Can we stop the privitisation of the NHS?

[nametakenagain]

The proposed changes to the NHS prepare the ground for heathcare in this country to follow the American model where you can have what you want if you can afford it, but there's not much for people that can't.

The NHS isn't perfect but it is the envy of the world for good reason - no other country gets the same high standards without putting in a lot more money.

Neither rich nor poor benefit where organisations make a profit out of sickness (the rich get encouraged to have unnecessary tests and surgery, the poor can't afford what they need).

Not many people in this cuontry would want this to happen, but it seems to be going ahead. I can't believe most of the MPs voting in favour realise the implications, or maybe they're too scared for their jobs. There have been a few campaigns to stop the bill but it carries on.

Any ideas?

Legislate to outlaw the use of any and all NHS hospitals doing any private work.

Anyone having private medical treatment that goes wrong to have to pay for any corrections that cannot be done in the private sector.

Tax private medical insurance as a benifit in kind at the 50% rate.

Or better still nationalise the private medical industry.

Like with the recent scandal of cosmetic surgery clinics cutting costs by using non-medical silicone in breast implants, they should be made to foot the bill of the corrective surgery?

Another problem with private companies (unlike NHS hospitals currently) is that they are not forced to share information publically about how often things go wrong because this info is 'commercially sensitive'.

This is why I've personally not risked laser eye surgery.

I'm not against there being some private healthcare though, to be honest, just that is has to be regulated properly, be clear what you're paying for, and face up to its own mistakes.

There are no plans to abandon the central NHS principle that the service is free at the point of need. There are no plans to adopt an American model either. There are better models of state healthcare in the world, however, that combine private and public to achieve better results. Private companies are already in the NHS mix - I've recently been referred to a private physio via the NHS, for example.

The elephant in the room is that there is a lot wrong with the current NHS provision largely due to a certain complacency at being the only choice available. Frankly, as a patient, I don't care who provides the care and whether they make a profit or not as long as it is prompt, excellent quality and I'm not asked to get out my cheque book.

CogitoErgoSometimes I think you will find that your attitude is the problem, by saying " I don't care who provides the care and whether they make a profit or not as long as it is prompt, excellent quality and I'm not asked to get out my cheque book." you place your needs above that of everyone else. Just so that you do not have to get your cheque book out might mean others have to, or others are denied treatment, or worse case scenario others have to die as a result of being pushed in to a 2nd rate 2nd best alternative.

I would also say that the nhs can be saved but it means a massive outcry similer to that about the war in iraq, people have to mobalise and not sit and moan about getting appointments at an early hour, or waiting ages in an a&e when they could have taken an alternative course of action. Universality means we all irrespective of income will need the nhs, no private emergency treatment, ambulance staff, training for all health care staff which sets the standard for the industry et.

WTF that mean 'place my needs above everyone else'? I want everyone to have an excellent experience when they need medical treatment and if that means a private company supplying that medical treatment rather than someone wearing an NHS badge, so be it. It's all right the NHS being free & universal and I support it staying free & universal... but not if that means we're expected to put up with something second-rate.

And I say that because I have far too many people in my own small family and circle of friends that have been let down & physically harmed by the NHS in its current form ... the worst examples being one dismissed as a hypochondriac when he had advanced cancer, another killed on the operating table (for which they have admitted liability).

I don't think there is anything we can do. I've given up on this country. I just live here now; it's not mine any more. There's no one left to vote for.

I don't see how CES's attitude is dismissive of others. It does not consign anyone to second best treatment - though clinical governance will be a major question.

If the choices are between remaining on waiting lists, or using third party providers accessed via NHS, which provides the best health outcomes?

And this debate is over a decade too late. The entrance of private providers into NHS is so long in the past now, and I do not think it is something which can now easily be reversed. Especially as it works.

Move to Scotland?
Health is a devolved issue.

I don't think moving to Scotland will help. Here's a Scotish Government paper from 2007 about private providers within NHS Scotland.

Private companies will not deal with the more complex or time consuming cases. They will not provide anything but the cheapest and most cost effective services and only to people they deem worthwhile. They will not set up clinics in more deprived areas, they will not offer out of hours or weekend services.

What I am saying to CogitoErgoSometimes is that the badge someone wears indicates the basis on how the service is offered. Private care always has to be for a profit, who do you think would make money out of services if they worked exactly as the health service does. Accepting that profit is the motive meaans making a choice about who receives those services. Poor people, the chronicly sick, the elderly, children will all be the ones that will be given no choice as the private sector will not touch them. So yes WTF actually you are the problem you should want a service for everyone that is fair and equal, no postcode lottery, no long waits, no budget for ivf or cancer drugs. Your money the money you are handing over in taxes will be paid to private companies and handed straight to shareholders who have no interest what so ever in you, your family, or your community. If they make a mistake, or perform badly what you gonna do about it, nothing absolutely nothing as the contracts they will have will be so tight that even should they kill you or your child the contract they will have will be more valuable and complex to get rid off. With public services we the public have the ability to hold service providers and the local managers to account.

"With public services we the public have the ability to hold service providers and the local managers to account"

Bollocks. Sorry, but that's crap. The BMA jumps in and protects doctors that shouldn't be allowed to treat gerbils, let alone people. The nursing bodies are very quick wring their hands saying 'lessons must be learned' whenever old people are found to be left starving in a pile of their own shit - yet again. We get zero accountability from the current system time after time after time and any moves to increase accountability or introduce managers or increase competition are met with the same 'you can't change anything... it's the NHS... it's lovely because it's free'.

Private companies get patients referred and are paid for the job done. Already happens. They aren't doing the referrals so they are not selecting one person over another - that's just scaremongering on your part. If they do a good job, their shareholders are happy and the company is making money it can invest and improve with new procedures. If they do a bad job, they won't get the referrals or make money. Taxpayers wouldn't be 'handing money to shareholders'... yet more scaremongering.

Having lived in this country for 10 years, I find it difficult to understand why people feel so attached to the NHS. In fact I'm surprised people aren't shouting for the NHS to be replaced! I think it must be inertia or just a preference for the devil you know.

The quality of the service here is very poor. True, my experience of emergency care has been good but pre and aftercare reverted to terrible. I've had two DCs in the UK and maternity care has been abysmal in both cases.

I come from a country (not US) where public and private healthcare sit side by side. Everybody uses private healthcare with the lower paid getting a big subsidy from the government toward their healthcare insurance. It works really well.

The problem in the UK seems to be that an inefficient public sector monopoly over the NHS is being replaced in parts by an inefficient private sector monopoly over the NHS. The one factor that make private healthcare work in my home country is real competition.

www.telegraph.co.uk/news/uknews/2236340/Number-of-doctors-struck-off-increases.html
Read and weep oh blinkered one, and when you have done that and gone to do a fruitless search on how many private health companies, there directors, or their shareholders, have been tried on corporate manslaughter charges, here is a clue BIG FAT ZERO. You seem content that instead of arguing to make things better you would rather make them worse for others just to see if an experiment works or not.
Scaremongering eh Can I suggest you tell that to the families and friends who once trusted this private care home. www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-13617464.
Simple truth we pay for what we get, we elect the numpties who rule in our name. You do not like either then do something about it.

I am arguing to make things better for everyone. I recognise the system ihatebabyjake is talking about and suspect it is somewhere like France, Holland or Belgium. Competition is the key. I realise that healthcare provision is something of a special case and can't be referenced entirely in commercial terms but wherever there are monopolies in any other field, the people responsible for them have a vested interest in maintaining the status quo, are not motivated to change things for the better, and they also develop a complacency towards their customers. That's what we have at the moment.

We have to have safeguards over how contracts are awarded and liability determined or we'll end up with the disastrous expenditure black hole that they have at the Ministry of Defence and more bad care homes like the one in your example. And we will need better civil servants working on those contracts.... people from the nasty world of commerce rather than a degree in philosophy.

But to keep arguing for the status quo when so much is so badly wrong. Not to want any involvement from companies that can provide state of the art medical services. Dismiss them out of hand just because they have shareholders... I think that's just ridiculous.

The problem is that most people in the UK haven't seen any other system than the NHS.

And in the same way that the US look at our model and shudder at the thought of 'socialised medicine', we look at their model and don't want a private insurance based system either.

Personally I don't see a problem with people having private health insurance. They are not clogging up the place for those who cannot pay. Do we really really want to add to our already bursting NHS queues by forcing people that can and are happy to pay to use the NHS?

The two important factors are to make sure those who choose to use the NHS are not getting some reverse state subsidy to do so and that no NHS beds are being used for private treatments. The latter does concern me because the temptation will be immense once competition takes hold.

But on balance we do need competition and choice and I'm open minded about the current reforms. A monopoly is rarely a good thing.

Great idea lets privatise the NHS, lets have clinical decisiond based upon how they impact on share prices, dividends and executive pay/bonuses.

I dont need a doctor who has to call head office for permission to prescribe expensive drugs and treatments.

Privatisation has worked wonders for the utilities and transport or at least for the directors. If the Tories want it then it must be bad for most of society.

Also (correct me if I am wrong please) but FOI does not cover private companies and hospitals.

No-one's arguing privatise the NHS at all. I'd be the first to be shouting from the rooftops if I thought the NHS was at risk. I've lived in the US and shudder at the thought of having to live there without medical insurance. Yet that's the reality over there with millions unable to afford it. In fact, it was one of the factors why I chose to come back as my employer at the time said they couldn't afford to pay for my family to have medical insurance.

But the other side of the coin is that the NHS is a mess in many areas despite the hard work of many. There is a lot of scope for improvement and like I said above, I'm giving the new changes an open mind.

As long as the principle of the NHS being free at the point of use and improves the service then I don't have an issue. Do you?

To answer the OP - no you are 10 years too late.
Secondary care has capacity & capital costs issues which are only going to get worse. Labour allowed a vast chunk of primary care to be slid over to private companies so although you see 'free at the point of care' , it is already absolutely profit driven.

Do a search on how many GPs work for/own shares in Assura, Virgin, BUPA etc and you will see why conflict of interest is a huge problem with the new commissioning set up.

The differences of opinion just go to show how complicated an issue a health system is, and why politicians should not be allowed to meddle with it on such a large scale so frequently. The current proposals for privatisation are an extension, I'd agree, of what has gone on before (not just the Tories) - but they go much further and drop us into competitive markets which simply do not work in the interest of the population when it comes to health.

Yes, markets work very well in many many areas of life, but not health (because that's what we want, isn't it? not healthcare i.e. not lots of trips to dr, hospital, tests, surgery, drugs, etc). Markets can work in some parts of healthcare - when you don't need help urgently, when it's easy to compare different options because they're not complicated, when you can trust your adviser is not advising you to line their own pockets, when you are not frightened. Complications arising from too much healthcare are of course much more common where the providers make a profit (and look what has happened here in dentistry.)

Competitive markets will make healthcare even more expensive (hence more expensive in france, germany etc. as mentioned earlier) and need a lot more regulation to be safe (see what has happened with breast implants recently). Either tax payers will have to pay more to cover the profits of companies (if the 'NHS' remains free at the point of use) and costs of more contracts, and costs of more regulation or pay for less stuff (leading to more private health insurance and stark problems of the US system).

No the NHS isn't perfect (and the current proposals have exposed the potential for conflicts of interests in GPs who are of course not NHS workers), but it would be in a lot better state if politicians would leave it alone for a while. Even so, satistfaction ratings with the NHS are at an all time high - and then the current government proposes the biggest change ever while making the biggest cuts ever (thanks, bankers). There's room for improvement, but leaving it to the mercy of markets isn't the solution.

Oh, the current bill also removes the responsibility of the Secretary of State to provide a health service. It's bad enough now trying to hold the government (any government) to account for what they do to the health service. There's no chance if this bill goes ahead.

"I dont need a doctor who has to call head office for permission to prescribe expensive drugs and treatments".

Substitute "PCT" or " NICE" for "head office" and you've exactly described the NHS. Cost-based rationing has been with us for decades, and will continue to be with us whatever the system looks like.

@niceguy2: I agree with you - if the NHS remained affordable (my tax payer hat) and free at the point of use (my patient hat) then it ought not to matter who employs who behind the scenes and how things are organised and taxpayers money already goes into a lot of profit-making outfits - it's mostly the same doctors and nurses anyway, at least at the moment. But it does.

Other people can explain it better. Have you seen this? www.healthprofessionals4nhs.co.uk/briefings/

As a mother and also a paediatrician and health service researcher (and part of the group healthprofessionals4nhs) - I am very worried indeed about the effects the NHS Bill will have on children's health and health care. This Bill spells the end of the NHS as we know it. It's not that there aren't problems with the NHS for children - but this Bill will make things worse. Worse for children with serious and life-threatening illnesses, worse for children with chronic conditions and disabilities, worse for children with problems that are expensive and difficult to fix.

It seems a lot of you on mumsnet (I'm new) are worried about these things too. Can't we start a campaign? I think DC's likely to take mums (women voters) more seriously than doctors!

Hi
I agree with childrensdocmum, I am a stay at home mum at the moment to young children but have worked in the NHS for most of my working life, I am appalled by the changes that Lansley et all want to make in the name of reforms.

Make no mistake the plan is to introduce private practice into the NHS. Not the nice woolly I can have my op on a private ward next week for nothing. NOPE! it's oh dear should I eat, pay my bills or see a doctor. For a large proportion who cannot afford insurance that will be the stark choice.

I still get post, emails etc from the medical establishment and what the reforms entail are really worrying but this full information does not appear to be making it's way out to the TV and papers.

So yes yes yes I'd be happy to support a campaign

Many thanks indeed Mostlymum. It's great to make your acquaintance.

Very well put about the distinctions between different aspects of private health care. I absolutely agree - this one, especially for children, will be all about more waiting, less transparency about outcomes, less focus on quality (look what's happening with the silicone thing today) for example, and more about profits. The private health care companies are overt in their efforts in the UK recently - they see us as a growth market now.

Let's see what happens in the next day or two regarding interest from other mumsnetters.

Alas much of the medical establishment (Medical Royal Colleges with the exception of the GPs) have mostly been too timid to stick their necks out and say in public what they say routinely in private - that they all know the Bill is a really bad idea for patients.

I do believe that a campaign through mumsnet could cut through to DC in a way that most other routes have failed.

I can't understand why labour aren't fighting this more