A PRIVATE company is performing thousands of patient check-ups as part of a flagship scheme to help address Scotland's appalling health record.
Nurses employed by management consultants Refer2Us are being brought in to screen people at risk of illnesses such as heart disease in some of Scotland's most deprived communities.
The first phase of the work in Lanarkshire is being funded by drugs company AstraZeneca to the tune of GBP100,000.
The situation has emerged at a time when doctors and campaigners are calling for a moratorium on private sector involvement in the Scottish NHS to allow a public debate about the issue.
Concern has been expressed about contracting out work which is part of such a highprofile Scottish Executive initiative to tackle the nation's entrenched health inequalities.
Four different health boards are piloting the KeepWell project, which was announced by Health Minister Andy Kerr last year. It targets people in poorer areas who are more likely to become ill but less likely to seek healthcare.
NHS Lothian, NHS Tayside and NHS Greater Glasgow and Clyde said they had no plans to farm out the work to private firms.
However, NHS Lanarkshire, which has made the deal with Refer2Us and AstraZeneca, said that it had turned to the private sector because of the high number of patients needed to be seen and, without its help, people would not have been able to benefit so quickly from the programme.
Senior doctors have questioned how patients will be handed from the Refer2Us nurses to the NHS for follow-up treatment and advice, and how this will affect the chance to build longer term relationships with hard-to-reach patients.
Concern is also circulating about how the KeepWell principles of preventing illness will become part of routine health services unless the NHS embraces the challenge and receives more resources. ProfessorAllyson Pollock, of the centre for international public health policy at Edinburgh University, said: "The whole point about Keep Well is for it to work it should be integrated into community health services and this is an example of disintegration and fragmentation.
"The health minister has repeatedly said they are doing things differently in Scotland because they are integrating healthcare, but this is an example where it is not happening."
She added that in the United States it was a known tactic of the pharmaceutical industry to become directly involved in the disease management of patients. "We know the pharmaceutical purpose is to open and expand markets, " she added.
It is hoped that some 40,000 patients will be screened as part of the Keep Well pilot in Lanarkshire.
A spokesman for NHS Lanarkshire said: "Because of the high number of patients expected to be seen during the early stage of the project, NHS Lanarkshire has been working in association with the independent sector.
"This involvement is at no cost to the NHS and, without this contribution, it would not have been possible to provide the benefits of Keep Well to patients as early in the project.
"Refer2Us's expertise, equipment, and staffing input is an enhancement to the project and is not an alternative to NHS Lanarkshire providing these services.
"This has allowed us to concentrate NHS Lanarkshire staff's involvement on the direct care of patients. Where medication is required, this will be prescribed by the patient's GP."
In a statement, AstraZeneca said: "As part of its mission to make a difference to the nation's health, AstraZeneca is committed to working ethically in partnership with the NHS to address health issues across the UK both locally and nationally.
"Any financial and other support provided by AstraZeneca to these partnership programmes is independent of prescribing decisions by the NHS or clinicians within its locality."
A spokesman for the Scottish Executive added: "As we have stated consistently, the private sector can offer us increased flexibility and additional capacity to help deliver better services for NHS patients."
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