The decision to outsource the running of Hinchingbrooke Hospital to the private sector is only the tip of the iceberg for the NHS, the Department of Health’s former director-general for commissioning and system management has claimed.

Mark Britnell, now head of healthcare (Europe and UK) at accountancy giant KPMG said more than 20 organisations could follow Hinchinbrooke’s lead in the next 12 months.

“Our own analysis suggests there are perhaps 20 or 30 organisations that will be in a level of distress not dissimilar to Hinchingbrooke’s over the next year or so,” he said, speaking at conference in central London.

“And I can’t absolutely say or guarantee that the state will want to be the provider of those services in the future.”

Britnell’s comments follow the revelation that privatisation is now all but certain for Hinchingbrooke Hospital, after the only NHS provider pulled out of the bidding to run the indebted facility.

The withdrawal of Cambridge University Hospitals Trust leaves five private sector providers still in the running.

When the East of England Health Authority awards the contract, Hinchingbrooke will become the first NHS hospital in the UK to be operated by a private firm.

Unions have claimed that the hospital, which has historic debts of almost £40 million, is being used in a dangerous experiment, as the five bidders have no experience in running an accident and emergency department.

Karen Jennings, health spokeswoman for Unison, said: “Global firms that come in with their lawyers and their know how and cost the public purse a lot more money in a bidding process that is a nonsense.”