Private hospitals treated a total of just eight Covid patients a day during the pandemic despite a multi-billion pound deal with the government to help stop the NHS being overwhelmed, a report reveals.
And they also performed far fewer operations on NHS-funded patients than usual, even though hospitals has suspended much non-Covid care, according to research by a thinktank.
The Treasury agreed in March 2020 to pay for a deal to block-book the entire capacity of all 7,956 beds in England’s 187 private hospitals along with their almost 20,000 staff to help supplement the NHS’s efforts to cope with the unfolding pandemic. It is believed to have cost £400m a month.
However, the Centre for Health and the Public Interest’s report (Pdf) says that on 39% of days between March 2020 and March this year, private hospitals treated no Covid patients at all and on a further 20% of days they cared for only one person. Overall, they provided only 3,000 of the 3.6m Covid bed days in those 13 months – just 0.08% of the total.
And while private hospitals undertook 3.6m NHS-funded planned procedures the year before, that dropped to only 2m during the first year of the pandemic – a fall of 43% – the thinktank says. Its conclusions are based on its analysis of two major sets of published NHS activity data.
“Despite the fact that the taxpayer paid undisclosed billions to the private hospital sector, which prevented some of the companies going bust, the official data shows that they barely treated any Covid patients and delivered less elective work for the NHS than they did prior to the pandemic,” said Sid Ryan, a researcher at the CHPI who wrote the report.
The NHS’s “under-utilisation of the private hospital sector” should not have surprised ministers, Ryan added, “because private hospitals may have beds and operating theatres, but they rely on NHS staff to carry out operations, and these NHS staff were busy working in NHS hospitals. Which begs the question: why then did the government agree to this generous deal?”
At the time NHS England (NHSE) lauded the deal as a vital way of boosting healthcare capacity at a time when it was feared that NHS hospitals would run out of space to treat Covid sufferers. In two letters to the wider NHS explaining why the deal had been struck and what it would cover, senior NHS officials were clear that it would include care for Covid patients with serious breathing problems as well as routine operations, such as hip and knee replacements.
Ryan criticised the continuing secrecy around the contract. Neither ministers nor NHSE have ever disclosed how much it cost the Treasury or given a breakdown of the number of non-Covid procedures that resulted.
Labour MP Meg Hillier, who chairs the Commons public accounts committee, said the findings showed the government and NHS had got poor value for money from the very expensive deal.
“Millions of pounds of unfit PPE languishing in costly storage and the £530m spent on unused Nightingale hospitals, the Department of Health and Social Care (DHSC) has repeatedly demonstrated its lack of competence in dealing with the private sector.
“Here taxpayers have covered an entire year of private hospitals’ costs in return for less treatment and care than before, and many of them now feel forced to pay those same private hospitals over again in the face of an NHS beset with lengthy backlogs.”
The DHSC should be open about how much care private hospitals did provide and try to claw back moneys for treatment that was paid for but not given, she added.
Under questioning by Hillier at the PAC in June 2020 Simon Stevens, NHSE’s then chief executive, promised to write to her disclosing how many of the 8,000 beds had been used and how much the deal was costing. However, when NHS England’s chief financial officer, Julian Kelly, later replied on Stevens’ behalf, he said the contract had cost £853m in just over its first four months but did not clarify how many beds had been pressed into service.
The Independent Healthcare Providers Network, which negotiated the deal on behalf of private hospitals, insisted that it was never intended to cover people with Covid, despite NHS England’s two letters making it clear that such patients were included.
“Given that the NHS asked the independent sector to maintain Covid-free sites for vulnerable patients including those with cancer it is not surprising that few Covid patients were treated in independent hospitals. To have done so would not have been appropriate or safe,” said David Hare, the IHPN’s chief executive.
He added that more than 3.2 million NHS patients were treated in the independent sector under the contract, without which the NHS’s 5.6m-strong backlog would be even bigger.
A DHSC spokesperson said: “We will make no apology for ensuring that the NHS has the resources it needs to provide care for patients during a global pandemic. The primary aim of the independent sector deal was to treat non-Covid 19 patients, providing urgent cancer services and other life-saving treatments.”
The contract meant that “around two million consultations, tests, operations and chemotherapy sessions for NHS patients [took place] between March 2020 and the end of 2020”, they added – far fewer than the 3.2m claimed by the IHPN.
