The Guardian has had a story that the Government is to lease NHS buildings to private healthcare providers. So the private sector will take over NHS assets and do work under contract there for the NHS. The Guardian also says that rules on 'poaching' staff from the NHS will be relaxed.
I am not sure why this story has not been followed up in other newspapers. It would appear that it might be significant - especially if the policy were to become widespread.
As to whether it is a good policy or not, the obvious advantage is that the private sector will have every incentive to operate efficiently and without wasting money. It will want to do procedures instead of, like many NHS hospitals, having an incentive to avoid doing procedures or even closing entire wards.
Another plus is that this kind of thing will build up the critical mass of the private sector in the UK which has been too small. (That is why there is not any really big private sector hospital with the capacity to deal with a large array of emergencies. Such hospitals are commonplace in the USA where the private sector is much bigger.)
But the drawbacks of the plan are substantial:
First, the real development of good quality care at the lowest possible cost only develops when there is choice for patients who can select between competing suppliers.
In theory this Government is in favour of choice and competition. In practice it is not. The only 'choice' a patient might get, even with new NHS-contracted private suppliers, is between one private supplier and one NHS supplier. That is not a real choice or real competition. What the patient needs - and what the system needs if there is to be a real improvement in performance - is competition between plenty of private suppliers. The money needs to be in the patient's hands and he or she needs to be able to choose anywhere in the country (or, indeed, outside the country).
Second, these private suppliers will be hedged in with rules and regulations about what they can and cannot do. So the advantage of having private suppliers will be severely reduced.
Third, in due course, these suppliers will not be given enough money to do the job well. So then they will - under Government pressure and inducement - cut corners and do the job badly. But the private sector will get the blame. When the private sector gets the blame and is considered to be part of the problem, then the general public will turn against it and the only real chance we have of moving to a much better system could be lost.
Posted by James Bartholomew • Indexed in NHS
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??? These 'private suppliers' are _govt contractors_. _Govt_ pays -- _not_ the patient. Why should contractors care? Their clients are the govt officials who issue the contracts. The contractor's return comes from satisfying the officials -- such that the contract is renewed. The whole thing is shadow-boxing: between those officials who want to spend tax revenues on govt employees & those who want to employ & supervise contractors. The very notion of patients directly buying services is incomprehensible to both sets of officials. Neither set would let taxes return to tax-payers.
Posted by: Sudha Shenoy at September 28, 2005 01:32 PM