UK GOVERNMENT ATTEMPT TO MIMIC THE PRIVATE SECTOR FAILS

A pioneering treatment centre hailed by Tony Blair as the "embodiment of the new NHS" faces closure after failing to attract patients and losing more than œ3 million. The clinic at Central Middlesex Hospital, North London, the first in Britain to offer elective treatments not requiring an overnight stay, could close by the end of the year. The fast-track "ambulatory care and diagnostic centre" (ACAD) was described by Mr Blair as "a brand-new type of hospital" when it opened in 1999. He said it would "work longer hours, including at weekends, and will involve much more day surgery".

Five years on, the centre is running at less than half capacity and has stopped working at weekends because of lack of demand. Paediatric wards have been described as "virtually empty" and more than 20 nursing staff have been relocated. When it opened, it was hailed by ministers as the start of a revolution in healthcare and a model for best practice. A further 25 clinics, offering popular elective work such as orthopaedics and general day-care surgery, and designed to cater for 200,000 patients a year, have since opened at a cost of more than œ350 million. But other centres, such as one attached to Hammersmith Hospital, have been hit by lack of use and falling revenues.

Nicky Bloom, the Middlesex centre's general manager, told the Health Service Journal that North West London Hospitals Trust was likely to close its unit, which has lost more than œ3.4 million in potential revenue. She said the centre, part of NHS Elect, a consortium of four NHS treatment centres, had performed 6,439 operations since April, against a capacity of 23,000. Ms Bloom said that favour-able treatment by the Government of the independent sector under its "choice" agenda meant that it was "not a level playing field".

However, this week the consortium said that it would expand to include nine more NHS treatment centres. According to the NHS Modernisation Agency, a target of 80 treatment centres to be completed by 2005 is likely to be achieved. Caroline Dove, director of NHS Elect, said the new centres hoped that being part of the consortium would help them to find ways to fill spare capacity and build up links with overseas providers. Robert Naylor, chief executive of University College London Hospitals Foundation Trust, which also has two treatment centres, said he remained concerned that the NHS centres were destined to fail because they could not compete with private providers. He said that the Government was assisting the independent treatment centres with inducements such as long-term guaranteed contracts at enhanced tariff rates, which the NHS centres had not been given.

Andrew Lansley, the Shadow Health Secretary, said that the problems faced by treatment centres were caused by bureaucracy and a lack of forethought by the Government. "Mr Blair said that the new NHS needed more capacity before it could offer choice. That's all talk. Here's an example of where capacity is available but Labour bureaucracy stops choice," he said.

A spokeswoman for the Department of Health said that competition from the independent sector was not to blame, and it had been the trust's decision to develop the capacity for 23,000 patients. "There is no advantage given to the independent sector under the choice process," she said.

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