The first 2 articles are about a GP surgery in Camden sold and care contracted out to UnitedHealth. 3 years later they sell it to another private firm (shares sold to The Practice, plc). The GP surgery closes down a year later leaving 4500 people without a doctor.
The third article is about another GP practice removing the eldery, vulnerable, and expensive
patients from their list at short notice, leaving the other local
general practices to take up these often medically complex patients at short
notice.
http://www.camdennewjournal.com/news/2012/jun/inquiry-camden-road-surgery-closure-raises-concerns-about-remaining-privately-run-prac
Inquiry into Camden Road Surgery closure raises concerns about remaining privately-run practices
Camden Road Surgery was closed in April, leaving more than 4,500 patients without a doctor
Published: 28 June, 2012
by TOM FOOT
by TOM FOOT
A FINAL report from a public inquiry into the closure of a privately run GP surgery has raised concerns over the future of two other practices in Camden.
Camden Road Surgery closed on April 13, four years after it was taken over by American health giant UnitedHealth, leaving more than 4,500 patients without a doctor.
The inquiry panel of three councillors – chaired by Labour councillor Angela Mason – said there was an “urgent need” to find a replacement for the closed surgery, adding: “We remain concerned about the remaining two contracts held by The Practice at the Brunswick Centre and King’s Cross, as contracts will end in 2013.”
UnitedHealth – the wealthiest health company in America – was awarded five-year contracts to run three Camden surgeries in 2008.
The inquiry’s in-depth report found a “serious loophole” in the original contract which allowed surgeries to be suddenly sold to another firm, The Practice plc, in April 2011. There was no competitive tender – as is normally the case – and the new company was not vetted in any way by its NHS paymasters.
The inquiry report said: “The panel were of the view that this was a serious loophole. In our view primary care by GPs should not be a commodity traded in the private market and prompt action should be taken to remedy this.”
The inquiry’s report concluded that Camden Road Surgery was a “casualty” of government NHS reforms and that a lack of consultation with other GP practices had led to “unnecessary anxiety” among patients.
The report added: “A number of those who gave evidence to the inquiry said they first found about the closure from the Camden New Journal. We note that the reporting of the Camden New Journal has been a consistent and reliable source of public information on what was happening at Camden Road Surgery.”
The inquiry heard from GPs, NHS officials, patients and anti-privatisation campaigners.
The report added that a “lack of planning” had led to the failure of the NHS to find alternative premises for a new surgery. The use of multiple locums was criticised for breaking a “continuity of GP care provided by the practice’s former owner, Dr Robert Harbord”.
The report concluded there was an urgent need for a new surgery in the area bounded by Camden Road, York Way, and St Pancras Way and that the estates at Agar Grove and Maiden Lane are areas of particular deprivation, adding: “We recommend the council begin urgent discussions with NHS North Central London (NCL) on both the proposals for new practices in the King’s Cross development and at Maiden Lane.”
Cllr Mason said the way Camden Road Surgery was closed was unacceptable. It had been a casualty of the cuts.
The increasing trend towards privatisation could have quite a massive effect on the notion of having a doctor, she warned. “We are moving to a situation where there is a real possibility that GPs are subservient to private providers,” she said.
Cllr Mason added: “It was disappointing that The Practice and UnitedHealth did not attend [the inquiry] and that does send out a message of concern.”
Officials from NCL were due to debate the report with councillors at the Town Hall last night (Wednesday).
Inquiry told how NHS chiefs were powerless to prevent GP surgery being sold on by American health giant before closure
Camden Road Surgery was closed earlier this year after being taken over by The Practice Plc
Published: June 7, 2012
By TOM FOOT
By TOM FOOT
NHS officials have admitted they were unable to stop an American health giant from suddenly selling a Camden GP surgery to another private firm – and are seeking legal advice to stop it happening again.
North Central London (NCL) NHS trust associate director Tony Hoolaghan, speaking at an inquiry into the closure of Camden Road Surgery on Thursday, revealed how the trust had lost control of the GP practice.
He said he had sought legal advice after United Health sold shares in three Camden surgeries to The Practice Plc in April 2011. The financial transfer shocked patients who were not informed about the deal until after it was done. Health bosses had not vetted or approved the new operator.
A year later, Camden Road Surgery closed, triggering a public inquiry at the Town Hall.
Speaking to the inquiry panel on Thursday, Mr Hoolaghan said: “We took legal advice at the time and we were informed that what had happened was legal. We couldn’t prevent it from happening. There was no change to what the new deliverer had to do – no change in the performance monitoring."
He added: “We are seeking legal protection for next time.”
Camden’s original alternative provider of medical service (APMS) contract with UnitedHealth for the running of Camden Road, King’s Cross and Brunswick practices expires in March 2013. Mr Hoolaghan said NCL would launch a tender for the two remaining surgeries, allaying creeping fears that they are also facing closure.
Lib Dem councillor Paul Braithwaite said: “We have identified a flaw in the contract”, adding that the closure had created a “large hole” in GP cover for Camden Town and Cantelowes.
NCL chief executive Caroline Taylor told the panel: “We are talking to our solicitors about it,” adding: “There is nothing to suggest that private providers are worse in any way for patients.”
This was not the opinion of Caversham Practice partner Dr Steve Amiel who, in written evidence submitted to the panel, said: “We are hearing anecdotal evidence from Camden Road patients of the fragmented care they received during the tenure of UnitedHealth and The Practice. Equally anecdotally, clinicians at our practice are concerned in some cases that there appeared to be little continuity of care at Camden Road and this might have impacted on clinical decision-making. The Caversham is on record as opposing the takeover of three practices by private providers, whose prime duty of care was to their shareholders, rather than patients. We feared exactly the outcome for Camden Road patients that has sadly come about.”
Dr Amiel, in his evidence, said: “We found out about the closure from the Camden New Journal. I gather other practices have said the same thing.”
Since the closure, his Kentish Town practice had seen “considerable pressure on both clinical and non-clinical staff, on waiting times to get an appointment and patient satisfaction”.
In further written evidence, Jagdish Vaghela, who has run Biotech Pharmacy in Camden Road for more than 30 years, said: “We feel that patients have been compromised. There was and still is a genuine need for a surgery in place of or in the vicinity of the previous Camden Road Surgery... The problems that came about had a strong link to the privatisation of the practice.”
But NCL’s Ms Taylor said she was “personally comfortable” with the closure and the way patients had been allocated. She added that 2,746 patients had been re-registered, 417 had moved away and 1,500 were still at large, the majority of them aged 16 to 30.
Inquiry chairwoman, Labour councillor Angela Mason, was applauded from the public gallery when she told NCL: “The nub of this is the very sudden closure of the surgery. I think it was badly done and you didn’t give enough time for the process – and we cannot understand why.”
The panel will file a report to the council’s health scrutiny committee later this month.
GP practice 'offloaded vulnerable patients to save money'
Practice run by supporter of Andrew Lansley's health reforms let go of 48 patients who needed high levels of care
Dr Charles Alessi at Churchill medical practice last year. Photograph: Frantzesco Kangaris
A GP practice run by a doctor who has been of one of the most prominent supporters of Andrew Lansley's health reforms de-registered elderly and disabled care home patients to save money, an NHSinvestigation has found.
According to documents obtained by a freedom of information request, the NHS launched an investigation into Churchill medical practice in Kingston last year after complaints that it had let go of 48 patients who required high levels of care. Local doctors complained as they had been expected to take on the vulnerable and costly patients – some with Alzheimer's disease – at short notice.
Churchill's senior partner was Charles Alessi, now chair of the National Association of Primary Care, who has written in the Sun and appeared on television backing the coalition's health reforms. According to the documents, the practice claimed it was forced to drop the patients because they had to cut staff after NHS funding dried up in March last year.
NHS South-west London found that Churchill was in breach of its "contractual obligations to patients" by removing the patients and that it had done so "predominantly for financial reasons". The NHS issued a breach of contract notice. Three infringements would mean that Churchill's GPs lost the right to practice.
In the documents, an unnamed NHS director leading the probe said: "I could draw no conclusion other than that you subsequently selected 48 vulnerable people for removal from your list of patients because of their demands on your practice's services and this by virtue of their age, medical condition or level of disability."
Local GPs told the Surrey Comet, which obtained the documents, that "patient care must not become a pawn in these processes".
The case became a cause celebre in the NHS because critics of the health reforms said that giving GPs power over budgets would see family doctors attempt to save money by dodging their responsibility to patients – by excluding the most sick and expensive.
When contacted, Alessi, who left Churchill this year to take his role at NAPC, said that the local primary care trust had "changed the contract and cut the money. We felt we could not deliver the care required any more and patient safety was our concern. So the decision was taken. I think that the contracts in the new NHS will be much better than these."
Labour's health spokesman, Andy Burnham, who has long warned of the possible consequences to patient care of the reforms, said: "It is simply unacceptable for vulnerable patients to be treated in this way. One of our biggest concerns is that the new system weakens accountability in the NHS and makes situations like this more likely as the public are less able to challenge it.
"The government must ensure that the full implications of these findings are communicated to all clinical commissioning groups to ensure there's no repeat of this outrageous practice."
In a statement, Churchill said it was "disappointed" with the NHS conclusions. "The decisions taken by the practice were all taken in good faith after the practice made attempts to communicate and get assent to the actions proposed. These events took place after a protracted and polarised contractual dispute between the practice and the PCT, and at a time of transition … The practice believes that these were significant contributory factors to events as they unfolded."
A spokesperson for NHS South-west London said: "We've issued a formal notice to the practice which states that they can't repeat the activities that have put them in breach of contract, and we continue to monitor the practice closely. We took action to ensure that all of the affected patients from Kingston Care Home were allocated a new local GP as soon as we were alerted to this issue, to ensure that their health needs continued to be met."
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