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Senior Whitehall officials had a closed meeting this month where they outlined plans to ring-fence 10 per cent of health trusts’ primary care budgets for contracts with private companies.
The move coincides with another policy change, expected in a White Paper this year, which will allow companies that invest in building local health centres also to provide healthcare for the community.
The plans, reported in Doctor magazine today, have been criticised as further evidence of the Government’s desire to “privatise the NHS by stealth”.
Health professionals have described the policy shift as a worrying indication that primary care — widely regarded as the foundation stone of the NHS — was going to be opened up for exploitation by private investors.
The Government has angered traditionalists by allowing companies to move into secondary care, where they receive NHS money to provide treatment centres for services such as orthopaedic and cataract operations.
The latest drive came at the meeting in the House of Commons this month, when private companies and investment banks were addressed by Stephen O’Brien, the Department of Health’s strategy director, and Ken Anderson, its commercial director.
The officials said that the treatment centre model was “very much the starting point for the direction we now wish to travel in.” They added that the department would be “ring-fencing 10 per cent of (primary care trust) budgets for innovative programmes”.
These programmes involve a mechanism introduced by ministers last year known as alternative provider medical services (APMS), which allows trusts to pay private companies for services, such as maternity and diabetes care and out-of-hours GP cover, if there is a shortage in the area.
Ministers have been disappointed, until now, that private companies have shown only a limited interest in taking up the challenge.
But with assurance of 10 per cent of the annual £12 billion primary care budget, attitudes in the private sector are expected to change.
Documents used by the Department of Health to brief private investors, seen by The Times, reveal other incentives planned to win over the independent sector. The Government’s Local Improvement Finance Trust (LIFT) scheme, which encourages companies to invest in building and refurbishing large GP centres, is likely be changed to allow them also to provide healthcare.
The LIFT scheme has raised concerns that it is bringing in large, impersonal “super- surgeries” at the expense of more personal GP care.
Allyson Pollock, Professor of Public Health at University College London, said she feared that the new drive would be a catastrophe for public health.
Describing the plans as the end of family medicine, Professor Pollock said that GPs had to wake up before they became the “salaried employees of large, for-profit organisations”.
“The strategy is to liquidate the old NHS and bring in the market, and it is being done quite covertly . . . they are redefining the NHS by stealth.”
Hamish Meldrum, chairman of the British Medical Association’s GPs’ committee, said that the proposals encouraged profit-driven market forces that could conflict with the NHS ethos of prioritising patient care.
A spokesman for the Department of Health denied that 10 per cent of budgets would be ring-fenced. “We are increasing old-style NHS capacity and while we are also increasing private sector capacity, the important thing to remember is it is still all free at the point of need for all patients.”
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