To ask- what do you think is actually happening when you hear "they are privatising the NHS"

[Arelen]

I keep seeing memes and petitions posted by friends who are concerned about privatisation of the NHS, or that the NHS is being sold off.
I wonder what people imagine is happening when they see or post these messages?

That private companies are being brought in to deliver certain services for a profit. It's a slippery slope.

That we will all have to have crazy health insurance policies in place before being seen, ones that don't cover everything and then having to pay silly amounts for prescriptions etc that's my fear

I think meh to be honest. Provided a service is delivered well I see no reason why it shouldn't be delivered by a private contractor. it's a tiny proportion of the NHS overall and I think most of the objections are ideological, not practical.

NB I'm not religiously pro privatisation - I think infrastructure services eg roads, rail, water are the proper concern of government and we do no benefit from privatising there as no meaningful competition is possible in those areas. But in some cases privatisation does improve services and I'm open minded about it in the case of the NHS.

There is a big difference however between a private company providing a health care service that the NHS pays for on behalf of the patient as opposed to the patient being expected to pay for it themselves. That's a very slippery slope to me and I feel that is what the Tories want.

The service I work in the NHS is odd as it normally sits within a local council. Needless to say several private companies are bidding to the CCGs to run the service. TBH they would probably do a far better job. For example we had a staff member leave. Sorry no money to replace them so now we are really understaffed and barely able to manage the workload. This is a prevention service.

I'm not saying this would work for EVERY service/department. But where I'm working it being privatised is no bad thing

We will look back at this period and think 'why the fuck didn't we fight harder for our NHS'.

I know a variety of people who worked for the NHS and in the last year or two have been taken over, the stories they tell are frightening: staff cuts, less patient contact, less equipment. The profits result in reduced patient care.

Services being delivered by private companies is not privatisation and less than 5% of services (by value) are in this position now.

This argument in the current environment is pretty meaningless. Wait until TTIP comes in - then you'll see "privatisation".

From my understanding so far NHS privatisation has been primarily companies coming in to provide certain services. In some ways fine.

BUT private companies want and need to make a profit. So they drop things that don't. Like an entire hospital. Or patients who don't fall at the 'easy and cheap' end of the treatment spectrum. Or post treatment complications.

So it massively concerns me. Someone wanting to make money out of my health.

I'm willing to admit that I am not an expert on these things so I am happy to have it explained but I don't see how a privatised NHS service can make money for it's shareholders without reducing the quality of service. It's not something that can make money unless they either charge patients directly or are using government funds to pay shareholders that would otherwise be spent on the service it's self.

I work in mental health for a not-for-profit organisation that has an NHS contract. What I've seen a lot in the sector, especially in services that are commissioned jointly by the local council and NHS (CCG) is that when a service goes out to tender, invariably the contract will now be won by one of a handful of large national organisations. In practice it means local organisations will fold because without the big contract they don't have enough income to be feasible anymore. The national organisations tend to pay their staff the absolute minimum and lack the local knowledge. (The sort of services I'm talking about include mental health day centres, substance misuse services, advocacy, counselling etc.)

I worry this will happen more and more in the NHS when contracts are put out to tender.

The Tories say they have invested into the NHS but in real terms there have been massive cuts because the need for services grows every year and budgets are going down.

That it is the end of health care as we know it.

And that once profit comes in to health care delivery, there will be a system were some will have fantastic care, many whatever they can afford and some v poor care indeed.

Health care by its very nature caters to the sick and vulnerable (stating the obvious) and I don't see how it could/should ever be allowed to be set up for private gain.

I have worked in US hospitals and what goes on there is shocking and not something I'd be comfortable in my own professional life.

I am a huge supporter of the NHS.

But common sense tells me that something of its size and diverse nature simply can't be provided centrally and run efficiently.

Better to outsource bits of it that can be run far better by experts/specialists.

What tilder said.

Also rather than reinvest their profits as a not for profit would, a private company has shareholders so they will take money out of the service to pay dividends.

When that isn't working or there isn't enough dividend, the company walk away as Circle holding have done with the hospital they were managing.

I think its a slippy slope as we move from small scale contracts let to larger ones - its not just the nhs, we're seeing it in all parts of the public sector.

I think it's scaremongering, tbh. What Jo Public cares about is free at point of usage and not a means-tested service. I can't see that any of the changes are going to alter those 2 features.

I think of it as - they are hiving off simple procedures that are taking too long to get to under the current system. that way the private firms can charge and make money from it, leaving the NHS with all the expensive difficult operations

which then put it into a spiral of high cost, high time patients meaning more gets hived off, until it all comes crumbling down with whatever government of the time saying it is now wholly unsustainable, BUT these private companies are doing SO well, so let's give them the job of running things.

That's it's being sold off to the highest bidder, services are being reduced in quality and that it won't be free at the point of use for much longer.

And yes I work in the NHS and have first hand involvment in commissioning.

I'm afraid I also think a certain amount - not all, but some at least - of the doom-mongering is motivated by supply-side self-interest. (I suspect the same was true of the teaching unions' visceral campaign against Michael Gove's education reforms.)

When an entire service is privatised it doesn't mean that the same service is provided just by a different company. The private companies are not in it for the patients, just high volume easy patients/procedures that generate profit. The complex loss making cases are sidelined. Whereas previously you will have NHS doctors and nurses fighting that patient's corner, their contracts will now be with the private company with their hands tied. Training will fall by the wayside. It already has, as some departments have not been allowed any specialist trainees after being privatised due to the poor quality of training provisions. As a patient you may not think this is important but your next generation of specialist doctors and local nurses skilled in that speciality is not gong to materialise overnight. If you don't train your only option is to import.

OTheHugeManatee

I work in a highly specialised service.
The CCG are putting it out to tender.
I know that the only way a private company could provide it more cheaply - (and of course they will offer a cheaper price, and the CCG will accept it because they haven't a clue about the actual standards required)-is to employ unqualified staff and a substandard service.

The people who conduct these negotiations usually have no knowledge or experience of the clinical area involved. I know this from first hand experience. It is a bit like asking a plumber to come and give you a quote for fixing your roof, then employing the plumber who gives the cheapest quote to do the job.

We have already seen this happen when contracts for certain operations were given to private companies in order to cut waiting lists. Only when patients were dying did anyone investigate the qualifications and experience of the surgeons they employed.

All private companies exist to make a profit. That profit has to come from somewhere.

There is a huge amount of waste and inefficiency in some parts of the NHS, I know, but this would be better addressed by sorting out the problems in the existing services, not selling them off to the lowest bidder.

I'm open minded when I hear about privatisation of the NHS, because I don't know I enough about which services it's going to affect and how to be able to automatically make a judgement that it's a bad thing.

I can see that there may well be problems with it, but I can also see that the NHS as it is is failing in so many ways, and something has to be done to change that.

I think, welcome to the world of client capture and incumbent contract-holders throwing their weight around.

Of uncertainty and paralysis every time contracts approach expiration, as the incumbent won't spend money when it might not be there in six months.

Of the govt being taken to judicial review by potential suppliers who don't win the contract, as Virgin did to the Department of Transport over the West Coast Main Line.

Of departments becoming so scared of suppliers suing, they fork out tens of thousands of pounds for consultants and lawyers to manage the bidding process.

Of suppliers each spending hundreds of thousands of pounds a year on bidding, and recouping that money out of the contracts they win. (Although I was rather delighted at rumours that a certain company associated with disability benefits spent over a million quid trying to break into a new sector, and have yet to win a bean.)

Can you tell some of my nearest and dearest work in farming government contracts, ahem, I mean, providing essential public services through the highly efficient private sector?