Published: 24 February 2006
Independent Sector treatment Centres a success?
Pouring billions of pounds into the second generation of Independent Sector Treatment Centres (ISTCs) is not necessarily the best use of NHS resources, the House of Commons Health Select Committee have been told.
In its submission to the committee - currently investigating the performance of ISTCs - Amicus Health asked MPs to consider whether there has been sufficient evaluation of the first tranche of ISTCs before the government embarks on spending a further £3 billion of taxpayers’ money over the next five years on the medical services these private companies offer.
Amicus Health, which represents 100,000 members working in the health sector, is concerned about the possible deterioration of working conditions of its members, such as breaches of the working time regulations, now that the government is relaxing the rules about NHS staff being employed by ISTCs.
Originally, ISTC providers were tasked with providing services ‘over-and-above’ those already provided by the NHS – the so-called ‘additionality’ principle. This meant that no NHS health professional could be recruited to work in the independent sector, if they had been employed by the NHS within the previous six months.
But what now concerns Amicus is that last July, Health Secretary, Patricia Hewitt relaxed the rules, saying that if there were no shortages in a particular specialism the ‘six-month’ guideline no longer applied. Also, the independent sector could employ NHS staff outside their contracted NHS hours.
Amicus told the MPs:
There is no evidence to support the implication that there are areas where we have enough staff or surplus staff in certain specialisms which would permit the transfer of those staff from NHS employment to independent sector employment.
Health professionals currently employed in the NHS are employed because their skills, expertise and qualifications are needed.
There is no scope for losing those staff where there is an underlying principle of increasing capacity to improve patient choice and reduce waiting lists for elective surgery and diagnostic procedures.”
Amicus asked the MPs to establish the legal basis on which the Health Secretary has expanded the principle of ‘additionality’ in this fashion.
Amicus stressed its members embraced innovation & modernisation, enabling greater patient choice, but the question remained whether the development of the ISTC programme since 2004 has delivered the anticipated results, saying:
“Would the billions to be spent on ISTC providers create the same benefits if spent on developing services within the NHS framework?”
Amicus said that there is anecdotal feedback suggesting that ISTC providers have been working with some slack in the system. This appears partly due to lack of referrals.
“As a consequence, the current independent sector providers may have been paid for work not undertaken due to the lower than expected referral rates.
This is an issue which needs further consideration before contractual terms are finalised with the wave two independent sector providers.”
Further information
Select Committee
Amicus Memorandum
Amicus/CPHVA
DH – Treatment centres
Commercial & legal issues
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