The NHS pays £ 2 billion a year to private hospitals to care for mentally ill patients because they don’t have enough beds of their own, the Guardian reports.
The independent sector receives around 13.5% of the £ 14.8 billion that the NHS in England spends on mental health, a dramatic increase since 2005, when it was paid £ 951 million. Nine out of 10 out of 10,123 mental health beds operated by private operators are occupied by NHS patients.
The NHS’s growing reliance on independent care providers comes despite fears from some health chiefs that there are persistent – and sometimes fatal – problems with the quality and safety of care in many of the mental health departments they manage.
These fears, shared by NHS psychiatrists, mental health nurses and charities, are confirmed by inspection reports from the Quality of Care Commission (CQC). Data he provided to the Guardian show that 71 different psychiatric facilities run by non-NHS providers caring for adults or people under the age of 18 have been identified as “inadequate” since early 2017 – more than one for every four of the 269 such units.
According to a recent study by leading health market analysts LaingBuisson, independent mental health providers receive £ 1.964 billion a year to treat patients in the NHS. They have gained a dominant role as the NHS has reduced its own stock of mental health beds despite growing demand for psychiatric care in a residential home.
The revelation that the NHS in England provides such huge sums of money to independent operators has prompted Dave Monday, a senior professional with the Mental Health Nurses Association, to condemn “the scandalous privatization of services that the most vulnerable rely on. to survive. “
Paul Farmer, Mind’s chief executive, said the “dangerous phasing out” of NHS beds in recent years had left him anxiously dependent on the private sector.
“While this use of private care providers is not in itself worrying, the fact that some patients are switching to private providers in half of the country or indeed providers that CQC considers to provide inadequate standards of care is incredibly worrying. , especially as some of these references appear to have led to tragic and fatal consequences, ”said Farmer, who chaired the NHS Mental Health Working Group in England in 2015.
LaingBuisson’s research also shows that:
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Independent mental health providers now make up 91% of their NHS income.
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Their typical profit margins are 15% -20%.
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The majority of hospital care for people under the age of 18 is now outsourced, with 55% of all children and young people hospitalized being independent operators.
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Non-NHS providers earn £ 316 million a year to treat children and young people.
In total, the four largest operators – the profitable companies Cygnet Health Care, Priory Group and Elysium Healthcare and the charity St Andrew’s Healthcare – receive £ 1.356 billion – two-thirds of almost £ 2 billion in total. This reflects that among them they manage 182 hospitals, containing 6,700 (66%) of a total of 10,123 mental health beds in the independent sector. Another sign of their dominant role is that the quartet has almost 40% of all secure mental health beds in England reserved for the sickest patients.
While private sector beds increased from 9,291 in 2010 to 10,123 in 2021, the number of mental health beds in the NHS fell from 23,447 to 17,610, down from 5,837.
The NHS supervisor gave the lowest score to 10 of 71 “inadequate” hospitals twice when, on repeated visits, CQC inspectors found no urgent improvements in ordering to improve care for people with conditions such as psychosis and bipolar disorder, with patients still at risk.
Dr Andrew Molodinski, Head of the British Medical Association’s Mental Health Policy, said: providers, many of whom are responsible for a catalog of patient safety deficiencies, putting many vulnerable patients at increased risk of inadequate care or, in the worst cases, of self-harm and suicide. “
The big four operators outside the NHS said staffing problems hampered their efforts to always provide the best possible care for patients with challenging and often complex illnesses, and that only a small number of their facilities were assessed as inadequate.
A Priory spokesman said: “Priory works in partnership with the NHS and the availability of independent mental health services allows the NHS to provide immediate access to many sick patients to treatment, which often lacks the appropriate facilities or capacity to offer and provide free to the much-needed NHS A&E beds occupied by patients in need of specialized mental health treatment. “
A Cygnet spokesman said the safety and well-being of service users was his “absolute priority”, adding that 82% of its facilities were rated “good” or “exceptional” by regulators.
Elysium said he was proud to provide care for people at “the most vulnerable moment of their lives.” It adds: “Although we are proud of the state-of-the-art care and therapies we provide in our hospitals, we never stop striving to learn and improve.
Jess Lively, CEO of St Andrew’s, said that while five of the nine services he manages are rated “good” by CQC, three are rated “requiring improvement” and one as “inadequate”.
“This is not a level of service we are happy with, and we have restructured our charity over the last few years to help improve the quality of care we provide,” he said. This included reducing the number of beds operated by a third and investing more in community mental health services.
A spokesman for the NHS in England said: “The National Health Service in England is clear that we expect all services to provide safe and high-quality care and fulfill our commitments in their contracts, whether NHS or independent sector.
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