03 December 2004
NHS foundation trusts are lobbying ministers to be allowed to bid for the next wave of private sector health care contracts, the Healthcare Financial Management Association conference heard last week.
The government will spend £2bn over five years under its independent sector treatment centre (ISTC) programme and is due to invite tenders shortly for the second wave of contracts.
Under the first wave, announced in September 2003, a range of mostly foreign private care providers were awarded contracts to provide elective diagnoses and surgery.
The private sector will perform 15% of NHS elective work within three years but concerns are growing that the initiative is leaving NHS capacity unused.
The London conference heard foundation trusts wanted to bid as they needed to maximise their income under the new payment by results (PBR) system.
'There is a debate about whether foundations should be able to participate in the second wave of ISTCs. It would be helpful if we could take part,' Mark Britnell, chief executive of University Hospital Birmingham Foundation Trust, told the conference.
'It's difficult when you know that by 2008 there could be a local ISTC taking up to 15% of your work. As a chief executive it is hard not to have small palpitations about that.'
Foundation trusts' regulator Bill Moyes said they could survive in such a challenging environment.
'I can sympathise with you over the volatility under PBR but I think health care is a predictable business compared to others such as retail,' he said. 'Patient numbers and cost is predictable. Healthcare is a complex business but I don't buy the theory that it is a risky business.'
NHS England finance director Richard Douglas acknowledged that finance staff believed the pressure on budgets was probably greater this year than ever before – despite the record levels of funding growth.
He said: 'I couldn't stand here and speak honestly without acknowledging the serious pressures all of you are facing. In some ways, it is not surprising. The government has a deal with the British people that world-class funding will deliver world-class services.'
He urged finance staff to 'raise their games' to make this a reality.
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