Independent Sector Treatment Centres (ISTCs) were part of this governments plans for the NHS. GPs were encouraged to use them: this was meant to be the epitome of “patient choice”. But not only have many contracts been issued on a “take or pay” basis, the cost efficiencies of these units have not been hauled up for scrutiny. Professor Allyson Pollock and Graham Kirkwood obtained data under the Freedom of Information Act in Scotland – no such data has been released elsewhere in the UK – and write in this week’s British Medical Journal about what it means. Poor value for money, and much missing data, they say: “If the same patterns apply in England, up to £927m of the £1.5bn may have been paid to ISTCs for patients who did not receive treatment under the wave one ISTC contracts”.

They conclude that “Contracts should not be renewed and new contracts should not be signed until a proper independent evaluation has been published assessing referrals, actual treatments carried out, and payments made for work done along with value for money analysis. Full contract details and costs must be placed in the public domain for this assessment to take place.”

Surely that can’t be argued with?