The Department of Health and Social Care (DHSC) has awarded significant contracts totaling £6 million to Deloitte and Addleshaw Goddard, prominent management consultants and lawyers respectively. These firms are tasked with advising the DHSC on the feasibility and structure of using public-private partnerships (PPPs) to build a network of new NHS neighborhood health centers across England.
Their responsibilities encompass developing a comprehensive business case for PPP involvement, designing the optimal structure for such a partnership, and creating detailed financial models. Interestingly, the DHSC’s remit extends to potentially engaging these firms in the procurement process itself, suggesting a possible collaboration with private finance companies throughout the project. The initial focus will be on establishing these centers in underprivileged areas.
The health secretary recently announced the locations of the first 43 centers, outlining a vision for integrated healthcare services under one roof, encompassing doctors, nurses, pharmacists, social care workers, and voluntary groups. This initiative aims to shift some healthcare services from hospitals to community settings.
However, concerns have been raised regarding the potential for a repeat of past PFI-style failures. Critics argue that private sector involvement risks mirroring the expensive mistakes of the private finance initiative (PFI) used in the 1990s and 2000s to build hospitals and schools. As highlighted by the National Audit Office in 2018, the PFI resulted in over £40 billion in outstanding payments to private firms, a burden the NHS continues to bear.
Campaigners, such as those at We Own It, vehemently oppose private sector involvement, citing the PFI’s disastrous financial consequences for public services. They argue that prioritizing profit over patient care is unacceptable and that any such move would contradict Labour’s pledge in its election manifesto to maintain public ownership and funding of the NHS.
The DHSC, in response to these concerns, maintains that it is exploring the feasibility of PPPs only in limited circumstances where they offer demonstrable value for money. They emphasize that this exploration includes the potential use of PPPs to deliver primary and community health infrastructure.
Conversely, some within the NHS, such as the chief executive of the NHS Confederation, advocate for private sector involvement, citing the NHS’s limited capital funding for building maintenance, repairs, and equipment purchases. They argue that private investment is crucial for modernizing healthcare facilities, while emphasizing the need to avoid repeating the mistakes of past PFI models by learning from international best practices in PPPs.
The DHSC insists that all proposals undergo rigorous value-for-money assessments to ensure responsible use of taxpayer funds. The final decision on whether to utilize private funding for the new clinics rests with the chancellor, who is expected to make an announcement in the budget on November 26th. The debate highlights the complex balancing act between securing necessary funding for crucial healthcare infrastructure and safeguarding the principles of public ownership and accountability within the NHS.