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Last Updated: Wednesday, 26 July 2006, 17:11 GMT 18:11 UK
Private GPs move in to the NHS
By Branwen Jeffreys
BBC News health correspondent

Rosemary Bird with a practice nurse
Rosemary Bird is happy there is now a GP surgery nearby
The signposts of deprivation are in the surrounding streets, the boarded up shops, and the tagged and scratched phone box in Broad Street.

This part of Dagenham is among the quarter of most deprived council wards in England.

Tucked away down a cul-de-sac the new health centre is conspicuously untarnished and modern.

The building is owned by Barking and Dagenham Primary Care Trust.

It is part of their answer to a serious problem. For years the health needs of this area were under-funded.

Poor neighbourhoods need more doctors, yet here they are about 10% short of the number of GPs the local community needs.

British general practice has been good but it hasn't moved on with the times
Dr Sushil Jathanna

The problem can only get worse. This area is earmarked for development as London's desperate need for housing pushes east into the Thames gateway.

First of its kind

But inside the Broad Street Health Centre, a small revolution is underway.

The first NHS GP service run by a private company in the UK has just opened for business.

Care UK plc won the contract in a deal brokered nationally by the Department of Health - the first of its kind - in a national pilot scheme.

The increased competition can only improve services for patients
Dr Sushil Jathanna, Care UK

The company will also staff a walk-in centre service with the aim of gradually encouraging more people to register with the practice.

When I visited on the second day the lone doctor had seen only a handful of patients.

Rosemary Bird walked in off the street with a sore and swollen leg.

Her usual GP is two bus journeys away and it is hard to get an appointment because of the pressure on local health services.

The Broad Street centre is branded with the NHS logo and she was surprised to find that it is run by a private company.

Impressive facilities

Mrs Bird was impressed with the new facilities and the courtesy of the staff.

She will be back - she doesn't mind who provides the service. But she says others might.

Paul Evans, Save Our NHS
'Private companies are looking to make a profit'

"I just think people are wary of private companies, we are so used to the NHS.

"People want to know will it be good all the time or just the first visit or all the time."

Dr Sushil Jathanna, one of the managing directors of Care UK, says they hope to innovate and offer better services than traditional surgeries by opening longer hours and eventually at weekends.

He argues that GPs effectively run their own small businesses, and that companies like Care UK are no different in principle.

"By having the independent sector providing services, only a small number of services, the increased competition can only improve services for patients."

Easier appointments

As I walked through nearby streets with Hilary Ayerst, chief executive of Barking and Dagenham PCT, a thunderstorm forced us to shelter in a local hairdressers.

It is not often you get to see a senior NHS managers explaining themselves to a group of women getting highlights or a set and rinse.

She told them the new centre should make it easier to get a GP appointment - a common complaint, and one the women raised immediately.

Hilary Ayerst has no difficulty in admitting that Care UK will need to make a profit, but says they've also been set tough clinical targets.

"We want to make sure that they are providing profit to their stakeholders - otherwise they wouldn't be in business - but we want to performance manage them to make sure they meet our requirements too."

She sees the Care UK operation as only one part of the strategy to increase the numbers of doctors locally, and rejects complaints that private companies were at an advantage in the national tendering process.

That is a concern raised by the head of the local medical committee, Dr Alok Mittal.

Doctors uneasy

A GP in the area for decades, he says there is unease among local doctors about a private company running services.

Some local GPs weren't even shortlisted to run the Broad Street service, and others missed the deadline to apply because some of the advertising was in national journals.

"The perception is that it was loaded against local GPs considerably - with local GPs who had not developed their groups not having much chance against such a large private company."

Barking and Dagenham is just the first. Elsewhere, contracts are being finalised either as part of the national pilot or as a result of individual tendering processes.

Health unions and organisations such as the BMA have expressed concern at the speed of change within the NHS.


Others, such as Paul Evans, claim it is part of a strategy of piecemeal privatisation of the NHS.

He is one of the campaigners involved in Keep Our NHS Public, which is backed by the major health unions and some doctors and Labour MPs.

"With a private company you will get investment in services, but you'll also get a large proportion of public money going towards guaranteeing a profit for shareholders.

"Across the country that means millions of pounds draining away from the NHS."

In community based care, as in the hospital sector, independent companies are likely to provide a small proportion of care for the foreseeable future.

The government is gambling that handing a slice of provision to private companies will act as a catalyst for innovation - leading to services that provide better care in deprived areas, and more accessible services to all.

Private firm 'GP monopoly fear'
01 Jun 06 |  Health
Is the GP market up for grabs?
01 Jun 06 |  Health

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