Clive Efford discusses the privatisation of the musculoskeletal services in Greenwich. As a result of this intervention by Clive, the Greenwich Clinical Commissioning Group has been forced to reconsider.
In June Greenwich Clinical Commissioning Group (GCCG) met to decide whether to award a £74 million three-year contract to provide musculoskeletal services in Greenwich to a consortium made up of Lewisham and Greenwich Healthcare Trust (L&GHT), local GP networks and Oxleas Trust or to Circle Holding PLC.
Due to the fact that the GPs were involved in one of the bids, they were required to withdraw from the meeting. This was the correct procedure, but it left the meeting inquorate. To overcome this problem, the remaining members of the CCG became the proxies for the ones that had left the room and by double counting themselves in this way they made the meeting quorate. The contract was awarded by this group to Circle.
I know of no other area of public service that would consider this an acceptable way to proceed when granting a contract of this magnitude. When I challenged a representative of NHS England about this practice at a special public meeting of Greenwich Council’s Health Scrutiny panel convened to inquire into this matter, I was told this was common practice because GPs were often involved in bidding for contracts.
I find it astonishing that the rules can be set aside in such a matter-of-fact manner. I am told by a leading expert in the law relating to the health service that the process in Greenwich was entirely illegal, but because no one had mounted a challenge within 28 days it was now impossible to do so.
When I tabled Parliamentary questions asking the government what they are doing to ensure that the proper procedures were being followed, I was told that these matters are for the local NHS.
I am aware of the knock-on impact that privatising orthopaedic services has had in Bedford, where it has seriously undermined the capacity of the local hospital trust to maintain other services, such as their A&E. When I asked ministers what assessment had been made of the impact that awarding the orthopaedics contract to Circle would have on our local hospitals, I was informed that this had been discussed in March and August at meetings between GCCG and the L&GHT. When I checked this with L&GHT I was informed that meetings had taken place, but that this matter had not been discussed.
When challenged at the public meeting about this NHS England admitted misinforming the minister and said they would apologise. Five days later I raised the matter in parliament because I had not heard from the minister to correct the error. The next day the minister’s office contacted me to ask for the details of my complaint. NHS England had misinformed the minister and apologised to me in a public forum, but had not bothered to inform the minister or apologise to him for their error.
In every answer I have received from the minister about the process by which Circle were granted this contract, I have been told that it is ‘a matter for the local NHS’. In response, I have demanded to know how the government satisfied itself that the correct procedures were adhered to by GCCG when awarding the contract. The answer was that the government has been assured by NHS England that the ‘procurement procedures’ were followed, despite the fact the meeting was inquorate.
The government is taking a laissez faire approach to how these contracts are awarded to the private sector and in turn NHS England is relaxed about the probity of the process, allowing inquorate meetings to be made quorate by double counting the people making the decision in direct contravention of the rules.
It is not possible to put £74 million of local NHS money in the hands of the private sector without enormous consequences for the funding for other services. Our NHS is an intricate web of services dependent on subsidy of money and personnel that it is impossible to untangle.
Circle are not a health provider and merely add another tier of management between patients and the commissioners. In Bedford, where Circle hold the orthopaedic contract, there are complaints that private providers are busy carrying out elective surgery whilst the local NHS operating theatres lay idle and the hospital tries to hold together essential services, such as A&E, which no private sector provider will touch.
Our NHS is being cherry-picked by the private sector as was predicted by the opponents of the Health and Social Care Act in 2012. The government assured us that responsibility for the NHS would remain with the Secretary of State, but as the lack of concern about how NHS services are handed over to the private sector demonstrates this was never the government’s intention, and the quicker they are privatised the better.