While the NHS heads towards the threatened second wave of Covid infection with inadequate funding, as we pointed out earlier this month, the private hospital sector is revelling in a succession of lucrative contracts to treat NHS patients, and celebrating what seems to be an ever-increasing link-up with the NHS.

Details are emerging of the first round of contracts signed by the NHS in the first two months of the pandemic, totalling £1.5 billion. The HSJ points out that – not least because most private hospitals are small (averaging just 43 beds) and separate from the main NHS acute centres – in many cases these contracts “paid for staff and equipment to be transferred to NHS hospitals as opposed to paying for ward space in private hospitals”.

However as The Lowdown has argued the secretive contracts still do not reveal exactly what staff, kit and services the NHS paid for, at what rate, how much it paid, and how much of this was delivered or used – making it impossible to estimate value for money.

As the HSJ points out, there was no widespread use of private hospitals for Covid patients: but nor was there any early resort to treating NHS elective patients in the private hospitals.

So what has happened since? There are tantalising glimpses of what may well have been going on, but the full picture may never be revealed. In mid March, HSJ revealed the first deal block booking up to 8,000 private hospital beds, including all “but tiny fraction” of private capacity.

The private sector stated that it was “not possible” to disclose a value for the deal, because it was not yet known how long the arrangement would be in place, or what the NHS would use, but claimed  all providers had “agreed to a fully transparent approach and to provide services at cost price.”

By mid June, with none of the first contract details yet revealed, the Guardian broke the story that the Treasury had blocked an NHS England plan to extend the deal with the private hospitals at an estimated annual cost of up to £5 billion. Treasury objections centred on doubts over how many of the block booked beds were being used, and the Guardian noted: “NHS England has refused to disclose how many patients have been treated by private providers since March, even though they collect this data each day.” It quoted vague claims by private hospital chiefs and NHS England that they had treated “tens of thousands of NHS patients” during the pandemic.

On July 31 an NHS England letter to trusts and commissioners urged them to include use of private hospitals as part of their plans to restore previous normal levels of treatment of elective and emergency patients, and referred to “£3 billion NHS revenue funding for ongoing independent sector capacity.”

However a week later the BBC reported this as a scaling down of the contracts: “NHS England has announced it is to end the deal that gave it access to more than 90% of private hospitals’ beds, staff and equipment.” Instead “it plans to move towards local agreements with the private sector in what it describes as the “next phase of the response to coronavirus”.

Ten days later another change of line, as The Independent broke the story that “the health service could spend up to £10bn of taxpayers’ money buying operations and treatment in the private sector over the next four years to reduce waiting times.” The £10bn figure had been revealed in a contract tender notice.

However September statistics highlighted by The Lowdown revealed that only 2,300 of the undisclosed total of private hospital beds block-booked by NHS England were being used in early September.

According to analysts Laing and Buisson private hospital activity is recovering to pre-pandemic levels, with cancer treatment exceeding 2019 levels: so what is the NHS paying for, and are they getting value for money?

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