Tuesday, April 06, 2010

Circle Health

Circle Health claims to be a different type of company, and has been proclaimed as basing itself on the “John Lewis” model of “partnership”, with 2,000 clinicians. But half of the company is owned by big financial institutions, and this is the source of the funding for a planned network of 30 new hospitals at a cost of almost £1 billion (Times Online).
Its brand new £30m showpiece hospital in Bath, lavishly spacious, designed by Lord Foster ‘s team and feted by the media for its innovative design, has just 28 beds – less than 10% of the capacity of a very different hospital in Hinchingbrooke, and of course has no facilities for emergencies or for patients with complex medical or surgical needs. And while Circle’s boss Ali Parsa, an investment banker, talks a good talk, there is no evidence that his company – accustomed to the generous budgets and relaxed, stress-free environment of private medicine – is capable of managing anything on the scale of an NHS general hospital.
Their website also confirms that Circle has no real grasp or experience of a busy and pressurised hospital environment. The company is aiming to open”surgical clinics and GP centres” where its surgeons can perform consultations and procedures that do not have to happen in a hospital setting in specialities such as dermatology, ophthalmology, ENT and plastic surgery. This, claims Circle, “drives down the price of healthcare by avoiding the unnecessary infrastructure of a hospital”. In addition, Circle says it will offer “services such as diagnostics, chronic disease management and post-operative homecare” through a mobile infrastructure and in peoples' homes. Again no evidence of appropriate experience in running a large and complex hospital.
Nor does Circle’s track record with NHS care inspire any confidence: in 2007 Circle Health took over Nations Healthcare, a company running three “independent sector treatment centres” with NHS contracts (Eccleshill in Bradford, Burton and Nottingham). Nations had been the company in charge of Eccleshill when a patient, Dr John Hubley, died after surgery because the centre did not keep any emergency supplies of blood on site. The scandal was exposed on BBC’s Panorama, and the coroner said at the inquest on Dr Hubley that he would most probably have survived if his operation had been carried out at Bradford Royal Infirmary, describing the centre’s policies as “Mickey Mouse”.
The takeover by Circle may have changed the management structure, but it has not substantially increased the performance of the treatment centres, which have delivered well short of the level of treatment stipulated in their £324m worth of NHS contracts. According to the latest official figures (April 2009) the Nottingham Treatment Centre was running at just 72% of contract, Burton at 76% and Eccleshill at 87%, leaving Nations 25% below contracted activity – equivalent to £82m of taxpayers’ money for treatment not delivered.
But at the end of last year, the local paper reported that Circle’s Barlborough Treatment Centre had delivered just £41,000 worth of operations in exchange for guaranteed payments of £791,000 in 2009, and had delivered just £4m of work for a £9m contract, to expire this year. (Nottingham Evening Post November 13).