Privatised eye care is undermining NHS provision – challenge from campaigners

In Keep Our NHS Public regular online meetings groups share their experiences of local campaigning and inspire others to take up similar actions.

Recently we’ve heard presentations from North East and Oxford KONP on issues relating to ophthalmology. These are summarised below, thanks to KONP members Roger Nettleship and Joan Stewart.

---

Outsourcing cateract surgery

Ministers claim the public has little or no interest in who provides a service as long as they have access to treatment. One response to this is that if people knew some patients were losing their sight as a consequence of the NHS outsourcing cataract surgery, the public would undoubtedly be outraged.

Cataract surgery is the most commonly performed operation in the UK, but a majority are now outsourced to the private sector. High street opticians can refer patients directly to cataract clinics leading to a lowering of the threshold for surgery (provider led demand). Patients in affluent areas are more likely to be referred, increasing health inequalities. The proportion of the budget for eye services spent on cataract surgery has increased at the expense of funding then left for NHS units to provide services 24/7 for complex patients. Staff are attracted away from the NHS departments for more highly paid positions with private providers, compounding the difficulties faced by NHS ophthalmology departments including a reduction in training opportunities.

Waiting times for cataract surgery may have fallen but at the expense of NHS services essential to a wide variety of patients, some of whom (glaucoma, macular degeneration, retinopathy, etc) risk loss of sight if not treated in a timely manner. The proliferation of private providers reflects a guaranteed stream of income from the NHS coupled with generous profits rather than representing the much touted ‘spare capacity’. All KONP groups are encouraged to look at the situation as it applies in their locality and raise with commissioners in the Integrated Care Board. Ideas of how to approach campaigning around this issue are set out below.

See Appendix 2 (‘How Ophthalmology can suffer from an excessive focus on waiting lists’) in
99% Organisation report ‘The Rational Policy-Maker’s Guide to Rebuilding the NHS’ provides further useful background on this issue.

North East KONP
Exposing the lie that privatisation increases the capacity of the NHS to treat patients

Those involved in the longstanding Save South Tyneside Hospital Campaign (SSTHC) have always taken a stand against the privatisation of NHS services and defended the right of all to health care.  In particular, what you can describe as the Tony Blair outlook – endemic in Westminster – is that as long as health care is provided ‘free at the point of use’ it makes no difference if those services are provided by private companies making profits from NHS public investments. They also claim that outsourcing patients to private hospitals and services is adding ‘spare capacity’ – that it brings in new beds, new services on top of what the NHS is already providing.  However, our work campaigning to save services shows this is not true: on the contrary, by cutting investments to the NHS and diverting NHS funding to invest in the private sector means, the capacity of the NHS to treat patients is increasingly reduced.  Access to health care particularly in the most deprived communities is reduced even further.

Professor Allyson Pollock is well known for her research work at the Faculty of Medical Sciences, University of Newcastle into the privatisation of the NHS and opposition to it. She spoke twice in 2017 at SSTHC public meetings during the fight to save services at South Tyneside Hospital.    More recently in 2025 Professor Pollock spoke online about her research with Graham Kirkwood and Peter Roderick [1]. The study covered the growth of outsourcing of hip and knee surgery to private providers over 20 years and the impact on the NHS of “outsourcing elective surgery, in particular hips, knees” was very revealing.   They found that “it is the same consultants and many of the same staff that are actually working in both sectors” and that admission rates to the NHS fell steadily from 2007/8 to 2018/19 whilst admission rates to the private sector rose fivefold.  Inequalities grew during the expansion of private outsourcing because of the parallel lack of investment in the NHS, damaging its capacity to treat the poorer patients and those with more complex needs.  Waiting lists have grown ever longer on Tyneside and nationally. 

In 2023 our campaigners analysed the extent of the privatisation of local and national services. We opposed the privatisation of diagnostic services by Alliance Medical [2] at STSFT, Spa Medica’s privatisation of ophthalmic services [3], Tyneside Surgical Services privatisation of surgery [4], and the privatisation of Northumbria Health using NHS facilities in Cramlington.  We also opposed the setting up of NHS trust-owned subsidiary companies (SubCos), such as Choice set up by South Tyneside and Sunderland Foundation Trust (STSFT) and QE Facilities set up by Gateshead Health NHS Foundation Trust (the Queen Elizabeth Hospital’s trust).

On April 11, 2024, SSTHC and Emma Lewell MP for South Shields jointly held a meeting with South Tyneside and Sunderland Foundation Trust (STSFT) and the Integrated Care Board North East and North Cumbria (ICBNENC).  The CEO of STSFT, Ken Bremner brushed off our challenge to their contract with Alliance Medical, saying that privatisation in the NHS was not the aim and that they will only use it where the private sector has expertise, such as diagnostics. The obvious challenge to that is that the very NHS staff who are the experts were being recruited by Alliance Medical with higher pay offers, reducing NHS staff capacity and expertise.  One of our governors, who researched it, showed this was a private contract imposed directly by the Government and NHS England on the NHS.

In contrast, our concern about Spa Medica and its inroads into the public provision of eye care seemed to hit home with STSFT and the ICB, though it fell short of them confirming all of our concerns about how this was affecting the NHS eye service. This was caused by significant NHS funds being diverted to Spa Medica, part of a national picture of profiteering in cataract surgery. The amount paid by NHS commissioners in 2023/24 to five eye care companies, including Spa Medica, was £536 million, of which £169m (32%) was profit [5]. Spa Medica’s profits of £71.8 million were almost a third of its turnover at the end of 2023.   We pointed out how Spa Medica were at that moment doing everything to poach staff away from the Sunderland Eye Infirmary. This was affecting what has been one of the best eye services in the country, previously offering prompt treatment for the whole population.  But this was no longer the case. The so-called extra private capacity was profitable for Spa Medica, but has already undermined NHS provision by creating staff shortages affecting the long-term treatment of complex eye problems, many threatening loss of sight, at the Sunderland Eye Hospital. Such complex eye problems and emergency care are less profitable to the private sector and predictably will largely be left to the public sector NHS to manage, but with reduced capacity through diminished staff and funding.

By cutting investments to the NHS and investing in the private sector the capacity of the NHS to treat patients is inevitably reduced.  Access to health care particularly in the most deprived communities like in South Tyneside, in Sunderland and in the North East are being reduced even further. In other words, safeguarding the future of the NHS means standing against the lie that privatisation and outsourcing increases the capacity of the NHS to treat patients.

Roger Nettleship
Roger is a member of Save South Tyneside Hospital Campaign and works closely with Keep Our NHS Public North East

See Notes at end of this article

Oxfordshire KONP: Summary of talk to KONP members and supporters meeting, Wednesday, 7 January 2026

Oxfordshire KONP has been campaigning for over a year to remove the threat to its local eye hospital from the unregulated rise in NHS-funded private cataract clinics.

Evidence of the threat was accrued from data collected by the Centre for Health and the Public Interest (CHPI), Freedom of Information responses from the BOB ICB and Oxfordshire University Hospitals Trust and submissions to government from the Royal College of Ophthalmologists (RCOphth). 

Throughout 2025, this evidence was put before the local health scrutiny committee, which agreed to write to the health secretary in support of the RCOphth’s call for a review into the use of NHS-funded providers in cataract surgery.

As a result, BBC Radio Oxford devoted one of its breakfast shows to the campaign. Public support for a letter writing campaign to MPs has been encouraging, and the Socialist Health Association has also shown strong support.

The campaign can claim some success. NHS England has announced plans to considerably reduce overall expenditure on NHS-funded private cataract companies. Because government is now incentivising these for-profit companies to invest in providing more complex eye surgery, which has the potential to once again destabilise Oxford Eye Hospital, the campaign will continue. 

Enter your postcode on this CHPI site for information on individual ICB spend on NHS-funded private cataract companies: https://www.chpi.org.uk/the-outsourcing-of-nhs-eye-care-profit-map

Joan Stewart, Keep Our NHS Public Oxfordshire 

---

Notes from NE KONP article

[1] Private sector expansion and the widening NHS treatment gap between rich and poor in England: Admissions for NHS-funded elective primary hip and knee replacements between 1997/98 and 2018/19. Graham Kirkwood, Allyson Pollock, Peter Roderickhttps://www.sciencedirect.com/science/article/pii/S0168851024001283?via%via%3Dihub

Professor Allyson Pollock – the impact of outsourcing cataract and hip surgery to private providers. Public meeting of Socialist Health Association. https://www.youtube.com/watch?v=JvU_sqcC6Q8

[2]  Alliance Medical a big player nationally, already run a lot of scanner services in North East and nationally under the NHS banner. They own all the PET scanners in area including Freeman hospital even before they opened the diagnostic centre at STDH.

[3] Spa Medica ( as of 2023) is a nationwide company specialising in NHS services for cataract removal and other eye treatments.  They are based in Team Valley, they have 40 such hospitals nationwide first hospital in Manchester 2008. 10^th hospital in 2018 now 40!  Now part of Veonet – European wide company. Latest accounts are for 2021(COVID!) They did 94,000 cataract ops nationally – an increase of 152%. Turnover was in 2022 £281.1m and profit after taxation increased to  £71.8m.

[4] Tyneside Surgical Services, also based on Team Valley also doing NHS referrals, originally based in QEH using QE eqpt and staff doing waiting lists. Caused problems, opened surgical factory in 2022. An “independent” provider of NHS care at moment exempt from producing audited accounts. “NHS” and private patients.

[5] Further information: Out of Sight – the hidden profits and conflicts of interest behind the outsourcing of NHS cataract care. 

https://www.chpi.org.uk/reports/out-of-sight-the-hidden-profits-and-conflicts-of-interest-at-behind-the-outsourcing-of-nhs-cataract-care