Who's afraid of the private sector



Dick Vinegar. Guardian Online. Healthcare-Network. 13th Feb 2012. Who's afraid of the private sector. (Accessed on 20th Feb 2012)

13 February 2012 11:17AM

The reforms will mean that big private companies get hold of all the commissioning business as GPs fail at that. These companies will offer insurance for healthcare only to those with whom it's economicaly viable, rather than according to need.

That is the big change.

What will remain of the old will be a safety net for the poorest, which will cost the taxpayer a lot, while providing much depleted care. The NHS costs a fraction of what healthcare costs in the US, which has a lesser life expectancy than the UK.

That will end.

62% of bankruptcies in the US now are because of medical bills, because of parents trying to save their sick children.

That is our future if this bill succeeds.

13 February 2012 1:27PM

For example, take out-of-hours services for GPs.

Oh yes, OOH providers, imported from Germany, who do not speak English, and who turn out to have a problem understanding the doses required. And your point about the private sector is?

That seems to be a real competitive market, with PCTs, GP-led "social enterprises" and private companies all hammering away at each other

Oh yes, "hammering away", its a pity that patients get in the way of this hammering, isn't it? Sorry but OOH is not a good example.

OOH is important. In my area, the OOH contract says that it has to be based at the local hospital, and the PCT then handed it over to a private contractor from out of the area (huh? why not have someone *local*?). The hospital is not happy. It is NHS through-and-through (and bid for the OOH contract themselves, but this was at a time when PCTs were told to out source everything that was not nailed down).

The hospital have this cuckoo in the nest imposed upon them. The relationship is not good.

The local GPs do not like the provider either, they did not appoint them. And now the hospital (who run the local community health services) have now set up their own urgent service (effectively OOH) to make up for the ineffectiveness of the OOH provider. (The OOH provider simply provides OOH on the same basis as GPs have done for 60 years, no inn7 March, 2013and patients who frequently use A&E, with a special service tailored for them.

Why didn't the OOH provider innovate like this? Because they don't have to, they can make a profit without improving the service.)

Incidentally, when it comes to out-of-hours the government is moving to an almighty, convoluted mess.

Under this Bill we will have:
- 999 service, delivered by ambulance foundation trusts
- minor injury units
- out of hours provided by Uncle Tom Cobbley and All
- NHS Direct, provided by NHS Direct Foundation Trust
- NHS 111 urgent services provided mostly by ambulance trusts

add to this the "in hours" services:
- community health services (eg district nurses)
- GP house calls
- social care services, both local authority and privately provided, but paid for by the local authority

And you'll see that there are many "interfaces", many providers, and any chance of integration is dashed. An effective and intelligent SoS will have looked at this mess and re-designed it from the patient's point of view. We have neither an intelligent, nor effective SoS.

And he does not care about the patient's experience of the service, if he did, he wouldn't be complicating this mess.

NHS 111 is not needed, but has to be provided to fill a gap formed by the silly decision to allow patients to register with a GP in another area. How do you have a GP house call if you live miles away from the GP (the local GP is not paid to treat you)? How do you get OOH service if the CCG, who your GP is a member of, does not commission the OOH service where you live (so the local OOH provider is not paid to give you that service)?

NHS 111 is the solution to a problem that should not exist. A typical Lansley fuckup.

But hey, you clearly get a DH gold star for the ad hominem attack on Dr Clare Gerada!

13 February 2012 4:05PM


You really have no clue about what privatised healthcare is all about. You also have no clue what general practice in UK is all about so let me educate you.

GPs are the back-bone of a service who dedicated their life to serve people like you regardless of the time of day or season of the year. Until in recent years, each still serve their local communities after hours, attending to urgent house calls as and when duty calls.

You can ask the wife of an old fashioned GP what this meant. They were leaders of their community. Rightly respected and held in high esteem.


Because all that Sheer bloody hard work and dedication done to look after their patients whom they take accountabilit7 March, 2013d to ask "Do you have medical insurance?" or " Cash or cheque?" before they set out into the cold dark wintry night to do their duty.

Patients best interest and accountability. Do you even understand these 2 words?

The "Modernisation" of the NHS by the government of the day gave the young GPs a road paved with gold to relief themselves of this onerous duty, and then conveniently filled this newly created void for after office hours cover with all kinds of privately run companies to provide a lesser service at higher costs (paid with tax payers money, of course).

Patients often admitted to AE by private locums who have never seen the patient or their family before, hence not having a clue about what is the real problem.

Often, these patients don't even need admission in the first place but that's the easiest thing to do, so that the next patient in the private companies list can be seen.

It is not their patient nor their responsibility when the sun shines again anyway, is it?

And now you want to use the partially privatised GP services against the good people of the NHS itself? Despicable!

Just another clever ploy to disempower the very backbone of the National Health Service in the continuous process of privatisation under stealth which began way back during the time of Margaret Thatcher era.

You ask why are people afraid of privatisation? I'll tell you why.

Imagine all the hospitals in UK privatised overnight. Imagine that the "best" hospitals have the most funds, frequented by the wealthy, hence able to pay exorbitant salaries for truly the best doctors, surgeons and nurses.

Then the rest of the country who is neither so rich nor wealthy will end up like the 47 million Americans who have no health insurance and have to avail of the services of the charitable hospitals staffed by not so great doctors, surgeons and nurses.

One service above the salt. Another below the salt. Just like the good old days before the NHS, eh?

In the UK, where you have the NHS that looks after you no questions asked, you have the luxury to be the "Patient from hell".

Privatise the health service and if you have no money, then you WILL become the patient IN Hell.

This is why the British people are right to be afraid of a privatised health care system and

to fight this harebrained idea of a reform.

Think about it, mate.

13 February 2012 4:24PM

The NHS....

Possibly the only institution in the world where the most able do their best for those most in need without having to ask the question:

"What's in it for me".

1.3 million of them...

13 February 2012 9:01PM

This is like Nick Clegg resonding to a query about 49% of NHS hospitals being used for private healthcare and saying in all innocence, apparently "What is wrong with that?"

1. These private beds are in NHS property, using NHS equipment, provided over years with taxpayers money, using medical and nursing staff whose training has been funded by the taxpayer. The taxpayer is being forced to sell its assets, and for what? - reducing NHS capacity and lengthening waiting lists for NHS patients.

We never got a chance to vote for this, and if we had been given one I very much doubt if we would have supported it.

2. What's the actual proof that the amount of money private health insurance will contribute will adequately compensate the taxpayer for our loss of healthcare capacity and material assets? Are there some projected figures?

My suspicion is that there are, and they show that this is a poor return on our investment - that's why this bill has maxed out the proportin of beds that can be used for private patients; in an almost cynical twist the the percentage point has been set at exactly the highest level that would only just allow the government to pay lipservice to the idea that the hospital is still NHS-run.

One assumes therefore that expectation must be that the hospital will make hardly any money out of each one.

3. When something goes wrong in one of those private beds, and a previously fit patient (such as private healthcare would be happy to take on) suddenly becomes unwell - the NHS will have to sort it out. The private healthcare companies won't be carrying the risk that goes with their profiteering - we will!

You know this is so because of the breast implant scandal. I know this is so because as a junior doctor I was called to see one of my consultant's private patients in the middle of the night on another wing of the hospital, because their blood pressure had dropped and he lived half an hour away.

In that situation, you cannot refuse to go, under duty of care legislation and GMC regulations.

4. What that story and several others I know illustrates, is that contrary to popular belief, private healthcare is less safe than NHS, as the organisations are simply not staffed to cope with emergencies, and of lower quality - it will not take on really complex needs.

It is also innefficient, treatment is not subject to the same rigorous cost-effectiveness rules as in the NHS, it is not allocated according to need, but to ability to pay.

That is why US Healthcare is so expensive with so little return.

13 February 2012 10:35PM

(Response to youarehavingalaugh, 13 February 2012 10:24PM)

What will you think and do if you CANNOT get a life-saving drug because you cannot afford it ?

Maybe great and clever people don`t WANT to make make money saving other people`s lives, maybe they just want to save lives ?

It is not the researchers who make the big money anyway, it is the big companies.

16 February 2012 10:49AM

(Response to Stewie996, 13 February 2012 10:45PM)

I cannot believe that you have any experience of oncology in the US. You are right that the US has areas of excellence, but they are islands of excellence in a sea of shit. And the islands of excellence are only available to the privileged few.

If you had spent any time in higher education (as I have, as a research physicist) you'll know that the US system is not particularly good. A UK science graduate knows far more, and is far more advanced than a US science graduate.

US students have to go to graduate school before they can get anywhere near the level of UK graduates. Now you may argue in terms of the UK over specialising, but it is a clear: US graduates are not at the same advanced level as UK graduates.

Of course, since there are five times more US citizens than UK you would expect the US to produce a larger number of skilled graduates. However, they do not do so proportionally. Have a look at the number of Nobel Prize winners per head of population.

Other than the outlier of Iceland, the UK has the highest number, far more per head of population than the US.

As to oncology - what you omitted was access. It is not just healthcare, it is welfare too. A US colleague - middle class, software developer - recently died from liver cancer. He died because of lack of access.

Once he got ill he could not work and that meant that he didn't have insurance, so he had to sell his house to pay for his treatment. Then when that money ran out, he went on welfare, but that didn't last too long and he then simply ran out of money and died.

What amazed me about him was that right up to his dying day he would not accept that there was anything wrong with the US healthcare system. He was so obsessed with protecting the US against "communism" that he could not accept anything that was not privately delivered, for-profit.

I guess you have the same mindset.

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