The first independent treatment centre to complete a five year contract will have delivered about 20 per cent less work than it was paid for, HSJ can reveal.

Netcare’s contract to provide mobile cataract surgery ends on 31 May - and is not being renewed.

The £42m contract was for 44,735 procedures, of which “more than 34,600” had been carried out by the end of March. By the end of May Netcare expects to have done just over 36,000 - or nearly 81 per cent.

The centre was on a “take or pay” basis, meaning the NHS will have to pay the full value of the contract, regardless of the number of procedures carried out. It is likely that it is paying for around £8m of work that has not been delivered.

Netcare said it is discussing continuing the service with individual PCTs - although the service is not being recommissioned nationally.

In a statement Netcare said: “We are absolutely delighted with the performance of our mobile cataract units. They have helped… to dramatically improve quality of life for thousands of patients.

“Whilst the number of procedures completed is lower than the number of procedures contracted, this difference may be attributed to the units helping to decrease NHS wait times much sooner than anticipated.”

However, King’s Fund chief economist John Appleby said the start of the fall in waiting times predated independent centres and was largely due to the health service doing more work. The number of operations has now levelled off, he added.

The national MRI scanning contract also comes to an end in July. The DH says more than 431,000 scans have been performed under the contract. HSJ calculates this will mean around 100,000 scans will have been paid for and not used by the end of the contract, which is thought to have cost around £95m for 560,000 scans over five years. It is not being renewed.

Many centres got off to a slow start - the mobile cataract contract was one of the better performers - but the Department of Health said in 2006 that it would work with providers to shift capacity where it was needed.

Now it says that its procurement of the first centres was based on the activity projections of the NHS and usage was dependent on patient choice and primary care trusts referring sufficient volumes.

Latest figures suggest that the centres are struggling to increase the number of patients they attract: in September last year, usage across the first wave was 85 per cent, compared with 84 per cent a year earlier.

Ten independent centres will complete their five year contracts in the first half of 2010 - just before the anticipated time of the next election - and almost all are likely to underperform, including the £17m-a-year Greater Manchester surgical centre, which was only performing three fifths of the expected value of operations by last September.

A Conservative spokesman said: “We have concerns about the residual values in contracts and so a Conservative government will have to look at that closely and work with the industry. It would also expect independent treatment centres to compete at tariff, rather than being given guaranteed volumes or a national contract.”