The Government are currently trying to pass a bill that will open up - or even encourage private competition within the NHS. It has been dubbed one of the most radical plans in the history of the health service - and has certainly proved controversial.
Some private companies already have contracts to run services on behalf of the NHS, and as part of the film I’m making I have been looking into one of those contracts.
Since March 2006 Serco have held the contract to provide out of hours GP services in Cornwall. Prior to 2004, the provision of this service formed part of standard GP contracts - effectively if you were a GP, you had a responsibility to look after your patients around the clock.
In Cornwall, a group of 329 local GP’s got together and formed a cooperative. Patients who fell ill in the night would get the care of a local GP, but the GPs would work together to ensure that the workload was shared.
When the contracts changed and GP’s were no longer required to look after their patients out of hours, the cooperative carried on. They registered themselves as a non-profit making mutual benefit society, and continued to deliver out of hours services for those in need across Cornwall.
Just over a year after the new GP contracts came into force, the local Primary Care Trust (PCT) announced that it would be cutting the budget for out of hours care, and soon after they invited bids to run the service from private companies.
Serco took over the out of hours service in March 2006, they had secured the contract for £7.5m a year, which was around £2.5m less than local GPs charged. A month into their new contract Serco announced that up to 30 jobs would be cut from the service.
Later in 2006, Serco doctors refused to visit the home of a seriously ill 97 year old man. His son later called an ambulance who took him to a hospital where he stayed for 8 weeks with severe lung and bladder infections. In response to the complaint Serco announced it would be strengthening the service with the appointment of a dedicated medical director, a lead nurse and a new service manager to improve local management.
Just a few months later, patients were left without urgent medication, because pharmacists were unable to contact Serco doctors. In fact in December 2006, 18% of calls to the service went unanswered. Serco publicly apologised, and promised to increase staffing and phone lines.
In February 2007, the Serco contract came under attack, Patients' watchdogs and a paramedics' union called for the out-of-hours doctor service to be run by the local ambulance trust. Cornish MP Matthew Taylor, even secured a debate in Parliament, after a survey of local GP’s found that 75% of them, had noticed an increase in complaints from patients about the service. The PCT even got involved deciding to review the contract - even though there were still two years left to run on it.
The PCT issued Serco with an ‘improvement plan’ and 20 days later, they announced that Serco had met all of the targets. A week later, a local family took their baby, who was suffering from breathing problems to a Serco GP. That GP sent the family home to wait, while he called the police - as he wasn’t sure how to call an Ambulance.
The problems continued, and in June 2010, A six-year-old boy, who had been unwell for a few days, was taken by his father to the local hospital. With no on-duty doctors, staff told the boys’ parents to call the out of hours service.
A telephone advisor asked the parents to examine the boy at 2am in the hospital car park, and then asked them to give him ibuprofen, a hot water bottle and make an appointment to see a GP the next day, saying there was nothing to worry about.
The next day, the boy collapsed in the doctors' surgery and died later at the Royal Cornwall Hospital, near Truro, from acute gangrenous appendicitis.
Two months after the boy’s inquest the local PCT, renewed it’s contract with Serco for another 5 years.