UK Government spin on success of NHS cataract privatisation criticised

Patricia Hewitt, the UK’s Secretary of State for Health, is wrong to announce that independent sector-treatment centers (IS-TCs) reduced waiting times for cataract operations, states the author of a correspondence letter in this week’s issue of The Lancet.

Patricia Hewitt recently announced to the Fabian Society that “the first wave of IS-TCs has already brought down the waiting times for cataract operations to three months, a target achieved four years earlier than promised”. However, ophthalmic surgeon Simon Kelly states that it is the National Health Service (NHS) ophthalmic staff and not the IS-TCs that have delivered improved services to English cataract patients. The letter follows the recent Lancet editorial, (Lancet 2005; 366:1293), which called for the UK government’s programme of wide-ranging privatisation of the NHS to be stopped until there is independent evidence on the effect of the policy.

Kelly states that targeted capital to construct new NHS ophthalmic facilities and improved practice arising from Action on Cataracts (an NHS scheme run along with the Royal College of Ophthalmologists) not IS-TCs increased the rate of cataract surgery from 170,000 operations in 1998/99 to over 300,000 operations per year by 2003/04. He also notes that the South African corporation Netcare, which won the bid for the Government’s mobile cataract IS-TC scheme, will have to be paid for over 44 000 cataract operations in contracts arranged over 5 years, irrespective of whether they are needed or even carried out.

Mr Kelly (Bolton Eye Unit, Bolton Hospitals NHS Trust, UK) comments: “It is not the IS-TCs that have delivered improved services to English cataract patients, it is National Health Service (NHS) ophthalmic staff�The Lancet is correct to call for a robust analysis of IS-TC evidence and dismiss spin.”

The Royal College of Ophthalmologists have produced a statement in response to this letter. Please visit rcophth.ac

Joe Santangelo
j.santangeloelsevier
Lancet
thelancet