Is US Healthcare Misconduct Coming to the UK?

February 19, 2024

We teamed up with Corporate Watch UK to take a closer look at some of the companies advising the Prime Minister on the National Health Service backlog; what is the scale of their involvement in the NHS and what run ins have they had with regulators?

A stethoscope is wrapped around a globe.
Source: Getty Images Signature

With recent news that American healthcare giant Centene Corp. is exiting the UK, there may be a sigh of relief from activists. Centene’s UK strategy – to encourage the NHS doctors in its GP practices to refer to their private clinics and hospitals – has apparently failed.

This is good news for those who want to see patients prioritised over profit. But a look at Centene’s record in the United States on Violation Tracker and the regulatory scrutiny it was beginning to face in the UK should serve as a warning to the UK public about U.S. healthcare corporations buying up NHS services; Centene is not the only US bad actor with stakes in our healthcare system.

Centene began moving into the UK healthcare sector in 2017. In 2020 it acquired Circle Health and later AT Medics becoming the largest private provider of UK GP surgeries.

Corporate Watch uncovered that Centene and its subsidiaries have received at least £970 million in NHS contracts since 2013; £346m of this was part of a £1.57 billion COVID contract issued in 2020.

In the US, Centene is in the top ten companies with the highest penalties for government contract related offences, having paid over $1 billion dollars in fines for filing false claims.

Our US tracker shows that since 2000 it has paid penalties in over 200 corporate infringements from insurance violations to fraud.

Centene may be exiting the UK healthcare market, but other US healthcare companies are still growing their UK subsidiaries and influence. UnitedHealth Group, a large US health and insurance company, has been heavily involved in the development of integrated care systems; a remodelling of the NHS to further financialise it along the lines of the US healthcare system.

In October last year, UnitedHealth completed its takeover of UK firm EMIS, a data management company used by the majority of NHS General Practices.

Like Centene, in the US UnitedHealth has run up penalties of over $2.2 billion since 2000, mostly for consumer-protection related offences such as overcharging patients and failing to pay claimants.

Two male hands in suits are shaking hands. In the background, the sun is setting over high-rise buildings.
Source: Khwanchai Phanthong

Despite these violations UnitedHealth subsidiary Optum is on the Commissioning Support Lead Provider Framework, essentially providing procurement advice to NHS commissioning groups.

It has also received accreditation from the Health Systems Support Framework in 18 topics including shared or integrated care records, business and clinical intelligence, decision support tools and patient pathway optimisation. This means that they have been green lit by NHS England to provide services in these areas.

Corporate Watch found that UnitedHealth had been paid at least £309 million in government contracts since 2014, including contracts awarded to EMIS, while Keep Our NHS Public found that 17 ICBS had paid the firm a total of £4 million.

Other US corporations with stakes in the NHS include HCA Healthcare, which has paid penalties of over $1.7 billion in the US for misconduct, and Universal Health Services Inc., which has contracts via its subsidiary Cygnet Healthcare to provide beds to NHS mental health patients in spite of serious patient safety failures in at least six of its facilities since 2021.

Despite Centene’s exit from the UK market, US companies with poor records of corporate misconduct are still winning large contracts to provide NHS services, and this is only likely to get worse. Thirty-two US-owned firms have now been accredited by the Health Systems Support Framework, many with extensive records of poor care quality and procurement fraud.

You can read more about the extent of Centene and United Health’s involvement in the NHS in Corporate Watch’s report here. You can use Keep Our NHS Public’s database of ICB spending here to check the spending of your local hospital. You can also read more about individual private providers at As ever you can search any company on Violation Tracker UK and Violation Tracker to see their record of corporate misconduct in the UK and in the US. Follow us on Twitter at VT__UK.