A private hospital in Scotland is in discussion with the NHS in England with the aim of becoming one of the 'health factories' the prime minister has identified as a model for public-private partnerships.
The move could mean the much-vaunted 'concordat' between the NHS and the private sector making its way into Scotland by stealth, despite differences between the health departments north and south of the border.
HCI International Medical Centre in Clydebank near Glasgow said last week that it was in discussion with unnamed health authorities in England. The hospital already provides cardiac and orthopaedic surgery for patients in Northern Ireland and for a few Scottish NHS patients.
Hospital director Ian McAdam told HSJ that HCI was 'ideally placed' to play a major part in the development of healthcare in the UK. 'HCI already has received a number of enquiries from England, and we are presently in discussion with a number of NHS purchasers, ' he said. 'HCI has the space, both occupied and nonoccupied, to be able to offer tailormade solutions to the problems the NHS is experiencing in England and in Scotland.'
The extent of private involvement in the NHS continues to be an apparent bone of contention between Downing Street and the Department of Health, with the prime minister thought to be open to the idea of a mixed health economy. The Scottish Executive has constantly argued that there is not the same culture of private healthcare north of the border.
This view is borne out by statistics. Less than 5 per cent of healthcare in Scotland is delivered privately, compared to around 15 per cent in England. About 4 per cent of Scots have private medical insurance - about a third of the number in England.
Scottish Executive sources say there is no split between England and Scotland and that the differences are a result of devolution.
But if HCI became a health factory offering 'packages' to English NHS patients, the situation might have to be re-examined.
Former managing director of BUPA Roger Hymas who now runs Health Care Navigator, a call-centre-based company offering advice to self-paying private patients, said: 'It is up to the management of HCI to make a case for a concordat in Scotland. But I see no reason why it should not become a health factory or a centre of excellence in cancer and cardiac services for all four countries.'
A Scottish Executive spokesman said: 'The independent sector in Scotland is much smaller than in England - only about 650 beds. Its lack of capacity means it couldn't sustain the long-term needs of the NHS, although it does work at a local level to meet short-term pressures.'