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Privatisation of the NHS- Please explain!

Can anyone please explain what is actually meant by privatisation of the NHS? I know there is a huge difference between this and the PRIVATE SECTOR, which is currently run at the moment as alternative health care alongside the NHS (E.g. Bupa, AXA PPP)

Does privatisation mean that we would have to PAY, like in the US, for our health care? Therefore, there would mean a huge inequality in health care provision, due to the fact that lower socioeconomic groups may not be able to afford treatment for chronic illnesses such as HIV, Breast Cancer, etc?

Thanks, if anyone could clear this up it would be a huge help.

:smile:
Reply 1
The private sector and the NHS are two different things. However you can have private contractors like virgin care working in the NHS but this is different and does not really mean privatization of the NHS.

The private sector refers to those entities offering healthcare that are not publicly funded essentially and have nothing to do with the government (for funding, the doctors are still regulated by the GMC ect.) such as the NHS. BUPA is one of those entities. If you want health care from a private provider such as BUPA you have to pay up front or at least have health insurance to cover it. In the UK these organisations work along side the NHS but the NHS is the main provider and the 'norm' for healthcare here. I don't know too much about the US but I know that they don't have an NHS and the main stream health service is done privately i.e. you need to pay up front or have insurance.

Private contractors working in the NHS is different to the above. They are organisations such as virgin care who can bid for contracts of the NHS. So for instance the new Clinical Commissioning Groups (CCGs) can give a contract for say hip replacement or cataracts surgery to either a private provider such as virgin care or an NHS hospital/provider. However the private organisations have to promise a few things such as good clinical outcomes and patient satisfaction, they can't just go all out for money.

That's basically it, hope it helps :smile:
Reply 2
The above person explained it very well, although I feel obliged to point out the pitfalls of going to private companies to provide services versus the NHS providing the services directly:

1. 'creaming off' profitable procedures. For instance, cataract surgery as above is very cheap to perform and is a way for NHS departments to make money because they are paid for their output just like private companies, under the current system. They have to balance the books so cataracts might be a profitable operation for the department and compensate for all of the retinal detachments which may not be profitable (for instance). However overall they break even. Private services tend to offer low risk, quick and cheap operations but they do not have the obligation to provide ALL care. So for instance they could take on all the cataract surgery and make megabucks, whilst the hospital department still has a responsibility for the retinal detachments but now no longer has the financial buffer of the cataracts. They also have a responsibility for the cataract surgery which goes wrong privately. So whilst you're getting great and cheaper services privately, you're actually doing this via sinking the NHS service which now just takes all the non-profitable things like multiple follow-ups, complex cases, high risk cases etc.

2. communication issues... already a problem in the NHS as highlighted in the Francis enquiry, even more of a problem where you're now breaking everything down into multiple companies with their own structures and paperwork. You can't find everything on a central system or wander into the secretaries office to find X person, 'cause it's not there.

3. technically, CCGs are run by people already in the private sector as GPs are private business owners, assuming they're partners, or employed by a private business if they are salaried GPs. So financial decision-making for the NHS has been handed out to people who also are trying to run a profitable business, which is not very helpful. The break-down into CCG structure and the changed role of NICE from regulatory to just 'advisory' also means an inevitable re-introduction of the postcode lottery as different CCGs take decisions as to what to fund or not fund with no real over-arching theme apart from a bit of common sense.

So it's reasons like the above that the 'privatisation', although not true in the sense that the NHS remains non-private on a technical level, is still very controversial and in my opinion (although obviously not everybody's... or at least not Jeremy Hunt's...) seems on paper like a hefty dose of idiocy. Only time will tell whether the ship settles into this new scheme (and actually saves/re-coups any money given how much £££ was wasted firing then re-employing a load of managers and trying to re-structure the system!). I hope it does, but for the above reasons I'm sceptical.
Reply 3
Original post by lindseyyy
Can anyone please explain what is actually meant by privatisation of the NHS? I know there is a huge difference between this and the PRIVATE SECTOR, which is currently run at the moment as alternative health care alongside the NHS (E.g. Bupa, AXA PPP)

Does privatisation mean that we would have to PAY, like in the US, for our health care? Therefore, there would mean a huge inequality in health care provision, due to the fact that lower socioeconomic groups may not be able to afford treatment for chronic illnesses such as HIV, Breast Cancer, etc?

Thanks, if anyone could clear this up it would be a huge help.

:smile:


Have a read through this thread, there's some really good stuff in it.
http://www.thestudentroom.co.uk/showthread.php?t=2395997

Also, the above posts explain your issues well.

In terms of whether we'll have to pay for services, this remains to be seen. It's currently being debated that perhaps GPs should charge for appointments and whether patients attending A&E unnecessarily should have to pay, however, these are more to do with trying to solve the problems with over-crowded (and under-staffed) A&E departments. The NHS will never become completely privatised like the US system, like many people think; I imagine it will always be free at the point of delivery.

What privatisation entails is basically the outsourcing of management of services within the NHS to external companies such as management consultancies, which don't have to be from the UK. A number of US companies have been very interested in winning these contracts. The problem with this is that it marketises the system, making service providers into businesses. However, you could argue that GP services have been like this for many years now without too much hassle and marketization encourages competition which would be patient-led and would thus drive the services to improve to satisfy patients.
(edited 10 years ago)

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