The signing of a controversial £74 million contract to hand over some key local NHS services to private company CircleHealth has been halted after fierce opposition from local campaigners and politicians.
Greenwich Clinical Commissioning Group has put on hold the signing of the five-year Musculoskeletal services contract after the decision to hand the contract to Circle rather than the local Lewisham and Greenwich NHS Trust triggered a public outcry.
Louise Irvine, a Lewisham GP and Chair of the Save Lewisham Hospital Campaign said: “Save Lewisham Hospital Campaign is delighted that the decision…has been put on hold pending an assessment of its impact on Lewisham and Greenwich NHS Trust.”
Greenwich Council’s Health Scrutiny Panel refused to endorse the contract after it was revealed that no impact assessment had been carried out by either the CCG, which plans and pays for local NHS services, or NHS England.
MSK services treat injuries and problems of the joints, bones and muscles and the contract includes outpatient orthopaedics, rheumatology, physiotherapy and pain management. The Lewisham and Greenwich NHS Trust, which covers both Lewisham Hospital and the Queen Elizabeth Hospital in Greenwich, currently provides the vast majority of MSK services in the two boroughs.
Campaigners fear that changes to the MSK services the Trust is paid to deliver may threaten its ability to provide other services, including A&E services at both hospitals.
“The [impact assessment] was quite rightly demanded by Greenwich Council Scrutiny Committee,” said Irvine. “It demonstrates the importance of local campaign groups, Save Lewisham Hospital Campaign and Greenwich Keep Our NHS Public, working together to challenge decisions to outsource and privatise our NHS services.”
A CCG spokesperson said: “Greenwich CCG have agreed that an independent impact assessment of the proposed change of service on the local health system will be carried out before we sign the contract with Circle.”
“We are in the process of agreeing the terms of reference for the impact assessment and will be working with Lewisham and Greenwich Trust to appoint an independent organisation to undertake this work.”
Circle achieved notoriety after the failed Hinchingbrooke Hospital contract, which it handed back to the NHS after only three years when a Care Quality Commission report described the hospital as ‘inadequate’. An investigation last year also found that Circle makes use of tax havens in its corporate structure.
Circle beat Lewisham and Greenwich Trust’s own bid – which was supported by local GPs – to win the contract. The histories of the bidding organisations were not allowed to be examined as part of the decision-making process, from which GPs on Greenwich CCG’s governing body were also excluded.
A Circle spokesperson refused to comment on the decision to halt the contract pending an impact assessment, but said: “We remain immensely proud of the work we achieved at Hinchingbrooke Hospital.”
Local campaigners are concerned that although Circle would still sub-contract some services to the Lewisham & Greenwich NHS Trust, it would seek to profit from the contract by reducing the amount of cases it refers to hospital and cutting the amount it pays for these.
This could have broader ramifications for services at Lewisham and Greenwich hospitals which use their income from elective services such as MSK to help fund acute care. A similar contract that Circle won in Bedford reduced referrals to the Bedford NHS Trust by 30 per cent.
In addition, reducing the number of MSK specialists that the Trust is able to support in Greenwich could make it harder for the Trust to continue to run the A&E at Queen Elizabeth Hospital, it is argued. This would also impact on Lewisham patients, as emergency care in the NHS is already said to be at ‘breaking point’ and were the Queen Elizabeth A&E to close it would intensify the pressure on neighbouring Lewisham A&E.
Irvine told ELL: “The NHS is like pieces of a wall – if you pull out some bricks it starts to destabilise it. The Trust is providing both emergency care and planned care. Losing the service contract in Greenwich could have both financial and clinical consequences on the [whole] Trust.”
“Financial difficulties could destabilise the Trust, which is already in deficit – and make it difficult for it to employ the full range of orthopaedic surgeons they require for the acute trauma aspect of care”, she said. “This would impact on patients across Lewisham and Greenwich”.
The potential impact of the contract change was not known and that was why it was so important an impact assessment was now going ahead, she said.
MP for Eltham Clive Efford told Circle at the recent Greenwich Health Scrutiny meeting: “We’re a Labour borough with a Labour Council and Labour MPs, we don’t want you here”.
Lewisham Councillor Paul Bell, of the Telegraph Hill ward, said “privatisation equals fragmentation and companies making money out of the sick. Greenwich CCG have no mandate and no right: my constituents say no [to this privatisation].”
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