NHS – Labour to Reduce Private Sector Involvement

NHSWith the 2015 general election strategies now well entrenched it is no surprise that Labour is concentrating on its most potent area, the National Health Service that it set up in 1948. Free at the point of use, apart that is from medication prescription charges (brought in very soon after it was set up), dental fees and a range of other chargeable fees for a number of specialist medical services that fall outside of the NHS’s main activities. However, some relief for a few of these charges is available to children, pensioners and people eligible for welfare benefits.

Originally, the NHS received revenue solely through money compulsorily taken as a contribution (not officially a tax) from wage earners and employers, called the National Insurance contribution. The money thus raised is deposited in the National Insurance Fund that also has to fund pensions and social security benefits. This worked well for a number of years until the NHS grew massively in size to accommodate the ever increasing number of users and the increase in sophistication of medical care being developed world-wide. This led to a funding crisis that could, and can only be addressed by taking money from other areas of primary general taxation thus reducing the amount that can be spent in those areas. Another funding stream used is borrowing, and in recent years that has been factored in on a huge scale never before seen in the British economy.

Labour is now talking up slashing the profits of private medical businesses that currently, or will in future, supply the NHS with valuable medical services. Their intended aim is to cap profits to 5% for contracts worth £500,000 or more (VAT included or VAT not included has not been stated). However, given that the NHS buyers already employ a tough approach to purchasing negotiations there is no actual factual evidence that the current pricing arrangements are seriously at fault, perhaps apart from non-directly medical purchases such as computer software systems that is. In addition to this 5% pledge is the charge that ‘privatisation of the NHS’, as it is termed by Labour, will be reversed. This seems a bit rich as Labour amazingly fail to mention that it was Tony Blair/Gordon Brown’s government that escalated the private sector’s involvement in the NHS further and faster than any other government before or since.

There is no road map in place to privatise the NHS and it is irresponsible scare mongering by a political party in a desperate bid to increase its voting share to suggest that this is actually the case. The inescapable truth is that the NHS has, since its inception, always involved a mixture of public and private provision and has had to pay (fund) and rely on external providers and will continue with this need to do so in future. The NHS is the face of health care in the UK, but it would not be able to function at all without the long list of businesses and organisations that it works closely with and relies upon so heavily on a daily basis. This includes the vast majority of GPs who are independent private contractors to the NHS as are most dentists and private high street pharmacies that process the overwhelming majority of the millions of prescriptions daily (including weekends and rostered evening openings), independent commercial medical laboratories also play an important and effective role in suppling services to the NHS as do legions of home-care workers. Additionally there is collaboration with drug companies, equipment and sundries suppliers, research centres at universities and medical charities such as Cancer Research UK for example. The fact is that the NHS is already, and always has been, a big user of services provided by the private sector. So, all this nonsense talked of impending increased privatisation of the entire NHS itself is just plain fiction and diminishes into virtual insignificance because the private sector has always been a major, integrated, contracted service provider that the NHS could not possibly disengage itself from and still function.

The NHS is basically a worthy contract between the people of the UK and a pot of their money collected from them by the government offices of the day on their behalf specifically to be used for funding certain health care facilities and services that are “free”, or subsidised at the point of use. Who actually provides those services is actually irrelevant, as long as the services are of a good standard for the patient and can be delivered at reasonable cost.

New technology is increasingly becoming more prevalent and funding for that comes with a hefty price tag attached for equipment and qualified trained staff. In the particular case of infrequently used high-cost medical equipment and techniques it makes perfect sense to outsource those treatments to the private sector at a discounted rate as is presently in place. A private sector company can afford to provide these services to the NHS cost effectively because the higher revenue generated by money received from their private patients is sufficient for them to invest in provision of such advanced facilities which they can then offer it to NHS patients at a discount. This is no different from NHS hospitals that have always had provision made available for private health care and charge accordingly.

The recent debacle regarding the shameful treatment of young brain tumour patient Ashya King and his family by NHS Southampton General Hospital has made it plainly obvious that successful treatments offered by service providers other than the NHS are to be welcomed and should not be demonised by either NHS staff or politicians. Let us all not loose sight of the fact that it is the patient that is most important and not the institution that is there for no other reason than to serve, not dictate. There should never be institutional cronyism and sacred cows when it comes to patient care. Never!

That is not to say that the NHS shouldn’t invest in new technology and the support systems and skilled staff required to operate it, it’s more a case of being sensible in the decision making process. It is absolutely impossible for the NHS to invest in all and every area of medical care and some proper, upfront honesty in this respect needs to be forthcoming from our politicians rather than using the NHS as a weapon for totally unfounded and grossly overly simplistic political point scoring.

With both a fast growing and ageing population it is vital for the overall tax raising economy, and thus the performance of many other vital public services, that a sensible balance is achieved within affordable budgets that will not burden future generations with intolerable and unsurmountable amounts of debt. There are no quick fixes or easy to introduce solutions that will satisfy all criteria and the debate as to what are the better solutions will no doubt go on for many years to come yet, and all this whilst pressures on the NHS continue to increase exponentially.