In what amounts to a fairly prolific series of blogs condemning the Conservative assault on the English National health Service (NHS), I have bemoaned their clandestine advance planning, their ideological subversion, the calculated politics of austerity from 2010-2020, and the two Health and Social Care Acts of 2012 and 2022 (the first of which left the door ajar for private providers of services, and the second of which is opening that door wider). This blog addresses one aspect of private provision in the form of the advance of Centene/Operose Health.
Operose was formed early in 2020 when the American company Centene Corporation brought together its UK subsidiaries, The Practice Group (TPG) and Simply Health. TPG had been acquired by Centene in 2016. In January 2020 Centene had increased its stake in UK-based health care by investing in Circle Care (a 40% stake according to Company House).
In February 2021 Operose Health acquired AT Medics and its considerable number of GP surgery contracts in London. Previously owned by six GP directors, AT Medics had been operating 49 GP practices across 19 London boroughs, providing services to around 370,000 people, with 900 employees. AT Medics was subsequently taken over when its directors resigned and were replaced by Samantha Jones (CEO of Operose, ex-head of NHS England’s new care models programme, and previously chief executive of Epsom and St Hellier University Hospitals and West Hertfordshire Hospital Trusts), Nick Harding (Director of Operose and formerly Senior Medical Adviser to NHS England for Integrated Care Systems and Right Care) and Edward McKensie-Boyle, Chief Financial Officer of Operose. See a pattern here? A case brought by a patient at an AT Medics surgery protesting the award of dozens of NHS GP contracts to Operose was dismissed by a High Court judge in February 2022.
Let’s pause just here for a moment to consider historical links between Blair and Brown’s neo-Thatcherite New Labour and AT Medics. Under the rubric of ‘modernisation’, ‘partnership working’ and ‘patient/consumer choice’, Blair/Brown actively encouraged initiatives like AT Medics, which was set up in 2004. The six founding ‘doctorpreneurs’ won several contracts under conditions allowing GPs and their companies to run publicly funded GP surgeries and to employ doctors. Patients did not pay fees but ‘GP consortia’ companies could profit from public NHS funds to run GP surgeries. So it was New Labour who pioneered new business models that the Conservatives were to develop post-2010 and refine post-2020.
At present (June 2022) the Operose Health website lists contracts for 20 GP surgeries, plus one treatment centre in Birmingham (plus nine ophthalmology services). This website also now lists the contract for AT Medics to provide the out-of-hour services for all of Croydon and some of the South-West London Clinical Assessment Service. With the addition of the AT Medics contracts, the company will have 69 GP surgeries and become the largest GP surgery network in the UK.
Samantha Jones (see above) has now apparently left Operose to become health adviser to PM Johnson, her title and brief being expert adviser for NHS transformation and social care delivery; she will work in the policy unit.
A well-advertised BBC Panorama programme shown on 13 June 2022 drew on the research of an undercover reporter, who found that Operose employees less qualified – and cheap – US-style Physician Associates (PAs) to see patients without adequate supervision. Reports from administrative staff confirmed that some correspondence had not been processed and seen by a GP or pharmacist for up to six months. The undercover journalist working as a receptionist at one of the company’s 51 London GP surgeries quoted a GP as saying that they were short of eight doctors and that the practice manager said they hired the less qualified PAs because they were ‘cheaper’ than GPs.
This new model of health care provision represents an explicit abandonment of the principles on which the NHS was founded. No longer is the NHS insulated from the profit motive. Centene/Operose are in it make money and they and their like are permeating our health care system with the blessing and encouragement of the Conservative government.
What we are seeing is the rapidly accelerating destruction of the NHS in favour of the much inferior modes of health and social care provision that have long since contaminated American society. Unapologetic pro-capitalist Conservative and New Labour governments have since the 1980s been ready to jettison the NHS; and Starmer’s New New Labour appears to be no different.
At present the awful but realistic prognosis must be that we are heading for a two-tier health system, providing a bleak safety net for the poor and co-payments and top-up insurance policies and fees for the more affluent. We will all be losers of this barbarianism is realised, and we are already far beyond the tin end of the wedge..