Can the private sector heal the NHS?

The government wants private firms to come and kick the NHS into shape. But will it prove a cure-all?

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Last Updated: 07 Aug 2013

Under new plans announced today, the Government wants to let private companies take over failing NHS hospitals and trusts, in a bid to improve performance. It’s not the first time it’s encouraged the private sector to get involved with the NHS – it’s already spent heavily paying for operations in private clinics, to reduce waiting lists – but this would be the first time that it’s handed over responsibility for the day-to-day running of hospitals to someone not employed by the state.

Health minister Ben Bradshaw is setting out minimum standards of safety, quality and finance for NHS trusts – and about 30 are expected to fall short. If the current management can’t fix the problems, they’ll all be sacked (without compensation) and replaced by managers from another NHS hospital – or from private firms. And it sounds like there’ll be no shortage of takers: private medical firms like Bupa and Nuffield, along with consumer businesses like Virgin, Sainsbury’s and Tesco, are all likely to fancy a slice of the NHS’s gargantuan £100bn annual budget.

The government is insisting it will keep a tight grip on the NHS’s main assets, namely its front-line medical staff and the various hospital buildings. But if it hopes this will stop people moaning about privatisation, it’s got another think coming. Take Geoff Martin, head of campaigns at lobby group Health Emergency, who called it ‘an effort to privatise the NHS on a scale that even Margaret Thatcher would have balked at’. He likened the plan to ‘the selling of franchises for Kentucky Fried Chicken’ and argued that privatisation ‘ripped off the taxpayer to the tune of billions’ and ‘destroyed cleaning standards’. Although we must say, the private hospitals we’ve been to haven’t exactly looked dirtier than their NHS equivalents…

Undoubtedly some of these private firms have a lot to offer the NHS: they’ll bring experienced managers who know how to get results in a fast-changing world, which could cut through some of the bureaucracy that undermines the NHS. On the other hand, presumably the interests of patients won’t always coincide exactly with the interests of shareholders – which could be a bit of an issue in a universal healthcare system. And what if the hospital’s problems actually run deeper than the management team? It’s not as if there are no good managers in the NHS.

What’s more, we’re still ultimately leaving it to the Government to make these procurement decisions. That’s the same Government that has just managed to squander £422m on eight Chinook helicopters that will only fly in cloudless skies on every third Tuesday (or something similar) – a process described by Commons public accounts committee chairman Edward Leigh as a ‘gold standard cock-up’. Doesn't exactly fill you with confidence, does it...?

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