I can cut the wait time for your eye operation – if only the NHS would let me, says
Imagine being told you will have to wait 18 months to see clearly again.
Not because the surgery is too difficult or the clinics are full, but because a health service accountant has decided that keeping you half-blind a little longer is the tidiest way to balance the books.
That, says Seb James, boss of SpaMedica, is what is happening to NHS cataract patients, though he puts it a little more tactfully.
James, 60, is best known for running Boots and before that Dixons Carphone. He now runs European eyecare group Veonet, called SpaMedica in the UK, which yearly performs thousands of cataract surgeries for the NHS.
The NHS allows people to opt to have the operation done by qualified private providers, at no cost to the patient.
Although some critics have raised worries about potential profiteering, the system had, James says, pushed down NHS waiting lists dramatically.
Big business: SpaMedica performs thousands of cataract surgeries for the NHS annually
But he says delays have now been purposely driven up by health service bosses intent on balancing short-term budgets.
‘It might appear to save money in the short term, but the patients are still there. It is not a real saving,’ he says.
‘Our view is the patient has to come first. If you can’t see properly a lot of other things can happen. You fall over for instance and break bones, which is costly to the NHS.’
James says SpaMedica, which provides 30 per cent of cataract surgeries for the NHS, can treat patients within two to three weeks, against a previous 18-month delay.
‘Sight is one of the most fundamental things to humans. Seeing our loved ones, seeing our way across the road. Cataracts are more or less universal among the over-65s, so it affects all of us in the end,’ says the Old Etonian, who, unusually for a chief executive, is a Labour supporter.
He acknowledges the hard choices facing NHS chiefs, and the pressure on Chancellor Rachel Reeves to try to curb increases. But his frustration is clear.
Private providers treated 5,000 fewer patients in the six months to January this year. Waiting lists shot up by nearly 40 per cent to 23,000 in that period.
James says: ‘Even though we could operate on a patient next week, they are telling us we may not do so.’
In charge: Seb James is the boss of SpaMedica
SpaMedica is the UK’s biggest provider. It’s parent Veonet, based in Munich, is owned by private equity group PAI Partners and the Ontario Teachers’ Pension Plan.
Other big players are Newmedica, owned by Specsavers; Optegra, an offshoot of luxury eyewear business EssilorLuxottica; and Community Health and Eyecare, owned by G Square Capital.
The role of private equity and European corporations has led to concerns of profiteering from the NHS.
Even James admits a sense of discomfort, saying: ‘Everybody, including me, feels a bit queasy about the idea of a private equity company making money out of my health, my mother’s health. I don’t know what the queasiness is, but I feel it. It feels like a moral question. I’m reconciled to it myself because if we don’t do the surgeries better and faster than the NHS we will not make any money.’
Critics also say operators such as SpaMedica lure the best NHS surgeons after they have been trained at the taxpayer’s expense.
‘We train ophthalmic surgeons every year in every country in which we operate,’ James says.
‘We are not all red-in-tooth-and-claw greedy capitalists. If you make sure providers don’t cherry-pick the best patients, make sure we train people, then why not work with private providers as part of the NHS ecosystem? If someone does the surgeries better and faster, and if they train doctors, then we should celebrate the fact they will make money.’
The Department of Health last year was reported to be investigating private cataract surgery providers over concerns about financial practices, poor after-care and unnecessary surgery.
‘There is a word in English law for performing an operation that is not needed,’ says James, ‘and it is assault. We’ve not been in trouble on this. If anyone is doing wrong the sanction should be severe.’
As for profiteering, the NHS sets the price it pays providers. This was recently cut for cataracts and raised for other eye operations where delays were longer.
‘They’ve just cut the price by 18 per cent for a cataract. That hits our profit margin,’ James says.
One reason private providers can offer an efficient service is specialisation.
‘We can do 28 cataract surgeries a day in one of our theatres. A typical NHS session will do eight or nine. We have half the national complication rate.’
James got a taste for healthcare in his previous job leading Boots. Rumour in the City has it that the pharmacy chain may float next year at a valuation of £6billion. Intriguingly, its boss Alex Baldock was chief executive at Currys, previously Dixons Carphone, so is following James’s career path.
Sounding wistful, James says: ‘I thought it would be a lovely thing to float Boots on the FTSE.’
On the subject of retail, he wants the Government to address the disproportionate tax burden on shops and ‘outrageous’ laws for business tenants that he says leave retailers carrying all the risk and landlords none.
He is also outraged about shoplifting, saying: ‘At Boots we were losing £170million a year of stock plus prevention costs of about £25million. When I was about eight I stole a Twix and was brought by my mum to the shop to give it back and apologise. That sort of social contract has gone.’
Recently a row broke out over the sacking of a 17-year-old employee at a branch of Waitrose for intervening to stop a shoplifter stealing Easter eggs. James himself has confronted abusive customers and chased shoplifters.
‘I was in the Boots on Seven Sisters Road and a bloke suddenly kicked off,’ he says of the outlet in North London. ‘Because I am big I stood in front of a colleague and told him he needed to leave. I was terrified. It took me a day and a half to recover.’
When not working, James is a devotee of Bridgerton. He says: ‘The plot lines are ludicrous but the writing is brilliant. I love the optimistic, always-spring world in which they all live. I like the cartoonish plots, the knowing gags, and the dances.’
Which character does he identify with? He says: ‘I’d like to be Anthony but that ship has sailed. Failing that, Lady Bridgerton.’
From Boots to cataract clinics via Bridgerton, Labour-supporting Seb James resists the stereotype of a private healthcare executive.
Whatever one’s views on private equity, his case that patients suffer when ideology trumps efficiency is not easily dismissed.
DIY INVESTING PLATFORMS
AJ Bell
AJ Bell
Easy investing and ready-made portfolios
Hargreaves Lansdown
Hargreaves Lansdown
Free fund dealing and investment ideas
interactive investor
interactive investor
Flat-fee investing from £4.99 per month
Freetrade
Freetrade
Investing Isa now free on basic plan
Trading 212
Trading 212
Free share dealing and no account fee
Affiliate links: If you take out a product This is Money may earn a commission. These deals are chosen by our editorial team, as we think they are worth highlighting. This does not affect our editorial independence.