NHS 'biased against private care'

Patients can opt for NHS care at private hospitals which do it at NHS cost

The BBC has learnt that many English trusts are introducing steps that make it harder for patients to opt to have NHS care done by private hospitals.

Health firms said it was a sign of bias, while ministers said there was no justification for the restrictions.

The behaviour of nearly half of local NHS management bodies is now being looked at by a government inquiry.

NHS patients needing non-emergency operations, such as hip and knee replacements, are already able to be treated by private hospitals that have agreements in place to carry out the care at NHS cost.

At the moment, only 3.5% of operations are done this way, but under the government's shake-up of the health service the number is set to increase.

Curb competition

However, in recent months managers working for primary care trusts have started trying to impose restrictions that channel patients away from private hospitals.

These include reductions in the range of treatments that private hospitals can offer NHS patients, caps on the number of people they can treat and promising NHS hospitals set numbers of patients.

Another tactic is to introduce minimum waiting times, which has the effect of slowing the flow of patients and cancels out one of the key benefits of being seen by the private sector - quicker treatment.

The issue is being looked into by the Co-operation and Competition Panel on behalf of the Department of Health. Its interim findings suggested as many as 70 of the 151 PCTs are employing such tactics.

Continue reading the main storyNHS tactics Block contracts - PCTs promise NHS hospitals a certain number of patients, leaving the private sector only what is left over Minimum waiting times - Insisting patients wait a certain length of time before treatment. Health firms say this is about lowering the bar so that they cannot use the pulling power of quicker care Activity caps - Limits on the number of patients that can be referred on to private hospitals Fewer options - Reducing the range of treatments the private sector can offer to NHS patients They refused to give the BBC the details of the complaints, but a source close to the inquiry said trusts seemed to be motivated by a desire to protect their local hospitals in the tight financial situation - in some cases specialist regional NHS centres outside trust areas were being hit by the restrictions - and a desire to curb competition in the health service.

Circle is one of the health firms that has complained. It has highlighted the behaviour of two PCTs - Wiltshire and Bath and North East Somerset, which cover the areas surrounding its Bath hospital.

Documents seen by the BBC show that the PCTs have proposed introducing a range of restrictions, including cutting the number of areas of treatment Circle - and any other private sector provider - can offer to NHS patients from 11 to five. Part of the reasoning is that it is needed to protect the local NHS hospitals.

The PCTs refused to comment about the plans, which were to be introduced in April but have now been postponed while the government inquiry is carried out.

Ali Parsa, head of Circle, said there needed to be a "change in mindset" in the NHS. "There is too much focus on who is delivering the care. It is quality that matters."