Three years ago, there was a public outcry at the sale of two Islington GP services to a large US Company, Centene – a company with many health contract violations on its record in the USA. NHS commissioners then gave their permission for this without consulting patients.  Now Centene has sold on the Islington practices and 58 others around the UK to another company without even waiting for permission.  Will the commissioners defend patients against these reckless companies who are willing to break their contracts and stand outside the law?  Or will they roll over and leave patients to their fate?

We believe these sales should be stopped. You can tell the North London Integrated Care Board (ICB) in charge of monitoring ownership of GP surgeries to stop the sale in a survey in which they call for our opinions. The closing date is 3 June so there is not much time to make our voices to be heard. You can find the survey here. Here is a suggested response for you to use or amend.

Please do not allow the sale of contracts for NHS GP services to take place between Centene / Operose and the new company owned by T20 Capital, the companies which have broken the terms of their contract with you.  It would be appalling if they still got agreement to the change of control even though they had broken the law. How could we trust GP services that had done that?

It was bad enough three years ago when you allowed the small company A T Medics to sell the contracts to Centene / Operose.  You did not consult us and the public in North Central London would undoubtedly have said no if you had, given the record of Centene in the USA.  Now, having discovered it is not so easy to make money out of the hard-pressed NHS, they want to walk away, selling on to a private equity company which was not even registered at Companies House until last year.  How can you allow this when you have a clear and legally justified route to cancelling the contracts and re-procuring them. 

Please, for our sake as members of the public, stop this farce going any further.

Here is more background on this sorry saga.

Commissioners are meant to consider patient safety, value for money and whether the new provider can be trusted to deliver good services to the half million people who are patients of these practices.

Centene Corporation, (subsidiary Operose), sold the 60 practices to HCRG Care Group in December 2023. HCRG is owned by a British private equity company, T20 Capital.

This happened without the NHS giving permission, or even being informed, and before all the necessary searches were completed as to whether the new owners were fit to run GP surgeries, or if they were financially viable.  

So, hundreds of thousands of NHS patients are signed up to GP surgeries that no longer have permission to operate under NHS contracts.

This is a breach of contract that should have automatically been met with immediate notice of termination.

Commissioners delayed informing patients and staff about what had happened until 15 April, and they have so far failed to take decisive action. This leaves patients dependent on services provided by a company that has not yet passed stringent financial and other fitness tests, in the second change of ownership in less than three years.

Large private companies have been taking over ever-larger chains of NHS GP surgeries since the NHS insisted, in 2014, that all new contracts should be open to bidding from private providers.

Some of the surgeries bought by Centene/Operose did not fare well.  Hanley Road in Islington had a couple of years still to run on its contract when the sale occurred, but evaluation of the company’s performance meant that the contract was not extended – as would have been normal. It has since been put out to competition again, this time with a commission requirement for strong local links and knowledge – presumably to forestall another big corporate takeover. North Central London ICB’s Primary Care Committee is about to consider whether to extend the current contract for the other Islington practice at Mitchison Road.  (We think this will be at an extra meeting called for 21 May.)

There are even more concerns about the new owner’s track record in health care, their financial robustness and business model.

HCRG and Virgin Care, have a poor track record with regard to service quality, contract compliance, and transparency.  HCRG/T20 are a complex, opaque group of companies that makes the scrutiny and due diligence necessary for procurement, and accountability for any adverse clinical or financial outcomes, almost impossible.

Private equity companies are not required to publish accounts. They operate at arms length, are never liable for failure or debt, rely on rapid profit maximisation, by cost cutting  and rapid sale. They are not interested in health care other than to make money, nor in the long term, and have had a disastrous impact on social care and early years provision.   

As Centene/Operose  could not make a profit from primary care, how can HCRG/ T20, except by cutting services and staffing?

The latest episode suggests that North Central London Integrated Care Board no longer have control over who owns and runs NHS GP surgeries. We need to remind them that we should own them and they should run them on our behalf.

Respond to the survey now!