A seemingly endless succession of large-scale “Framework Agreements” have been rolled out by NHS England and the Department of Health in recent months, creating conditions for more rapid award of contracts with a pre-authorised shortlist of private,  public sector and non-profit providers with limited if any further competitive tendering.

Recent examples include a £500m facilities management framework NHS and public sector, an £800m framework for a range of health IT services, a £10 billion “open opportunity” to reduce waiting times, and a massive £47bn construction framework.

It’s possible to trawl through the general terms of these agreements and also check out  the NHS SBS Approved Organisation List  and over  1194 Approved Organisations  that have access to the framework agreement portfolio and as such, can utilise any NHS SBS framework agreement whenever required.

But what do the framework agreements look like at the local level, when a hospital trust signs up with one of the pre-approved providers and agrees a contract for a specific set of tasks?

The recent publication of a contract for “provision of mobile and strategic clinical solutions and associated goods” between Somerset NHS Foundation Trust and the private cancer company Rutherford Diagnostics and Rutherford Infrastructures gives us a glimpse into just how opaque and secretive these deals can be.

Rutherford’s chief medical officer is one of the media’s favourite private doctors, Karol Sikora, who famously claimed on the BBC in 2017 that the NHS was the “last bastion of communism” and needed a “total rethink”. Such scruples obviously do not stop Rutherford from eagerly hoovering up cash from NHS hospital contracts, although they do seem more than a little shy on revealing any details.

The contract was only published at all as a response to a Freedom of Information Act request to the Trust  – but, as with so many documents grudgingly released by secretive management, the 97-page contract has been heavily redacted to remove almost any useful information.

All of the content or the whole page has been completely blacked out in 28 pages, including all 18 final pages. All detail of penalties in the case of failure to deliver has been expunged from pages 49-50 and 70-71, as indeed has any information on the Key Performance Indicators (basic contract requirements) for the supplier (page 68), and all the detail on the company handling private patients on behalf of the Trust (page 41).

Many pages have been so heavily edited it’s impossible to see what has been removed from public view, but it is clear that all of the details of the quantity and cost of the services (page 13) and milestone dates of the implementation plan (20-21) have been blacked out. Even the date of the agreement has been obscured on page 51.

With so much of this agreement apparently embarrassing to one party or the other, it’s hard to avoid the conclusion that this and many similar framework agreements are funnelling substantial and disproportionate profits to private providers while trust bosses hide from any public accountability – and that the NHS budget is being more systematically milked for private profit.

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