The government has broken more than 50 years of ideological tension between the NHS and private hospitals by signing a long-term treaty with the independent sector to establish joint planning and exchange of patients. The deal is expected to lead to about 100,000 more NHS patients being treated free of charge in private hospitals and nursing homes, often by teams of doctors and nurses working under their normal NHS contracts.
It was broadly welcomed by doctors and health service managers as a pragmatic move to treat more patients more quickly by using spare capacity in the private sector, currently working at about 50% capacity.
But it provoked hostility among Labour backbenchers and the health unions whose support is needed by ministers to push through plans to modernise and expand state sector provision.
David Hinchliffe, Labour chairman of the Commons health select committee, said Alan Milburn, the health secretary, should not have "got into bed" with the private sector. "Giving comfort at a time when it is known that the private sector is struggling is not something that I would expect a Labour government to do," he said.
Tony Benn, the veteran Labour MP, said the deal was tantamount to privatisation of the NHS. "The NHS is run down for lack of money, so you bring in the private sector. Once you have done that, why not make it all private?"
Unison, the health service union, said any concordat with the private sector could only be justified as stopgap politics until the NHS had sufficient capacity to manage on its own.
The concordat was signed by Mr Milburn after four months of negotiations with the Independent Healthcare Association. It will encourage all health authorities to build on informal arrangements already operating in some areas.
Department of Health sources said the NHS spent £1.25bn in 1998/9 on contracts with the private sector, worth 4.6% of the NHS budget. This paid for about 350,000 operations.
The new concordat was expected to boost this by about 100,000 operations a year, but the private sector would remain a minor player compared with the 6m performed by the NHS.
Mr Milburn emphasised: "The patient will remain an NHS patient, the doctors will be NHS doctors, by and large the nurses will be NHS nurses and, of course, most importantly of all, the care will remain free."
The concordat covers:
• renting spare operating theatres from the private sector for hip operations and other elective surgery by NHS doctors and nurses working under their normal NHS contracts;
• commissioning private or voluntary sector hospitals to provide elective care, using their own staff;
• agreements for transfer of critical care patients between sectors, reducing the number of cancelled operations;
• joint work to develop intermediate care to improve preventive and rehabilitation services;
• sharing information on workforce supply and demand, clinical mistakes and local health improvement strategies.
