The Economist prints 9th May 2015: Public goes private. Private provision in the NHS will increase in coming years
AS FAR as it possibly could, the Labour Party tried to make Britain’s general election a referendum on the National Health Service. The NHS is a Labour creation; the Tories, the party claimed, had a “secret plan” to cut and privatise it. In fact the use of private companies in the service is likely to grow over the next few years, regardless of who comes to power.
The NHS already uses the private sector to a larger extent than is generally known. A familiar statistic—that 6% of its budget goes on private providers—glosses over the fact that NHS equipment, from plasters to X-ray machines, has always been produced by independent companies. The figure does not include general practices—where most Britons go to see their general practitioner (GP)—which are run like small businesses. Fully 16% of the mental health budget goes on private providers, a sector all parties have pledged to boost.
Mr Stevens’s scheme promises efficiency savings of £22 billion ($33 billion) a year by 2020-21. Using private companies has so far proved the most effective way to cut costs in the NHS. Independent diagnostics companies, for example, have made hospitals considerable savings. And, with reforms leaving £8 billion to be found in funding, parties would be wise not to rule out investment from private sources.
Most of all, carrying out the five-year plan would mean a radical shift in the way care is managed. A third party, rather than individual hospitals, would have to oversee people’s treatment, tracking them from GP to hospital and from specialist unit to care in the community, in order to minimise inefficiencies. This third party will be recruited in an open competition. Because private companies are the most experienced at this kind of thing, one of them is likely to win.
In the Spanish city of Valencia, for-profit companies run national health-care services for 20% of the population, at better value for money than public providers and at no cost to patient satisfaction. Mr Stevens, who has worked for such a company, UnitedHealth Group, is aware of their merits. Britain recently introduced such a system in Bedfordshire, co-ordinating the treatment of musculoskeletal patients. It chose Circle, a private company, to run it.
The next government will have hard decisions to make about NHS funding. Money is tight, yet the population is ageing and increasingly demanding. Election promises are one thing; post-election realities another thing altogether.
NHS reality agrees and lists below some interesting comment from The Times letters and leader.. Until rationing is overt and fair for the “big and expensive” services there is a lot more do be discussed before any decisions on change should be made.
More with Less (Leading article)