Dev Lall

Private practice looks attractive with the mounting challenges of the NHS

As a general surgeon who left the NHS for the big wide world in 2010 I thought it high time I popped back to see how things were going in the NHS.

So I did a locum assisting another consultant in theatre.

Since the biggest thing I miss from the NHS is the surgery, why not?

So I was looking forward to a stint working at St. Elsewhere’s Hospital, London. I’d been there as recently as 4 years ago, although I’d never worked there.

And you know what struck me above all else? Not only how much the place had deteriorated but how fast.

It was just awful.

The reception and some of the public corridors looked good. Well stocked shop and newsagent. Nice coffee shop. Clean and looked after.

Even paintings on the walls.

But the places the public don’t see so often? Ghastly.

Squalid, almost.

Corridors lined with old beds and furniture.

Theatre changing rooms resplendent with peeling paint and lifting floor coverings. Theatre blues lying scattered over the floor. Blood – stained clogs and boots dumped in the corner.

The theatres themselves weren’t much better.

Clean(ish), yes. But tired and shabby beyond belief.

This particular hospital was always slightly “down at heel” but it never used to be as bad as this.

The staff recognised the place was “a bit rough” but I don’t think they twigged just how bad it was. Familiarity often means you don’t always notice the cumulative effect of things falling apart or being uncared for.

Besides, you’re so busy you don’t have time to notice. But for an outsider the deterioration was very, very obvious to see.

The future doesn’t look good for the NHS and the patients who depend upon it.

And private practice?

Personally I’m bullish about the future of private practice.

Though it too has its challenges, the advantages to working privately can probably be summed up in one word:


Control over the quality of care we provide. Control over the conditions we treat. Control over our income. All of which seem to be absent in the NHS.

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