The announcement that Circle Health is to become the first private company to take over an NHS district hospital was greeted with apprehension, if not alarm, in many quarters – as was to be expected. Not only do NHS hospitals occupy a special place in the UK population's heart – witness the campaigns to save them when they are threatened with closure – but the awarding of the contract to Circle was seen by many as proof that the Government's NHS reforms are all about privatisation of medical care along dreaded American lines.
Such a knee-jerk negative response is misguided. The hospital concerned, Hinchingbrooke in Cambridgeshire, has hardly prospered – in any sense – under NHS management. Nor can the NHS be hailed as offering, always and everywhere, a cast-iron guarantee of exemplary medical practice and humane treatment. As the inquiry into the deaths at Stafford Hospital showed – and subsequent inspections across the country have confirmed – the health service has serious flaws. Some health authorities have also run up long-term debts by unwise use of Private Finance Initiative agreements, which have delivered expensive and not always suitable new buildings.
If Circle believes it can do better – and some of its existing ventures give cause for hope – it should be allowed to try. If it succeeds, its model should inject some much-needed new thinking into NHS hospitals. Treating patients as 21st-century consumers expecting decent standards of service would be a respectable start. If it fails, the Government will have no alternative but to review key aspects of its reforms.
The difficulties of reforming the NHS are formidable – not least because of the vested interests that are threatened. But there are obvious pitfalls that must be avoided, and they include the sort of accountability gaps that have emerged at the UK Border Agency and in other places where there is arm's length government. Contractual lines of responsibility must be made absolutely clear. If Circle fails at Hinchingbrooke, ministers, taxpayers, staff and patients all deserve to know exactly where, and with whom, the fault lies.Reuse content