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As NHS defenders continue to protest about the stealthy takeover of a group of GP practices in London by a giant US corporation with a questionable record, candidates from eight parties standing in the mayoral and London Assembly elections next month have taken the London Patient Protection Pledge, stating that if elected they will fight to take back the NHS surgeries and oppose any other takeovers by profit-driven private corporations. Evidence from a survey of more than 8,000 practices shows that patient satisfaction is lower across four out five key indicators when they are run by limited companies rather than traditional GP partnerships.

The campaign against the transfer of 49 surgeries to Operose, a subsidiary of the US health insurer Centene, is being coordinated by We Own It in collaboration with a further 22 organisations. They are asking election candidates to take the London Patient Protection Pledge and to date around twenty have done so. The most prominent candidate to have signed is the Green Party's Sian Berry, who is standing for Mayor of London. She is also standing as a London-wide assembly member, as is her colleague Caroline Russell, another signatory.

The London Patient Protection Pledge

london patient protection pledge

Centene, the US health insurance company, through its UK subsidiary Operose Healthcare, has recently taken over 49 GP practices across Greater London.

I am deeply troubled by the implications of these takeovers for the quality of patient care and for the pay and conditions for GP practice staff.

I worry that this could increase health inequalities for Londoners.

Operose’s track record of closing GP practices for not being profitable here in the UK[1], as well as their owner’s (Centene’s) own track record in the US of being found guilty of underpayment of doctors and underprovision of doctors for patients[2], suggests Londoners’ primary health care needs should not be put in Centene’s hands.

I, therefore, oppose the takeover of GP practices in London by Centene’s subsidiary, Operose Healthcare.

If elected, I will fight to take back our NHS GP practices from Centene and oppose any other takeovers by profit-driven private corporations.

If elected, I will also fight against the privatisation of the NHS at every opportunity I have as a London Assembly member or as Mayor of London.


1. The Daily Mail covered Operose abandoning a practice they were running in 2018.

2. A recent We Own It London local leaders open letter, signed by 180 London councillors from all parties, catalogues Centene's extensive track record of bad practices.

The particular grounds for opposition to the Centene Corporation have been detailed in previous reporting and even the rightwing Daily Mail has criticised its record of prioritising profits over patients. However, there are more general concerns about a shift away from the traditional way that GP practices have operated in the UK - a move away from GP-led partnerships towards limited companies. Research published in the Journal of the Royal Society of Medicine based on data from more than 8,000 GP practices found that

"...analysis of variations in patient satisfaction across different types of provider reveals that practices run by limited companies perform worse on four out of five key indicators - frequency of consulting a preferred doctor, ability to get a convenient appointment, rating of doctor communication skills, ease of contacting the practice by telephone and overall experience."

This is unsurprising, as the way that NHS contracts with GP practices work means that the only way that these limited companies can increase their profits is to cut costs - for instance, by employing fewer or less qualified staff and by reducing the services they provide. Centene, whose questionable operating model confirmed by court verdicts in the US, is just an extreme example of the incompatibility of profit-driven companies with general practice. Unfortunately, former senior Centene executives have recently been appointed to positions within the government and NHS which have influence over the future shape of the NHS and how it commissions services - raising obvious concerns about conflicts of interest. And to make matters worse, the transition from local clinical commissioning groups to larger "integrated care services" will reduce public accountability and scrutiny.

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