The Coalition is trying to hide its big idea for health - the privitisation of commissioning and further use of private sector providers in the NHS. Why not be honest?
The coalition’s big idea for health is that while the government would still pay for NHS treatment, all commissioning will be carried out by private GP consortiums and service provision will be further opened up to private companies, with the odd sprinkling of not-for-profits. Market competition will drive up standards and lower costs, bringing value for money for taxpayers.
So why not say so? In health secretary Andrew Lansley’s consultation on the reforms, due to close tomorrow, there is no use of the words ‘private’, ‘market’ or ‘commercial’. The issue is clouded over with the words “any willing provider” and “independent providers”. Is the coalition trying to sneak the reform past a public, less than a third of whom support private companies in the NHS, as surveyed in the 2009 British Social Attitudes survey?
Martin Rathfelder of the Socialist Health Association, said:
“These are weasel words, not bureaucrats forgetting to use plain English but an attempt to stop people saying what they think about NHS privatisation. Companies owned by shareholders and hedge funds are not independent. They are accountable to owners who want to see profits.
“It is sad when a public consultation document that claims to be ‘about giving people the information they need to exercise control’ is doing the opposite, for fear of the public saying what the Conservative-led government already knows they think.
“A lot of people think that services owned by shareholders and hedge funds won’t have their long-term interests at heart. They will try to introduce top-up charges. These reforms undermine the comprehensive service which the NHS provides. To make more money, the private sector’s long-term plan will be to increase charges to those who can pay. That is the logic of a market in health care.”
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16 Responses to “Lansley’s “weasel words” hide coalition’s true intentions for NHS”
sianelendavies
RT @leftfootfwd: Lansley's 'weasel words' hide Coalition's true intentions for NHS: http://bit.ly/hXoIeJ reports @DanielElton
william
If you think private health care is expensive,work out how much more free health systems cost.
Simon Landau
@william’s brief comment is curious – let us unpack it.
1. ‘private health care is expensive’ is either true or untrue. Does it matter what I think ? To an individual who has not been paying for health care it must be true that paying for health care at the point of use is more expensive than not paying for it.
2. ‘work out much more free health systems cost’. Well if one pays at the point of use it must cost more than a free service at point of use.
3. If one pays through an insurance premium then it must cost more if the insurance premium is a private scheme (as the insurance provider has to borrow at a higher rate than governments and has to provide a return to investors who provide the capital on which the borrowing is secured).
4. If one pays through a public insurance premium (NI and tax) then an internal private network must cost more for the same reasons as in 3.
I think the above is what Martin has been patiently explaining to us all (including you, William).
Richard Blogger
Just to be clear, the consultation that will close tomorrow is on patient choice, not on the white paper “reforms” (that consultation ended last year and the response from the DH was published at the end of last year; the response can be summed up as “lala lala I’ve got my fingers in my ears and I am not listening to you”).
If anyone wants to know about patient choice, I suggest you start by reading this blog post from GP Jonathon Tomlinson. Real patient choice is not about whether it is Nuffield, Spire or NHS.
Richard Blogger
@william’s response is bizarre. But anyway, let’s look at some figures. Last year I looked at the cost of one treatment – replacement of cataracts.
The figures I got were (per eye).
NHS £741
ISTC £939
Private £1300-£2950
The NHS figure is the average for all hospitals across England, so some hospitals will be performing the procedure for less. This is the so-called Tariff for the procedure, and next financial year (2011/12) all tariffs will be reduced by 1.5% (“I will cut the deficit, not the NHS”? Huh? Huh?).
ISTCs are private providers working for the NHS on a bizarre contract that put no risk on them. Studies show that they only complete 85% of their contract even though they get paid the full 100% (there is a clause that allows them to re-refer difficult cases back to the NHS). Taking that into account, that puts up the cost to about £1100.
Note that the NHS suppliers get risk pooling and liability insurance from the government, which private contractors don’t (although ISTCs had ludicrously beneficial contracts with the NHS). On the other hand, the NHS pays for training (£4.8bn out of the £105bn) and private companies benefit from that.
It’s clear to me that the NHS is very cost effective.