According to bioethics expert Professor Donald Light, private sector health insurers are anticipating a slice of the NHS action under a new government arrangement called FESC (Framework for Procuring External Support for Commissioners).
The aim of the FESC is to strengthen the way the health service decides what services patients need, such as how many hip operations or MRI scans are needed, who should provide them, where and for what price.
But Professor Light, from Pennsylvania, says the UK should take care what it is buying and from who. Speaking at last week's NHS Alliance annual conference (23 November 2007), he said that some of those now moving into the British market have a track record in the USA that is not entirely spotless.
He told delegates that doctors have received financial incentives to cut costs by delaying or withholding medical care, it is alleged in a current lawsuit by millions of American patients against United Health Care, Aetna and several others.
One company was charged by officials across 36 states with misapplying fee schedules and delayed payments to doctors and other providers. Others have been charged with misleading and fraudulent sales tactics.
Professor Light said: "Here in the UK, the officers of these big corporate companies may well be – probably are – talented and moral individuals. The problem is the larger corporations above them.
"NHS managers buying their services need to be very careful, and clear about exactly what they are buying with transparent measures of results.
"There is a conflict between NHS agendas and corporate agendas that seems to be forgotten. The NHS is a public service organisation that has to operate within a fixed annual budget. Corporates are expected to maximise their revenue and profits on a three-month schedule. The dangers to the NHS and the British taxpayer are clear."
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"Absolutely, they are there to make a profit for their shareholders" - Allan M Stewart, Bebington