Critics have claimed that private healthcare firm Circle is putting profits before patients after documents showed it will received at least the first £2 million Hinchingbrooke Hospital makes annually.

A contract obtained by HSJ shows Circle will receive an initial two million pounds as well as more than half of the trust’s annual profits, unless this exceeds £6 million.

Christina McAnea, Head of Health at UNISON, called the agreement a “disgrace” and said patients and staff will “pay the price” for such a deal.

Circle began its ten-year contract in February 2012 and became the first private company to manage an NHS hospital and its full range of services.

Hinchingbrooke Hospital in Cambridgeshire has debts of around £40m. At the time of the deal, Circle said it would invest millions of pounds into the hospital in an attempt to clear the debts.

When the deal was announced, Circle Chief Executive Ali Parsa likened management of the hospital to the John Lewis chain.

Management at the hospital claim it has already made substantial improvements and transformed its A&E department from one of the worst in the region to one of the best.

However, Shadow Health Secretary Andy Burham aired concerns about the terms of the contract. He commented: “The structure of this deal holds worrying implications for the future of the NHS. It gives Circle a financial incentive to make eye-watering cuts.”

A spokesperson for the Department of Health said the deal has preserved this “valued local service – had it not been agreed, the hospital may have had to close.”

Campaigners against privatisation of the NHS have said the money earned by Circle should’ve been reinvested into improving services or treatments, or reducing the debt.

A trio of the NHS’ most experienced leaders have turned down the opportunity to join the NHS Commissioning Board.

Former NHS Acting Chief Executive Sir Ian Carruthers, Dame Ruth Carnall and Sir Neil McKay all declined the opportunity commence to high profile roles on the commissioning committee.

Ian Dalton, Chief Executive NHS North of England, has already been appointed as the Board’s Chief Operating Officer.

However, it was expected that Sir Ian, who is Chief Executive at NHS South of England, Dame Ruth, Chief Executive at NHS London, and Sir Neil, Chief Executive at NHS Midlands and the East, would fill regional positions within the reformed health service.

But the trio told HSJ they had no intention of being part of the new structure. They are expected to continue in their roles until Strategic Health Authorities are abolished in April 2013, but intend to pursue new career paths.

Sir Ian expects to be involved with the NHS when SHA are abolished, the Journal said, but will not seek a major full-time role; Dame Ruth indicated she intends to work as a freelance consultant, and Sir Neil said he was is still considering his options.

The National Commissioning Board, which was established in shadow form in October last year, will support Clinical Commissioning Groups when they take responsibility for the NHS budget this time next year.

Several Liberal Democrat peers are supporting a number of amendments to the Health Bill focused on the regulation of competition within the NHS.

Several senior Lib Dem peers support the amendments and could force the Government to change aspects of the controversial legislation following concerns the Bill could still extend the application of European competition law to the NHS.

Lord Clement-Jones, a former Lords health spokesman who backs the changes, says the amendments would “balance the competitive powers and the integrating duties”.

More than a dozen amendments have been tabled by Lib Dem peers. They include the constraint of Monitor’s action against anti-competitive behaviour, that private income generated by Foundation Trusts would be used solely for the benefits of NHS patients, and that public interest be considered when the Office of Fair Trading is consider mergers.

Speaking to the HSJ, Lord Clement-Jones said he and his colleagues aimed to “make sure we didn’t fall into having a health service covered by European competition law” and that “we don’t have competition red in tooth and claw across the health service”.

The consideration of the Bill at the committee stage in the House of Lords is set to continue until the New Year.

Further delays to the progress of the controversial Health and Social Care Bill are expected due to several challenges to its proposals during its passage through the House of Lords.

Baroness Glenys Thornton intends to seek crossbench alliances in order to question aspects of the reforms, including the role of the health secretary and competition regulation.

Labour’s health spokeswoman said to the HSJ that peers were likely to “demand” that the legislation was analysed in a Lords bill committee, rather than on the floor of the house.

A bill committee is the only way the house can hear evidence from external bodies.

The Baroness says the rare move away from a discussion on the floor would be justified due to the Bill’s length, complexity and as it has been significantly amended following the Government’s NHS Future Forum’s recommendations.

It’s believed that the move to a committee discussion has support from Lib Dem peers, although it is understood the Government has serious concerns about the resistance and further delays.

Baroness Thornton raised a number of issues that had not been discussed in the House of Commons because a lack of time and other amendments had not been scrutinised fully.

She said that due to the Bill’s impact being so “big and fundamental” it would usually be subject to a comprehensive parliamentary debate and a draft bill before the proposed legislation was published.

“There is certainty a case that some parts of this bill need more attention,” she said.

“Clearly the Government might find itself in some difficulty.

“We are taking this bill very seriously… There is a cohort of members who are well informed about this bill.”

She added that it was impossible to predict likely further delays but said that royal assent may be take place beyond when it is currently expected in early 2012.

The DH estimates the cost of the NHS reforms is nearly at £1.5 billion.

Figures published alongside the department’s Business Plan 2011-2015 calculate that £1.49bn has already been spent on structural changes.

Opposition to the high cost of the reforms, particularly redundancy payments made to staff exiting their jobs, has been questioned by a number of MPs in recent months.

When the Health Bill was first publishing in January, the DH’s Impact Assessment report estimated that the total cost of the structural transition would be around £1.33bn.

The DH said that the benefits of the changes “far outweigh” the costs of reform with the original assessment expecting the overall financial benefit of the structural shift to be in the region of £11.7bn – mostly down to the reduction in “administrative” spend.

A new impact assessment will now be completed by the DH following the Government’s recent amendments to the Health Bill after the NHS Future Forum’s recommendations. Analysis by HSJ has already shown that the commissioning transition had already cost £228 million since July last year.