Wednesday, 11 May 2016

Prison Healthcare Privatisation

Anyone who has dealings with prisons or prisoners here in the UK will have lots of horror stories regarding healthcare within the system. Rather naively many of us, including myself, thought that things would improve when responsibility passed from the Prison Service to the NHS in 2002. It didn't of course and now that privatisation is almost complete, are we confident that things will improve? This from the Financial Times:-   

Care UK becomes biggest jail healthcare provider in Britain

Care UK has become the biggest provider of prison healthcare in Britain after winning a further 21 contracts, as more National Health Service trusts hand provision of key services to the private sector. The deals, which started in April and run for five years, mean that the private equity-owned group will be working in 31 jails across the country. The deals are worth £50m a year in total and involve the transfer of about 700 employees to the company.

“Over the past few months we’ve worked closely with NHS England and our partners to ensure a seamless transition from the incumbent providers,” said Ross Dowsett, a manager at Care UK.

The deals underscore the piecemeal nature of healthcare outsourcing. With the Department of Health expected to trim billions of pounds from its budget during the next few years, the number of NHS workers transferred to the private sector has accelerated, with everything from community hospitals to individual services such as pathology, sexual health or dentistry being put out to tender. According to LaingBuisson, the industry analysts, the market for out-of-hospital services could be worth £10bn to £20bn a year.

David Hare, chief executive of the NHS Partners Network, which represents independent sector providers, said he expected the market to “continue to evolve at a steady pace”. The market is patchy but continues to develop. The NHS continues to draw on the independent sector and where the outsourcing is well researched and developed you tend to see good results.”

The engagement of the private sector in the NHS remains controversial, with doctors holding anti-privatisation placards during recent protests against changes to their pay. A healthcare conference attended by private sector suppliers in London last week was also disrupted by campaigners. Nor have all private sector ventures in the NHS proved profitable, while contract blunders have undermined industry confidence.

In December, one of the biggest NHS contracts for patient services, covering parts of Cambridgeshire and Peterborough, collapsed after only eight months because it proved financially unsustainable. Earlier in the year Circle Holdings, the Aim-listed company, pulled out of its contract to manage Hinchingbrooke Hospital in Cambridgeshire only three years into its 10-year deal. Hinchingbrooke had been the first to be handed to private sector management and dashed the hopes of those who wanted more private sector takeovers of Britain’s state-run hospitals.

Justin Crowther, head of healthcare at Catalyst Corporate Finance, said that the prison healthcare deals illustrated the significant flow of opportunities for the private sector but added that the market remained challenging for companies wanting to provide services for the NHS.

“The market certainly hasn’t died a death. But while opportunities for the private sector still exist and in some cases are still growing, the time, resource and cost associated with bidding for contracts can be substantial and economic returns uncertain. On top of this, there is the political risk inherent in the relationship between the NHS and private providers.”

Outsourcer Serco faced losses on a series of contracts including a £140m deal to provide community healthcare including specialist nursing, children’s services and speech and language therapy in Suffolk. Mitie, the FTSE 250 outsourcer, has also reported that its new homecare business, which provides support for the ill, disabled and the elderly, is less profitable than expected and that it is struggling to recruit and retain sufficient numbers of care workers. Other providers of healthcare services in prisons include G4S and Virgin Healthcare.

The National Offender Management Service handed responsibility for the provision of healthcare services in prisons to the DoH in 2002, with responsibility delegated to local health commissioning boards four years later.


Who the hell are Care UK? This from wikipedia:-


The company was formed as Anglia Secure Homes in 1982, becoming Care UK PLC in 1994. In 1997, the company acquired Care Solutions Limited, a learning disabilities provider responsible for 59 homes in Newcastle, Bradford, Staffordshire and Guildford. In 1998, it took on a further 7 care homes in Hampshire and the south coast with the acquisition of The Care Partnership.

Care UK delisted from the stock exchange in 2010 following a management buyout. Since 2010 its major shareholder has been Bridgepoint Capital. It bought Harmoni in 2012 from ECI Partners for about £50 million. In January 2014 it was announced that Philippa Slinger, the former chief executive of the troubled Heatherwood and Wexham Park Hospitals NHS Foundation Trust is to join Care UK. Since the Health and Social Care Act 2012 came into force in April 2013 Care UK has won three contracts worth £104m. In 2014/5 its turnover was £728 million.


Care UK operates 85 care home facilities for older people as well as supporting over 17,000 older people and those with disabilities through home care services. The company runs 4 clinical assessment and treatment centres (CATS) and 7 NHS treatment centres, offering a range of procedures for conditions such as cataract surgery and hip replacements. In 2011, independent research organisation, Dr Foster, named Care UK as the best performing provider for hip operations.

Care UK also operates 12 GP-led health centre facilities providing walk-in services and a range of specialist mental health services including 18 homes and hospitals and residential treatment programmes for young people who have serious eating disorders.

In 2013 a joint venture with Sussex Partnership NHS Trust was created to purchase a 32-bed mental health rehabilitation unit in Gosport, and to create a 24-bed self-contained accommodation unit later in the year.

The company strategy is to concentrate on the provision of primary and secondary NHS health services. In May 2015 the company sold its mental health assets, consisting of 322 beds, to Partnerships in Care and its learning disability services group to Lifeways Group. In June 2015 the home care service which generated revenue of £72.2 million and looks after approximately 13,000 people across the UK and employs around 6,000 staff members was sold to Mears Group. It is the largest firm providing Out-of-hours services in England services with more than ten million patients.


  1. Very interesting blog thanks Jim for keeping us informed


    1. 13,000 suspected and convicted criminals on run after skipping bail.

      More than 13,000 suspected and convicted criminals facing charges including murder, rape and child sex offences are on the run after skipping court bail, according to information released by the police under the Freedom of Information Act.

      Some forces in England have more than 1,000 outstanding warrants, some dating to the 1980s, for individuals who failed to attend court hearings, figures given to the BBC show.

      As a result, thousands of potentially dangerous and violent criminals remain at large, escaping justice and leaving some victims in fear of further attacks, campaigners warn.

      The Metropolitan police, West Yorkshire police, West Midlands police, Greater Manchester police and Thames Valley police reportedly have the greatest numbers of outstanding warrants.

      According to figures supplied to the BBC following FOI requests, there are 13,492 known warrants outstanding. The broadcaster asked all 39 forces in England to give details of arrest warrants issued by the courts after a suspect failed to attend hearings. Nine forces refused to provide details or did not reply.

      The oldest outstanding warrant related to a man accused of attacking a police constable in 1980. The warrants included those suspected or convicted of fraud, drugs offences, grievous bodily harm, sexual assault, child abuse, rape and murder.

      David Padgett, from the charity Victim Support in Essex, said victims feared reprisals, particularly if the accused had been convicted. Victims could also be concerned the same could happen to others.

      He said: “This can play on how people recover from their crime. It is pretty awful to find out someone has gone on the run. If that person suddenly appeared can you imagine how that would be?

      “Some of these people are accused of some really nasty offences; rapes and grievous bodily harm.”

      The National Police Chiefs’ Council lead for criminal justice performance, DCC Gary Knighton, told the BBC officers based their decision on who to pursue on the severity of the offence.

      Once a warrant is issued it is circulated on the police national computer.

  3. I've frequently commented on the failure of police to respond to an arrest warrant for a lad, been in breach of curfew/suspended sentence, since 21/12/2015! Still no action and I presume Crapita being paid all along!

  4. I can cite a number of examples of HMP Winchester recently releasing prisoners on methadone without having arranged a bridging script, plus those on prescription medication without a few days supply of the tablets. In the case of the prisoner with a heart condition, it was to 'prevent him taking an overdose on release'.

  5. PS And as I generally have to wait 2 weeks for an appt with my GP, how said prisoner with the heart condition was expected to sort that out in short order is anyone's guess.

  6. Prisoner released yesterday with a methadone script HMP failed to inform the local area drug team and he was given a second script the same day-

  7. It is only when NPS and CRC are seperated that we get this unhelpful sense of division and discord. Another consequence of a very flawed TR plan
    All in it together? We should be.

    1. My point a little lonely now Jim has deleted previous entries, but granted they were off topic and not particularly helpful. However, the more general point is about working together, there is real value, not always profit, in working together for the good of all.


    1. Very informative article. Would be good if it was given a higher profile and a mention on the news but sadly the bbc are more interested in crass off the cuff politicians comments and the queen expressing a human emotion! It will all come to light and get coverage once the thinkable happens. I think most of us know this and dread the day.things are not currently safe and it is due to get much worse!