From April 2017 onwards, Virgin Care will oversee more than 200 health care and social care services in Bath and north-east Somerset including adult social care, continuing healthcare and children’s community health.
This in itself isn’t anything new. The private sector has been providing public services in the health, social care and prison sectors for some time. For example, both G4S and Serco run a number of the UK’s prisons and custodial services.
And Branson’s empire is no virgin to the healthcare industry – having been set up in 2006, it now runs more than 230 NHS health and social care contracts worth over £1 billion.
There are two things the Government can do to ensure that private service provision is managed effectively:
1. Be open about performance
The public are deeply sceptical about privatising services, particularly something as sacred as the NHS. The only way to reassure them is to be open and transparent about how private providers of public services are performing. Currently, it is difficult for the public to know how much providers are being paid and how well providers are performing against these contracts.
Some central government contracts are now required to include transparency provisions (thanks to work we did in 2015).These provisions require private providers of public services to make key information about contract performance available to the public. The Bath Virgin Care contract would do good to include such clauses. Or, even better, Virgin Care would provide this information off its own bat without the need for any legal obligation.
2. Don’t get locked down
The rationale for privatisation is that competition drives efficiency and innovation. But, as we’ve seen in other public services and contracts (for example, from Hinchingbrooke or the G4S and Serco tagging scandal), this has not always the case.
There is a tricky balance to strike between the value for money gained by signing long-term contracts versus the flexibility and competitive pressure offered by short-term contracts. The Virgin Care contract for Bath is a minimum seven-year contract which is at the longer term end of the spectrum. Ensuring sufficient commercial controls, and appropriate clauses to review contract performance, will be vital to maintain competitive tension throughout the contract lifecycle. It also important to allow the contract to be revised to reflect any new innovation or learning from the outside world.
Fierce debate still rages about the relative merits of private, for-profit service provision. Part of the problem is that there is lack of data to compare performance between privately run services, let alone to compare with government-provided services. While the jury is still out on privatisation, open and flexible contracts between the Government and these private sector providers is essential to making them work for citizens.