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Accepting the lowest bid could be disaster for care
• I AM dismayed by the decision of the Camden Primary Care Trust (PCT) to award the contract for management of the Brunswick Health Centre to the American firm United Health (Anger deepens over private GP takeover, March 6).
The PCT says in a letter dated January 25 that United Health has elsewhere delivered improvements in care, extended opening hours, increased opportunities for patients to have their say and introduced a wider range of services.
All of these “improvements” are already in place a Brunswick Medical Centre after less than a year of work by the new team that has succeeded in cleaning up much of the mess left by years of poor quality service delivery and administration.
I am very happy at last to have a doctor in whom I have confidence, who exhibits caring and gives me clear advice. I appreciate the admin’ support team who give me helpful guidance in dealing with the wider network of NHS services.
It doesn’t make sense that the NHS would seek “new ways of delivering service” from the US, a country which operates its medical system on principles so different from those in the UK, and which has a poorer healthcare record than our own.
United Health is a for-profit business, whose first commitment is to its shareholders. The NHS is a service provider of the UK, whose principal focus is its patients, the citizens of our country.
As I understand it, the practice at Brunswick was a finalist bidding for the Camden PCT long-term contract to provide medical services to the Brunswick Medical Centre, and scored 80 per cent, the highest bid, for service delivery based on a cost per patient of £100.
A “value for money” criterion was not part of the original terms of reference of this contract, but was added late in the process, without ensuring that all bidders were advised of the addition.
The United Health bid, which I understand was scored at 65 per cent, based its service delivery on a cost factor of £75 per patient.
However, their bid was for three practices, including the Brunswick Medical Centre.
Because of the “value for money” criterion, ie £75 rather than £100 per patient, they were awarded the contract for Brunswick, notwithstanding their much lower score overall.
I have had a lot of experience with the contract bidding process, and know from bitter experience the disastrous results that can occur when the lowest bid is selected without analysing how the services are to be delivered at the lowest cost.
One cannot get blood from a stone – and economies of scale often lead also to economies of service.
MARY WILSON
Upper Woburn Place, WC1
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