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Report reveals private care switch

A report into the impact of NHS reforms from the Blair government has revealed the proportion of patients seeing their local NHS trust has significantly fallen, while those attending privately-owned centres has risen.

The research was carried out by the Institute for Fiscal Studies and commissioned by the Nuffield Trust in order to determine how the reforms of 2006 and 2008 have changed where care takes place.

The study found that in 2010, most patients still received care from their nearest NHS trust, but GPs were increasingly referring patients to a wider range of providers.

Independent Sector Treatment Centres (ISTCs), privately-owned centres that treat NHS-funded patients, had gone from a "negligible presence" in outpatient care to accounting for 3.5% of all first appointments in 2010/11 - equivalent to almost half a million that year alone.

According to the study, the overall volume of patients seeing all providers has increased since 2006, but there had been a shift away from local NHS trusts and towards private providers.

ISTCs increased their market share of inpatient admissions for a range of operations, with referrals to ISTCs accounting for around half of the change in where GPs refer patients since 2006/07.

The number of hip replacements carried out in local NHS hospitals fell from 68% in 2005/06 to 54% in 2010/11, with privately-owned centres increasing their proportion of the operations.

Elaine Kelly, a research economist at IFS and one of the authors of the report, said: "The use of private providers to treat NHS patients is no longer a marginal policy reform and deserves greater investigation.

"There has been a significant shift in market shares over the past five years from patients' nearest NHS hospitals to private providers. For some procedures, almost one in five NHS-funded operations are now carried out by the private sector."

Anita Charlesworth, Nuffield Trust's chief economist, said the report showed improvements in patient choice. She said: "Together, increased private provision and choice reforms have achieved major steps towards the Government's goal of providing viable alternatives to existing providers and GPs, and patients are now exercising choice over where treatments take place."

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