Labour gets into bed with private medicine
Soon NHS patients will have their hernia operations 'outsourced'.
This is one example of co-existence that governments all around the world are experimenting with. There is no one ways on doing Public and Private Partnerships they vary from Country to Country from Municipality from Municipality. Governments have come to realize they cannot fund health care in the same old way. This is a global technological village it takes less then a click of a button to have a video conference with your associates half way around the world. A surgical suite that was built 6 years ago can become obsolete 6 months from now. Technology has vastly changed our society it has completely changed the world and industries. Still most hospitals computers do not talk to each other. Most patients are still transporting their records by hand. Some medications are being given to the wrong patient. IT departments in hospitals are becoming more and more important as an integral part of patient care. I for one am glad that some Governments are recognizing this. Private and Public can co-exist I will go further and even say it must exist. To keep up with the aging population and our changing lifestyles.
By Melvin J. Howard
Two weeks ago a Labour government signed the 'unthinkable'. Smashing 50 years of ideological hostility towards private medicine, Health Minister Alan Milburn agreed a historic 'concordat' with
Milburn reportedly acted on Prime Minister Tony Blair's direct order to cross this Rubicon in a bid to avoid a repetition of last winter's emergency bed crisis sparked by a flu epidemic. Front page news stories featuring sick patients lying on trolleys in corridors seemed to prove the NHS was on the critical list. And this under a Government 'trusted' to run it.
But the five-page concordat goes far deeper than averting a short-term public relations disaster by asking private hospitals to admit winter snivellers. The World Trade Organization is lobbying for national governments to allow the private sector greater involvement in health provision and financing through what is known as Gats - General Agreement on Trade in Services.
'With profits in manufacturing falling, the corporate lobby is targeting the proportion of gross domestic product that governments spend on public services,' said University College of London health finance expert, Professor Allyson Pollock. 'In health and education alone, government spending is in excess of 15 per cent of GDP in many European countries, but much of that goes on voluntary and public sector provision.'
Most health industry insiders acknowledge that PFI is an expensive way of building new hospitals which means less money is left to spend on patient care. But Milburn said he wants to see PFI extended 'beyond the hospital gates to include GP surgeries, community pharmacies, health centres, intermediate and long-term care facilities'.
However, the significance of the concordat is chiefly in its effect on the direct provision of health care which has so far largely escaped the private sector. The Independent Healthcare Association (IHA) says the amount of elective surgery (operations the patient can survive without) it takes on for the NHS is worth £35 million - less than 5 per cent of the sector's overall revenue, or the equivalent of six hours of the NHS's £40bn annual budget.
Currently the biggest players in private healthcare are Bupa, the provident association; BMI, owned by General Healthcare; Nuffield Hospitals, a charity; Community Hospitals Group, which is the subject of a takeover bid by Bupa; and US-owned HCA. Combined, they turn over £2bn from acute health provision. The majority of this comes from private medical insurance, with 22 per cent self-paid or from overseas patients.
These days private hospitals can treat a wide range of ailments but are known particularly for the five Hs: hips, hernias, hysterectomies, hearts and hemorrhoids. Barry Hassell, IHA's chief executive who helped frame the concordat, believes the
But it won't be easy to make this outsourcing work. 'There's still some hostility to contracting out client services but it may well be that the Government will push the NHS and local authorities towards agreeing contracts with the independent sector,' said leading healthcare analyst William Fitzhugh.
It will be in the intermediate sector - or rehabilitation - where the private sector will gain most. Westminster Healthcare, run by Chai Patel - an influential government adviser - will within days be the first group since the concordat to reach agreement with the NHS to take on this work. Patel said the deals involve no more than 15 beds but it is the shape of things to come. 'The private sector can offer long-term care more efficiently, at lower cost and more competently.'
But Steven Weeks of health workers' union Unison disagrees. 'All the evidence suggests that private sector involvement will push up the cost of long-term care. This is the main area where the private sector operates. Staff get worse wages and conditions. Some people in government will say that's not a problem.'
Healthcare isn't always a license to print money for the private sector. In the area of long-term care Nursing Homes Properties, which built hundreds of nursing homes in seven years, is on the verge of financial meltdown having lost £7.1m in the six months to March, because a number of its tenants went to the wall. They got burnt when local authorities scaled down their fees.
But this hasn't diminished the private sector's appetite for medicine. And so critics fear the concordat will lead to more contracted out services, charging for health care and eventually mean that what the Government - and therefore all taxpayers - can achieve with its health budget will diminish because private providers, which have to make profits, will be dearer.
Hassell disagrees: 'What's important is that contracting authorities get value for money,' he said. 'But it's an assumption to say the private sector will be more expensive. The Department of Health won't reveal cost information so nobody knows the true picture.' Perhaps a little forensic analysis should be undertaken before we proceed with this operation.
Sickness and wealth: What countries spend
Country / % of GDP / % through public / % through provision private health insurance
France / 9.6 / 76.4 / 12.2
Source: OECD
