Warch out for massive NHS contract tendering

Boris Enters 10 Downing Street

It’s quiet on the NHS tendering front – for the moment – but watch out for a flurry of activity once the Party Conferences get underway.

Politics has given us a leader who slips on banana skins: buying illegal water cannon, uttering ill-advised remarks about a British woman imprisoned in Iran, etc.

Currently, Boris the Loose Cannon is sending shivers down the spines of those opposed to any deals with US health providers, poised like vultures ready to strike more deals with the NHS.  America’s President Trump has been a firm supporter of US involvement in providing services for the NHS, saying that the NHS would be “on the table” in trade talks with the USA. Although Trump backtracked, there are too many NHS staff who have worked for the major US health providers in positions of power who might be involved.

My email inbox is full of requests to sign petitions in an attempt to stop US involvement with our NHS. But politicians tend to ignore Petitions unless they agree with them.

So let’s play them at their own game

Some time ago I ended up sitting on a Dept. Health committee, as one does, looking into providing a joined-up programme of healthcare for the elderly.  We were paid, plus expenses, and it was run by a US firm of Management Consultants, led by Little Miss Uncongeniality.  Reliant on PowerPoint, she spent her time with her back to us, reading from the screen – which was just as well because her slides were seriously over-crowded and we couldn’t have read them.

She announced that her firm had taken reps. from the local CCG over to the States, where they had toured their training facility.  The upshot was they had agreed to import 200 American nurses at a salary of £50,000 pa each to run this programme. Her firm’s ‘finders’ fee’ was fudged over, however much we tried to question this.

The mind boggled at what American nurses would make of “I’ve got problems with my waterworks” and similar English expressions, but our committee were assured that this would be addressed in the nurses’ induction programme.

It got worse – so we needed to come up with a plan to stop this lunacy.  Sweetly we asked “Can we be assured the American nurses will be welcomed and treated properly?”

“Of course”

“Will they receive all the benefits British nurses are entitled to – such as NHS care?”


We sat back satisfied.  In the States, medical insurance packages are almost more important than the salary.  So the result was the American nurses, no fools they, saw their medical care would be covered by the NHS.  Only six nurses applied.

What’s happening now

London has had its full share of disasters with poor care from private firms cobbled together to tender for a lucrative NHS contract.  Moving to Oxfordshire, I had no high expectations until friends told me they had very good experiences with the local private health provider, The Circle Hospital.

Yes, the same company that pulled out of Hinchinbrooke Hospital.  But as Tom Levitt, writing in The Guardian said “The failure of Circle at Hinchingbrooke hospital, in Huntingdon, where the company very nearly managed to remove an operating loss inherited from the public sector, was due to the failure of the NHS to deliver its side of the bargain, not least the over-demand on A&E which was well above what the company was told to expect. Circle was conceived as a partnership between doctors and financiers and its record on delivering physician-led quality services in the private sector was well established long before it took charge of Hinchingbrooke.

Lessons have been learnt, and when I booked an NHS appointment for a clinic run at The Circle in Reading, care was exemplary.  I’ve had two NHS appointments there – last week the  Doctor apologised for keeping me waiting 10 minutes, then proceeded to give me a full half-hour of undivided attention, with no computer screen in the way.  At the second visit she remembered what we had discussed previously, I was given more sensible advice, and she took the time to give me a detailed account of the pros and cons of the pills she was prescribing.

Other friends say this hospital offers excellent MRI scans, with very little waiting time.

Involve patients in the commissioning

After a completely hashed-up MRI Scan offered by a privately contracted firm, I asked Chelsea and Westminster Hospital why they hadn’t made use of the very savvy patients they treated and asked them to look at the contracts being awarded to private firms?

They replied that their Board of Governors looked over the contracts before these were awarded.

At Oxford’s John Radcliffe Hospital, a son was told his mother would have to wait 12 hours (until 3 am) for his mother to be sent home by Ambulance.  He worked in transport, so found out that the new hospital transport contract had been awarded to a firm that promised ‘every patient will have their own individual transport’.

As he said, you can’t expect the NHS to provide this – his mother, sitting in a wheelchair was perfectly capable of sharing a vehicle; she wasn’t infectious.  But this contract meant the firm would be supplying, and getting paid for, many more trips.  He knew where to create a stink, and the contract was ‘amended’.

So why not involve patients when contracts are scrutinised?

Every NHS hospital has a variety of patients who work in a wide range of jobs.  Would it be so difficult to ask any with relevant managerial experience to cast their eyes over a potential contract?

Their expertise would look behind the phrase “every patient will have their own transport”, and raise immediate questions, where the hospital Board had obviously thought “how kind”.

More than likely patients might also have had first-hand experience of the facility tendering for a contract, and their knowledge could be used when evaluating a bid.

Doctor Margaret McCartney, in her book ‘The State of Medicine‘ outlines the appalling cost of tendering for an NHS contract.  Reading, it is easy to see where a  vast pot of NHS funding is being wasted.

So let’s get patient expertise working with their local hospital Trust to deliver better contracts.  Then everyone will benefit.  Patients will know which private healthcare companies provide a good service, and which ones are only interested in profit. So let’s look for

  • Private health providers who provide a good service
  • Private providers who have spare capacity 
  • Contractors who can promise and deliver, shorter waiting times for an appointment
  • Doctors able to give more time during a consultation
  • and not forgetting private Outpatients often have swish coffee machines (free)! 

So if you are a patient with expertise – why not see if your experience could get a better deal for everyone;  patients, NHS and Trust Accountants?  Play the game and get a better deal for everyone – except the vultures hovering over NHS contracts. 



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