Independent sector treatment centres, which have provided controversial private treatment for NHS patients, face an uncertain future as the NHS weighs up whether it can afford to continue paying for them.
The privately-run centres have provided more than 1.7m operations and other procedures since 2005. But they have been criticised; the first wave of five-year deals, due to end next year, gave private providers guaranteed volumes of patients and higher prices than those in the NHS.
Earlier this year, Professor Allyson Pollock, of the University of Edinburgh, who has been fiercely critical of the centres, published an article in the British Medical Journal saying no contracts should be renewed, and no new contracts should be signed until a proper independent evaluation was carried out of "actual treatments carried out, and payments made for work done along with value for money analysis".
Today, the government announced changes to the way contracts for the centres are awarded. New services will be commissioned by local primary care trusts and existing contracts wil be reviewed "on a case-by-case" bases. The centres will also be paid under the same pricing arrangements as NHS providers and services will be delivered under the same terms as those used by NHS providers.
Health minister Mike O'Brien said greater local control would enable the services offered by the centres to be integrated into local NHS plans. The changes will take effect in the next batch of contracts, due to be advertising from next month.
But he also revealed, in a newspaper interview, that as existing contracts expire, the NHS is likely to have to pay about £200m for operations that it agreed to buy but has not used, and another £200m to buy back premises built by the private sector operators.
