An American private healthcare firm will launch the first of a new wave of 'surgery factories' in Britain next month under radical plans to slash NHS waiting lists.
The express clinics will use overseas surgical teams to perform routine operations such as hip replacements, and are expected to treat patients faster than an ordinary NHS hospital. They could even perform operations that currently require an overnight stay as 'day surgery' - meaning patients go home the same day as having the procedure.
The Royal College of Nursing has already warned against the risk of creating impersonal 'sausage factories' hustling the patients through to order.
But Tony Blair is expected to outline how the clinics could help reduce waits for treatment in his monthly press conference on Wednesday, as the Government struggles to resume a domestic policy agenda overshadowed by David Kelly's death.
NHS patients will be treated free in the Diagnostic and Treatment Centres (DTCs) with the state footing the bill, leaving firms which run and staff the centres free to reap profits. However, they are set to be controversial, with Labour MPs who fear a creeping privatisation of healthcare.
'The concept is quite positive for patients, but the arrangements behind them do need to be looked at very carefully,' said David Hinchliffe, Labour MP and chair of the Commons Health Select Committee. 'I am uneasy when we start talking about bringing in American private companies, because I have some suspicions about where it might all end up.'
A leading US firm is expected to be named in August as the so-called 'preferred bidder' for the first foreign-run DTC, earmarked for Bradford. Documents drawn up by the North Bradford Primary Care Trust suggest that it will 'extend and challenge current boundaries of what can be provided as a day case' when it begins accepting patients early next year.
Another 10 contracts will be announced over the summer, with German, South African, American and Canadian as well as British private firms in the running.
In total, they should provide around 39,500 extra operations annually by 2005, treating patients within a few weeks of referral and potentially sending them home sooner.
In some NHS-run express clinics, set up as forerunners to the forthcoming privately owned centres, patients go home four days earlier than is usual after a hip or knee replacement, thanks, the Department of Health says, to more focused nursing and fast-tracked physiotherapy or aftercare.
Ed Mayo, chief executive of the National Consumer Council, said the clinics could transform the lives of people now waiting months for operations and bring cutting-edge medicine to Britain, but there were concerns about who would be held responsible if something went wrong.
'It seems very unclear how these are going to be regulated and what rights of redress or complaints people are going to have,' he added.
US doctors working here are likely to be required to register with the General Medical Council, but patients complaining about treatment at a foreign-owned DTC will do so through their local trust.
The only existing privately managed clinic in Britain so far is the Bupa Redwood hospital in Surrey. Bupa says that project - which concentrates on endoscopies, a type of diagnostic test - is popular locally and that there is no question of cutting corners clinically to maximise profits.
Richard Jones, deputy managing director of Bupa Hospitals, said the clinics could treat more people in a day than an NHS hospital simply by not doing such a wide mix of procedures. 'If we can cut costs it is by economies of scale rather than cutting corners with individual patients. If you are manufacturing hundreds of thousands of Mercedes cars, it may be cheaper than manufacturing a few.'
The firm is pitching to run a chain of cataract clinics across the South of England. Jones expects this summer's wave of contracts to be 'just the first of many' - precisely what worries Labour MPs.
A Department of Health spokeswoman said the new clinics could cut recovery time because they did not deal with emergencies or complex cases, allowing the staff to focus better on patients: 'On general wards staff have a lot more pressure on their time, and can't spend as much time with their patients.'
The clinics may also use more specialist nurses carrying out procedures once performed by doctors.
