Past experience of outsourcing health services to private care providers has been less than satisfactory for Cornwall as the following instances show. Despite that, The Royal Cornwall Hospital Trust and the Kernow Clinical Commissioning Group continue to press ahead with privatising services.
SERCO out-of-hours service for Cornwall
SERCO was accused of falsifying NHS records with regards to its £32 million contract to provide out-of-hours service in Cornwall. A report by the National Audit Office refers to a ‘forensic audit by Serco’, covering every interaction which passed through the switchboard between January and June 2012, found that two members of staff made 252 unauthorised changes to performance data. This represented 0.2 per cent of all interactions with patients during the six-month period. The same report states that during 2012 Serco ‘regularly had insufficient staff to fill all clinical shifts. It also frequently redeployed some GPs, taking them out of the cars available for home visits and using them to cover clinic shifts instead’.
In July 2012, the Care Quality Commission reported that the out-of-hours service did not have enough qualified, skilled and experienced staff to meet people’s needs. An inspection in December 2012 by the Commission found that, although the number of clinical staff had increased, Serco needed to take further action because there were not enough health advisers who handle incoming calls.
A later report by the House of Commons Public Accounts Committee highlighted ‘a culture of bullying’ which ‘inhibited whistleblowers from being open in the patients’ interest. MPs on the committee also criticised the NHS Cornwall and Isles of Scilly PCT, saying ‘it did not have the appropriate skills to negotiate with private providers’ and its chair Margaret Hodge added: ‘Even when it knew that Serco staff had massaged the figures, the trust did not fine the contractor or terminate the contract. The failures in this contract matter, because the NHS will be making increasing use of private and voluntary providers to deliver NHS services' .
Serco later lost the contract to Two GP provider companies, Cornwall Health and Kernow Health, who launched the new out-of-hours on 1 June. Cornwall LMC which had led the bid for GPs to take on the service amid a number of safety concerns. GP-led social enterprise Devon Doctors, which already runs the Devon out-of-hours services, is behind Cornwall Health, while Kernow Health has been launched by Cornish GP practices as a community interest company.
MITIE is a FTSE 250 company which took over the cleaning and catering at acute hospitals in Cornwall. It was awarded the contract despite the fact that the in-house services – formerly part of the NHS – were assessed as one of the most cost effective and of the highest standard compared to similar sized hospitals in the South West. One of the board trustees, Mr Rik Evans, also warned the board about MITIE’s poor track record with regard to performance and staff relations. His concerns have since been born out by BBC investigations which document a dramatic rise in service failures. According to the latest BBC report of 28th July 2015 Mitie had more than a thousand service failures at the Royal Cornwall Hospitals Trust (RCHT) in May, up from 200 in April.