Confusion reigns over private sector participation in the NHS.
On the one hand you have Hinchingbrooke Hospital, which is being lined up to be run by the private sector, and on the other you have NHS Great Yarmouth and Waveney, which didn’t even allow the independent sector to bid for its community services tender because it wants to keep them NHS run.
So, why are some trusts ushering in the private sector with impolite haste, while others are actively excluding them?
The answers lie in health secretary Andy Burnham’s autumnal speech on the NHS being the ‘preferred provider’ of healthcare. He signalled a dramatic change in thinking by suggesting that NHS units would be given every chance to turn around failing services, before private or independent would even be considered.
Everyone got excited about this. Too excited. Was this a U-turn? How did this sit with existing policy and guidance? Was this the beginning of the end for private sector involvement in NHS delivery? The BMA had been running a high profile campaign trying to achieve just that and there were a fair few doctors rubbing their hands with glee.
But, as the weeks passed and no new guidance appeared on what this actually meant, we started to realise this was policy on the hoof (apparently it’s now due any day…). In the meantime, trusts interpreted it themselves. Great Yarmouth’s decision led to a challenge through the Cooperation and Competition Panel. And, just as it was about to make its decision, the government cancelled all tendering of community services in the Eastern region.
Surely it couldn’t have done this because it feared the CCP’s decision. The government is now facing multiple freedom of information requests on the move and potential investigation by he Office of Fair Trading.
Funnily enough, Burnham is now saying his original speech was misinterpreted. Silly us. He wasn’t trying to deter private or voluntary sector providers, just point out that public services should be given a chance to improve.
From my position, it looks like Burnham wanted to curry some favour with the unions and thought a pro publicly delivered NHS speech would help achieve it in the run up to the election. He underestimated the momentum behind the marketisation of the NHS and the potential backlash from wannabe providers.
I’m sure Gordon has had a little word.
This little escapade has offered some insight. For better, or for worse, an increasing proportion of NHS services are going to be delivered by private and third sector providers and it’s going to take more than a secretary of state for health to put the brakes on it.
Tags: CCP, Preferred provider, Privatisation
I don’t agree. If public sector workers keep sending a consistent message that we want publicly delivered services, then politicians will have to listen.
And, here’s a crazy idea, we could even vote for political parties that aren’t advocating a greater role for the private sector…
What irritates me about all this is the confused thinking. If you’re going to introduce the private sector, fine, but make them compete on equal terms.
Let’s also see the outcomes. We hear so much about how popular ISTCs are with patients, for example, but where’s the hard outcome data. They don’t have it.
If the government wants to dispel the suspicion around the private sector then it needs to make their contracts, operation and performance more transparent. There’s always a fudge going on.
It is interesting, those who harp on hard outcome data from private sector should reflect on the fact that there is almost no hard data on clinical outcomes in the NHS.
What is the complication rate for, say laparoscopic hernia repair, in your hospital for the last 3 years? Who is the surgeon with the best and worst results?
How many surgeons bother to record their complications, short and long term outcomes then audit their figures and present them. Even if you wanted to, the NHS provides little or no support ( try putting this in your job plan). If you are open about your complications and outcomes and do present them, you leave yourself vulnerable.
The only real solution is competition, if you are good and have the courage of your conviction, move out of the cocoon of the NHS and survive in the real world.
Of course, that will need a level playing field with patients having the real choice, not this fake market. So we will plod on in the NHS and fight the change, till it overwhelms us.