PCTs are now carrying out tendering exercises for new GP led health centres, Polyclinics, Urgent Care Centres, GP surgeries, physiotherapy, radiology etc. etc. The costs are enormous and yet nobody can say how huge they are.
For example a PCT has to stage a tendering exercise for a GP led health centre. There are 50 applications for the first stage, each submitting a 70+ page document. Once these are analysed, a process taking up to 2 months, a short-list of, say 5 are invited to submit a final, much longer tender. Many of these applications are from local GPs who will, on the whole complete the applications themselves either on days off, or considering the amount of time required, by taking time out from when they would normally be seeing patients. They may have to employ locums to see their patients, or at even greater cost they could employ someone to write the tender for them. The overall cost to a GP surgery can be in the region of £40k plus all the additional human costs in terms of patients being unable to see their own doctors, lack of senior clinical support, weekends and evenings away from families and so on. And at the end of this, only one bidder will win the tender. For a small business, as most GP surgeries are, tendering is far too great a risk. They simply can’t afford the financial or human costs.
The cost to the PCT for a tender such as this is unknown. Unofficially I’ve been told it us up to £3 million. I’d be very happy to see evidence to the contrary. This is £3million that could have been spent on front line staff; there are still desperate shortages in many areas. Most PCTs are being forced to carry out several tenders a year with millions of pounds going on administration. Meanwhile thousands of hours of clinician time are taken away from patients as GPs struggle to keep services in the hands of people who are still committed to the NHS.
Once a GP practice has lost a tender or 2, bidding will become financially unviable and the costs to existing patients unacceptable. Soon only massive private companies will be bidding, and, given enough time there will be a handful of corporate interests running NHS primary care. More and more money will be swallowed up on administration and transaction costs and less and less on caring humans.
We already have the most parsimonious universal healthcare in the world, and yet it is possible to make it more efficient by ending the market driven reforms, not by forcing more.