A dispute about the takeover of one of the UK’s biggest GP practice operators by the US healthcare giant Centene Corporation has reached the high court, in a case that could overturn approval for a deal condemned by campaigners as “privatisation by stealth” of the NHS.
The request for a judicial review, which will be heard in the high court in London on Tuesday and Wednesday, was crowdfunded by a coalition of NHS campaign groups and the Unite union. It is being brought by Anjna Khurana, an NHS patient and Islington councillor. She claims she is one of 375,000 patients across London who were only informed of the takeover of their GP surgeries after the event.
Health campaign groups Keep Our NHS Public, 999 Call for the NHS and We Own It have joined Unite in bringing the case. Two crowdfunding campaigns by Khurana have raised more than £77,000.
A year ago, Operose Health, a UK subsidiary of Centene, acquired the privately owned AT Medics, which was set up in 2004 by six NHS GPs and ran 37 GP practices across 49 sites in London. The merger created the largest private supplier of GP services in the UK.
The group now serves 570,000 patients across 67 practices, and employs 1,500 healthcare professionals, including 350 GPs. Alongside GP practices, Centene’s UK interests include Circle Health Group, one of Britain’s biggest private hospital operators.
A coalition of doctors, campaigners and academics has voiced concerns in a letter sent last year to the then health secretary, Matt Hancock, describing the takeover as “an example of the privatisation of the NHS by stealth”, and asking him to order an investigation by the Care Quality Commission.
They claimed at the time the change of control was approved for eight practices in the London boroughs of Camden, Islington and Haringey in a virtual meeting on 17 December that lasted less than nine minutes, during which no mention was made of Centene and not a single question was asked.
Approval was granted by the North Central London clinical commissioning group (NCL CCG), a local NHS body that purchases health services from GPs, hospitals and others using taxpayer funds.
The judicial review will focus on the lack of consultation of patients, and will ask the court to quash the decision by NCL CCG. Since the news broke, hundreds of patients, councillors and members of the public have written letters and protested outside surgeries.
Khurana said: “Like everyone else, I want to feel I can rely on my GP to be on my side. That is what we get with the NHS. But without my knowledge, my surgery has been sold to a giant American healthcare company, one with a very poor reputation. How can that be right? I needed to stand up and make my voice heard. So many people have been in touch to let me know they support me that I know I am not alone. We cannot allow this stealth privatisation of the NHS to carry on.”
The court will rule whether, in making their decision, the NHS commissioners acted unlawfully in three respects: misdirection – they failed to consider all the implications of the takeover because they assumed they had no choice but to accept and approve the proposal; lack of due diligence – they failed to give due consideration to the risk to patients, if the GP contracts they agreed to transfer to Operose Health turned out not to meet its parent company Centene’s profitability targets; and lack of consultation/involvement of patients.
An NCL CCG spokesperson said: “We are committed to offering residents high-quality, safe and accessible care. Our commissioning practices in relation to AT Medics have followed the same rules and guidance we apply to all our GP contracts, with decisions informed by legal and national guidance.
“The CCG is defending its decision and the process and will not comment further while a judicial review is under way.”
Dr Louise Irvine, a London GP and member of Keep Our NHS Public, said: “Of course patients are worried. When a large American corporation like Centene takes over this many GP practices we have to question their motive. It’s a deeply worrying situation and I am delighted that the high court has seen the important public interest in this case.”
Doctors in Unite supported a protest outside the high court at the Royal Courts of Justice, with more protests planned on Wednesday.
The Unite general secretary, Sharon Graham, said: “This is a landmark case in the fight against the accelerating pace of privatisation of the NHS in England. Unite, with 100,000 members in the health service, fully supports the judicial review. We will not allow our GP services to be hived off to profit-hungry American private healthcare companies.”
An Operose Health spokesperson said: “It is not appropriate for us to comment as the judicial review is between an individual and the North Central London Clinical Commissioning Group over issues of process.”
