Does Hinchingbrooke spell the end for privately run NHS hospitals?

Well, it doesn’t look good, does it? The private sector comes in with a flourish and then when the financial going gets tough and they’re about to get a dressing down on quality, Circle just walks away. However, the reality is a bit more complex than that.

This hospital has struggled financially for years. For years before it was built, there was argument about whether there was a need for a DGH half way between Peterborough and Cambridge. And, as many small hospitals do, it’s struggled financially (also not helped in this case by a substantial PFI). Size causes other problems too – for example in A&E. Hinchingbrooke has about 35,000 patients a year in A&E compared with double that number at neighbouring West Suffolk and three times as many at Addenbrooke’s in Cambridge. Being small makes rotas really hard to staff, with a lot of night duty for senior staff, and this in turn has made it very difficult to recruit consultants. Dis-economies of scale are felt by small hospitals in other areas too, so the real question is whether there’s a place for the small DGH in our NHS. The 5 year Forward View seems to say ‘Yes’, but maybe in a different form.

Then there are the problems with quality. When Circle took over two years ago, quality of care seemed to improve and the hospital even got awards for the excellence of its care. Now there’s a damning CQC report, and on one of the visits CQC asked for eight beds in a medical ward to be closed immediately as there just weren’t enough staff. I suspect Circle got caught, as many hospitals do, with being asked to make cuts and then struggling to maintain quality.

So what does this tell us about the private sector? Well, Circle are perfectly within their rights to walk away. Their contract allowed them to do that if they were going to have to plough more than £5m of their own money into the hospital. For me, it says more about the problems of small DGHs than about the private sector. However, some will be relieved that the private sector doesn’t have a magic solution to the problems of the NHS. And maybe those NHS clinicians and managers struggling on in other hospitals aren’t such duffers after all.



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