Today the BMA has written to the national medical director of NHS England1 expressing concerns about the government’s new contract with private practice providers – in which the NHS has reserved a significant number of private hospital beds to be used for urgent NHS care in the event of a Covid-19 surge. This is the second time this agreement has been arranged and based on the previous outcomes, the BMA is warning that this contract may have a significant negative impact on private patient care, including those receiving treatment for life threating conditions such as cancer.
The Association understands the government’s desire to secure additional capacity if Covid-19 threatens the NHS’ ability to provide urgent care. However, there is little evidence to suggest that the reservation of private hospital beds will increase NHS capacity and ample evidence to suggest that it will adversely impact private patient care. When this decision was taken in March 2020, despite many of these reserved private hospital beds going unfilled, a BMA survey found that 60% of the private practice doctors who responded were unable to provide care to their private patients and approximately 25% reported that private patients presented later than they should have - citing NHS bed reservation and subsequent limited capacity as the reason. As such, the BMA is concerned that this new contract will mimic the previous one and result in even more private patients having their care interrupted, including those needing cancer operations and those on immunosuppressives.
The BMA is also of the view that there is a financial aspect to be considered. There has been a lack of transparency around how much was spent by the NHS on purchasing services from the private hospitals early in the pandemic without a clear indication of what the NHS received in return. This agreement is costing the government a considerable amount and has the potential to prove to be a serious misuse of taxpayer’s money.
The Association wrote to Professor Powis in March 2021 to highlight concerns about the outcomes of the previous agreement and earlier this week the NHS’ own Chief Executive raised similar concerns.2 Now in today’s letter the BMA is calling for the government to meet with the BMA private practice committee (PPC) to discuss several issues including:
- What provisions it plans on providing for private patients whose care will be interrupted - as a result of this agreement - to ensure their conditions do not further deteriorate, including those who will be placed on extensive waiting lists;
- How it has calculated the number of reserved beds needed considering so many went unused during the previous agreement;
- What support private practice doctors will receive as they face mounting pressure from their patients whose expectations will inevitably fail to be met and;
- What support private practice doctors who experience a significant income reduction will receive. BMA survey2 findings show that many private doctors experienced a loss in income during the previous agreement with some reporting an 80% reduction. These doctors were not paid out in the way that private hospitals were and did not qualify for the furlough scheme.
Dr Jeremy Lawrance and Dr Jennifer Yell, BMA private practice committee (PPC) co-chairs, said: “It’s shocking that the government decided to make this decision without consulting doctors working in the private sector, particularly after how unsuccessful the previous agreement was. While policy makers might think this is a good idea, doctors on the ground do not – we are of the view that this agreement will not fulfil its intention of boosting NHS capacity but rather further impact private patient care and prove to be a waste of taxpayer’s money.
“If the PPC had been asked our opinion, as we suggested in previous communications, then we would have made it very clear to policy makers that this decision will lead to patient’s conditions deteriorating and increase the private sector’s backlog. For far too long the government has sought to manage NHS underfunding with outsourcing rather than developing a credible plan to actually increase NHS hospital capacity and ensure patients receive the care they deserve in a reasonable timeframe.
“This new contract is an exercise in smoke and mirrors and the BMA are now demanding that the government listens to the views of private doctors and looks to urgently addresses our concerns before even more private patients are harmed as a result of this agreement.”
Notes to editors
The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- Letter to Professor Powis
- Request for direction on independent sector contracting from NHS England Chief Executive Officer to Secretary of State for Health and Social Care