Private Sector Misconduct in the National Health Service (NHS)

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?

An elderly man sits on the edge of his bed looking forlorn. In the background is a cane and some medicine bottles.
Source: Cottonbro Studio / Pexels

Corporate Watch UK has uncovered that Bupa, Bridgepoint and Spire have had over £3.35 billion in contracts with the NHS since 2013, and an unknown share of billions more as part of our project looking at the corporate misconduct of companies profiting from the NHS. Meanwhile Violation Tracker UK reveals how these companies have been fined repeatedly for care-quality offences.


Corporate Watch research found at least £360 million in contracts with the government to provide dental and care home services.

But Bupa has one of the worst rap sheets for care-quality violations amongst healthcare companies on Violation Tracker UK, with multiple deaths and injuries to patients and residents in their care.

In 2015, Bupa was fined £1.6 million (initially £3 million later reduced) by the Health and Safety Executive (HSE) for the death of a care home resident from legionnaire’s disease caused by failings to control the bacteria over a long period of time.

The following year, they were prosecuted again by the agency and fined £400,000 after an elderly woman was found dead next to her bed at their Beacon Edge facility. The death had occurred the same year that serious abuse had been uncovered at the care home.

More recently the HSE brought a case against the firm for failures to maintain trees which led to an 8-year-old girl suffering life-changing injuries, for which Bupa paid another fine of £400,000.

The Care Quality Commission (CQC) has also issued fines to the firm. In 2015 they fined Bupa £4,000 for failures to mitigate risks to residents in one of their care homes. In 2019 they fined Bupa over £123,000 for failures in care that led to the prolonged suffering of residents.

The CQC has rated multiple Bupa Homes inadequate over the last few years, including one London home where relatives claimed that the firm had refused to administer pain relief to ease end-of-life suffering. Last year another Bupa resident choked to death after being wrongly fed undercooked cauliflower.

The Local Government and Social Care Ombudsman (LGSCO) have upheld at least 22 complaints against Bupa since 2019 for poor quality of care.

Bupa has even been prosecuted by the London Fire Brigade and ordered to pay a fine and costs of over £1 million for fire safety failings that led to the death of a wheelchair user in one of its homes.

Bupa’s UK violations are repeated elsewhere. In 2019 it was reported that more than a third of Bupa nursing homes in Australia were a ‘serious risk’ to residents.


Bridgepoint Group Plc, which has been awarded astronomical contracts worth at least £2.4 billion, have also been the subject of investigation by regulators.

Its subsidiary Care UK was prosecuted by the CQC and fined £1.5 million after care failings that led to a resident choking to death. Another subsidiary was fined £80,000 for the death of a resident from urinary sepsis after failures to identify a blocked catheter despite obvious distress.

One employment tribunal case against Bridgepoint contains evidence of abuse at a Bridgepoint facility, although it does not appear to have resulted in any regulatory action being taken.

Cases of gross negligence may be linked to Bridgepoint’s record on employment. In 2021 they were on the government’s list of employers who had failed to pay the minimum wage and it lost two employment tribunals for disability discrimination and unlawful deduction from wages last year.

Bridgepoint has twice been the subject of investigations by the CMA. In 2019 Care UK formally committed to ending additional fees for residents after the CMA found these charges to be misleading and unconnected to any services or products. In 2020 they agreed to refund more that £1 million to residents who were already funded by the NHS, in what the CMA described as a breach of consumer protection law.

LGSCO have fined the firm 19 times in the last few years for social care failings.


Another company advising Rishi Sunak on the NHS backlog is Spire, which Corporate Watch found to have received contracts worth almost £600 million.

CEO Justin Ash received a £1.2m pay packet in 2020, despite Spire being found to have  taken part in illegal price fixing of initial consultation fees.

The pay out also follows multiple cases of gross misconduct. Three separate Spire shoulder surgeons since 2019 have had patients recalled for unnecessary or inappropriate procedures whilst another was jailed in 2017 for performing unnecessary operations on breast cancer patients.

In 2021 Spire was fined by the Care Quality Commission for failing to apologise or disclose details of failures in the treatment of four patients.

Despite histories of repeated failures to ensure the safety of patients in their care, these three companies continue to receive lucrative contracts in the NHS and enjoy privileged access to highest bodies of government. You can read more about the firms and the extent of their involvement in the NHS in the accompanying report by Corporate Watch UK. You can also use Keep Our NHS public’s database of ICB spending here to check the spending of your local hospital. Read more about individual private providers at As ever you can search any company on Violation Tracker UK to see their record with UK regulators. Follow us on Twitter at VT__UK.