Private equity is a horror story for the NHS – yet one fifth of the health service budget goes to it

The latest data shows the NHS privatisation agenda successive governments have pursued writ large. Privatised NHS services now treat around 10% of patients, compared to 3% in 2011. Crucially, there are around 59,000 private contracts in the NHS – with many giving profits to private equity. The cost of these to the public purse is around £29bn a year – nearly one fifth of the entire NHS budget.

This trend has continued in 2024 with the Labour government overseeing a £1.3bn sale of community services across Bath and North East Somerset, Swindon and Wiltshire to private equity firm HCRG Care Group, formerly Virgin Care.

There are various studies that demonstrate that private equity-controlled healthcare services are not only expensive, but dangerous.

NHS privatisation leads to ‘preventable deaths’

There have also long been warnings from the US. In a recent case in May 2024, Steward Healthcare filed for bankruptcy, leading to closure of facilities nationally and disrupting care for thousands of patients. It cited debt and operational difficulty.

David Schildmeier of the Massachusetts Nurses Association said:

Steward’s focus on profits and its desire to expand its empire nationally and internationally resulted in chronic short staffing, lack of maintenance of equipment and an ongoing shortage of supplies that delayed patient care

He further pointed out that the privatised model:

contributed to substandard care and preventable patient harm, including significant deaths.

Research backs the view that private equity poses a risk to healthcare outcomes. BMJ research looked at 55 studies across eight countries, with a focus on private equity healthcare in the US. It found that such ownership was “associated with mixed to harmful impacts on quality” and in some cases “was associated with reduced nurse staffing levels or a shift towards lower nursing skill mix”.

Private equity was also “most consistently associated with increases in costs to patients or payers”.

This is not an simply an issue across the Atlantic. The evidence suggests privatisation is already impeding on healthcare outcomes in the UK.

Research from Oxford academics found that increased NHS privatisation might have led to 557 excess deaths from 2013-2019. And it looks like this pattern has only continued. The NHS paid out a record £175m over the last five years in compensation and legal fees after private providers carried out botched procedures leaving people dead, needing amputation, more surgery or in unnecessary pain.

Even more private provision in NHS mental health

When it comes to mental health, 13.5% of the NHS’ budget goes to private providers. That’s £2bn every year – more than double the £951m in 2005. In a clue that this is complete profit extraction, NHS patients occupy nine out of every ten private mental health beds. Likewise with the rest of private healthcare, the government should nationalise these services.

And there are further signs of profit-seeking leading to worse health outcomes. A 2022 Sky News investigation into five mental health hospitals that private equity-owned The Huntercombe Group ran reported on allegations of youngsters ‘treated worse than animals’, with complaints of over-restraint and inadequate staffing. The allegations stretch back more than a decade.

Featured image via The Telegraph – YouTube