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Think again on surgeries
To the Camden Primary Care Trust Board
• WE are writing as members of the campaign group opposed to your proposals for King’s Cross Road, Brunswick Centre and Camden Road GP practices to be run by a subsidiary of the US multinational company United Health to express our deep concern over procedural failures in the tendering of these services.
We are against a private company that is driven by shareholders’ rather than patients’ interests running our primary health care services. Furthermore, we believe that the PCT did not properly conduct the consultation and evaluation procedures prior to selecting United Health as the preferred service provider.
Specific failures in the consultation we are aware of include:
l Many patients at these practices did not receive letters, while others received letters only on the day a consultation meeting was due to take place, at too short notice to attend.
l Patients were not asked whether private, profit-making companies should be used to provide these services.
We are also aware of specific failures that show the tendering and evaluation procedures were not conducted fairly and the PCT did not choose the highest possible standard of services for patients. These include:
l Full details of the financial requirements of running each practice were not given to competitors bidding for the contracts.
l The PCT did not score bids prior to shortlisting as laid out in the selection criteria document, which states that bids must score a minimum of 80 per cent in every area of the service delivery plan to be shortlisted. As a consequence, bids later found to have scored as low as 50 per cent were kept in the running, while higher-scoring bids may have been rejected.
l An arbitrary value for money index was introduced at the end of the evaluation. This index and its influence was not revealed until after the PCT had announced United Health was the successful bidder. In the case of the Brunswick Centre practice, use of this index meant United Health’s bid was successful despite scoring 10 per cent less on the service plan than local GPs. It appears the inferior bid was chosen because it cost less. United Health allocated only £74 per patient compared with the local GPs’ £100 per patient, such a significant undercut that local GPs are extremely concerned United Health cannot sustain even this lower standard of service provision without subsidising it from a central fund. Furthermore, we understand United Health has now requested additional money from the PCT to pay for necessary services for one practice it says it was not aware of. Despite emphasising to prospective bidders that each individual practice had its own unique needs, the PCT gave competitors who bid for more than one practice a single score for their bids combined. The winning bidder United Health received a single score for all three Camden practices, raising the concern that it may have put in a poor proposal for one practice but been pulled up by scoring well on another bid. This also raises the possibility it may have been favoured at one practice for being prepared to take on another. This information is not available, however. It also remains unclear whether any single bid for the Camden Road practice was even shortlisted.
United Health and subsidiaries are currently under investigation over allegations of fraudulently under-reimbursing patients’ medical expenses in the USA. The company has reportedly paid out over US $16million in fines since 2002 for similar offences and defrauding the US Medicare system, raising the concern that the PCT did not properly investigate the probity of bidders.
We believe the details above show that the PCT broke regulations by changing the tendering and selection criteria after bids had been submitted, such that competitors were not on a level playing field. Furthermore, by placing more weight on the cost and not properly scrutinising United Health’s track record we believe the PCT has jeopardised the standard of services that patients can expect in the future.
The PCT can be in no doubt that local residents are extremely concerned about the proposed takeover by United Health, following protests and all these points being raised at the public meeting on March 10. Yet despite assurances that these concerns would be taken into consideration we understand the board plans to go ahead with these proposals. We urge the PCT to put the proposals on hold, listen to our concerns and re-evaluate the prospective service providers for these practices.
Members, Keep Camden GPs in the NHS Campaign Group |
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