NHS warned over letting drug companies run patient services

The NHS would be behaving like "a turkey voting for Christmas" and for its own privatisation if it strikes deals with drug companies allowing them to run patient services, a leading doctor warned yesterday.

The alert came as Stephen Dorrell, the Secretary of State for Health, is considering allowing NHS Trusts and GPs to strike "disease management" deals with pharmaceutical firms.Under the agreements, the companies would provide anything from an asthma service to, at the extreme, a complete cancer service.

Dr Harry Burns, director of public health medicine at the Greater Glasgow Health Board, said the move raised ethical issues and would have profound implications for the NHS.

Having banned such deals in 1994, Mr Dorrell has now issued a working paper setting out a framework under which they may be permitted when the ban runs out next month. A Department of Health spokesman said no decision had been taken, but the paper makes clear Mr Dorrell's interest.

Dr Burns warned, however, that the packages could be a ploy to ensure a company's products were used in preference to a competitors, or to cheaper generic drugs. Single-disease management risked losing co-ordinated care where patients had more than one illness, and drug companies in the UK while "highly competent, ethical and well-managed" have "no track record in the provision of health care".

In the US, they run cancer centres and packages for asthma, diabetes, epilepsy and high blood pressure, aiming to pay for the service from savings from unnecessary admissions.

Dr Burns stressed he had no ideological objection, but "if the NHS does this, it should do so with eyes fully open to the consequences. Trusts would be letting private companies take over their business. It would be privatisation of health care."

Contracting out care management, data analysis, treatment guidelines and other areas in which the pharmaceutical industry is interested would be handing over the areas essential to delivering cost-effective care, he said. The likely result would be "like turkeys voting for Christmas".

The Department's working paper attempts to answer the criticisms by saying any deals must take into account other conditions from which the patient suffers. Doctors would have to remain free to prescribe any drug, and not be restricted over where they were treated. Data collected from patients should remain confidential and services should be published and open to public scrutiny.