No evidence that they’re better value than NHS, yet private treatment centres will get billions

Were ITCs ever anything but an exercise in subsidising corporate profits?

It would appear not.

Here is The News Line‘s feature article:

‘£5BILLION WASTED’ ON PRIVATE TREATMENT CENTRES – NHS left to pick up the pieces, says BMA

There is no good evidence that independent sector treatment centres have provided additional capacity, value for money, or high quality care, argue researchers in this week’s British Medical Journal (BMJ).

Despite this, says the BMJ, the government is continuing with the programme.

Commenting on the paper, Dr Jonathan Fielden, chairman of the BMA’s Consultants Committee, said: ‘This paper adds to criticisms from the Public Accounts Committee and the Healthcare Commission relating to the quality and cost effectiveness of these centres.

‘We have repeatedly raised concerns that this is £5 billion wasted on ideology rather than evidence.

‘The government seems to have been charmed by the private sector, but is unable to prove its effectiveness or value for money.

‘The lack of integration and collaboration with local NHS services leads to fragmentation of care for patients, leaves the NHS picking up the pieces, and has a major impact on training future doctors – with long term consequences for the NHS.’

In the BMJ article, Professor Allyson Pollock and Sylvia Godden from the University of Edinburgh warn that this will contribute to NHS deficits, NHS service closure and staff redundancies.

The policy of the Department of Health in England is to use NHS funds to contract with for-profit multinational healthcare corporations to deliver clinical services, they explain.

Part of this policy is the £5bn independent (private) sector treatment centre programme, which over the course of two phases (waves) aims to provide extra capacity to the NHS and reduce waiting times for elective surgery.

Yet, four years into the programme, the Department of Health has not gathered adequate data to justify the policy, say the authors.

They reviewed the available data and evidence in terms of the programme’s objectives and found a worrying failure to collect and publish data on performance.

For example, data on the number of available and occupied beds are collected annually from NHS Trusts, but no such data are collected from independent sector treatment centres.

Without these data, it is impossible to assess the contribution that these centres make to capacity, productivity, or efficiency.

A recent report by the Healthcare Commission found that incomplete and poor quality admissions and outpatient data from independent sector treatment centres limited their ability to assess quality of care.

Furthermore, the first research on the quality of work undertaken by private centres, published in October 2005, stated that data were so variable in quality and so incomplete as to render ‘any attempt at commenting on trends and comparisons between schemes and with any external benchmarks, futile.’

The Royal College of Surgeons of England also reported ‘increasing evidence’ that these centres were unable to manage complications and patients were being readmitted to the NHS.

The failure on the part of the DoH to collect meaningful systematic data about quality of care heightens concerns about standards of care, write the authors.

Data on workforce, contract performance and finances are also lacking.

The government’s assurance that staff employed by the private sector in treatment centres would be ‘additional’ rather than parasitic upon the NHS has not been honoured.

It has reneged upon its original guarantees, so that more than a quarter of the staff employed by the private sector are NHS staff.

Furthermore there is growing evidence that NHS funds are being diverted to the private sector for services they have failed to provide under the contract, they warn.

The government’s failure to collect and publish meaningful relevant data on the productivity, performance, staffing and quality of private independent treatment centres, and its refusal to provide any data on their value for money is worrying, they say.

Professor Pollock cautions: ‘The policy of diverting scarce NHS funds into independent sector treatment centres is leading to fragmentation and financial instability and NHS beds and services are being closed to make way for the for-profit private sector.

‘Despite assurances by the secretary of state for health, Alan Johnson, the available evidence suggests that the private sector is profiting at the expense of patients, the public, and the NHS.’

l Amid global calls to end drug companies’ direct sponsorship of doctors’ education, this week’s BMJ reports on an investigation in Australia which reveals sponsor involvement in the education of thousands of general practitioners.

This weekend, a programme by the Australian Broadcasting Corporation will show that it is not uncommon for drug company sponsors to suggest speakers at sessions that are assumed by the thousands of general practitioners who attend them to be totally independent.

Drug industry representatives have confirmed that similar practices take place in the United Kingdom, where roughly half of all education for doctors is sponsored by drug companies, writes Ray Moynihan, honorary lecturer at the University of Newcastle in Australia.

He describes how leaked documents and emails from a range of sources show drug company sponsors having input into the selection of some speakers at seminars held in recent years, despite the fact that these have been aggressively sold to general practitioners in brochures claiming that ‘all content is independent of industry influence’.

The drug industry’s representative body Medicines Australia has confirmed that the practice of inviting input from sponsors into the selection of speakers is by no means uncommon.

Industry representatives in Australia and the UK strongly argue that, in the interests of transparency, doctors attending educational sessions should be fully and explicitly informed if sponsors have suggested speakers for these sessions.

Such a degree of disclosure could radically change perceptions of the content of accredited education, says Moynihan, which many doctors believe to be independent of sponsor influence.

The evidence, such as it is, tentatively indicates that the prescribing habits of doctors may be affected by attending sponsored educational events, albeit only in the short term.

Oversight of these educational events is currently a self-regulatory affair, and institutions seem uninterested in guaranteeing independence, argues Moynihan.

Potty about privatisation: govt plans PFI toilets

No kidding:

Private partnership for public convenience
By Jim Pickard, Political Correspondent
Published: February 22 2008 22:12 | Last updated: February 22 2008 22:12

The public convenience could be consigned to history under government proposals to shift provision to the private sector.

It is understood that Hazel Blears, communities secretary, plans a strategy in which councils will be encouraged to pay restaurants, pubs and bars to let the public use their facilities.

Participating venues would receive up to £1,000 a year.

But the number of public lavatories in the UK, which has been dwindling in recent years, is likely to plummet as a result.

The British Toilet Association, which campaigns for better provision, says the number of facilities has halved in a decade.

Richmond upon Thames introduced a pilot scheme whereby 66 venues were each paid £600 a year to make their facilities available to the non-paying public. Stickers on their entrances and signs on nearby lampposts advertise the fact.

The Department for Communities and Local Government will next month urge other councils to follow suit. It will express “growing public concern” at the declining number and standard of public lavatories.

The government believes the public do not care who provides and maintains toilets as long as there are enough of them and they are accessible. Other measures in the DCLG document include the wider use of “SatLav”, which is used by Westminster’s council to send text messages to people allowing them to find the nearest public toilet.

It will also urge more loos be built in new developments such as sports arenas.

In the 1980s Richmond had about 30 public lavatories but this was down to 13 when it began the pilot scheme three years ago.

Since then, the council of the London borough has been able to cut the number to just four, according to Martin Elengorn, Richmond’s cabinet member for the environment.

Mr Elengorn said it was cheaper to pay the 66 participating businesses than run the 13 public toilets – let alone pay for their wear and tear. Some of the former WCs have been sold on by the council.

An incentive for pubs and restaurants is the possibility of attracting passing trade. “Some cafés and pubs find people come in [to use the toilets] and think – nice pub, I’ll come back,” Mr Elengorn said.

If this policy were replicated elsewhere, it could see public toilets disappear further from the streets. This is in contrast to many other developed countries, such as Australia, where clean, well-maintained public conveniences are taken for granted.

A step towards equal rights for agency workers

After failing to defend the right of prison staff to take industrial action, Labour MPs get their act together over giving agency workers the same rights as permanent staff – but wait, this is only a vote to give the bill a second reading…

Brown is meeting with union leaders on Monday – he favours an “inquiry” rather than action. It will be interesting to see what happens. Will they take the opportunity to push him on this, now momentum has been built?

Labour MPs have stepped up pressure on Gordon Brown over rights for agency workers ahead of a meeting on Monday.

Backbenchers rallied enough support to get a second reading for a private member’s bill to give temporary workers the same rights as permanent staff.

Mr Brown has pledged an inquiry into the issue instead, but he is to meet union leaders to discuss a way forward.

More than one million people are employed via agencies, which means they do not get benefits such as sick pay.

MPs voted by 147 to 11 – a margin of 136 – to back Labour MP Andrew Miller’s bill, proposing to give agency workers the same rights as permanent staff.

Among the 136 Labour MPs who voted for the bill’s second reading was former work and pensions secretary Peter Hain.


Tony Woodley, joint general secretary of Unite, said: “The message today sent by Labour MPs to their government could not be any clearer.

“Nothing less than primary legislation, delivered now, can quell the clamour that has come from MPs, the Labour Party’s ruling body and from the wider labour movement.

“Hopefully today’s vote has also quashed the idea of a commission to look into agency working.

“The evidence of the need for legislation now is overwhelming and we will not accept the promise of jam tomorrow.”

Mr Miller’s bill was helped on to the next stage by dozens of Labour backbenchers who took part in the debate, many of whom might normally have spent Friday in their constituencies.

Mr Miller, MP for Ellesmere Port and Neston, said he was facing the same “doom merchants” who had opposed the introduction of the minimum wage.

He told MPs: “It’s in the best long-term interests of the economy to encourage employers to plan for the long term and establish a well-trained and well-motivated workforce.

“What the bill proposes is morally right. How can it be right for people to work alongside each other with the same skills doing precisely the same task and yet one category of employee is worth less than another?”