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Eye surgeon claims that new treatment centre is a threat to NHS

London Owen Dyer

Doctors at the Oxford Eye Hospital say their service is threatened by government plans to farm out cataract operations to a diagnostic and treatment centre run by a private foreign company.

John Elston, a consultant surgeon at the hospital, told BBC Radio 4’s Today programme that the private scheme was a "serious threat."

"The cataract work subsidises the work in chronic eye disease so it could well mean that we would lose numbers of our trainees, and if we lose staff, then we lose the ability to offer the full range of services," he said. "You need a critical mass to attract the referrals and to provide the specialist expertise."

The Department of Health argues that diagnostic and treatment centres will ease the burden on waiting lists, increase national capacity, and allow hospitals to focus their expertise on complicated elective work. But Mr Elston said the hospital had already halved its cataract waiting list and had a plan that would enable them to meet government targets by April 2004.

Health minister Lord Warner told the Today programme that doctors’ concerns were due to poor communication from the Thames Valley Strategic Health Authority. He said the health authority and local primary care trusts had given him a "categorical assurance" that it was not their intention to reduce the staff or budget of the Oxford Eye Hospital. He added that most planned diagnostic and treatment centres would not be private but would form part of the NHS.

Liberal health spokesman Dr Evan Harris, who is the hospital’s local MP, says that documents leaked to him suggest that the health authority had been told "you must maintain your expression of interest." He said the proposed cataract operations, at £799 ($1270; €1144) apiece, would cost more than those currently done at the Oxford Eye Hospital.

A spokeswoman for the Thames Valley Strategic Health Authority told the BMJ that the authority was in favour of the scheme for ophthalmic diagnostic and treatment centres, which would "provide another choice for patients, provide a service closer to home, and reduce waiting times and the number of cancelled operations."

The BMA’s chairman, Mr James Johnson, said: "DTCs [diagnostic and treatment centres] will help the government meet its waiting list targets, but more importantly will benefit patients whose quality of life may be seriously impaired while waiting for treatment. However, the BMA does have a number of concerns, and we will be taking these up with the Department of Health.

"Obviously if more resources were directed to NHS hospitals they could take on this additional work. It is essential that DTCs do not destabilise the local economy of district hospitals. Primary care trusts have to fund local hospitals that are offering a 24 hour service to patients, and it is essential that resources are not redirected to DTCs."

A spokesman for the Department of Health said: "DTC services are being procured from the independent sector because the NHS simply does not have sufficient existing capacity to meet the waiting time targets that have been set for 2005. This DTC will not be in operation until 2005, so there is still a great deal of discussion to be had on the arrangements for it."
 
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Rapid Responses:

Read all Rapid Responses

Serious threat to private practice?

Dinesh Verma, et al.
bmj.com, 26 Sep 2003 [Full text]

Much Ado About 'Do and Go' ...

Joseph .C. Obi
bmj.com, 27 Sep 2003 [Full text]

Re: Much Ado About 'Do and Go' ...

Gordon N Gillespie
bmj.com, 2 Apr 2004 [Full text]

Analysis of oranges and lemons? Productivity in Treatment Centres.

Mr Simon P Kelly, FRCOphth
bmj.com, 8 Jan 2005 [Full text]