Controversial GP surgeries takeover was ‘buried deep’

High Court told how US giant took control without patients being given a chance to object

Friday, 4th February — By Tom Foot

Centene demo

Anjna Khurana (right) outside the High Court with campaigners opposing the GP surgeries takeover

ONE of the biggest health insurance firms in the United States took control of GP surgeries in Islington without its past performance being considered – and with no opportunity for patients to object, the High Court was told this week.

A two-day legal ­challenge against a decision to wave through a “change in control” at two surgeries in the borough began on Tuesday.

The Mitchinson Surgery in Canonbury and the Hanley Primary Care Centre are both run by Operose Health – a subsidiary of the Centene Corporation in the US.

The judicial review has been brought to court in the name of Anjna Khurana – a councillor for Tollington ward – and the legal firm Leigh Day.

It is supported by a host of campaign groups including Keep Our NHS Public and Doctors in Unite.

The change in control was not widely known until being revealed by the Tribune last year.

The lack of debate or information for patients occurred despite “widespread public interest” in a growing influence of US healthcare companies in the NHS, the court heard.

Lawyers for the applicants said that a string of “serious allegations” against Centene, including billion-dollar financial settlements made for “overcharging the state for healthcare services” in the US had not been considered by North Central London (NCL) Clinical Commissioning Group.

Barrister Adam Straw QC told the court: “There is a long history of fines against Centene and its subsidiaries, for similar problems. This could rationally be considered as relevant by the defendant… They might overcharge the NHS in the same way… There was at least a risk, and the defendant should have looked at the allegations.”

He added that NCL “were unaware that Operose Health’s finances were very precarious… there had been very large losses and liabilities”.

Mr Straw argued that NCL had relied on flawed legal advice that had wrongly led to cabinet councillors from five local authorities, including Camden Council’s health supremo Councillor Pat Callaghan, being left in the dark.

He said there had been “widespread public concern” but the decision had been “buried deep” in a 168-page report to the NCL board.

Operose Health was allowed to take over the contracts held by AT Medics – the company previously running the practices.

NCL’s barrister Fenella Morris QC on Wednesday hit back by arguing Centene was “six degrees in the background” to the running of the surgeries and that “being a well-informed group of individuals they [NCL] knew that”, adding: “What would a CCG rationally seek to acquire by way of tunnelling so far back into the corporate structure?”

NCL’s legal team argue they did not need to consult further according to clear legal advice from NHS England they had sought before making the decision in December 2020.

On the allegations of lack of public engagement, Ms Morris said there had been “a constellation of questions and responses” since the public had become interested in the decision.

The court heard how Lord Finsbury, Chris Smith, had raised questions about the lack of consultation in the House of Lords, as had Baroness Joan Bakewell. An early day motion was signed by 76 MPs and a petition had been signed by 55,000 people.

Labour leader Keir Starmer has sent “correspondence” about the takeover, suggesting NCL should have done more to involve the public before the decision was taken.

Companies are allowed to transfer control of surgeries to other companies because of Alternative Provider Medical Services (APMS) contracts that were introduced by Tony Blair’s Labour government in what it hoped would be a way to drive up standards through competition.

Weeks after the transfer from AT Medics to Operose Health was approved, Operose Health chief executive Samantha Jones quit and agreed to become Boris Johnson’s top health adviser at No 10.

The proceedings had begun with Mrs Justice Henrietta Hill answering concerns from NCL’s lawyers about her pro bono consultancy work with the Keep Our NHS Public, which had run a high-profile campaign against the surgery take-over. She said this work would not influence her judgment, which is due in the coming weeks.

If she upholds the judicial review it would likely lead to the GP contracts having to be retendered, the court heard.

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