Laing’s Review reveals mixed fortunes for independent providers, while public sector outsourcing continues apace

None of the 12 market segments covered by the latest (2013/14) edition of LaingBuisson’s Healthcare Market has been immune from government austerity measures and pressures on disposable income. But with some exceptions – including those companies which still have a massive debt overhang from pre-crunch days – they remain in fundamentally good shape, with solid prospects for growth in the medium to long term as the economy recovers during 2014 and beyond. On the negative side, those markets which rely on government funding have had to adapt in many cases to real terms fee reductions. But on the plus side, public sector commissioners have reacted to financial pressures not by protecting their own in-house provision, but by increased outsourcing. Taking 2010 as the base point, when the coalition government was formed and before austerity measures were implemented, all but one of the markets for which recent data are available has witnessed an increase in public sector outsourcing. The exception is private acute medical care, where the outsourced activity gains from Choose and Book have been matched by losses in the scale of the ISTC programme. The share of NHS paid elective surgery which is undertaken by independent providers remains below 5%, see Table, though this looks certain to expand in the future as awareness of Choose and Book grows.