The bill for the NHS in Scotland's use of private hospitals during the pandemic has risen to more than £30m.

The Scottish government has refused to say whether the deal with independent hospitals to treat NHS patients is still on a not-for-profit basis, as it was at the start of the pandemic.

A total of £30.6m has been paid up to March 2021, according to figures released in response to freedom of information requests, while a contract notice posted online suggests the overall amount may approach £40m.

Trade Union UNISON said services were better provided ‘in-house’ by the health service but said this had to be balanced with the “real concern that the NHS would be overrun” in the early days of the pandemic.

The Scottish government programme of sending patients to independent hospitals for treatment started in the first wave of the pandemic, as a way of allowing the most urgent surgery to go ahead in facilities that were not also treating covid-19 patients.

Activity was restarted in January when the number of virus patients in NHS hospitals began to climb again.

healthandcare.scot asked the Scottish government for details of activity in private hospitals during the pandemic, as well as how much was paid for these services.

During the first wave of the pandemic, NHS Lanarkshire sent more patients for outpatient appointments in private hospitals than all other health boards put together.

Between March and September 2020, nearly 5,000 Lanarkshire patients were sent to Glasgow’s Nuffield hospital, compared to 1,400 for all private hospital referrals across six other boards.

Between them, NHS Lanarkshire and NHS Grampian accounted for nearly two-thirds of the 4,300 patients sent for surgery over the same period.  

Judith Park, NHS Lanarkshire director of acute services, previously told the Glasgow Times newspaper the board had faced a higher proportion of covid-19 cases than elsewhere in the country and procedures had to be diverted for “safety reasons”.

She said: “To ensure our clinically urgent patients could be diagnosed and treated as soon as possible, we approached the independent sector for additional surgical and outpatient capacity. This also allowed us to focus our efforts on covid-19 inpatients and emergency care.”

Activity was spread more evenly across different health boards during the second wave of the pandemic.

Figures covering October 2020 to March 2021 reveal NHS Ayrshire & Arran sent the most patients for private treatment, with 348 day case surgeries carried out at BMI hospitals, out of a country-wide total of more than 1,100.

There were more than 600 inpatient surgeries over the same time frame, with NHS Grampian and NHS Greater Glasgow & Clyde each accounting for a quarter of that total.

According to the Public Contracts Scotland website, the contract with private healthcare groups has a value of £36.7m.

The Scottish government said the spend so far had been around £31m but suggested the final cost would higher. 

Publication of details of who had been awarded the contracts had been delayed due to “resource constraints” during covid-19, the notice states.

BMI hospitals have received nearly £16m from the Scottish government for treating NHS patients during the pandemic, according to figures released under freedom of information.

Another £9m has been paid to Spire Murrayfield and £6m to Nuffield Glasgow.

Last year the Scottish government told healthandcare.scot that a not for profit arrangement had been agreed with all the private hospitals supporting the treatment of urgent elective NHS patients.

A spokesperson refused to confirm whether this was still the case, stating: “We are making use of the independent healthcare sector, including operating theatres, outpatient rooms and the full spectrum of diagnostic capabilities, to perform vital cancer and elective surgery within a covid-free environment. This decision was made with the goal of saving lives.

“The final cost of NHS patients being treated through the independent sector will be determined by factors including the number of beds reserved and the number of procedures carried out.”

Willie Duffy, UNISON head of health, said: “All our NHS services are best provided in the public sector, even in a pandemic. This is the best for patients and staff.

“We are seeing a number of problems where the private sector are more expensive than keeping service in the NHS – the vaccination programme for example is paying private contractors substantially more than what we are paying NHS staff to do the same job.

“This £40m paid to private hospitals would have paid for over 1000 extra NHS nurses, or millions of extra vaccines.

“However, we do have to balance this with the fact that in a pandemic the NHS needs to increase its capacity – and protect itself from surges in demand. At the beginning of the pandemic there was a real concern that the NHS would be overrun and we needed to do everything we could to ensure that did not happen.”

 

Read more: Cancer patients sent private to ease pressure on NHS; NHS spending millions on private beds in covid deal; Fears over “forgotten” diagnostic test backlog

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