CHPI evidence to the COVID 19 Public Inquiry on the use of the private hospital sector to support the pandemic response

CHPI evidence to the COVID 19 Public Inquiry

The Centre has been the only organisation which has carried out a detailed analysis of the contracts between the NHS and the private hospital sector during the pandemic. We have conducted two previous studies of this issue based on Freedom of Information requests and analysis of financial data and hospital activity statistics.

You can read these reports here and here

These contracts were put in place to provide additional capacity to support the NHS and to ensure that patients were able to gain access to treatment on the basis of need rather than ability to pay.

However, our evidence to the COVID 19 public inquiry shows that these contracts worth around £2 billion did not compel the private sector to support the NHS and actually provided it with financial incentives to increase the amount of private fee paying work that it undertook.

In our evidence we explain how lives could have been saved had the NHS compelled the private hospital sector to support the pandemic response rather than treating thousands of private fee paying patients

According to our analysis had the private hospital sector dedicated all its resources to treating NHS patients, 1 million additional NHS patients could have been treated.

In its evidence submitted to the Inquiry, the CHPI states the following:

For a large period of the pandemic, the NHS paid the private hospital sector’s full operating costs at an estimated cost of £2 billion.
The public were told that this contract was put in place so that there was additional capacity to assist the NHS when it was being overwhelmed.
However, our shows that the contract with the private hospital sector contained financial incentives for the private sector to treat large numbers of fee-paying patients and placed limits on the amount of NHS patients which could be treated.
As a result of this flawed contract, at the peak of the pandemic in January 2021, when NHS hospitals were being overwhelmed senior NHS officials in London had to issue a public appeal asking NHS consultants to stop doing private work and to focus on NHS patients who were seriously ill.
The Secretary of State should have used his emergency powers to require that the private hospital sector prioritised NHS patients on the basis of need not ability to pay.
Had he done so, an estimated 1 million extra NHS patients could have been treated between 2020 and 2022.
Overwhelmed NHS hospitals acted as a safety net for private hospitals when things went wrong in the treatment of private patients– over 6000 patients were transferred from private hospitals to the NHS during the pandemic.
The deal with the private sector was the largest procurement of services during the pandemic worth an estimated £2 billion.
Yet despite this, no statutory body or parliamentary committee has conducted any detailed inquiry into this contract or the overall approach to using the resources in the private hospital sector to support the response to the pandemic.

We set out in our evidence 5 key questions which the Inquiry should ask of NHS England the Department of Health and Social Care:

Question 1: Why did the government permit and actively encourage private hospitals and the NHS consultants working in them to carry out non-urgent operations on fee-paying patients when these resources could have been used to treat NHS patients who were in greater need?

Question 2: What was the impact of the policy of actively encouraging private hospitals to undertake fee-paying work in the middle of the pandemic on a) the pandemic response b) the growing backlog of NHS operations?

Question 3: How many NHS patients were denied access to care because available healthcare resources were being used to treat private patients and how many preventable deaths did this lead to?

Question 4: Why did the government not use the emergency powers available to it to bring the private hospitals and NHS consultants practising privately directly under the control of the NHS for the duration of the pandemic in order to support the pandemic response?

Question 5: Did the private companies involved in providing services to the NHS under the contract with the private hospital sector generate a profit, despite assurances given by the NHS that this would not happen?

Question 6: What were the implications for the NHS and individual patients of the large volume of patients transferred from the private hospital sector to the NHS during the pandemic?