Who runs your GP surgery? Private firms under fire for backstage deal

Branson joins big businesses eyeing up practices

Friday, 19th April 2024 — By Tom Foot

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FURIOUS health chiefs say they are considering next steps after a private firm dumped two Islington GP surgeries onto another company without their approval.

The North Central London Integrated Care System – which is in charge of NHS funding in Camden – said the unauthorised “change in control” just after Christmas appeared to be a breach of contract.

The Tribune reported in December that Operose Health, which was owned by Centene Corporation in the US, was seeking authorisation for a plan to transfer its contracts to another profit-seeking company.

But the NHS said this week the company had pushed ahead and rubber-stamped the changes without its say-so and before it could do its “due diligence”, adding: “Under the terms of the contracts, providers may not undergo a change of control without the NHS’s prior authorisation.”

Professor Sue Richards, a chair of Keep Our NHS Public (KONP), said: “Rather than waiting for the Primary Care Committee of the Integrated Care Board to agree this change of control which it needs to undertake due diligence first before it can agree, the change of ownership has gone ahead anyway.

“This has just been discovered by the body which manages the ICBs contract for it and the proverbial is beginning to hit the fan.”

Operose Health Ltd, which is fully owned by the US health insurance giant Centene Corporation, took over running doctors surgeries at Mitchison Road Surgery and Hanley Road Primary Care Centre in 2021.

On top of its contracts in north London, the same deal saw the firm seize control of 65 surgeries nationwide, making it the biggest single provider of GP services in the country.

The move – unknown to the public until it was revealed by the Tribune – triggered a massive row about privatisation and the influence of US healthcare giants in the NHS. Patients had no say over the switch and therefore who would be running their surgeries.

KONP took NCL to the High Court over its decision to approve the transfer of surgeries to Operose, arguing patients were not consulted and there had not been enough consideration was made to the role or financial position of the Centene Corporation in the US.

Profit-making companies are able to bid for NHS GP surgery contracts due to controversial legislation introduced by Labour government more than 20 years ago – known as Alternative Medical Provider Services (AMPS).

But the rules state that the NHS must be given time to properly assess any new company taking over surgery contracts, including its “financial standing, ownership model, structures and governance, handling of patient data, proposed staffing and management changes and evidence of engagement with patients”.

We reported last year how Centene Corporation had signalled its intent to get out of the NHS market and was selling up its portfolio of GP practices in the UK, including its four in Camden and two in Islington.

It has sold the surgeries to T20 Osprey Midco Ltd, part of The HCRG Care Group, which took over NHS contracts held by Virgin Care, a company founded by the billionaire business magnate Sir Richard Branson.

An NCL statement said that “under the terms of the APMS contracts, providers may not undergo a change of control without the NHS’s prior authorisation”.

“We have been informed that a ‘change of control’ took place on 28 December 2023. The NHS was not informed of this at the time. All general practices work under contract to the NHS and whether owned by GPs or other organisations must be able to meet strict standards and regulations.”

The HCRG Care Group statement said there had been “a change of ownership at the ultimate parent company” to “an experienced provider” and that “patients will continue to be seen by the same practice teams and access care in the same way”.

Stay alert

TRYING to follow the story of who controls some of Islington’s doctor surgeries, it’s almost as if the twists and winding turns were purposefully designed to make you feel dizzy.

The intricacies of health contracts might also not be the sexiest stories for your favourite weekly read over a cup of tea today. It can’t be missing cats on every page!

But the Tribune keeps an alert eye on the switching of control from one big business to another because so much of it is hidden from public view.

Surely patients deserve to know who is running one of the services they most rely on? Don’t they deserve the biggest say on the future of their GP surgeries?

At least this time, the health board seems to be angrier than normal about the quiet shifting of ownership.

Then there is the debate over whether companies should be seeking to profit from people’s health needs in the first place – and whether the cash figures on a spreadsheet will always be their driving priority.

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