• Campaign group sends more than 170,000 survey responses to NHS England consultation
  • Most say they want competiton rules changed so services don’t “have to be put up for auction”
  • Comes as NHSE seeks to persuade politicians to support legislation proposals
  • Independent providers say services do not have to be tendered, and that the responses are not representative

More than 160,000 people have told NHS England via an online campaign survey that they want the law changed “so that contracts to run NHS services no longer have to be put up for auction”. 

The submissions from 38 Degrees come as NHSE seeks to build pressure for politicians to support its proposed changes to legislation, including amendments to “free the NHS from overly rigid procurement requirements”. 

The website – which has hosted several popular campaigns on NHS funding and private involvement in recent years – invited its registered users to fill in a survey, whose responses have been submitted to a call for views by NHSE.

Independent sector representatives have said the views aren’t representative, pointing to research which found many people are agnostic to the type of provider. They said only a very small proportion of NHS services are openly tendered, and there was no blanket requirement to do so.

The 38 Degrees survey asked: “To what extent do you agree the law should be changed so that contracts to run NHS services no longer have to be put up for auction?” Just over 150,000, 89 per cent, said they strongly agree; 6 per cent that they agreed; 1 per cent disagreed; 3 per cent strongly disagreed; and 1 per cent said they were neutral. There were 173,750 survey respondents.

Asked whether “local health services should typically be run by the NHS, not private companies”, 97 per cent agreed or strongly agreed, in the results, shared with HSJ.

They were also asked to name “any exceptional circumstances where you think the NHS should consider allowing private companies to bid on contracts”. The highest result - with 44 per cent agreeing - was “as a short term fix in an emergency situation or to bring down waiting times”.

Mike Matters, a campaigner for 38 Degrees, said: “Privatising the NHS has led to an inefficient, fragmented health service that doesn’t work for patients.”

NHSE said nearly 200,000 individuals had responded to its engagement including via 38 Degrees. It is thought to be an unprecedented response for NHSE.

Independent Healthcare Providers Network chief executive David Hare said: “This 38 Degrees survey was based on a false premise that NHS services are being ‘auctioned off’ and that high performing NHS services have to be tendered. Neither of these things are true and indeed recent evidence has shown that just 2 per cent of NHS services by value are let by competitive tender with the vast majority simply being rolled over with incumbent providers.”

He said polling by “credible research organisations such as ComRes and Ipsos MORI has shown time and time again that a representative sample of the public are entirely comfortable with independent organisations delivering NHS care”.

Many observers are sceptical that the proposed legislation – which responds to an offer by the prime minister last year to consider suggestions – could be passed through the current Parliament. The government has no Commons majority and any bill is likely to see controversial amendments from the opposition and other MPs. 

Health and social care secretary Matt Hancock told HSJ last year he would support limited legal change, but warned that if other MPs “add things to [a bill] that don’t work, or cost too much money, or are going to cause us problems, then we may have to drop the bill altogether. And it will be the people bringing forward additional baubles whose fault that would be, not mine.”

Assembly debates legislative proposals

The NHS Assembly, formed by NHS England to “support and challenge” it, discussed the legislation proposals at its first meeting at the end of last month.

Assembly co-chair and London GP Clare Gerada told HSJ that while the meeting did not adopt clear positions, the discussion was generally supportive of the proposals. Dr Gerada, who campaigned vociferously against the Health Act 2012 as Royal College of GPs chair at the time, said: “For me personally it felt like closure. I respect NHSE for looking at this issue and understanding Lansley’s Act has to be changed in some ways to deliver the care we need.”

Her fellow assembly co-chair Sir Chris Ham said he was “very, very pleased” to have the discussion about changing the legislation, but pointed out that if it is successful, it will not come into force for a long time, so health and care leaders should not wait for it. They highlighted the large numbers responding to the engagement.

NHSE’s director of strategy Ian Dodge said in February that “even if the process were to move as rapidly as we could conceive… it is quite hard to see how we can get provisions up and running before April 2022”.

The Commons health and social care committee is also carrying out an inquiry on the legislation proposals and will report later in the year, making recommendations to government.

Under the NHSE proposals, current procurement rules from the Health Act 2012 would be scrapped and replaced with an as yet undefined “best value test”. Some experts have argued this would be insufficient to remove the NHS from wider competition law.