The highly controversial overthrow of the health service in England in 2012 by Health Minister Andrew Lansley in the Tory-Lib Dem coalition government has forced local health agencies to tender for service contracts. Billions of pounds of taxpayer cash have since been handed over to private companies to treat NHS patients, according to the landmark review. It shows that the increase in health contracts outsourced to private companies has been associated with declining quality of care and higher rates of treatable mortality – the deaths of patients deemed avoidable with timely, effective health care. The University of Oxford analysis was published in the journal Lancet Public Health. “The privatization of the NHS in England, through outsourcing services to for-profit companies, has been steadily increasing [after 2012],” says. “Private outsourcing accounted for significantly increased rates of treatable mortality, possibly as a result of declining quality of healthcare services.” With a record 6.5 million patients now waiting for care and private companies lining up to help deal with delays exacerbated by the Covid-19 pandemic, the research will raise new fears of possible harm from increased outsourcing NHS care. “Our study shows that for-profit outsourcing by clinical outsourcing teams has increased [CCGs] “In England, it may have negatively affected the quality of care provided to patients and resulted in increased mortality rates,” the authors said. “Our findings suggest that further privatization of the NHS could lead to worse outcomes for the health of the population.” Graph: deaths from treatable causes over time The study looked at the impact of the 2012 UK Health and Welfare Act, which “intensified pressure on the NHS to outsource services from public to private, for-profit providers”. The researchers analyzed data showing how much 173 CCGs were spent in the UK for outsourcing between 2013 and 2020, which increased from 3.9% to more than 6.4%. In total, £ 11.5 billion was delivered to private companies during the period, although the amount differed significantly between CCGs. The analysis shows that an annual increase in outsourcing of 1% is associated with a 0.38% increase in treatable mortality – or 0.29 deaths per 100,000 people – next year. Researchers claim that an additional 557 deaths between 2014 and 2020 could be attributed to increased outsourcing. The authors hypothesized that the higher mortality could be due to private companies “providing poorer quality care, resulting in more health complications and deaths,” or because greater competition for contracts may result in for-profit providers prioritizing shorter waiting times “at the expense of the quality of care”. “While some have argued that the health and social care law will improve the efficiency of health services by increasing competition, our findings add value to long-standing concerns that it could instead lead to lower costs and worse outcomes for health, “said study leader Benjamin Goodair. of the University of Oxford. Dr David Wrigley, vice-president of the British Medical Association, said the doctors’ union had repeatedly expressed concern that ministers were throwing “huge sums of money into private companies instead of investing in rebuilding the healthcare system”. “An outsourcing policy with minimal oversight, governance or transparency is a policy that will lead to reduced quality and poorer patient care, as today’s Lancet study shows,” he said. The NHS care waiting list in the UK this month reached 6.5 million. Dr Danny Bhagwati, vice president of the Medical Association, said: “Given the scale of the delays and the proposed solutions for private sector use, this data highlighting the risk to patient safety should examine the regulation in this area as a matter of urgency “. Further analysis looked for any correlation between outsourcing and preventable mortality – deaths that can be avoided with effective public health rather than medical intervention. None were found, suggesting that the link between NHS service delivery and treatable deaths is related to the quality of care, rather than as a result of general trends in the health outcomes of the population. Subscribe to the First Edition, our free daily newsletter – every morning at 7 p.m. BST “We have been sounding the alarm for years about falsely promoting outsourcing as better for healthcare and better for the NHS,” said Alan Taman, a spokeswoman for the Doctors for the NHS campaign. “That justifies what we say.” The authors acknowledged several limitations in their research. Their findings are not evidence of a causal link between outsourcing and death, so no other factors can be ruled out. Nigel Edwards, CEO of the Nuffield Trust, warned that the study “leaves many questions unanswered – especially whether outsourcing is directly responsible for these results or simply related to them”. However, the study’s co-author, Dr Aaron Reeves, of Oxford University, said: “These results clearly have implications for the NHS privatization debate, suggesting that increased outsourcing decline in the quality of care provided to patients. “While more research is needed to determine the exact causes of the declining quality of healthcare in the UK, our findings suggest that further increases in NHS privatization would be wrong.”
When the NHS outsourcing has problems
Hospitals In 2012, Circle became the first profit-driven healthcare company to head an NHS hospital when it took over Hinchingbrooke Hospital in Cambridgeshire. However, he handed over the contract back to the NHS in 2015, after the hospital ran into financial problems and could not keep up with the growing demand for care, which was described as “insufficient” by the Quality of Care Committee. Eye care Vanguard is being prosecuted for a series of eye surgeries performed in 2014 at Musgrove Park Hospital in Somerset. A confidential report for Vanguard stated that the surgeries seemed hasty and that the surgeons were able to continue the practice even when patients reported serious complications. The hospital terminated his contract with Vanguard after just four days. Mental health The leading chains of private mental health hospitals treating NHS patients have been criticized by medical examiners and investigators dozens of times over the past decade for providing unsafe care. Priory, Cygnet and Elysium have been punished at least 37 times for errors and care errors related to the deaths of patients, including many children.
