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Wednesday, 8 August, 2001, 12:34 GMT 13:34 UK
Heart Hospital - a bargain?
The NHS has taken the radical step of buying a private hospital.
It is being trumpeted as a good news story - a "heaven-sent opportunity" in the words of one minister.
But there are a lot of unanswered questions about just how good a deal the £27m hospital was.
So was the Heart Hospital a good buy? Doctors and heart experts are agreed that boosting cardiac services in London can only be a good thing.
This move will more than double the number of heart operations the hospital trust can do.
And it will allow facilities at the Middlesex Hospital, where heart operations are currently carried out to be used for other work.
The hospital has only briefly been in the possession of the private sector - it was an NHS hospital until 1989.
And it is possible that the boundaries between it and the health service were alreadly blurred, with NHS patients needing heart surgery sent there to keep waiting lists down.
Certainly that would have been the case in future under the new NHS "concordat".
Robert Naylor, chief executive of the UCLH Trust said it could have been bought up by property developers and turned into flats if his trust had not acted.
Facing the threat of losing access to this important "reserve" of beds, the NHS may have had little option but to move in.
"The foreign market kind of shrank towards the end of the 1990s.
"It is not that we were doing badly, just that we needed more money for our strategic purposes."
In the end, the company sold it for the same price as it paid for it.
In terms of cost, it really does seem to be a bargain for an up-and-running state-of-the-art hospital.
In comparison to the Heart Hospital's £27m cost, the recently opened Cumberland Infirmary - the first hospital to be built under the private finance initiative - cost £87m.
One of the key questions is how staff will fare under the new arrangements.
One hundred and sixty doctors, nurses and technicians currently work in the hospital, and they are set to retain their current terms and conditions.
A spokeswoman for the Royal College of Nursing said they expected to closely involved in negotiations for nurses' terms and conditions.
She said: "Sometimes the pay in the private sector might be the same but the conditions may be better."
Robert Naylor glossed over possible problems which might arise with NHS and private staff working under different terms and conditions.
He guaranteed jobs, saying: "We absolutely need to make sure that we keep all the staff both at the Heart Hospital and from the Middlesex."
And he said the difference in terms and conditions between both sets of staff was just "5%".
But Steve Dewar of the independent think-tank the King's Fund said the real question was what was going to happen to doctors' terms and conditions, as doctors in the private sector are usually paid per operation - which could prove far more expensive than the contracts NHS doctors work under.
"It's unlikely that doctors providing services in the private sector are under contract. Their services are probably paid for on a fee per service basis."
There are some concerns from the unions that the NHS has simply "bailed-out" a failing private hospital.
A spokesman for the GMB union said: "Privatisation of the NHS is now reaching levels of farce. The trading and wheeler dealing would not be out of place in a Turkish bazaar.
"We have got to stop running the NHS like a business and start running it like a service."
But their main concern is staff.
Phil Thompson of Unison told the BBC: "I wouldn't be surprised if staff in the private sector were paid more because there are shortages in all the specialties across London, and because pay is so poor in the NHS."
UCLH has promised to bring NHS and private staff's pay into line, and Mr Thomson said if NHS terms and conditions were equalled up to the level of the private colleagues, that would be "very good news".
But does it open the door for more swoops by the NHS into the commercial health sector? Opinion is divided.
The head of the NHS, Nigel Crisp, has said this could happen again, should any suitable private facilities come up for sale.
But a spokeswoman for private healthcare provider Bupa said there were no major implications of the Heart Hospital sale for the company or the sector.
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