Thursday 18 March 2010
Commercialising the NHS
The British Medical Association has launched a campaign to raise public awareness about commercialising the NHS (http://www.lookafterournhs.org.uk/) . At the moment, there is a big push to involve commercial providers to bid for NHS services. This ranges from the PPI building projects (seen in many other government sectors) to treatment centres. The idea is that competition improves value for money and performance. Some concerns are that money is diverted away from the NHS to private companies. Unfortunately some of the contracts currently in place defy belief- one company I know of is paid up front to perform a given number of minor operations, regardless of whether patients are referred to them or not. At the end of the financial year, there is a big campaign to get GPs to use these centres, in order to make the payment worthwhile! I do think various elements of the NHS (as with any large bureaucracy) need a prod with a sharp stick, as all too often it is easy to sit back and adopt a reactive approach, but is the current approach really benefitting the patients and the tax payers, whom we ultimately serve?
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Over the next few years the UK economy will be smaller than forecast and therefore public sector spending will reduce. The NHS will inevitably have to manage with less. Competition should help to achieve both genuine efficiency gains and continuing improvements in patient care. Whilst many have concerns about private sector involvement, I see little difference in principle between money leaving the NHS in the form of wages and salaries to staff on the one hand, and to contractors and private sector businesses on the other. The real challenge for the NHS is to manage effectively those providing services whether 'in-house' or not. Experience with PPI for example, suggests there is room for improvement.
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