@Didimum
It drains staff and resources from the NHS.
Private providers rely on the same limited pool of doctors, nurses, and specialists trained by the public system. When those professionals move to private work, often for higher pay or better conditions, it reduces staffing capacity in the NHS and can actually worsen waiting times
No, it won’t. You are saying this as you can’t conceptualise how it can work. Again, I have worked in this model for decades in the public A&E space and no one is ‘drained of resources’ due to private either in A&E’s or private hospitals in general.
Where privates exist, consultants/residents often work a proportion in each. The whole point of private is to INCREASE capacity, not to shift it from one system to another.
I’ll try and make it super simple maths. Let’s say a public hospital requires 10 staff, and a private required 5 staff. That’s 15 staff in total. It’s NOT that the public hospital now only has 5 staff left. You are thinking of your current model with staffing dictated by NHS constraints. In our system, it’s usually the same consultants work across both, so say the 15 in total (just for the purpose of the simple illustrative maths example) will work an average of 60% public, 40% private. There is no stealing from one system to another. By doing this initially, and having 15 rather than 10 heads, you can actually increase training spots as well as they can do so across the two systems under the same consultant if that makes sense.
Given the NHS at present, to set this up, yes, the immediate limitation is staff, however you can address this by getting staff from equivalent health systems globally, and then this will gradually increase your local training capacity so you can decrease your import need over time.
Private A&E wouldn’t reduce NHS pressure.
Emergency departments deal mostly with patients who either cannot choose where they go (ambulances, life-threatening emergencies) or cannot afford private fees. A private A&E would therefore mainly treat the small group who can both pay and are stable enough to choose, while the NHS still handles the majority of emergencies.
Some of this is just bulldust, and some just lacks understanding of A&E throughput. Yes, most life-threatening emergencies will always go through public A&E, however this is not the majority of A&E throughput. So, if you do have a life threatening emergency you will be prioritised accordingly in a public A&E irrespective of whether you are homeless living in the street or have millions to spare. The ‘small group who are stable enough to choose’ you refer to is not small. It’s large. That’s where you can really reduce A&E pressure. Yes, won’t reduce for pressure trauma or critical issues, but fractures, gallbladders that have decided now’s the time, acute asthma etc, by removing relevant people in this group to the private system does indeed ease pressure and increase capacity/decrease waiting times for people who don’t have the ability to use the private system. That’s a fact, I’ve lived in for decades and from the public perspective, being incredibly grateful of the private system we do have.
The issue here, is you are looking at the NHS model as it is now (again, am very familiar with it as worked in it for a number of years, in your A&E). Yes, what I’m describing can’t happen tomorrow in your model as it is now, which is all you seem to be conceptualising, but if your model is revised it can work as evidenced by other successful global models based on free universal healthcare but with additional options/mixes. I’m not including the US system obviously as that’s not universal healthcare, it’s not something anyone should want.