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five politically-connected healthcare giants have profited from a share of public contracts worth at least £70 billion – despite a murky history of scandals and regulatory violations, a new report reveals.
Corporate Watch, a corporate-critical grassroots research organisation, spent several months delving into government procurement data on Bridgepoint, Bupa, Centene, Spire, UnitedHealth Group (UHG) and their myriad of subsidiaries.
In partnership with Good Jobs First, researchers targeted these companies because all five are members of the Independent Healthcare Providers Network – a lobbying group with close links to Rishi Sunak’s post-pandemic Elective Recovery Taskforce, which has effectively ‘turbo-charged’ private healthcare capacity.
During the past 10 years, these firms won a share of public health and social care contracts with a combined value of £70.59 billion, with serious questions also emerging about the opacity of reported contracts, as well as the integrity and reliability of the data made publicly available.
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Between 2013 and mid-2023, £61.87 billion of this overall total was awarded without a breakdown of how much money each of the winning bidders were paid. More than one-fifth of contract award notifications did not even report a total value, meaning that the true figures could be far higher.
Other significant obstacles to reporting included missing details related to the extension of existing contracts, inconsistent figures across datasets, and a lack of uniformity in the way data was presented.
Even so, the length of awarded contracts appears to have been increasing over time, as the Conservative administration has sought to ‘lock in’ privatisation, with some tenders set to run for up to 15 years.
Corporate Watch and Good Jobs First uncovered a plethora of financial scandals and violations of patient and worker safety.
In particular, corporate giants Centene and UHG have faced hefty penalties for defrauding patients and public healthcare systems in the United States, where both are based, including to settle allegations of overcharging for Medicare, a US Government health insurance programme, through duplicated or inflated claims.
Perhaps the most egregious scandal to have engulfed any of the UK-based companies targeted in the report was the case of Ian Paterson – a former breast surgeon currently serving a 20-year prison sentence for performing unnecessary or unapproved procedures on more than 1,000 cancer patients at Bupa and Spire hospitals in the West Midlands, with a further 1,500 victims discovered on an old IT database in February 2023.
After his conviction in April 2017, Spire released a statement saying that “what Mr Paterson did in our hospitals… absolutely should not have happened” and expressing “how truly sorry we are” – only to then sue the NHS four months later for allegedly failing to warn it of his conduct. That action came just weeks after the firm was sued by hundreds of Paterson’s patients, who claimed Spire had allowed the surgeon to continue work well after his 2012 suspension by the General Medical Council.
Meanwhile, Bridgepoint subsidiary Care UK has been repeatedly slammed for cost-cutting at the expense of both staff and patient welfare. In 2022, it was fined more than £1.5 million after a resident choked to death.
Similar criticism has been levelled at Bupa, with its UK care facilities variously described over the years as “disgraceful”, riddled with “systemic failings”, and sources of “serious concern”.
In Australia, the 2019 death of an elderly cancer patient, admitted to hospital with maggots crawling in an open and fungated ear wound, saw the firm’s CEO forced to “unreservedly” apologise for “totally unacceptable” shortcomings in its aged care network.
The list of top executives and shareholders at each of these firms are politically-connected figures.
When the Government announced the launch of its Elective Recovery Taskforce in December 2022, it was little surprise that David Hare and Jim Easton had seats at the table. As chief executive of the Independent Healthcare Providers Network, it is Hare’s job to represent the interests of firms including Bupa, Centene, Bridgepoint and UHG at Westminster; while Easton previously held several senior NHS positions before becoming CEO of Practice Plus (a Bridgepoint subsidiary) in 2012.
Care UK co-founder John Nash, and UHG’s former head Simon Stevens, who was chief executive of NHS England between 2014 and 2021, join the ranks of at least 16 members of the House of Lords who have at various times declared interests in the companies featured in the recent report.
The wife of Conservative Health Minister Neil O’Brien also currently acts as GP engagement lead for Centene subsidiary Circle Health, while former Tory MP Mark Simmonds has previously worked as a strategic advisor at the firm.
COVID-19 appeared to provide the context for the Government to accelerate a policy of privatisation stretching back over decades. As demand for private treatments slumped, private healthcare providers were given publicly-funded bail-outs – which available evidence suggests actually did little to benefit the NHS or its patients. Significant financial commitments have now been made, either through the issuance of new awards or the inflation and extension of existing arrangements.
The paucity of publicly-available data on these commitments, alongside the list of scandals and regulatory violations, compiled by Corporate Watch and catalogued on Violation Tracker UK and Violation Tracker, raises serious questions about the Government’s decision to entrust the provision of public healthcare to these five companies – themselves just a small handful among hundreds of other firms being awarded contracts, with little competition.
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