Most news stories which address private healthcare in England only serve to accentuate the difference between the private and public health systems - and more often than not, celebrate the quality of services available at privately- run facilities. But a story last week painted a less than perfect picture of one privately- run hospital. The Lister Surgicentre, a private unit at the NHS Lister Hospital in Stevenage, is set to be handed over to the care of the NHS after an unsuccessful 18 month takeover by a private company, Clinicenta Limited.
Following several months of poor performance, bad press as well as genuine fears for patients' safety, The Lister Surgicentre has lost its licence to operate and has been bought back by the NHS. Rumours about the unit, which offered a range of surgical services including head and neck surgery, orthopaedics, gynaecology and eye care facilities, began to circulate soon after Clinicenta Limited stepped in back in 2011, when it was first investigated for incidents of a serious nature. Complaints ranged from clumsy incidents such as the loss of patient information and news that medical notes of a total of 8,500 patients were never updated. There were also cases of medical negligence involving reports that six patients at the on-site urgent eye clinic permanently lost their sight following eye operations.
Even more tragic news came in September 2012 with reports that three patients at Lister Surgicentre had died after undergoing what should have been routine operations. Following these deaths, the public learned that the Surgicentre had actually been responsible for a total of 21 incidents of either a clinical nature or a patient information governance nature. In the end, the decision to take the unit out of Clinicenta Limited's hands came because of an overall lack of public confidence in the unit and because GPs had become so concerned that they had stopped referring their patients there.
The Lister Surgicentre was created with the aim to treat some 15,000 NHS patients on an annual basis- particularly those who would otherwise have to join long waiting lists to receive quite routine operations such as hip and knee replacements, hernia repairs and cataracts. The intention was to take some of the pressure off NHS wards as well as providing a solution for those patients who might otherwise have their operations delayed or cancelled due to the overwhelming number of patients and lack of NHS resources.
The failure of the privately funded £31 million state-of-the art Surgicentre has gone some way towards restoring public faith in the NHS. Last week, the local MP for the area, Stephen McPartland celebrated the NHS' acquisition of the unit, stating: "I am delighted that the Lister Surgicentre will now be managed by the Lister Hospital...(as) it should have been from day one."
While there is certainly an air of celebration that the Surgicentre has been saved by the national health service, this case raises questions about the value of the NHS independent Sector Treatment Centre procurement programme which enabled the construction company to operate the unit in the first place.This programme has been in effect since 2002 - and works as an extension of the NHS treatment centre programme that began in 1999. The initial reason for using private companies rather than continuing with an NHS model was because the increasing demands of patient numbers and waiting lists could not be met by the NHS alone. Therefore, the current system allows private companies to bid for, and provide elective and diagnostic services under the NHS brand. Although these services are privately funded, the NHS stresses that any companies which win the bids to provide care on behalf on the NHS should deliver in line with NHS standards and values.
Initially, there were worries that private companies could not meet these demands, so in response to this, the Patient Outcomes in Surgery (POiS) audit was introduced with the aim of comparing the recovery and opinions of patients who undergo surgery at independent sector treatment centres and NHS providers. Over the years, results have suggested that patients treated in ISTCs tend to be healthier and have less severe primary conditions, so cases like those at The Lister Surgicentre are not common. Nevertheless, the fear is that methods for assessing which companies are allowed to bid for NHS services have slackened.
Those who allowed the construction giant, Carillion Plc to bid for the Lister hospital unit have been heavily criticised. Using their expertise, Carillion succeeded in building a hi-tech, three-storey health care unit, but the dangerous operation of the unit indicates that they should ever have been put in charge of highly sensitive and complex surgical procedures.
News that services will transfer to East and North Hertfordshire NHS Trust this month has been welcomed by relieved patients in the local area. But many sceptics are asking if the procurement programme should be allowed to continue due to the unacceptable number of incidents which risked the health and safety of patients in the Stevenage area, and because the Department of Health has now been forced to spend £53m of taxpayers money to repurchase the unit from Carillion Plc.