The benefits of contracting out operations to independent sector treatment centres, such as those providing cataract treatment, are no greater than if they were done within the NHS.
That is the main conclusion of a report by the Commons health select committee into the role of ISTCs in the health service. The committee said waiting lists had fallen but this is more likely due to increased funding in public health. It believed ISTCs may not provide better value for money than NHS Treatment Centres or partnerships made with private hospitals and it criticised the DoH for making no attempt to quantify their effect systematically.
Of the 29 first-phase ISTCs, 12 provide ophthalmology services and are the subject of cataract referrals from optometrists.
Health secretary Patricia Hewitt, speaking to the committee in April, said that to get cataract waiting times down to three months or less, 'around a third of those additional operations were done by the ISTCs'.
The Royal College of Ophthalmologists fiercely disputed this however, describing ISTCs' contribution as 'very little as waiting times for cataract surgery in England came down before the cataract ISTCs became operational'. It said ISTCs had led to a 7 per cent increase in capacity.
Former non-executive director of South-West Oxfordshire PCT Jane Hanna told the committee that the PCT board has been bullied by the DoH to change its mind after it had voted not to approve a contract with Netcare UK for a private cataract unit. The committee said such allegations cast serious doubts on the degree to which local autonomy is respected.
It also questioned the wisdom of further investment in ISTCs in the second phase of the scheme: 'The decision to maintain the commitment to spend £550m per year despite changing circumstances ... seems to sit uncomfortably with the Secretary of State's admission that "in other [areas] it has become clear that the level of capacity required by the local NHS does not justify new ISTC schemes".'
There were also concerns on training of ISTC doctors, many of whom are from overseas and evidence that the centres' introduction has driven down prices.