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Concerns over expansion of fast track surgery

Published on 28/10/03 at 02:51pm

Doctors and health unions have expressed their concerns about the effect of new fast track surgery centres on the rest of the NHS.

The Government has announced 25 new Treatment Centres to be run by private companies across England will treat 250,000 patients a year, complementing the 25 NHS-run centres already established

The Government says the innovative NHS-private sector partnerships will help it meet the 2005 target of ensuring no patient waits longer than six months for an operation, but the BMA has expressed serious doubts about the centres.

BMA Chairman James Johnson said he welcomed the Government pledge to increase the number of operations, but said NHS hospitals could take on the additional work if they had received extra resources.

"Any move that truly increases capacity and provides extra operations over and above what the NHS can do at the moment is good news for patients.

"However there is a big BUT - DTCs must not take staff or resources away from NHS hospitals. There is no point in having up to 70% of the staff in DTCs coming from the NHS, if that leaves hospitals short of doctors to carry out all the other work that trusts provide for patients around the clock.

"This would leave hospitals that are already struggling to cope in an even worse situation. If you assume that the NHS is currently working to capacity - as are its staff - how can you justify taking those staff out to work for somebody else?"

He added that the BMA welcomed DTCs providing training opportunities for junior doctors, but said systems must be in place to ensure it was of a high standard. These concerns reflect long-standing warning by the Royal College of Surgeons.

Health Secretary John Reid said fears about staff being taken from the NHS were groundless: "Not only will we not be poaching NHS staff, it is legally prohibited under the contracts to do that."

But Mr Reid says some Trusts have requested the transfer of some of their routine work to the centres, with their staff to follow, but usually only on a part-time basis and for a limited period.

Many routine operations are currently cancelled at short notice because of emergency cases claiming beds in NHS hospitals, a problem the Treatment Centres will not suffer from.

Mr Reid said: "Everybody wins in this." Using the example of the success of an established treatment centre in Birmingham, he said: "People were previously waiting nine to 15 months for minor operations. They are are now getting them in six weeks because we have an NHS treatment centre that is not only adding capacity, but changing and reforming the system so that we don't interrupt constantly the routine operations by the emergency operations."

Two British companies and five overseas companies have been selected as preferred bidders to run the new centres, including two mobile centres offering opthamology services in the North West and North East of England, Oxfordshire and Buckinghamshire.

Healthcare union Unison has strongly opposed the private sector involvement in the new centres.

Spokeswoman Karen Jennings said: "This is another fast-track solution with the private sector which is actually going to create more problems than it is going to provide solutions."

"We are going to see large, private-vested global interests coming into the NHS, who are going to be given five-year contracts, and who are going to be able to charge more than the NHS."

The government rejected these claims, saying the money paid per operation to the centres will the same as the tariff paid to the NHS.

Mr Reid said: "Just because some trade union leaders have a political objection to buying treatment from the voluntary or independent sector, and some surgeons don like it because it reduces the waiting lists, and therefore reduces demand for private practice, I not going to leave people in pain."

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