From 2005: Failure of Private Medical Scans Brought into NHS

I found this article in Private Eye’s edition for the 19th August – 1st September 2005, reporting the extremely poor performance of the private MRI scans administered by Alliance and Medical as part of the then Labour government’s privatisation of the NHS. They were so poor, that the results had to be double-checked by NHS staff.

Alliance Medical
Double Cheques

Last June, as part of Labour’s drive to transfer NHS duties to the private sector, health minister John Hutton awarded a £95m scanning contract to Alliance Medical. he claimed that private MRI scans would increase capacity and prove “good value for money”.

The deal was certainly good value for Alliance and its parent company Bridgepoint Capital, which – by an eerie coincidence – was employing Alan Milburn MP as a £30,000-a-year consultant at the time when Milburn’s old flatmate John Hutton awarded the contract. But it didn’t turn out to be quite such good news for patients, especially as most of the scan images were sent abroad for analysis – leading to delays, language misunderstandings and mistakes in diagnoses.

“I think everyone acknowledges that it has been a complete disaster,” Dr Gill Markham, chair of the BMA’s radiology sub-committee, told the Today programme in February.

After early complaints about the quality of Alliance’s work, the government appointed Professor Adrian Dixon of the Royal College Radiologists as a “national clinical guardian” to monitor standards. According to documents obtained by the Eye, Prof Dixon’s advice is that “because of anxieties concerning reports in the first few months of the contract, it would seem prudent that cases scheduled for surgery or similar intervention on the basis of an AML
[Alliance Medical Ltd] report issued up to the end of 2004 should be discussed with the local radiology department.”

In other words, scans carried out last year by Alliance now have to be double-checked by NHS radiologists – thus placing an extra burden on the health service’s time and resources.

Alliance’s failures haven’t deterred ministers, however. In July, health secretary Patricia Hewitt announced a “choice of scans” programme whereby people waiting more than six months for various diagnostic tests – including MRI and CAT scans – will be able to go beyond their local provider and get a speedier service from private firms such as Alliance. But how speedy are they? In an audit of Alliance’s work for the NHS, conducted in May, Prof Dixon discovered that although the company scanned patients more quickly, this advantage was sometimes lost because Alliance was then “twice as slow” to report the results.

In a direct comparison of Alliance’s work with that of its NHS counterparts, Dixon noted that “the language was better in most NHS-generated reports”, and that “clinical opinion was judged slightly better in most NHS reports”.

The Royal College reacted to the audit by warning that Alliance is only “suitable for non-complex examinations”. It added that NHS staff should keep a “clerical/governance” check on Alliance work to make sure that reports about “serious lesions” are spotted and fast-tracked.

The Eye asked the department of health if – and how – it would be funding all this extra double-checking work, but answer came there none.

This story is still important, as the government is privatising the NHS piecemeal under the assumption that private enterprise is more efficient. As this story shows, it is not. Indeed, without the results being double-checked by the NHS, the poor results of the private medical scans would be a danger to patients’ health.

The privatisation of the NHS needs to be stopped. Now.

Vox Political on Private Healthcare Overcharging the NHS

18th Century Satirical Print: The Rapacious Quack. It depicts a poor family at the mercy of a doctor, who has taken away a flitch of bacon in lieu of unpaid fees. Its caption reads
‘The Rapacious Quack quite vext to find,
His patient poor, and so forsaken
A thought soon sprung up in his mind
To take away a piece of bacon.’
Which just about describes the grasping attitude of the private healthcare firms mentioned in the report.

Earlier this evening I blogged a piece on Mike’s story over at Vox Political on Ed Miliband’s promise to rebuild and strengthen the NHS. The piece is Will voters support Labour’s vision for the NHS? and it’s at http://voxpoliticalonline.com/2015/01/27/will-voters-support-labours-vision-for-the-nhs/. It offers hope for an NHS decimated by the Tories, but also by Blair and Brown.

Mike also wonders in the piece whether Alan Milburn, Blair’s former health secretary, is really a member of the Labour party, or a Tory, who has worked his way into Labour to undermine it. He isn’t the only one. A few weeks ago, Johnny Void pointed out how one of the authors of the Archbishop of Canterbury’s report suggesting the establishment of a national network of food banks was Frank Field, and made the same comments about him. Field is notorious for recommending further cuts to the welfare state to encourage unemployed hoi polloi to find work. And it isn’t only his critics, who have suggested he should join the Tories. He also has admirers within that party, who’ve actually made the invitation. The politically Conservative Cranmer blog actually invited Field to cross the floor and join the Tories.

And the same comments could have been made about much of the New Labour leadership. Remember the computer programme back in the 1990s that made anagrams from politicians’ names, supposedly revealing their real character? Michael Portillo was ‘a cool, limp Hitler’. Blair came out as ‘I am Tory Plan B’. Lobster compared Blair to Ted Heath. Both were men leading the wrong parties. Giles Brandreth, who served on John Major’s Tory cabinet in the 1990s, on Have I Got News For You described the Blairs, both Tony and Cherie, as natural Tories. They were, and they similarly pursued a policy of privatising the NHS piecemeal.

In the first few years of this century Patricia Hewitt wanted to sell of the £64bn commissioning and supply arm of the NHS, but ended up having to reject the plan, claiming it was mistaken. She therefore just privatised hospital management. And one of the brilliant ideas of Blair’s administration was the inclusion of private healthcare companies to pick up work that could not be done by an overstretched NHS. Who was the brains behind this, ahem, operation?

Alan Milburn.

And in 2009 Private Eye carried a story about an independent report that concluded the private healthcare providers were overcharging the NHS, including billing for work they did not carry out. The article was in their edition for the 15th – 30th May. Here it is.

NHS Plc.
ISTCs: A Crying Sham

Another crumbling New Labour initiative, independent sector treatment centres (ISTCs) for NHS operations, has ben exposed as a shambolic waste of money.

ISTCs were supposed to provide low-cost operations to an overstretched NHS. But the have long been suspected of creaming off the most lucrative ones under favourable contracts without providing the quality to be found in the NHS.

A 2006 parliamentary report questioned their value for money and asked the National Audit Office to look into it. Several billions of pounds of public money were at stake, but the audit body has oddly shied away from the subject despite reportedly expressing some concern over the ISTCs’ performance and £100m+ procurement costs 18 months ago.

Now academics Allyson Pollock and Graham Kirkwood at Edinburgh University have obtained the contract for one ISTC under Scottish freedom of information laws (contracts in England remain confidential). This shows that the NHS in Tayside paid an ISTC run by Amicus Healthcare – a joint venture of private equity firm Apax and South Africa’s Netcare – for 90 percent of referrals even though the centre only performed 32 percent of them. The academics estimate that Tayside’s overpayments could be dwarfed by those across England, where the NHS could have been stung by up to £927m for operations not performed.

The £5bn ISTC programme was pushed through by the Department of Health’s commercial directorate, set up in 2003 by the then health secretary, Alan Milburn, now earning £30k a year from the private equity firm Bridgepoint that owns ISTCs through Alliance Medical. The directorate was run by American Ken Anderson (since decamped to Swiss bank UBS’s private health investments) and was exposed by the Eye two years ago as home to 220 consultants on an average £238k a year, much channelled through tax-efficient service companies. It has since been quietly disbanded without ever having faced the scrutiny it warranted.

This effectively explains why Milburn was so keen to pour scorn on Miliband’s plans for the NHS: he’s working for a private equity firm that will lose work in that area if Miliband starts to take seriously the NHS’ commitment to providing free state medicine.

It also shows how better governed Scotland is than England. The two academics are able to get details like this through the Scots freedom of information act, which is denied to citizens south of the Border.

As for Amicus Healthcare, I remember Amicus as the American rival to Hammer films way back in the 1970s. Although American, they used much of the same actors and production staff. Sadly, Hammer and Amicus passed away, though the horror continues under the Amicus name.