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Wednesday, 15 May, 2002, 06:41 GMT 07:41 UK
Fears for NHS links to private sector
Most consultants do NHS and private work
More must be done to ensure the NHS does not lose out through its links to the private sector, MPs have warned.

A report from the cross-party Health Committee raises the prospect of possible conflicts of interest when consultants do both private and NHS work.

The MPs also express concerns that paying for some patients to have private treatment in a bid to cut waiting lists may not represent value for money.

They are concerned that the NHS may become too dependent on private health care, putting private hospitals in a position where they can increase prices in the longer term.

NHS links with private sector
60,000 NHS patients have operations in the private sector every year
There are 11 PFI hospitals - more than 50 others are being planned
75% of NHS consultants do some private work
But they also found that private finance initiatives (PFI) - where contractors pay for construction and lease finished buildings back to the NHS - is still being blamed for "numerous ills" not directly related to it.

The report has prompted a senior member of health workers union Unison to accuse the government of undermining the NHS.

Geoff Martin, Unison's London convenor, told BBC Radio 4's Today programme: "I do not think they are wedded and committed to the principle of an national health service at all.

"I think they want to see it broken up and fragmented in a way that even the Thatcherites would have baulked at."

Job plan

Most consultants work for both sectors and a previous committee report warned that situation could lead to a perverse conflict of interests.

PFI is still being blamed for numerous ills not directly related to it

Health Committee report
It said some may decide it is to their advantage to keep NHS waiting lists long, so more patients come to them for private treatment.

The new report says very few would exploit their position.

But it does call for a formal job plan outlining how much work they are expected to do for the NHS.

Direct threat

The committee warns of regional inequalities in the standard of care patients receive because of differences in the way the private sector is used.

It also found wide variations in the cost of private treatments used and called for an urgent review by the Audit Commission.

The report suggests the NHS can use the independent sector in the short-term, where it has too little capacity.

David Hinchliffe, health select committee chairman
Hinchliffe hopes using the private sector can be avoided in future
But it says it is crucial to ensure the NHS itself has the capacity, resources and staff to keep down waiting times.

It warns money aimed at cutting lists should not be directed solely towards use of the independent sector, but to whatever services would best serve local need - including the NHS.

The report said it had still to be shown that using the private sector more posed no threat to NHS resources.

Committee chairman David Hinchliffe told Today: " We believe that the NHS itself must develop sufficient acute capacity to avoid in future having to make use of the private sector."

The extra money promised by ministers should make that possible, he added.


The committee says PFI may have become a "convenient scapegoat" for problems such as reductions in bed numbers, which were actually down to poor bed planning.

"PFI is still being blamed for numerous ills not directly related to it whereas the many benefits to PFI have yet to be proved," it said.

It calls for decisions about PFIs to be more open and transparent.

Staff in PFI hospitals have regularly complained they have problems because of basic errors in the way they are built.

The health committee says in future PFIs, staff should have a greater input into the building's design - even to the extent of asking for a mock-up of a whole ward to be constructed in advance of building work.

'Common myths'

But Barry Hassell, chief executive of the Independent Healthcare Association, said he was delighted that the Health Committee "has jettisoned its traditional hostility to the independent sector".

A spokesman for the Department of Health said: "It is particularly encouraging to see that the committee have scotched some of the common myths and scare stories about PFI."

But the Conservative shadow health secretary Liam Fox accused the committee of being more concerned keeping the system than helping patients.

Dr Fox said: "It completely overlooks the huge amount which the private sector has already done in helping to tackle the shortcomings of the NHS."

Liberal Democrat health spokesman Dr Evan Harris said: "This endorses our criticism of the government's counter-productive and short-termist rush to use the private sector at the expense of value for money and mainstream NHS provision."

The BBC's Matthew Hill
"Business has been booming in the private sector"
Karen Jennings, National Secretary of Health for the
"PFI is the only game in town"
Labour MP David Hinchliffe
"There are practical reasons why the government have chosen to use the NHS"
See also:

15 Jan 02 | Health
Anger at major NHS overhaul
08 Nov 01 | Health
Public bill for PFI hospitals
03 Sep 01 | ppp
NHS's private plans
08 Aug 01 | Health
Heart Hospital - a bargain?
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