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NHS (Private Sector)

Volume 458: debated on Tuesday 13 March 2007

The NHS has always used the private sector for many services and will continue to do so where it can help the NHS to give patients even better care and better value for money. By the end of next year, patients needing elective treatment will be able to choose from any health care provider—NHS or independent sector—that meets NHS standards within the NHS price.

When Ministers held the proverbial gun to the heads of primary care trusts and told them to privatise the easiest elective procedures—or else—was the Secretary of State aware that under European competition law she was opening a Pandora’s box in that if she wished to run the NHS by market rules, she would have to play by those rules—even to the point that that would perpetually restrict her capacity to intervene to protect the public interest?

I do not accept for one moment the hon. Gentleman’s accusation. It is a great pity that he does not recognise the contribution that the independent sector is making at the Bodmin treatment centre, for instance, or—in a different part of his region—at the Shepton Mallet independent sector treatment centre. The latter is not only giving the patients whom it receives very good and much faster care, it has also led Yeovil District Hospital NHS Foundation Trust to change the way it organises its services, making it one of the first hospitals that will achieve for most of its patients the 18 weeks target—and a year ahead of the goal that we set.

My right hon. Friend will be aware that successive Secretaries of State for Health have assured the Health Select Committee that the policy of developing the use of the private sector is being pursued to address lack of capacity in the NHS. Can she confirm that that remains the major reason for that policy?

My hon. Friend is right. When we began the new compact with the private sector through the NHS plan in 2000, it was precisely to address the problem of additional capacity. However and as we have made clear in several successive documents—including the 2005 Labour party manifesto—we also use the independent sector where it can help to challenge under-performing parts of the NHS, support patient choice and give patients even better care. The fact is that there has always been private health care in Britain, but the difference is that under a Conservative Government, private hospitals recruited patients on the back of NHS waiting lists and treated only the few who could afford to pay. Today, thanks to our reforms, private hospitals and treatment centres are part of the NHS family. They are helping to cut waiting lists and to treat NHS patients—all of it free at the point of need.

To continue the theme, the Secretary of State is possibly aware that there is a charitable health trust associated with Epsom hospital. It has put in a bid to the local NHS agencies and authorities to purchase that hospital, and the intention is to run it for NHS, charitable and private patients. It has the backing of the local medical fraternity, and enormous financial backing. Is the Secretary of State willing to meet a very small delegation at or near the end of those discussions, so that it can set out its innovative and expanding programme?

I would certainly be happy to meet the hon. Gentleman to hear about what sounds like an interesting proposal. I will draw it to the attention of the local primary care trust, which will—I am sure—look at it with interest.

The independent sector treatment centre in south Yorkshire has done a good job in helping to reduce waiting times throughout the area. It has been able to do so because it has been guaranteed money over and above the tariff, unproblematic cases and a set number of patients. If those advantages are to continue, eventually the centre will be in conflict with NHS hospitals, which will struggle to survive against that unfair competition. Will my right hon. Friend ensure that that situation does not come about and that the independent centres do not threaten the existence of NHS acute hospitals?

All treatment centres take the simpler cases—that is why they are there—whether they are run by NHS hospitals, as the majority are, or by the independent sector. That is what they do, they do it well, and it speeds up care for hundreds of thousands of patients who need elective treatment. My hon. Friend is right that in the first wave of the independent sector treatment centres a premium was paid, although far less than the premium that the NHS used to pay to the private sector when it needed to use it to reduce waiting times. That was needed in the first wave to bring in new capacity, especially from abroad, when it was desperately needed. As I have indicated, what we are seeking to do is to move to a level playing field so that the independent sector and NHS hospitals will all provide care to the same quality and price, and all free at the point of need.

To assist integration between private sector treatment centres and the NHS, will the Secretary of State look at the practicalities of letting NHS consultants work in the private sector treatment centres even if they are in, for example, orthopaedics, which is currently defined as a shortage specialty?

That is an important issue and one that we keep regularly under review. We have discussed it over the past year or two, especially with the Royal College of Surgeons, and as a result have made some changes to both the shortage and the additionality rules in order to ensure that NHS surgeons and other consultants make their time available to their NHS employer first and foremost. If they have additional time that is not needed by that employer, they may make it available to those parts of the independent sector that are also treating NHS patients within the NHS family.