A new study found that alternative providers of primary care in the UK's NHS do not perform as well as traditional GP practices.

Alternative providers have been contracted to offer primary care in the NHS since 2004 under reforms designed to increase competition from the private sector but scholars from Imperial College London say these providers performed worse than traditional GP practices on 15 out of 17 indicators  - but private sector alternative care providers tend to serve more diverse, economically deprived populations than government-financed health care. Only 4.1 percent of practices in England are run by alternative providers such as companies and charities but the people they help need more.

Christopher Millett, lead author of the study, from the School of Public Health at Imperial College London, argues that's a reason to do away with alternative health care providers. "The lesson is that increasing diversity does not necessarily lead to better quality. Regulators should ensure that new providers of NHS services are performing to adequate standards and at least as well as traditional providers."

Except traditional providers were not doing it, that is why alternative providers were financed there. It would be like demanding that a poor urban school have the same test scores as a rich private one. Volunteer organizations can't match the funding and resources of the NHS.

The study used indicators from the Health and Social Care Information Centre and the national GP Patient Survey, which included access measures such as how easily patients can get appointments, clinical measures such as how well they manage patients' blood pressure, and efficiency measures. Alternative providers had worse results for patients' diabetes control, higher hospital admission rates for chronic conditions, and lower overall patient satisfaction.

That's a demographic issue, not a quality one. Homeless people tend not to take their medication.

Citation: Performance of new alternative providers of primary care services in England: an observational study (DOI: 10.1177/0141076815583303) by Felix Greaves, Anthony Laverty, Utz Pape, Anenta Ratneswaren, Azeem Majeed and Christopher Millett Journal of the Royal Society of Medicine Friday 24 April 2015.