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Experts disagree about privatisation dangers

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Why does the King’s Fund’s Professor Chris Ham argue privatisation is not an issue for integrated care?

The arguments that accountable care or integrated care systems will lead to privatisation are very wide of the mark, King’s Fund chief executive Professor Chris Ham said this week.

Speaking at a King’s Fund breakfast debate, Professor Ham dismissed concerns, saying that private providers do not have the capabilities to take on an accountable care organisation (ACO) contract.

This would require bidders to offer community care, social care and some hospital-based services. ‘There are few if any private providers in a position to provide all that,’ he said.

‘It’s very unlikely that private providers will choose to compete when the accountable care organisation (ACO) contract becomes available.’

He added that only two areas, Dudley and the city of Manchester, have said they wish to use NHS England’s planned ACOs contract when it becomes available, and that both have identified an NHS trust as the preferred provider.

Former NHS medical director Dr Graham Winyard, who has been involved in mounting a judicial review of the ACO contract, praised the work being done on integrated care through integrated care systems.

However, he warned that the NHS is moving to a situation where most of the decisions that matter to the public will be taken by non-statutory bodies.

These could include private and commercial partners whose priority will be profit, he said.

‘The history of the private finance initiative (PFI) should leave us in no doubt that if there are opportunities to profit from the NHS they will be ingeniously and enthusiastically exploited. This is entirely possible within the legal framework set out in the ACO contract.’

Dr Winyard added that his reservations would disappear if Parliament made ACOs democratically accountable.

Also speaking at the event, Dr Claire Fuller of the Surrey Heartlands sustainability and transformation partnership (STP) said her organisation had no aspirations to become an ACO.

One reason was that the STP had ‘leaky’ borders, with patients naturally going out of the area for treatment.

However, integrated care partnerships in Surrey would take on responsibility for capitated budgets by 2019.

Further information

Crowdjustice: Urgent legal action for our NHS – round 2

Surrey Heartlands Health and Care Partnership: About us

YouTube: Breakfast event — Integrated care: what does the future hold?