NHS chiefs defend role in US takeover of GP practices as campaigners condemn ‘lack of transparency’

Regional NHS chiefs faced a grilling from councillors from across North Central London (NCL) last week on the transfer of ownership of 49 GP practices across the capital from AT Medics to a subsidiary of US insurance giant Centene.

Keep Our NHS Public (KONP) campaigners describe it as a “revelatory incident about the approach and attitude” of the NCL clinical commissioning group (CCG), which covers Camden, Islington, Haringey, Enfield and Barnet.

KONP’s Sue Richards criticised the CCG’s handling of the takeover as “not about transparency, not about engaging locally, not about understanding local public opinion, but about obedience to orders from above”.

Responding to questions from councillors, Frances O’Callaghan, accountable officer for NCL CCG, said: “We have acknowledged from the beginning that with hindsight in the middle of the December pandemic, we all wish we had picked up the phone to an elected member and said, I need to make you aware of this.

“There was no attempt to keep information away from people, and in some correspondence it has been noted that NCL did publish its papers the week before in terms of our commitment to transparency.”

In Camden, AT Medics holds contracts for the King’s Cross Surgery, the Somers Town Medical Centre, the Brunswick Medical Centre, and the Camden Health Improvement Practice. Two surgeries are run by the group in Islington – Mitchison Road Surgery and Hanley Primary Care Centre.

O’Callaghan said the transfer of control to Operose, a subsidiary of Centene, would not result in patient data being shared, and explained that the CCG could only have objected had there been changes in service or concerns about quality.

She said CCGs across London had been presented with a choice to either approve the transfer or reject it, with lawyers saying the latter would leave them open to challenge.

CCG chair Jo Sauvage said: “It is unfortunate that in the media my involvement in what was effectively a pan-London decision has been singled out.

“I have received a lot of letters from many people who have asked me to reverse the decision, which is not in my authority to do, not just for NCL but for a decision that was made pan-London.”

She added: “Whilst I completely understand there are concerns about what has happened here, it is really important I make it very clear that the most important thing is to ensure continuity of services to our residents in NCL, and make sure the contract as it stands provides good quality, safe services to our residents.

“It would not be the correct action to cease those contracts at this moment and put them out to competitive tender.”

O’Callaghan described the fact that Centene had not been named in public when the transfer was discussed at the CCG as an “oversight”, and rejected any notion that it was down to “ill intent”. 

Cllr Pippa Connor accepted there is now “no form of challenge” over the decision, but asked whether the CCG itself could have raised concerns about the quality of services provided by Centene in America.

Pointing to the fact that Tim de Winter, deputy director of test and trace for the Department of Health, is a director of Centene, Cllr Tricia Clarke said: “It is quite good in a way that the Centene situation has arisen, as it has woken people up to their worst fears. No-one wanted their care to be handled by a US insurance company, that is for sure. 

“In Islington we have a GP Federation that comes to our scrutiny committee, we get a relationship with them and scrutinise them, and that would have been the ideal situation for our two surgeries in Islington and the rest of the 49 surgeries in London and the 370,000 patients that have been handed over to a US corporation. 

“Sometimes these things have a way of working in our favour, as it opens things up.”