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UHE awarded GMS contract: not a popular decision

Lynn Young
Primary Healthcare Adviser for the RCN

Summer 2006 is heading towards autumn 2006 far too quickly for my liking, and with this great speed there is more news to share on the general practice front.You may have read about the problems in North Eastern Derbyshire PCT, where an independent company - United Health Europe (UHE) - was awarded a contract to provide general practice services in two villages. Previously the service was provided with a personal medical services contract and the PCT had great concerns regarding the poor standards of care offered to patients.

In line with the white paper - Our Health, Our Care, Our Say(1) - the PCT invited a number of potential providers of general practice services to tender for the business. Apparently a significant number of bids were sent to the PCT, which, after due consideration, decided to award the contract to UHE. A number of local people were not pleased with the decision and a patient, Pam Smith, complained that North Eastern Derbyshire PCT had failed to properly consult local people before awarding the contract to UHE. The legislation used by Ms Smith to obtain a judicial review was under section 11 of the Health and Social Care Act 2001, which demands that there must be proper public consultation regarding changes to be made to local health services.

The case involved the PCT and Secretary of State, who argued that they had acted in accordance with the legislation because the new contract with UHE was not about the development of new services, but simply the same services being provided by different personnel. Pam Smith made the case that the legislation did apply because patients were concerned about future service provision. The judge declared that PCTs have a duty under section 11 to consult with the public and in this instance had failed to do so, but that there was not a duty to consult personally with Ms Smith as a patient. Consultation should have taken place with the local patient forum. The verdict proved to be somewhat strange as Ms Smith won her legal argument but lost on her approach to the judicial review, which resulted in the PCT being ordered to pay 75% of Ms Smith's legal costs.

The point is that as the Our Health, Our Care, Our Say policy digs deeper into traditional general practice, and competitive tendering spreads throughout primary care, people need to be better informed of meaningful consultation. Clearly local patient forums must be involved, and if major changes are to be made then the overview and scrutiny must be considered in the consultation process.

So now that the judge has made his decision, UHE has been given the go-ahead to take over the general practice services in North Eastern Derbyshire PCT. It will be interesting to learn how progress is being achieved and whether the standards of care for local people begin showing genuine improvement. In the meantime, Care UK has been awarded a contract in Essex to provide general practice services to a previously poorly served area and also a walk-in centre. Such action is just the beginning of things, and as 2006 comes to a rapid end and another year begins, it is likely that the number of alternative providers of general practice and community services will increase enough to become the norm.

On the other hand, and who knows at this point, PCTs could remain as the major providers of community health services and traditional general practice the most popular option. The English government has opened the door to market forces and competition in primary care, making new opportunities possible for a whole range of different providers. UHE, Care UK and Chilvers McRae have certainly started the ball rolling, and it will be fascinating to see how diverse provision becomes in the future.

Reference

  1. Department of Health. Our health, our care, our say. 2006.