In early 2021, AT Medics was taken over by Operose Health Ltd, a subsidiary of the large US health insurance corporation Centene.
AT Medics was a private company which ran 49 GP surgeries across London, some on APMS, (Alternative Providers of Medical Services) contracts and some on standard contracts. It was formed in 2016.
APMS providers were only introduced in 2004, when the British Medical Association (BMA) agreed to a significant change to the General Practice contract, allowing private companies to bid to run GP surgeries and ending the GPs’ monopoly of primary care.
ATP Medics was owned by six GP directors and became a profitable limited company. Their 49 GP surgeries served 375,000 patients and employed 900 staff.
Centene provides health plans for 2.9m people in 24 US states.
It runs traditional commercial private health insurance but also has become prominent in providing contracts for state funded Medicare and Medicaid. Profit is made from the difference between the funds provided by the state and the cut costs of care to patients. It looks to do the same thing in the UK.
In 2021, Centene considerably enlarged its portfolio of health care services in the UK, and became a leading provider of primary care in London.
Operose Health Ltd, was formed in January 2020 by the fusion of two previous acquisitions of Centene – ‘The Practice Group’ and ‘Simplify Help’.
By December 2020, Operose Health Ltd also had 20 more GP surgeries across the country and an urgent treatment centre in Birmingham.
Through its ownership of ‘The Practice Group’ it also acquired a Kent dermatology clinic, and ten ophthalmology clinics. A total of 500,000 patients are covered.
Operose Health Ltd works under the Centene subsidiary, MH Services International UK.
In January 2020, MH Services International UK Ltd, borrowed money from Centene to acquire a 40% voting interest in Circle Health Holdings, another UK company.
Circle Health is the largest provider of private hospitals in the UK.
However, local people in London had no idea that their GP surgeries were changing ownership and when some of them did find out they were angry that they had not been informed and that US health insurance companies, instead of traditional GPs, were running their GP practices.
13 Clinical Commissioning Groups (CCGs) from all parts of London, finalised the takeover of AT Medics on 10 February 2021.
The new directors consisted of leading lights in Operose Health Ltd, including two who had been very high up in the hierarchy of NHS England, the governing body of England’s NHS – Samantha Jones, the CEO of Operose, who was formerly the head of NHSEngland’s ‘new care models programme’, and Nick Harding a Director of Operose and formerly Senior Medical Advisor to NHSE for ‘Integrated Care Systems’ and ‘Right Care’.
Jones resigned a few weeks later and became Health Advisor to Prime Minister Boris Johnson, which clearly confirms the Tory government’s rush to hand over NHS services to US health insurance companies.
The CCGs came from Barking and Dagenham, Brent, Central London, City and Hackney, Hammersmith and Fulham, Harrow, Newham, North Central London, Redbridge, Tower Hamlets, West London, South West London and South East London.
On 25.2.21 representatives of campaign groups against NHS privatisation, wrote to Matt Hancock, the then Secretary of State for Health and Social Care, questioning the legality of the sale of ATP Medics to Centene.
These campaigners included: Professors Allyson Pollock and Peter Roderick from the University of Newcastle; Jackee Applebee, chair of Doctors in Unite; Louise Irvine, secretary of Health Campaigns Together; John Puntis, co-chair of Keep Our NHS Public; Paul Evans, Director NHS Support Federation; Steve Carne, 999 Call for the NHS; and Brian Fisher, Chair of the Socialist Health Association.
They stressed that the CCGs had ‘published very few documents on the change of ownership and held no public meetings.’
On 20th April 2021, Labour MP Apsana Begum, tabled an Early Day Motion in Parliament, expressing alarm at Centene taking over GP practices, suggesting it could lead to the loss of GP surgeries.
She said: ‘We must fight for the NHS to return to complete public ownership, so that we have a service which is funded by the public for the public. The NHS should not be run for profit, because profit does not care for people’s wellbeing.’
The Campaign group ‘We Own It’ started a petition to stop Centene taking over GP practices, which gathered more than 50,000 signatures. A demonstration was held outside Operose HQ on 22 April.
There then followed a series of protests by patients and campaigners, backed by local councillors and MPs, outside local surgeries.
There have been several demonstrations in Tower Hamlets in East London, where Operose surgeries have been forced to close and decamp into new premises further away.
In May, an Islington patient and councillor, Anjna Khuran, filed a claim for a judicial review against NHS commissioners, for allowing Operose Health to take over existing NHS contracts.
She was supported by KONP, ‘999 call for the NHS’ and ‘We Own It’.
A 500-strong Zoom meeting on 28 June featured Jeremy Corbyn.
The flier for this linked the campaign for the Judicial review, to the demand ‘We want our NHS back’.
It said: ‘We also need to – ‘Oppose the new NHS Bill – which threatens patient care, jobs and the future of the NHS as a public service.
‘Call a halt to the reorganisation of the NHS in England into Integrated Care Systems – ICSs are based on a model from the United States which aims to spend less on care while handing profits to the private sector.’
It also said: ‘What’s wrong with Centene?
- Currently slashing 3,000 jobs in Texas and Iowa;
- Fined for not providing enough doctors and hospitals for Obamacare programmes;
- Accused of profiteering and insurance plan fraud in US;
- Fined for serious mismanagement of Medicaid contracts in more than a dozen states;
- Locked in a battle to keep control of health services in Valencia, 90% of shareholder of Ribera Salud.’
The campaign started by Councillor Anjna Khuran has so far raised over £43,000, which would be used to cover capped costs to the lawyers representing the CCG of North Central London, in the event of the judicial review failing.
The judge has granted permission for the judicial review on the following grounds.
- Ground No.1 – Mis-direction. The leaflet explains that: ‘The CCG did not consider all the implications of the takeover because they approached the takeover decision thinking they had no choice but to accept and approve the proposal.
- Ground No.2 – Failure to inquire/take into account relevant consideration. The leaflet explains that: ‘The decision-makers made no attempt to carry out “due diligence” i.e. a full investigation into the workings of Operose and the relationship to the American corporation Centene.
- Ground No.3 – Consultation involvement. The leaflet asks ‘What involvement? What consultation?’
- There were demonstrations outside the High Courts yesterday, Tuesday 1st, and today, Wednesday 2nd February at 9.00am.
- On Monday, 31 January, MPs debated a motion that the government should restore England’s publicly provided NHS by reversing all the privatisation legislation, including the Private Finance Initiative building contracts.
A petition by Unite the Union and ‘Your NHS Needs You’ had gained 135,000 signatures, sufficient to make the government allow the debate.
The call is for the NHS to be renationalised, and for Integrated Care Systems to be scrapped. Unite and YNNY plan activities in February including a Day of Action on 26th February.
However, successive Tory and Labour governments have pursued a policy of handing the NHS over to American private health insurance companies.
Simon Stevens, former CE of NHSEngland drew up the legislation now hurtling through parliament in the form of the health and Social Care Bill, which gives these private companies complete dominance in the 42 Integrated Care systems.
We have seen how the pandemic has been used to shift billions of NHS spending into private pathology labs and Test and Trace, data collection, virtual wards, and private hospitals, while millions of patients have been denied care, rather than spending it on desperately needed new staff – doctors, consultants, GPs, nurses, paramedics, midwives, hospital beds, community facilities and GP surgeries.
Nothing less than the mobilisation of the entire trade union movement in general strike action to topple this government will save the NHS and set up a workers government committed to socialist policies to bring it all back in-house, dedicated to patient need.
Social care must be renationalised too.
- Renationalise the NHS!
- Down with the Health and Social Care Bill!
- Kick the Tories out!
- For a Workers Government and Socialism!
