Open letter to Nicola Sturgeon regarding outsourcing of patient experience
programme surveys
[To view this as a pdf: http://www.health.ed.ac.uk/CIPHP/]
Nicola Sturgeon MSP
Cabinet Secretary for Health and Wellbeing
St. Andrew’s House
Regent Road
Edinburgh. EH1 3DG
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Dear Minister
We are concerned that the recent decision of the Scottish Government to
outsource surveys on the patient experience programme to the private sector
introduces serious commercial conflicts into NHS service planning and
information and public research. The project was launched under the
previous administration.
http://www.scotland.gov.uk/News/Releases/2007/03/01103247
According to the recent press announcement by the Scottish Government on 04
February 2008, the Scottish Government has awarded £1.36 million to
PricewaterhouseCoopers (PwC), a for-profit management consultancy firm, to
act as a coordinating centre for the Scottish Patient Experience programme
(PwC is the Technical Partner, contract number HCC/001/19 awarded 14
December 2007).
http://www.scotland.gov.uk/News/Releases/2008/02/04094521
A further £2.16 million for social research services under the Contract for
the Scottish Patient Experience Programme's Framework is currently out to
commercial tender.
http://www.nhstenders.net/modules.php?
op=modload&name=News&file=article&sid=23569&newlang=eng&topic=193&catid=0
First, we are concerned that the contract award to PwC, which was signed by
the Scottish Government on 14 December 2007 and the current commercial
tender of social research services represents a major step in the
commercialisation of core public health and information functions and
academic research. We are also concerned that the process places in
jeopardy the principles of accountability and transparency to which the
Scottish Government is committed.
Second, patient experience and survey work has traditionally been the
responsibility of the Scottish Executive and departments of public health
within health boards. Patient surveys allow service planners and providers
to conduct needs assessment and rapid appraisal in order to address
population needs for services. However surveys are vulnerable to political
manipulation and bias and for this reason it is normal practice to involve
academic departments in design and analysis.
However, according to National Procurement NHS Scotland, PwC has now been
given the remit of:
'developing the guidance and instruments which NHS boards and their
framework contractors will use to survey patients and carers; analysing and
disseminating the results of surveys undertaken by health boards and
general practices; and finally advising boards, general practices and
framework contractors on using the information to improve services'
The Scottish Government has not specified what the requirements are for
scholarly peer review and public consultation regarding these factors and
it is therefore unclear to what extent the private sector will control the
methods, instruments, standards, analysis and results of patient survey
through the patient experience programme, as well as the dissemination and
control of information into needs assessment and service planning and
service reconfiguration.
Third, indicators of patient experience (satisfaction or responsiveness)
are conceptually complex and require values to be determined by the
investigator. We are concerned that the delegation of these matters to the
private sector provides an opportunity for introducing methods and
manipulating results for commercial ends rather than what is in the best
interests of the needs of the public and the NHS. In England, millions of
pounds of NHS funds are being outsourced to private sector companies under
an equivalent programme called NHS Surveys.
http://www.nhssurveys.org/approvedcontractors
Although the Healthcare Commission (HCC), the organisation responsible for
quality in England, has been unable to show that using the private sector
provides better access, quality of care and value for money, there are
concerns that patient experience surveys are being widely used to promote
the privatisation of NHS care and reconfiguration of services.
http://tinyurl.com/2jdnzc
Finally, the full tender document and contract with PwC is not in the
public domain, and key areas have been redacted. We have not yet been able
to establish whether patients are aware that they will be giving their data
to a private for-profit provider, or what uses the instruments, analysis
and data may be put to. Nor do we know what will be subject to commercial
confidentiality and covered by intellectual property. The whole programme
lacks sufficient clarity and transparency and warrants proper scrutiny and
an independent review.
The Scottish Patient Experience programme represents a significant threat
to the academic integrity of survey design, to the vital independence of
public health departments, and the integrity and reliability of public
information organisations such as the Information Services Division. Public
information is the lifeblood of any health care system. The
commercialisation and privatisation of these functions represents a very
considerable threat to public health care and research.
It is for this reason we call upon the Scottish Government to publish and
review in full the tender and contract with PwC and to halt the current
£2.16 million procurement of social research services under the Scottish
Patient Experience Programme's Framework.
Yours sincerely
Prof Allyson Pollock, Director, Centre for International Public Health
Policy, University of Edinburgh
Prof Gerry Fowkes, Director, Centre for Public Health and Primary Care
Research, University of Edinburgh
Prof Harry Campbell, Professor of Genetic Epidemiology and Public Health,
Department of Public Health Sciences, University of Edinburgh
Prof David McCrone, Co-Director of the Institute of Governance, University
of Edinburgh
Dr Sarah Wild, Core Director, Epidemiology and Statistics, Wellcome Trust
Clinical Research Facility / University of Edinburgh
Prof Graham Watt, Professor of General Practice/Head of Section, General
Practice & Primary Care, University of Glasgow
Prof Phil Hanlon, Professor of Public Health, Department of Public Health &
Health Policy, University of Glasgow
Dr Ian Harper, Senior Lecturer in Social Anthropology, School of Social &
Political Studies, University of Edinburgh
Prof Patricia Jeffery, Professor of Sociology, School of Social and
Political Studies, University of Edinburgh
Prof Roger Jeffery, Professor of Sociology of South Asia, School of Social
and Political Studies, University of Edinburgh
Prof Kath Melia, Professor of Nursing Studies, School of Health & Social
Science, University of Edinburgh
Prof Adrian Sinfield, Professor Emeritus of Social Policy, University of
Edinburgh
Prof Janette Webb, Professor of Sociology of Organisations, School of
Social and Political Studies, University of Edinburgh
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