Privatising cancer care in Staffordshire could harm patients, campaigners say

Cancer care for patients in Staffordshire could be cut after it is taken over by profit-driven firms in the biggest privatisation of NHS services yet, campaigners are warning.

Handing the £700m contract to the private sector could see hospices closed, less money being spent on treatment and patients left at risk of experiencing poor care, they claim.

The fears follow the publication on Monday of a secret document prepared by the four local NHS clinical commissioning groups (CCGs) in Staffordshire involved in the outsourcing deal to rouse interest in the contract among private firms. They plan to appoint one company to act as the “prime provider” of cancer services, including diagnosis, treatment and aftercare, with that firm then sub-contracting more services.

The 24-page memorandum marked “Commercial in confidence” is thought to be the first document of its type to be disclosed, despite the extension of private firms’ involvement in running and managing NHS clinical services in recent years.

Campaigners – including Kate Godfrey, Labour’s parliamentary candidate for Stafford in the general election – claimed the document proves that the winning bidder will be “given ‘discretion’ to design services they would like to deliver, slash spend per patient and propose the payment structures most beneficial to themselves”.

Godfrey also warned that front-line services could be sold off so that “core NHS responsibilities such as radiotherapy, surgery and chemotherapy could be delivered by the private sector, with no mechanism for patients to seek redress following failures of care”.

In addition, she claimed, the winning bidder will be “given freedom to alter or exit any existing contract – for example, funding for much-loved hospice care – without patients given any chance to challenge”.

The CCGs, which manage the care of almost 800,000 people, have sparked huge controversy by offering a £700m 10-year contract to deliver cancer care in the county alongside a £500m contract for end-of-life services, another hugely sensitive type of NHS care. The Guardian revealed the plan last year.

The Guardian also disclosed last week that NHS Supply Chain has handed the highest value NHS privatisation deal to date, worth £780m and covering operations and diagnostic tests, to 11 different private health firms, including three who have been criticised for providing poor care to hospital patients or residents of care homes.

But the combined £1.2bn value of the contracts for the “Staffordshire and Stoke-on-Trent transforming cancer and end of life care programme” makes them by far the biggest privatisation in the NHS’s history and have attracted considerable interest from private sector firms such as Virgin Care and United Health, the US healthcare giant that the NHS England chief executive, Simon Stevens, worked for between 2004 and 2014.

The memorandum of information for the cancer care procurement (published in full on the website of the campaign group Open Democracy), dated June 2014, explains that the CCGs have decided to appoint a “prime provider” to tackle what it says are “serious shortcomings” in existing services for the disease.

“The commissioners [CCGs] have identified that the current service model for cancer patients has serious shortcomings which can cause people to experience real problems with their care, including: poor information and communication; unnecessary delays (some due to systems and processes); lack of compassion; dignity and respect; no coordination across services; people having to give their details repeatedly; lack of effective care planning with little/no involvement of the patient or carer in that care planning.”

All the evidence they have gathered indicates “a fragmented, poor quality, unresponsive service that sees patients ‘falling through the gaps’ at transition points and leaves patients and carers feeling unsupported”.

Responding to claims that the CCGs had not undertaken meaningful public consultation over their plans, a spokesman responded that: “The programme is about the way the care is coordinated. We are increasingly finding that local people are understanding why we consider it to be so important. Ultimately it has the potential to greatly benefit patients.”

Meanwhile, seven of the 11 private health firms which have jointly won a £780m NHS privatisation contract – the biggest yet concluded – have links to the Conservatives, Labour research shows.

The seven include three companies which have been criticised for providing inadequate care to NHS patients or care home residents they were looking after. Two of them, Circle and Care UK, have been taken to task by the Care Quality Commission for that while a third, Vanguard, is under fire after 31 eye operations it performed under contract to the NHS last year left patients with continuing sight problems.

For example, Vanguard is majority owned by MML Capital. Rory Brooks, its founder and chief executive, has donated £300,311 to the Tories and gets privileged access to David Cameron as part of the ‘Leaders Club’ of Tory donors.

Care UK’s chairman until 2010 was John Nash, who was made a peer by Cameron in 2013 and is now an education minister in the House of Lords. He and his wife Caroline have given £251,000 to the Tories.

Circle, which recently pulled out of running Hinchingbrooke NHS hospital in what was hailed as a pionerering extension of the private sector’s role, is part-owned by Lansdowne Partners and Odey Asset Management. Their founders, Paul Ruddock and Crispin Odey, have given £843,783 and £241,000 respectively to the Tories, and Odey’s firm another £20,000.

“It is only right that the close financial ties between the Tory party and private health firms which have won contracts under this government are revealewd before people go to vote”, said Andy Burnham, the shadow health secretary.

A government spokesperson said: “For the first time ever, spending decisions in the NHS are now taken by doctors and nurses, not politicians – and not a single pound of NHS money has been committed through this contract. In fact, Labour are running away from a record that saw their use of the private sector increase at a faster rate than under this government.”