Vital Oxford cancer diagnostic services are being privatised -InHealth to take over

Vital cancer services provided by Oxford University Hospitals NHS Foundation Trust (OUH) have been privatised. NHS England has reprocured the contract for PET-CT scanning services and awarded it to InHealth, a private, for-profit, company.

Oxford is not the only place affected by PET-CT privatisation. Starting in 2015, NHS England selected a Collaborative Network, led by Alliance Medical Ltd, to provide PET/CT scanning services across 30 locations in England.

Alliance Medical Ltd, which describes itself as “Europe’s leading independent provider of imaging services”, was acquired by the South African company Life Healthcare in 2016

Oxford University Hospitals NHS Foundation Trust (OUH) has apparently lost the contract to provide PET (positron emission tomography) scanners used in cancer care in the Department of Nuclear Medicine at the Churchill in Oxford.

The Oxford Mail has reported that CANCER treatment in Oxfordshire could be seriously downgraded if national NHS bosses award a new contract to a private firm.

Negotiations are currently ongoing which could see Oxford’s largest NHS trust stripped of the contract to provide specialised cancer scans in the region.

This follows the decision by a regional NHS England commissioning board that the Oxford PET scanner services – NHS ones – should be put out to tender. Even though the Churchill ones are working perfectly well. The Churchill location is convenient for patients, consultants and nurses.

Trained and qualified staff operate the scanners, which are a key part of the ‘patient journey’ for certain forms and stages of cancers. The scanners are part of the hospital equipment at the Oxford University Hospitals NHS Foundation Trust (OUH).

But NHS England put all PET scanner services out to tender across the South East, whether they were working or not. This meant that OUH had to put in a bid to run its own scanners. Which they did, explaining how the existing budget is needed for the service to function.

NHS England’s feeble excuse

NHS England has said that EU competition regulations required them to do this, and that proposed NHS primary legislation to repeal s75 of the 2012 Health and Social Care Act would remove that requirement. This is a feeble excuse.

In a letter to the Guardian, Peter Roderick writes:

“A repeal of the 2012 Health and Social Care Act is long overdue, but it is not necessary to repeal key sections of it in order to end “automatic tendering” (Time to curb privatisation of care, NHS chiefs tell PM, 8 January). The act only empowers the government to require tendering and the requirement is imposed under secondary legislation – the National Health Service (Procurement, Patient Choice and Competition) (No 2) Regulations 2013. These can be revoked with the stroke of a ministerial pen.

“Getting rid of these and abandoning the intended long-term “integrated care provider” contracts would start to give some credibility to claims that privatisation of the NHS in England is ending.”

David J Hunter , Professor of Health Policy and Management and director of the Centre for Public Policy and Health at Durham University, points out that:

“Nothing in EU law requires member states to open up public services to competition from the independent sector.”

He explains that EU competition law only kicks in with regard to organisations engaged in economic activity. It is unclear whether this applies to the NHS, as it has been partly privatised – or whether the NHS still counts as an organisation that’s fulfilling a purely social function, and whose activity is based on the principle of national solidarity (a core EU value) and is non-profit making. If the NHS still counts as a non-profit making organisation based on the principle of social solidarity, it’s not subject to EU competition law.

Was there any public involvement and consultation for the Oxford procurement?

Crucially, this NHS England Jan 2016 “Proposed procurement of phase 2 PET-CT services: Guide to 30 day engagement period”  document

“any potential change in location of PET-CT services may need public involvement and consultation.”

InHealth has loads of contracts for PET/CT services and in 2006 set up the UK’s first public private partnership for a PET-CT and integrated cyclotron facility

InHealth describes itself as

“the UK’s largest specialist provider of diagnostic and healthcare solutions to the NHS and independent sector”

They have over 300 sites where they provide NHS diagnostic and healthcare services, in 200 hospitals and over 100 community based medical centres, GP surgeries and health clinics

As well as the Oxford University Hospitals NHS Foundation Trust (OUH) PET CT contract, InHealth has been awarded the NHS PET/CT Diagnostic Imaging Service contract  for the delivery of PET/CT services at 15 locations in the south of England, for 11 cancer care networks.

The InHealth blurb on the Pharmamatching website says,

“The service uses mobile units containing 6 slice Siemens Biograph TruePoint PET/CT scanners. The staff are all highly skilled technicians and radiographers. The units visit the following locations: Basildon, Bournemouth, Cambridge, Colchester, Leicester, Maidstone, Northampton, Norwich, Nottingham, Plymouth, Poole, Southampton and Taunton, with urgent cases utilizing InHealth’s 16 slice scanners at the static units in London and Nottingham. The service also accommodates paediatric patients who are seen at Guy’s and St Thomas’ Hospital in London.

“We work closely with the UK PET/CT Advisory Board and local cancer networks to provide an effective and efficient service to patients. In addition, to ensure best practice in clinical governance, InHealth has established an Independent Advisory Board, which is chaired by Professor Sir Michael Peckham and includes experts from all the relevant clinical specialities.”

In Health also says,

“Launched in 2006, The PET-CT facility at the InHealth Specialist Imaging Centre in the grounds of Nottingham City Hospital was the UK’s first public private partnership for a PET-CT and integrated cyclotron facility.”

This Leicester Hospitals webpage says InHealth has the NHS England contract to supply PET/CT services at Leicester and the services are provided by InHealth to Alliance Medical Ltd (AML).

The privatisation of PET/CT services looks like national thing – Alliance Medical Ltd leads the Molecular Imaging Collaborative Network (MICN)

Here is Wikipedia about the ten-year NHS contract to provide PET-CT scanning services across 30 locations in England in January 2015. (Now 31.)

And here’s the Alliance Medical webpage about NHS England’s 2015 selection of the Molecular Imaging Collaborative Network, led by Alliance Medical under a new 9 year National Contract:

“The Molecular Imaging Collaborative Network (MICN), led by Alliance Medical, is delivering PET-CT services to 60% of England under a new National Contract.”

In 2015 NHS Trusts challenged NHS England’s decision to award a PET CT scanning contract to Alliance Medical Ltd

This was reported by the National Health Executive:

“A number of NHS trusts has launched a formal challenge against an NHS England decision to award a 10-year, £80m contract for PET CT scanning to a private company.
The contract, which covers about five million patients, was awarded to Alliance Medical in December, beating a bid from a consortium of the University Hospitals of North Midlands Trust, Wirral-based Clatterbridge Cancer Centre Foundation Trust and the Royal Liverpool and Broadgreen University Hospitals Trust.”

At the time, Conservative MP Malcolm Rifkind sat on the Allliance Medical Ltd Board. Buzzfeed reported that the bid from the NHS hospitals consortium was £7m cheaper than the commercial company’s bid.

Alliance Medical Ltd is a subsidiary of South African company Life Healthcare

The Alliance Medical Ltd website says the company  is:

“Europe’s leading independent provider of imaging services”.

In 2016 Alliance Medical Ltd was acquired by Life Healthcare, an international healthcare company that describes itself as:

“a leading hospital provider with 63 hospitals and clinics, over 8,600 beds and treating circa 650,000 patients each year in South Africa.   They also have significant operations in India and Poland.  
Their vision is to be a market leading, internationally diversified healthcare provider focused on delivering sustainable, high quality and cost effective healthcare.  The entry into diagnostics is a natural evolution of this strategy.”

The Alliance Medical News webpages are worth a read

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