Haringey Keep Our NHS Public
4 September 2024
Background
In 2021, the North Central London Clinical Commissioning Group (CCG) gave permission for eight GP contracts to pass from AT Medics to Operose Health, the UK operation of the giant US Centene. Subsequently, Operose became the owners of a large number of GP practices and the largest single provider of primary care services in England for 640,000 patients.
Scrutiny of the sale by AT Medics to Operose in 2021 by the five London CCGs, was ‘light touch’ at best, and driven by NHS England. There was no consultation with patients, and it appeared little active involvement of the CCGs.
Campaigners supported a legal case for judicial review against the takeover of NHS GP surgery contracts by Operose Health, a UK subsidiary of the Centene Corporation. One of the arguments was the loss of stability for NHS primary care in the hands of a large US-based operative, whose operating priority was profit-taking and who could opt out of the contract at any moment. The judicial review was unsuccessful in 2022.
In July 2022 CCGs were disbanded and Integrated Care Boards (ICBs) were put in place – locally that became the North Central London ICB, one of five ICBs covering the previous CCGs in London’s 32 boroughs.
In August 2023, Operose/Centene announced plans to sell its operations in the UK, because they were not profitable, despite being paid 14% more per patient than AT Medics, from whom it bought 50 GP practices in London in 2021. The sale affects 640,000 patients, including those in sixteen other practices across England.
On 6 December 2023, the London Integrated Care Boards (ICBs) announced that the proposed sale was to HCRG Care Group Holdings Ltd, (known as Virgin Healthcare Holding Ltd until 2021). The majority holding in HCRG is T20 Osprey Midco Ltd, and T20 Pioneer Midco Ltd, in turn owned by Twenty 20 Capital, a private equity company.
Estimates suggested that the sale could raise £51.2m, and Operose had already sold its network of 53 UK hospitals (Circle Health) to Pure Health, a Middle Eastern company, for £948 million.
The sale to Operose/Centene attracted significant opposition then, and patients do not want a repeat of this process. However, there has been a worrying lack of communication from the ICBs about the plans for patients, who first learned of it in the general media.
Campaigners in North London Keep Our NHS Public groups were central to opposition to the sale in 2021 and protested once again at this destabilising rapid re-sale and called on the ICBs to oppose the resale. The decision by North Central London ICB to terminate the Operose contracts under that NCL ICB’s governance was reported in the HSJ 3 September. This amazing victory was welcomed by Haringey KONP in a press release the next day.
Campaigners Claim Victory as GP Contracts Stripped from Private Equity Firm
NHS Commissioners took the decision to terminate all of Operose’s GP contracts in Islington and Camden, having previously ended the contract at Operose’s St Ann’s Road GP Surgery in June.
This comes after North Central London Integrated Care Board (NCL ICB) disclosed that they were not informed, nor gave permission for the takeover of Operose by the private equity firm Twenty20 Capital.
In December, the NHS began a due diligence exercise to consider the proposed change of control. However, while checks were still ongoing, NCL ICB was informed on 15 March the change of control had already taken place nearly three months before, on 28 December. The NHS was not informed of this at the time.
Local campaigners from Haringey Keep Our NHS public argued that this is a breach of contract that should have automatically been met with immediate notice of termination.
Operose runs GP surgeries right around the country, and no other ICB has terminated contracts as a result of the ‘serious breach’ of contracts following Operose’s takeover.
NCLs Primary Care Committee have bucked the trend where other ICBs have not acted on this breach of contract
Members of the committee took the view that they had lost trust in Operose, and a precedent needed to be set to other providers that contracts cannot be broken. They highlighted the importance of showing they were listening to voices of stakeholders ;and they had to act in the best interest of patient care.
Representatives from Operose did not even turn up to the Committee to present their view.
Alan Morton on behalf of Haringey Keep Our NHS Public has said that:
We welcome the decision of North Central London’s Primary Care Committee (PCC) to terminate the contracts of Operose following serious contract breaches. We hope the PCC awards future contracts to local providers who prioritise improving the health and care of residents in the five boroughs of NCL and not to private equity companies and others who seek maximum profit from investments in health and care services.
Background
AT Medics /Operose have over 50 GP surgeries, mainly in London, previously owned by the US health insurance giant, Centene Corporation, operating in the UK under the name Operose. Centene sold the practices to HCRG Care Group in December 2023 without NHS permission. HCRG is itself owned by a British private equity company, T20 Osprey Midco Ltd.
Haringey Keep Our NHS Public
4 September 2024 Contact Rod Wells on 07584 253699
Leave a Reply