Mobile cataract centres are to be privately run

The scheme is part of controversial plans to provide fast track surgery centres for simple procedures in order to reduce NHS waiting times.

Doctors' groups fear poaching of NHS staff, and a loss of training opportunities for would-be surgeons.

But Mr Reid said many patients would receive quicker treatment.

Knee surgery

This is good news all round for the tax payer, for the patient and for the whole of the NHS. John Reid SA company counters criticism

The announcement that the South African firm, Netcare, will start running the treatment centres from next month has revived debate about the government's long-term health agenda.

Ministers have promised that by the end of 2005 there will be a total of 80 fast track treatment centres.

Some of these will also be run by private companies.

The centres will provide cataract, hip and knee surgery for 250,000 NHS patients a year.

Long terms costs

The aim is to expand capacity in the NHS, but critics question this and raise doubts about whether the scheme provides value for money.

Ministers claim Netcare will perform cataract operations nearly 10% cheaper than if they were carried out by the NHS.

Opponents also question the long term costs, and fear the scheme is just a short term measure that does nothing to address the problems of the health service in the longer term.

They fear that treatment centres will simply cream off the simplest surgical cases, leaving the NHS to deal with the more costly complex ones.

Netcare facts Africa's largest private hospital network Listed on Johannesburg Stock Exchange in 1996 Currently owns 45 hospitals Recently bought Medicross Family Medical and Dental Centres Expanding its business beyond South Africa

That is an allegation the government strongly denies.

Health Secretary John Reid told the BBC capacity in the NHS was being expanded more quickly than ever before, but - because of decades of under-investment - thousands of people were still waiting for care.

"This is good news all round for the tax payer, for the patient and for the whole of the NHS."

Dr Reid said the contracts would ensure that the new centres made provision to train doctors, and that they would not attempt to poach NHS staff.

He also stressed that the government was fully to committed to the concept of the NHS.

Complications

In December an MP called for an investigation into allegations about work done by Netcare.

A trust in Cumbria said three out of 900 patients developed a serious and rare complication after surgery carried out by Netcare professionals.

The condition, called endophthalmitis, usually occurs in one in 1,000 patients.

Changes were made to sterilisation procedures and the use of antibiotics after the surgery - and no further cases emerged.

Liberal Democrat health spokesman Paul Burstow said: "Our concern is that these contracts seem to be ones that will allow millionaires to be made out of a number of surgeons who are flown in specially to do the operations, they will cost the NHS more, and in general terms will not be adding extra capacity.

"It will simply mean cherry-picking the easy operations, making the profits and leaving the NHS to pick up the bill."

Doctors' concerns

Dr Paul Miller, chairman of the British Medical Association's consultants committee, said any move to increase capacity in the NHS and bring down waiting lists was welcome.

But he was concerned that trainee surgeons might get less opportunities to hone their technique, and that the the new centres might focus on "easy" operations, leaving the NHS to deal with complex and troublesome cases.

He said: "It needs to be realised that this is a short term solution to the shortages of staff in the NHS.

"I don't think anyone would think it was a good way long term to plan to run your services by flying in surgeons for a couple of weeks at a time from all over the globe to do a few operations and then go home.

"We need reassurances that this is not going to impact on NHS services."

Tim Yeo, Shadow Health and Education Secretary, warned treatment centres could be underminded if doctors and other health professionals were recruited directly from the NHS.

He also questionned how the NHS would cope with the increased demand for post-operation care if the new centres had no duty to provide it.