Private firms look set to run 24 new fast-track surgery centres in England.
The centres aim to help drive down NHS waiting times
Ministers have selected two British companies and five from overseas as preferred bidders to run the centres.
These are from Canada, South Africa and the United States. The centres are expected to be up and running early next year.
They will carry out non-urgent surgery on NHS patients, such as knee, hip and cataract operations. Ministers hope they will help cut NHS waiting times.
Over 20 diagnostic and treatment centres are already in operation. However, they are all managed by the NHS.
This will be the first time that private firms will be involved.
Under the government's plans, private firms will run 22 new treatment centres and two mobile units, which will offer ophthalmology services.
Where the centres will be based
South West Peninsula
Horton Hospital, North Oxford
North East Yorkshire
Barlborough Links, Nottinghamshire
Chase Farm, Barnet, London
King George Hospital, Redbridge
Royal National Throat Nose and Ear Hospital, Kings Cross
Trafford, Greater Manchester e
Royal National Orthopaedic Hospital, Stanmore
Shepton Mallet, Somerset
Mercury Health Ltd, a British based company, will run nine centres across England.
Birkdale Clinic, which is also British-based, will operate a centre at Daventry.
The remainder will be run by overseas companies.
Anglo Canadian, a Canadian-led consortium, will operate three clinics in London.
Nations Healthcare, a US-led consortium, will run two centres in Bradford and Burton while another US firm New York Presbyterian will run two centres in Stanmore and Somerset.
A South African company called Netcare UK will run a centre in Manchester and the two mobile ophthalmology units, which will travel around England.
Care UK Afrox, a partnership between a South African and British company, will operate three centres in Maidstone, Nottinghamshire and Plymouth.
The decision to allow foreign firms to run the centres is controversial.
There are concerns that the centres will not provide value for money and will poach staff from NHS hospitals.
Netcare UK (South Africa)
Mercury Health Ltd (UK)
Care UK Afrox (South Africa)
Anglo Canadian (Canada)
Nations Healthcare (USA)
Birkdale Clinic (UK)
New York Presbyterian (USA)
But Health Secretary John Reid said: "There will be 250,000 more operations, they will done more quickly, there will be less chance of cancellation for the patients, and there will be a better service. Everybody wins in this."
Nevertheless, the British Medical Association warned that the move could destabilise the NHS.
Its chairman James Johnson, said: "DTCs must not take staff or resources away from NHS hospitals." by leaving hospitals without enough doctors and nurses."
Trades unions have also voiced their opposition to the policy of allowing private firms to run the centres, accusing ministers of privatising the NHS.
A spokeswoman for Unison, the largest health workers union, told BBC News Online: "These centres will be an expensive drain on the NHS both in terms of resources and staff.
"They will tie trusts into five year contracts where they will be paid more than the NHS for each and every operation and a drain on staff because the government seems to be back pedalling on its original commitment that staff would not be taken from the NHS to work in these centres."
The Royal College of Nursing said it was concerned about the impact the centres will have on the NHS.
A spokeswoman said: "The RCN has concerns about the practical working arrangements and the impact this might have on existing staffing levels in NHS and is seeking assurance that the impact of this development will be properly evaluated."
Dominic Slade, secretary of the Association of Surgeons in Training, expressed concern that the new centres could damage surgical training.
Shadow Health Secretary Liam Fox suggested the contracts being offered to private firms were too expensive.
"The patients and the taxpayers will be paying the price."
Liberal Democrat health spokesman Evan Harris said: "This is an expensive use of taxpayers money. The price per case is more than it's costing the NHS."
Andrew Fairburn of the Independent Healthcare Association said: "If the government made better use of the country's existing 218 voluntary and independent hospitals, then it could get more patients treated more quickly ¿ as well as securing better value for money for taxpayers."
Phil Gray, chief executive of the Chartered Society of Physiotherapy, said: We also have concerns that this will drain more physiotherapists from acute care - exacerbating the existing staff shortages and potentially leading to longer waiting lists in the NHS."
Read a selection of your comments below.
Non-profit privatisation may bring the benefits of better management and greater efficiencies. For profit privatisation, however, promotes capitalisation and exploitation of the sick and ill. It is the most disgusting economic models to emulate in healthcare.
I have seen Americans losing their homes and life savings to pay for major surgeries that are not covered by insurance policies - which are owned and operated by private firms. Stockholders motivated by profit, not doctors or health institutions, indirectly decide on whether you get treatment or not, or ultimately if you live or die.
The Ontario government is pursuing a privatisation policy in health provision but there is strong opposition to bringing the profit motive into the equation. The patient pays, whether in taxes or in direct subsidy. Keep your public health system public and well funded for the most equitable service.
Elinor K. Leard,
I think it's a good idea for the new fast-track surgeries. After visiting my GP with an extremely painful knee, I have been waiting for over 6 weeks and have not even received a letter with an out-patients appointment. When I do I shall probably have to wait 2/3 years for any treatment.
Barnara Baker, UK
I am a UK qualified nurse working in the US. Both systems are deeply flawed. In the UK this is due to poor delivery of services, lack of choice and long waiting lists. In the US, those who are uninsured or under-insured have difficulty getting treatment and may end up in debt.
Melissa Krausey, USA
If human resource is not being taken from the NHS to man these centres, where are the doctors and nurses going to come from? I assume they will be from overseas, as John Reid says there will be 250,000 extra operations per year. If this is true, there must be some good in it, but only if the NHS human resource is not degraded.
Stuart Pilsworth, UK
I am a qualified experienced nurse and midwife with 4 qualifications and 19.5 years NHS service, but now embarking on a new different career. I would not work in either the NHS or private sector ever again, but I cannot understand the fuss about staff recruitment in these proposed clinics. Surely any employers have the right to advertise for staff, as private sector and public sector employers other than the NHS already do and it is the choice of the staff where they work. All is fair in love and war and the open market.
Sian Morgan, UK
I have a really bad feeling about this.... I can foresee a time when we will all have to pay for our medical care just like in pre-NHS times....
My wife is a nurse here in Ontario. The Americans are always coming up here and offering more money and large bonuses to go there. I can see that happening with these clinics.
They will be able to offer more money than the NHS and of course the nurses will go. They will not only draw nurses from the NHS in England but in the border areas from Wales and Scotland as well.
I am a UK expat working in the US. Based on my experience living and working in both countries I would say that introducing American healthcare practices into the NHS should not be seen as a positive step.