The NHS now subcontracts to the private sector about 35% of its facilities management services, including catering, cleaning and security, according to a new report published by the trade union, Unison.
Its
NHS Market Report, published this month, also reveals that 51% of contracted-out services are controlled by just four companies - Compass, Sodexho, Rentokil Initial, and ISS Mediclean.
Catering accounts for 13% of these services, with combined services, including "hotel" contracts, accounting for 18%. At 29%, cleaning was the most contracted-out service.
The report says that the NHS tends to change contractors less frequently than other public sector areas, as contracts are often "rolled over" when they come up for renewal.
There has been a dramatic rise of combined contracts in the past seven years, says the report, with companies providing portering, reception, parking and security services as well as cleaning and catering.
The trend towards combined service contracts is driven by companies such as Compass and Sodexho which are able to cut costs by targeting large contracts that provide economies of scale, the report says. A growth in Private Finance Initiative contracts, which typically include support service deals that run for 25 to 30 years, is also a factor.
The report claims that the larger companies are pushing smaller contractors out of the market, which is worth £1b, because they are able to offer combined services.
Further details can be had by e-mailing Unison's bargaining support group,
bsg@unison.co.uk.