MORE than a million NHS patients are to be offered the choice of having their operations privately by the end of next year under radical plans disclosed in government guidance to health chiefs.

Documents from the Department of Health reveal that under the Government’s policy of offering patients a choice of four or five hospitals, there is an “expectation” that one of the options should be from the private sector.

The restricted guidance, sent to primary care trusts, expects “at least one independent sector provider” to be offered for five or more of the ten most common hospital operations. The move, part of government plans to increase the use of private healthcare, has led to fears that the independent sector could end up swamped with patients while NHS hospital beds lie empty.

Use of the private firms is scheduled to rise dramatically to improve the capacity of the NHS, with up to 15 per cent of hospital operations expected to be carried out privately by 2008. Last year about 100,000 operations were bought from the private sector — under 2 per cent of elective care delivered to NHS patients.

David Hinchliffe, the Labour MP who chairs the Commons Health Select Committee, said: “It would worry me if there is pressure on for a target proportion of care to come from the private sector because it is contrary to the philosophy of choice. This is being more restrictive about how the money is spent rather than devolving decision-making to the frontline.”

Of the most common procedures likely to be offered privately, internal examinations — known as endoscopies — currently account for a million operations a year, followed by 263,000 cataract operations and 172,000 procedures to remove skin lesions. Other common operations include dental surgery — such as the extraction of wisdom teeth — hernia repairs and hip replacements.

Bob Ricketts, head of capacity, plurality and choice at the Department of Health, told Health Service Journal last week that the Government wanted primary care trusts (PCTs) to “gear themselves up” to offer a range of choices for patients, including mandatory use of private healthcare.

He said that private treatment centres, which will provide thousands of orthopaedic and cataract operations, were likely to do most of the work. “We want to ensure that most patients have as wide a choice as possible,” he said. “We will leave it down to primary care trusts to decide which procedures they offer to patients (from the independent sector); it would be wrong to be prescriptive.”

Health leaders have questioned the strategy, expressing fears that use of the private sector will destabilise the NHS, leading to the closure of less popular hospitals.

Michael Dixon, chairman of the NHS Alliance, which represents PCTs, said that he did not see the need to involve the private sector if NHS providers performed well. “If the local population feel happy with the local NHS, I am not sure what is to be gained by bringing in private providers.”

A spokesman for the Department of Health said: “Offering choice is not about creating instability in the NHS. It is a lever to improve the quality of services. If more patients choose to go to independent providers it means the NHS will have to improve its game.”

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