Saturday, 28 July 2012

Can the NHS Stay in the Race?

In the wake of the heartfelt celebration of the NHS at the Olympics opening ceremony in Britain, it is vital to remind everyone that the goal posts for the survival of our public health service have been moved to favour private competitors.

The UK Conservative-led coalition Government has been telling voters that although they had previously promised they would not subject the NHS to another costly top-down reorganisation, they had changed their mind because they had come to believe that the NHS was too inefficient in saving lives and it would only improve if the private sector was given a much bigger role in delivering health services as it does in the US.

However, voters may have serious doubts about the government pressing ahead with reforms estimated to cost between £1.3 billion and £2.5 billion (Dept of Health and Treasury’s estimates respectively) when they learn two key facts.

First, Professor Colin Pritchard, whose research has been praised by the government, has undertaken a study (with his colleague, Mark Wallace), ‘Comparing the USA, UK and 17 Western countries’ efficiency and effectiveness in reducing mortality’ (published in the Journal of the Royal Society of Medicine Short Reports). Out of the 19 countries examined, the UK with its NHS system came 2nd in terms of cost effectiveness in saving lives. The US with its heavy reliance on the private sector came 17th. The UK has in fact a much more efficient health service when it is far less dependent on the private sector like the US.

Secondly, the Government’s insistence that injecting a much greater dose of profit-motive into the NHS would have positive rather than negative effects becomes less convincing when the widespread suspicion that profit-seeking would undermine healthcare is being confirmed. In its report, ‘Private hospital told doctors to delay NHS work to boost profits’, The Independent newspaper [ 22 July 2012] revealed the practice by a private hospital of deliberately delaying operations it has been contracted to carry out for the NHS in order to nudge patients towards signing up for private healthcare which would give the hospital a bigger profit.

As the Government pushes ahead with steering NHS hospitals to do much more private work, the profit-motive would spread faster and wider, and hospital administrators would increasingly weigh money-making opportunities more and more against caring for patients who do not pay. The only prospect of halting this is for the Government to have a change of heart, or for the UK to have a change of government.

[For a report on the unlikelihood that the substantial reforms costs would lead to any long term savings, see:; for a PDF version for Pritchard and Wallace’s study:]