Takeover of London GP practices by private US healthcare company could face judicial review

Following public outcry at the takeover of GP practices in London by US health insurance giant Centene, a patient at one of the affected practices decided to challenge the decision of her local Clinical Commissioning Group (North Central London) in court.

Ms Anjna Khurana is a local councillor, representing Tollington Ward, and is a patient at Hanley Primary Care Centre in Islington.

Ms Khurana’s ‘crowdfunder’ has been supported and promoted by a small team, including members of Doctors in Unite (DiU), 999 Call for the NHS, Calderdale 999 Call for the NHS and Keep our NHS public. Showing the strength of public feeling against corporate takeover of GP practices, in four days donations amounted to about £43,000 towards the costs of a possible judicial review brought by Ms Khurana.

This would challenge the lawfulness of the recent takeover by Centene’s UK subsidiary Operose of the privately-owned AT Medics LLP – the holding company for AT Medics Ltd. AT Medics Ltd was set up in 2004 by six NHS GPs and now runs 37 GP practices across London, under the ownership and control of Operose Health Ltd.

Ms Khurana’s claim was submitted to the High Court some weeks ago. Recently her legal team at Leigh Day gave the court her reply to papers that the North Central London Primary Care Committee have produced in response to her claim. The legal team have been strong and clear in the reasons why the case should be granted permission and Ms Khurana and her support team now wait for the judge’s decision about whether the case can proceed to Judicial Review.

Protest Centene’s takeover outside Dept of Health and Social Care, 6pm Monday 5th July

To drive the message home, there will be a socially-distanced demonstration against Centene’s takeover outside the Department of Health and Social Care, 39 Victoria St, London SW1H 0EU at 18.00 on Monday 5 July – the NHS’s 73rd birthday.

Doctors in Unite chair Jackie Applebee said:

“Ministers and senior NHS executives have repeatedly mouthed the mantra that the NHS is not being privatised, but that is patently not true as the awarding of lucrative contracts to private healthcare firms continues apace.

“We are supporting a patient who is now hoping to test this policy with a judicial review as to why a huge swathe of English general practice, including the data of nearly half a million patients, was  handed over to US health insurance giant Centene – with a breath-taking lack of transparency and openness. We have been told by the patient’s lawyers that she has a strong case.

“There is a world of difference between a multinational corporation that operates to make a profit, often by cutting staff and services, so that it can pay dividends to shareholders; and local GPs who are very much part of the NHS ‘family’ and provide services from a budget fixed by the Treasury.

“The NHS, whose 73rd anniversary we celebrate on Monday (5 July), is being steadily sold off to profit-hungry healthcare companies – in this case one whose headquarters is in America.”

Keep Our NHS Public co-chair Dr John Puntis said:

“Centene has its eye on becoming embedded in the new integrated care systems proposed in the pending Health and Care Bill.

“The move into GP practices is a foothold on the path to much bigger opportunities for siphoning public money away from patient care and into the pockets of shareholders.

“Health Secretary Sajid Javid should learn the right lessons from the Covid pandemic — privatisation of health care is costly and inefficient.”

However, whatever concerns Javid has expressed about the new Bill, Downing Street has overridden them.

Former Centene UK CEO is Johnson’s health adviser on NHS Transformation and Social Care

With former Centene UK CEO Samantha Jones ensconced in 10 Downing Street as Boris Johnson’s health adviser on NHS Transformation and Social Care, this is hardly surprising.

Before joining Centene UK, Samantha Jones was the NHS England adviser on New Care Models, which are central to the new Integrated Care Systems. She played a central role in giving the USA Centene Corporation access to NHS contracts.

In Downing Street, Ms Jones is to work with Boris Johnson’s special political adviser on health, Will Warr – a former lobbyist at the firm of Lynton Crosby, who masterminded numerous Conservative Party election campaigns and Johnson’s successful 2008 London mayoral bid.

Open Democracy has reported that,

“Warr described the NHS as ‘outdated’ in a Telegraph article penned shortly before he and Johnson entered Downing Street last year, suggesting that the incoming prime minister should ask himself: ‘If I created the NHS today from scratch, what would it look like?’ Warr answered: ‘Nothing like the monolith we have today.’”

As Johnsons’ adviser on NHS Transformation and social care, Samantha Jones will also be working with management consultancy McKinsey alumnus Adrian Masters – another key Johnson health adviser. Adrian Masters played a key role in shaping the last major piece of NHS legislation, the 2012 Health and Social Care Act. McKinsey was reported to have drafted large parts of that bill.

According to Open Democracy, Adrian Masters re-joined Number 10 in 2020 as civil service policy lead on a secretive “No.10 Health and Social Care Taskforce”, where he advised on elective care recovery. The Taskforce reported to a Steering Group chaired by Munira Mirza, the influential head of Boris Johnson’s policy unit, that met weekly from July to September with a further meeting in October. Open Democracy added,

“Mirza’s leading role and the lack of leaders from the Department of Health suggest that [the taskforce’s] work is politically focused…
Both the Department of Health and the NHS now appear to be taking a back seat in policymaking. Stevens is not on the task force, and none of the four top senior servants in charge comes from the department.”

New NHS Cuts and Sell Offs Bill a bonanza for private companies

The NHS Integration and Innovation White Paper that Matt Hancock laid before Parliament on February 11th 2021 proposes that private companies’

“ongoing role in complementing NHS provision would continue; through national and regional procurement exercises as are currently underway to boost NHS capacity to provide elective services; and through simplified AQP arrangements.”

(7.4 NHS Provider Selection Regime Consultation document February 2021)

The “elective recovery” policy is to create a bonanza for private companies, through yet another NHS England framework agreement, and a “simplified” Any Qualified Provider list for GP referrals to elective care that would allow the statutory Integrated Care System NHS Boards envisaged in the White Paper to pre-select companies without any procurement process. All the Integrated Care System NHS Boards would have to do is “demonstrate the providers meet the stated service conditions”.

In December 2020 NHS England published the £10bn Increasing Capacity Framework – Provider List. This is a lengthy list of private health companies including Operose Health (plus 2 London NHS hospitals), that NHS hospitals can contract to help clear the huge waiting list for elective hospital care – particularly for cancer diagnosis and treatment – that has built up because of the government’s response to Covid19.

NHS hospitals can pay the Increasing Capacity Framework providers to carry out:

  • NHS inpatient and day case services (including full supporting pathology and imaging) and urgent elective care and cancer treatment in line with nationally set criteria;
  • NHS Diagnostic Services;
  • Clinical facilities and related services (the ‘Services’).

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