Private money for public health?

Andrew Lansley, according to this morning’s Guardian, is removing the cap on NHS hospitals making money from private health provision.

Concerns have been raised as to whether this will create a two-tier system of health provision and reversion to longer waiting times for NHS patients with private patients jumping the queue.

If those concerns could be addressed – would it be a good thing to reap the profit for the NHS given that it is NHS training that our doctors and consultants get?  If private money could be poured into the NHS rather than watch those profits go to private providers would that be a good way to address the looming funding gap (with the caveats as above) or not?

0 thoughts on “Private money for public health?

  1. As someone who is an NHS patient except for “vanity” treatment such as sports injuries where I use a private physio, I would go further. I believe that the average cost of treating someone, including adminstration, is £7,000 a year in the NHS. Keep £2,000 for A&E and for people who need subsidising and we all get a health voucher. That health voucher can used for 24x7x365 NHS healthcare or can be used towards a private medical insurance plan.

    I believe the competition would be good for both sectors and would help rid the NHS of its jobsworth, bureaucratic incompetence and slim down the administrators who not only add no value but detract from it.

  2. But it clearly will lead to a two-tier health service, won’t it? The most important thing is for the NHS to be available to all, not for it to make a profit from selling private treatment. How do you propose to prevent NHS prioritising big-money private patients over those who can’t afford it? Lansley’s proposal is to do away with the last government’s cap on private provision by the NHS – without a cap then how on earth do you propose addressing those concerns?

  3. This will lead to some people namely the private patient being able to chose when and where they are treated and the NHS patient having to wait. It will lead to a two tier healthcare system within the NHS.
    As a Lib/Dem its beyond me how you can support such a thing.

  4. Thank you for this, Lynne, it feels much more like a conversation.

    This is an expert area for me as I’ve been having treatment/surgery for the last 16 years in each of the sectors (private/privateNHS/NHS).

    I know the Guardian article talks about new infrastructure, marketing etc. However, this is more about the hospital consultants and their time. If Andrew Lansley is effectively saying they can divert even more of their time to private healthcare, then yes, we will have a two tier system.

    Those able to pay or with insurance will receive the attention of hospital consultants (and private rooms, etc). The NHS patients will have to make do with what’s left of the consultants’ time and ‘the team’ (those still in training, and believe me, after seeing many hundreds of these doctors, you know that they’re still in training and some are really quite dangerous).

    NHS patients presently see very little of the consultant for various reasons…. one of my consultants only dealt with specialist cases and had his time split between two major NHS specialist centres in London, a healthy private patients list, lots of speaking/fundraising appointments (he is an imminent professor) and time at home. Believe me, he often seemed nothing more than a name to me although he was still the one who had to make the key decisions. It paralysed my treatment at times because ‘the team’ couldn’t get hold of him.

    So if you’ve got an awful lot of money, great, if you’ve got health insurance it’s ok but please beware that I had cover withdrawn many years ago due to the fact that I was too ill (I continued working 14 hours a day for quite a few years after that).

    This talk of deregulation is worrying because this is an area that must be regulated, deregulation will mean deaths not just major inconvenience or cost to the taxpayer (like the railways, the banks, the utilities, etc, etc, etc) I mean really dreadful deaths – people don’t tend to slip away in their sleep in hospitals, it’s always rather gruesome made more so by the fact that staff can sometimes fail to notice.

    I guess I’m lucky, I’m under a hospice and see them regularly so hope to avoid that nightmare.

  5. @Dave Atherton

    I’m not sure where you got your figures from but appear to be wrong.

    Have you spent time in any private hospitals?

    I have and what you get in the private sector instead is lots of temporary nursing staff who you never see two nights running and mistakes. There’s also the fact that in an emercency you’re reliant on god knows who to sort it out as your consultant isn’t around most of the time. Oh well, who cares, as long as you get rid of ‘NHS jobsworths’.

  6. So, Lynne, you find out what the government is planning by reading the papers. And you have to ask us what to think. Interesting.
    Isn’t it obviously Lansley’s latest move will create a two-tier service? That’s the whole point!
    The rich will get the best treatment and the rest will get what’s left over. Whatever they say, the Tories don’t believe in a socialised healthcare system.
    What do you think, Lynne?

  7. Come on Mr Bubblebath, tell us who you *really* are! Keith Flett? Karen Jennings? Joe Goldberg? I think we should be told!

  8. What’s with the desire of these people to “unmask” everyone? As far as I’m aware, the only people on here who are “political activists” of some sort are Lynne herself and right wing Tory-boy Justin “look at me! look at me!” Hinchcliffe.

    No Justin, we don’t need to be told. Grow up.

  9. We’ve been through this – it’s a blog! Are you trying to dismiss his pertinent points because of a funny name? It won’t wash….
    It’s fine that you use your real name but equally you haven’t made it clear as yet that you speak for a particular Party.

  10. Bob – that is a key point – whether consultants have to maintain their NHS hours and that the hospital has to use its theatres or whatever for a set number of NHS hours. If that was managed – then Mr Bumbblebath’s concerns about ‘the rich already get the best treatment’ could be alleviated as he is undoubedly right – they always will be able to buy the best treatment – so why not get the money off of their treatment and put it into the NHS rather than only the pockets of the big private providers.

  11. Lynne, you say ‘the rich will always be able to buy the best treatment.’ Why do you say this and seem to accept it so complacently? Why not aspire to a society in which rich and poor have equal access to the best treatments for whatever they need at the point at which they need it. If you held this as a value then you would see through Andrew Lansley’s plan which will split the NHS into rich and poor tiers. I think you should represent the feelings of your constituents – and you already know the strength of local feeling for the Whittington and other NHS hospitals and services.

  12. If you don’t think a two tier NHS is a good idea, then say it louder, say it to you bosses, your colleagues, say it in more public places and spaces. Oppose it. Encourage other people to oppose it.

  13. Lynne,

    You say it’s clear what you think from your post – it’s not. The evidence so far with private patients earnings in Foundation Trusts is that the Trusts have re-invested in private patient services – so it creates a cycle of improvement for those who can pay. There is no mechanism in the White Paper to stop that and require re-investment for the public good.

    The lifting of the cap is part of the wider ambitions of the white paper which is about liberating the NHS to full on market forces. Once this happens the NHS as we know it will be finished: international and EU law which sees returning to public provision as anti competitive.

    Also, Foundation Trusts in future will have unlimited borrowing against NHS assets. Our public assets! What happens if a trust get into financial trouble – currently it would be taken back in to public ownership (by law). Your Govt is repealing that law.

    All private sector providers take staff away from the NHS – leaving shortages and leaving patients in the NHS who need them – unless they can afford to go private. The cap on private patient income was to protect the public from this – there will be virtually no mechanism now in place to stop this.

    The Lib Dems had a policy on supporting Primary Care Trusts and board member places for patients – if we had retained this communities would have had a voice. But this was lost, sacrificed as part of the coalition deal. So we now have a full on Tory agenda in health with Lib-Dem supporting full-on privatisation of our greatest institution – the NHS.

    Please don’t support this.

  14. Actually Lynne appears to be proposing that we nationalise the private health industry, which wasn’t in either the Tory or Lib Dem manifesto, but is an interesting idea.

    I wonder what other sectors could be nationalised in this way. How about the government starts its own fee-paying schools and re-invests the profits in state education?

  15. Lynne – this assumption about the rich always getting the best treatment is a bit of a myth in my opinion.

    Ok, if you choose a private hospital it’s going to look more like a hotel but that’s where the priveleges stop. In my experience, private providers rely more on agency (temporary) staff so that they can be flexible. For me, not having that continuity of nursing care is a really bad thing – experienced nurses were always crucial to me getting over treatment/major surgery. What’s more, it was due to two serious nursing errors that I insisted that all further treatment/surgery was carried out in an NHS hospital with employed staff.

    Yes, the NHS is currently two tiered, however, it isn’t too obvious if you’re very sick (it may be different for smaller problems????). The main signs are appointments…. NHS runs very very late and isn’t compatible with work (not where I’ve worked in the past anyway).

    Private patients always see the consultant, even if it’s for something really minor. They also get seen roughly on time and they receive their surgery (it normally is) whenever it suits more or less.

    In contrast, the NHS for me now (bearing in mind that there is nothing more they can do other than drain my chest/abdomen periodically) is that I have direct access to several healthcare professionals all of whom can have me admitted to my local hospital under the same consultant who knows me well. Although for appointments it’s still chaotic and the admin sometimes breaks down. These healthcare professionals are all prescribers and can give me the pain medication I need as well as dress wounds, give lots of emotional support, liaise with my GP, etc.

    It wasn’t always like this, the NHS is obsessed with specialist centres and for serious conditions this is where you go. They’re far from home (except for some), expensive to get to in terms of travel and it’s awful on the way back if you’ve had aggressive treatment (I often used to spend an hour throwing-up in the back of cabs on the way home after treatment). It’s difficult seeing visitors when you’re an inpatient because they spend so much of the visit stuck in London traffic (having driven across London) and this is the sort of hospital where your consultant is so well qualified that you only see them briefly if you’re lucky….. you have to make do with the team and it’s often very stressful.

    I could go on but that’s just a snapshot of what my experience. The NHS has vastly improved in the last 10 years but there’s still some way to go to make it more patient focussed.

    Thank you again for inviting input, I don’t know what the answer is but if you get it wrong it means people suffering real horrors and death believe me I’ve seen it and experienced it in the dreadful year and half + I’ve spent in hospitals.

  16. I have spent several seconds this morning pondering Lynne’s proposition that by asking a question she is making her position clear.

    I have concluded that she is in principle actually right so in the spirit of helpfulness I have prepared a sample election leaflet for next time round:

    “Hi I am Lynne Featherstone your current local MP and Conservative candidate for the Wood Green and Hornsey seat for 2011.

    I have broken a great many of the promises that were made in my previous party’s electoral manifesto but it was all in the national interest.

    Can you think of any reason why you might want to vote for me this time around?”

    PS Lynne how about we get the fat (your minister’s phrase) rich white blokes to help pay for the women pushed out of the labour market, BME and incapacitated people’s access to an NHS by doing something radical like a fair graduated taxation system where people who earn lots of money pay proportionately more? How about you go the whole hog on VAT and charge people who “choose” to use private health insurance 100% VAT and channel all that VAT into the NHS?

  17. Sorry, Lynne, but it wasn’t at all clear from your post what you thought about this issue – and I still don’t know what you think.
    Are you in favour of opening up the NHS to more private customers? Do you think that mean a welcome influx of money into the NHS which will improve services generally? Or do you think it will mean a two-tier NHS – one level of service and care for those who can pay, and a lower level for those who cannot?
    My view is that it would inevitably lead to the latter – otherwise what would be the point? I know there are often concerns about the standard of healthcare in private facilities now compared to the NHS, but once it is really opened up, you’ll find the private services will be much better, with better medical care, much nicer accommodation, wider choice of treatments etc. Obviously this would happen, otherwise, as I say, what would be the point of doing it?
    Sorry, Lynne, but if you choose not to speak out against this one, your commitment to the NHS is really in question.

  18. I worked for the NHS for many years and anything that improves the service for all of us is a must, many of my friends still work there and I do hope this has a positive impact for them as well as the patients

  19. I agree with Nick profit should not be what the NHS is about. The NHS is a public service that needs to remain as such.This government are hell bent into turning it into a business and that will destroy the ideals and tradiition of the NHS which the vast majority of people in this country support.

  20. I take it this is the same Andrew Lansley who thinks that advice on school dinners is best provided my the manufacturers of junk foods ?

    As for the NHS and private patients I don’t quite get it. If we were to be convinced that this would benefit NHS patients ( and it is a very big IF) then it begs the question what’s in it for the private patients ? What do they hope to obtain other than treatment in the same building by the same doctors and the same nurses, same cleaning staff etc ? Surely they would expect something more and whatever it is this should be made clear.

  21. If private money is ploughed back into the same areas of the NHS which generate the income – as people with experience say is the case – then what about those parts of the NHS which don’t have a private option? There is little private provision available to people with some chronic and long-term conditions, for example, nor is there a trauma speciality in the private sector and no neo-natal care or care for children with life-long and / or life-limiting conditions. If these areas fall behind under a new scheme then rather than a two tier NHS we would have a three, four and five tier NHS with some of the people who really need help and care being shoved to the bottom of a pile. It would show once again that compassion and a sense of fair-play was left of the Coalition. How does this sit with you Lynne?

  22. Helen I am afraid that compassion and fair play are two things that you will not get from this government. Sadly Lib/Dem ministers are more interested in the trappings of power than fighting for the ideals and principals they said they had or the people who elected them.

  23. i do not agree with private medicine my step father paid into bupa and when he had a heart bypass they did not do it properly when he had a heart attack he
    had better treatment on the nhs, i have early breast cancer through a routine check on the nhs because of my family history and i am greatful for all the care
    and the old labour government guarantee seeing a consultant within 2 weeks we should stop knocking our nhs, also my beloved husband would be dead with without the nhs as he was born 49 years ago with a big hold in his heart in north middlesex also he has diabetes we found out too little too late that all his mothers family had the disease it has cost him his sight job at aged 49 after bupa paid for the botched operation bupa wanted 400 pounds a month and he had to stop paying into it why he could not afford it. i nor my husband have drunk smoked nor overweight. my husband is under a kidney consultant as he has renal failure
    will be on dyalsis in future we should all defend the nhs not knock fight for proper funding and fueding should stop