Outrage growing over 'stealth privatisation' of Islington GP surgeries

Both Mitchison Road Surgery in Canonbury, and Hanley Primary Care Centre in Hornsey are run by AT Medics, but ownership has been transferred to Operose - a subsidiary of American giant Centene.

Hanley Primary Care Centre in Hornsey (Image: Google)

The arrangement went to the primary care committee in common (PCCC) for North Central London for agreement.

In a meeting with Islington councillors, Clare Henderson, director of integration at North Central London clinical commissioning group (CCG), said that there was “no legal or contractual basis” to reject the request for transfer of ownership.

Health chief Cllr Nurullah Turan revealed he had been told that following legal advice from NHS England, the CCG would have faced a “very high risk of legal challenge” had they done so.

Both the CCG and Operose/Centene have stressed that there will be no change in service for patients, with the same staff remaining on site and contracts “essentially unchanged” at the two Islington surgeries, both of which hold a ‘good’ rating from the Care Quality Commission.

Addressing Henderson at the meeting, Cllr Tricia Clarke said: “AT Medics has 370,000 patients across London.

"It is a big deal, and it is being called a stealth privatisation.

"I wrote to the CCG and to Matt Hancock, from whom I’ve had no reply, but had a reply from the CCG saying that the patients won’t notice any difference.

“I thought that was really patronising. There was no patient consultation, no public scrutiny of this deal, and I can see why you did that, because the outrage is growing.

“It’s here in this meeting. It’s going to be at the joint health overview and scrutiny commission, all the local papers – there is an outrage about people having their medical records handed over to this huge American insurer.

“[What people] are asking is for these contracts to be terminated and let’s have some consultation.”

Henderson said in return that she “absolutely accepted” Clarke’s points, while remaining “not sure [she could] particularly respond very well to that”.

Cllr Turan made clear that the administration at Islington consider the “main perpetrator” of the change not the CCG itself but the government for “paving the way for privatisation” through the Health & Social Care Act 2012.

Cllr Martin Klute quizzed Henderson on what level of local scrutiny and redress was possible should services begin to suffer, or if priorities were shifted at the two practices to see more patients virtually rather than in person, given that the owners of the practices are outside UK borders.

Henderson responded: “If the services started to suffer, these contracts are still held, we still manage those contracts, and CQC continues to regulate these services.

Klute went on to press Henderson on what recourse lay available to local systems if the surgeries’ operators “frankly out of commercial interest” sought out a preference of dealing with younger, fitter, less medically vulnerable people, and if councillors began to notice that the practices’ patient profile “had mysteriously got younger”.

Henderson responded: “It is a challenge. Previously we used to have boundaries within which patient lists sat, and now because of patient choice, practices can register patients who are not from Islington, for example, so the Babylon-type service that was talked about a lot a couple of years ago in Hammersmith, which does offer a digital or a telephony service to younger people.

“To be honest, there is not a huge amount we can do about that if practices do extend their list and register more patients from out of area for example. What we do is work very closely with practices to make sure lists are managed and kept up to date and that access for all patients is maintained.”

Hammersmith & Fulham CCG ran up an over-£20m deficit in May 2019 after tens of thousands of people signed up for Babylon’s GP at Hand app based out of the borough.

Klute called Henderson’s response “not terribly encouraging”.