft.com/cms/s/0/75aebad8-3db7-11de-a85e-00144feabdc0.html

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