Posted: 6/4/2008 5:42:14 AM EDT
Private companies to take over failing hospitals
By Rebecca Smith and Andrew Porter
Last Updated: 2:51AM BST 04/06/2008
Private companies are to be drafted in to run failing NHS hospitals for the first time, under plans to be announced.
A number of private firms have expressed interest in providing NHS services
Poor managers are to be sacked without receiving large payouts and replaced by staff from profit-making companies who would be paid with public money.
The NHS will retain ownership of hospital buildings and services but the private firm will "take over" the day to day running of the hospital.
Ministers believe the proposals will drive up standards within the health service.
The NHS has an annual budget exceeding £100 billion and is one of the world's largest employers with 1.3 million staff. Critics have called it a monolith that is unable to run efficiently.
It has long been argued that private firms are better placed to react to innovations in health care and provide fast, efficient care for patients.
But doctors, patient groups and academics said the strategy would amount to a significant step towards privatisation of the NHS. They expressed fears that the needs of shareholders would be put before providing vital patient services.
It is thought about 30 hospitals will be warned to improve or face the sacking of their managements. Hinchingbrooke hospital, Cambs, is one that could face a full private sector takeover.
Front-line staff, including doctors and nurses, will keep their jobs under such a move. Ben Bradshaw, the health minister, will set out minimum standards in quality, safety and finances that hospital trusts are expected to meet.
Hospitals with high rates of superbugs will be identified and managers will have a deadline to produce plans to rectify their problems.
If this is not met, David Nicholson, the NHS chief executive, will be able to sack the whole board and bring in management from within the NHS or the private sector.
Interested companies would negotiate a performance-related fee.
The private firms Virgin, Bupa, Nuffield, Boots, Sainsbury's and Ramsay Health are already providing NHS services or have expressed an interest in doing so.
Under the plans, sacked managers will not receive large payouts, which in the past have run into several hundred thousand pounds.
Ministers were embarrassed that Rose Gibb, who was chief executive of Maidstone and Tunbridge Wells NHS Trust when at least 90 people died after contracting Clostridium difficile, was due to receive in excess of £150,000 and was eventually paid £75,000.
The announcement coincides with a call by the British Medical Association for ministers to leave the NHS alone and free it from Whitehall control.
Alan Johnson, the Health Secretary, briefed the Cabinet on the new plans and said 30 hospital trusts out of 240 acute trusts in England accounted for half of patients waiting more than 18 weeks for treatment and almost half of all cases of MRSA.
These are understood to be the first in line for special attention.
Mr Johnson said the NHS had turned a £1 billion deficit into a £1 billion surplus, proving the health service can tackle failure.
But he admitted that too often, poor performance had been dealt with only after a serious problem had emerged, as happened with Britain's biggest superbug scandal at Maidstone.
Mr Bradshaw said: "What we've never done before is to allow the private sector to take over the running of a whole hospital in the form of a franchise, which is one of the options that would be included in this performance regime.
"What we know from our experience of involvement in other parts of the health service is that the private sector can bring different skills, different management skills, different techniques."
But Jonathan Fielden, who heads the BMA's consultants committee, said there was plenty of talent within the NHS without having to resort to the private sector whose only concern would be turning a profit.
"The record of the private sector particularly in turnaround is to look for the quick easy hit and that means services that are critical for the local population will be at risk and that is privatisation of the NHS. We do not believe that is what the public wants."
Prof Allyson Pollock of Edinburgh University, a member of Keep our NHS Public, said the Government had "squandered" billions of pounds on private schemes.
"Alan Johnson is continuing to create a climate of fear and culture of anxiety among hospital managers so that they can no longer represent patient and public interests," she said "He is preparing the way for total privatisation without a democratic mandate.
"The private for profit sector has no expertise in providing universal health care, their motivation is toward shareholders and minimising risk."
Geoff Martin, of the pressure group Health Emergency, said: "We have no problem with incompetent top brass being kicked out without mega-bucks pay-offs but yet more management consultants on fat fees has the hallmarks of another expensive policy failure."
A Government source said: "We can only proceed with the next stage of public sector reform if we have tackled failing hospitals and eliminated unfair variations in services. We can only do that if we have a stringent set of minimum standards and enforce them."
Still wont stop our assholes in Congress from pushing that bullshit here.
My local Healthcare Trust Hospital (of which I am a Trust Member), is not failing.