Private sector providers have secured a third of the contracts to provide NHS clinical services since the Health and Social Care Act began in April 2013, an investigation by The British Medical Journal (The BMJ) has found.
The BMJ analysed 3494 contracts awarded between April 2013 and August 2014 disclosed via FOI requests - finding non-NHS providers (including private sector, voluntary sector, and other providers) have secured 45% of contracts awarded since April 2013.
The analysis of the data supplied by clinical commissioning groups (CCGs) showed that 1149 contracts (33% of the total) were awarded to private sector providers, 335 (10%) to voluntary and social enterprise sector providers, and 100 (3%) to other types of provider, such as joint ventures or local authorities.
A total of 1910 contracts (55%) were awarded to NHS providers. This category included NHS hospitals, community and mental health providers, and general practices.
Of the contracts that were analysed, 195 (6%) were awarded by competitive tender. Private sector providers were most successful at bidding for these contracts, winning 41% of these contracts.
Dr Mark Porter, chair of the British Medical Association said: "These figures show the extent of creeping privatisation in the NHS since the Health and Social Care Act was introduced. The government flatly denied the Act would lead to more privatisation, but it has done exactly that.
"Enforcing competition in the NHS has not only led to services being fragmented, making the delivery of high-quality, joined-up care more difficult, but it has also diverted vital funding away from front-line services to costly, complicated tendering processes.
"What's worse is that there isn't even a level playing field as private firms often have an unfair advantage over smaller, less well-resourced competitors, especially those from the NHS and social enterprises. To undo this damage we need an honest and frank debate about how we can put right what has gone wrong without the need for another unnecessary and costly top-down reorganisation."
Meanwhile, David Hare chief executive of NHS Partners Network described the value of private contracts as a "tiny fraction."
He said:"The BMJ's figures suggest that a significant number of contracts have been awarded to private sector providers since April 2013, the total value of those contracts is a tiny fraction of those secured by publicly-owned providers. Between 2012/13 and 2013/14 there was a 0.4 per cent increase in the amount of NHS work conducted in the independent sector, with less than six per cent of services delivered by private organisations.
He said that patient choice was about being able to choose the best provider.
He added: "What matters to patients is being able to choose the best available provider and to ensure that local healthcare provision is good quality. With lower than average wait times for treatment, excellent levels of patient satisfaction and strong evidence on quality, the independent sector plays a small but important role in ensuring that the NHS meets the needs of all patients."