New dialysis unit prompts fears of creeping NHS privatisation

Martin Shipton

Plans to open another privately run kidney dialysis centre in Wales have increased fears about creeping privatisation in the NHS.

Swansea Bay University Health Board has applied for planning permission to open a new unit in a former gym at Brackla, Bridgend, with the capacity to treat 21 patients at a time. But – like the 17 other dialysis centres across Wales – the unit won’t be managed by the NHS but by a private sector firm called Fresenius Medical Care. Fresenius and two other private companies called Braun and Renal Services UK run all the dialysis centres in Wales.

For some, this makes a nonsense of Welsh Labour’s commitment to keep the NHS as a wholly public service.

Creeping privatisation

Plaid Cymru’s Health and Social care spokesperson Mabon ap Gwynfor said: “Plaid Cymru is firmly opposed to the creeping privatisation of the NHS in Wales.

“Although I’m pleased to see one of the candidates for the First Minister also saying that he opposes NHS privatisation [Vaughan Gething], he allowed for services such as the dialysis service in the Welsh NHS to be run privately on his watch.

“North Wales MS Llyr Gruffydd first raised this issue in 2018 – the Labour Government has allowed privatisation to continue rather than bring these services back in-house.

“There is also the huge issue of hundreds of millions of pounds going from our NHS to private agencies for staffing rather than investing in a sustainable Welsh NHS workforce. This is unsustainable, and requires not just warm words from the next First Minister, but action.”

Astonished

An NHS patient from Bridgend, who is undergoing kidney treatment and didn’t want to be named, said: “I was astonished to discover that the service is provided by the private sector. Welsh Labour politicians are constantly claiming that they are opposed to creeping privatisation and defend the NHS as a public service. Yet the existence of these privately run centres shows that claim up as hollow.”

With dialysis treatment costing £600m per year in the UK as a whole, it’s likely that the cost in Wales will amount to at least £30m.

The development of a privately run dialysis network in Wales follows a paper written by four academics in 2006 and published in QJM: An International Journal of Medicine. The paper said: “It is clear that the numbers of patients needing dialysis, and in particular in-centre haemodialysis, will continue to rise. In Wales, dialysis capacity is overwhelmed, more than 20% of the population still lives more than 30 minutes drive away from a dialysis unit, and there are areas of relative under-provision. There is, therefore, a need to plan the building of additional, appropriately resourced, facilities.”

A statement on the website of Fresenius, whose corporate headquarters is in Germany, states: “Fresenius Medical Care is the world’s leading provider of products and services for individuals with renal diseases of which around 3.9 million patients worldwide regularly undergo dialysis treatment. Dialysis is a vital blood cleansing procedure that substitutes the function of the kidney in case of kidney failure.
“Fresenius Medical Care aims to further consolidate its expertise and to use this competence as a basis for sustainable, profitable growth.

“We aim to continuously improve our patients’ quality of life by offering them high-quality products as well as innovative technologies and treatment concepts.”

A Welsh Government spokesperson said: “The NHS is free at the point of delivery and we are committed to maintaining that. The Welsh Health Specialised Services Committee (WHSSC) is responsible for commissioning renal dialysis services on behalf of health boards in Wales. The vast majority of WHSSC’s services are commissioned from NHS providers, but in some specific instances, such as renal dialysis, it is more cost-effective to procure high-quality services from the independent sector.

“The commissioning of independent providers for renal dialysis is a long standing arrangement. Patients receiving renal dialysis through these arrangements remain under the care of NHS consultants.”

Mixed economy

A spokesperson for WHSSC said: “The Welsh Kidney Network was established during 2009, and inherited a mixed economy of provision of dialysis including both NHS and Independent Provider provision.

“As such, provision has been jointly made quite some time in advance of this date, and was previously managed on a health board by health board basis. We believe this to be the model across the UK.

“The commissioning of independent providers for renal dialysis is a long-standing arrangement which pre-dates the establishment of both the Welsh Health Specialist Services Committee and The Welsh Kidney Network.”