The Centre for Health and the Public Interest (CHPI) is a London think tank founded in 2012 to defend "the founding principles of the

NHS The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...

". It is a registered charity. Professor

Colin Leys Colin Temple Leys (born April 8, 1931) is a British political economist who is emeritus professor of political studies at Queen's University, Canada, and an honorary research professor at Goldsmiths, University of London. From 1956 to 1960 he t ...

was involved in its foundation.

Research

It has produced several reports on the

Private finance initiative The private finance initiative (PFI) was a United Kingdom government procurement policy aimed at creating "public–private partnerships" (PPPs) where private firms are contracted to complete and manage public projects. Initially launched in 199 ...

in the

English NHS The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the ...

. It said in 2017 that PFI companies had made pre-tax profits of £831m in the past six years which could have been spent on patient care. In 2022 it pointed out that expenditure on staff, equipment and other capital projects can be cut by an NHS trust, but not their PFI payments. It warned councillors in

Newham The London Borough of Newham is a London borough created in 1965 by the London Government Act 1963. It covers an area previously administered by the Essex county boroughs of West Ham and East Ham, authorities that were both abolished by the s ...

that NHS

sustainability and transformation plan In England, a sustainability and transformation plan (STP) is a non-statutory requirement which promotes integrated provision of healthcare, including purchasing and commissioning, within each geographical area of the National Health Service. The ...

s were untested. Its scrutiny of the role of markets and competition in the NHS found that information about quality and safety in private hospitals was not available in the same way as with NHS providers so it was not possible to compare the two. Only seven contracts with private providers had been terminated by

clinical commissioning group Clinical commissioning groups (CCGs) were NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services in each of their local areas in England. On 1 July 2022 they were abolished and replaced by Integra ...

s due to failings, though 16% of their care budget is spent in the private sector and there are some 15,000 contracts with private providers. It has also reported on

Social care in England In England, social care is defined as the provision of social work, personal care, protection or social support services to children or adults in need or at risk, or adults with needs arising from illness, disability, old age or poverty. The main ...

It claims that "the quality of care in adult social care has declined over the past two decades as a result of privatisation". The CHPI estimates that £1.5bn annually, (that is 10% of the care home industry's £15bn income), "leaks" and often enriches owners or other firms linked closely to owners. The £1.5bn is shown as rent, profit, directors' fees and debt repayments, instead of going to the care of residents. It is the same amount of money the government promised to give to social care, because of worries about the large cuts to the social care since 2010 when

austerity Austerity is a set of political-economic policies that aim to reduce government budget deficits through spending cuts, tax increases, or a combination of both. There are three primary types of austerity measures: higher taxes to fund spend ...

started. The CHPI stated, "It's very difficult to find out where the £15bn ends up." Vivek Kotecha, CHPI research manager who did the above research stated, "Some of the largest care home businesses are extracting a lot of profit disguised as rent and loan repayment costs. This makes it hard for local authorities and individuals to know how much extra funding the industry actually needs and how financially sustainable it really is." The CHPI cautioned that a large increase in public funds for the sector could just produce bigger profits for operators, since many firms lack financial transparency. In July 2019 it produced a study on Conflicts of Interest between the NHS and the Private Hospital sector in England. It found that more than 600 NHS doctors owned either shares or equipment or both in the private hospitals to which they referred patients. Most of the shareholding was in

HCA Healthcare HCA Healthcare is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owns and operates 186 hospitals and approximately 2,000 sites of care, including sur ...

. In October 2019 it produced an analysis of expenditure on

private providers of NHS services The private provision of NHS services has been controversial since at least 1990. Keep Our NHS Public, NHS Support Federation and other groups have campaigned against the threat of privatisation, largely in England. The 1997 Labour Party manifest ...

in England. It concluded that rather than the 7% of NHS expenditure which the government say was spent in this way in 2018-9, a fairer analysis would produce a figure of 26% – an increase of 20% over the previous year.

References

{{reflist Think tanks established in 2013 Think tanks based in the United Kingdom Charities based in London 2013 establishments in the United Kingdom