Published: 30/05/2002, Volume II2, No. 5807 Page 4

Fourteen trusts are talking to US healthcare giants Johnson & Johnson and Inventures, the commercial arm of NHS Estates, about setting up privately owned diagnostic and treatment centres to treat NHS patients.

Under the scheme, doctors and other healthcare professionals may be offered shares in the new businesses as an incentive to improve productivity. The talks came to light last week after Inventures signed a 'strategic partnership'with Johnson & Johnson.

It will allow them to offer services ranging from consultancy through to building, designing, staffing and managing DTCs providing day surgery for NHS patients, and could lead to six new units being set up by 2004. This is the first time a US private healthcare provider has moved to take a share of NHS business.

Inventures presented the partnership as a 'win-win' solution.

Inventures has experience of NHS estates, while Johnson & Johnson has experience of developing and managing DTCs. The company owns 30 similar units in the US, where they are known as ambulatory care services.

Dr Tom Mann, Inventures' director of clinical development and strategy, said no money had changed hands under the agreement signed last week but stressed: 'This is a business arrangement. Johnson & Johnson is looking long term to have a bit of the business of the NHS.'

He declined to name the trusts involved, but said two were possible foundation trusts and one was a primary care trust interested in setting up a day-surgery unit.

Talks are at an early stage, he stressed, but involve plans to establish DTCs as separate local companies, known as specialservice vehicles. Issues such as who will employ the staff and USstyle incentives, including share ownership, are up for discussion.

Dr Mann said: 'The US experience has been that if people are incentivised properly, their productivity improves dramatically.

Trusts are very keen to explore this, not just for doctors but others too. There needs to be equity.'

But the share ownership proposal was immediately condemned.

Andy Burnham MP, Labour health select committee member, said: 'There is clearly a conflict of interest here.You could not have a situation where a local GP or consultant had shares in a unit at a local hospital to which they were referring patients.

It would have to be ruled out.'

Guy Routh, chair of the NHS Consultants Association, pointed out that in the US doctors are not employed in both the private and public sectors, as in the UK.

'I think one would have to look very seriously at the conflict of interest that would arise, ' he said.

News of the partnership sent shock waves through the independent healthcare market in the UK, where several players - notably BUPA and General Healthcare Group - have expressed an interest in developing DTCs.

Inventures is due to be privatised in the next year. So far, Johnson & Johnson - whose spokesperson was not available for comment - has not expressed an interest in buying it.