Private sector takeover not as imminent as some may have it
The week began with a media feeding frenzy around the government’s NHS reforms created by the imminent publication of the health bill. Dire warnings were ten a penny, while the PM adopted a Thatcherite “no alternative” stance.
The BBC’s Nick Robinson declared: “David Cameron made clear his view that ‘choice, competition and diversity drives up standards’. He is counting on groups of GPs - often in partnership with private companies - to drive a harder bargain with hospitals.”
The truth is that increasing private sector involvement in the management of the NHS is very hard
If competition and greater private involvement really is the PM’s goal, then he is likely to find it as difficult to achieve as Tony Blair before him.
The truth is that increasing private sector involvement in the management of the NHS is very hard. Preferred business models collide with a political desire not to scare the horses (BMA, RCN etc) and the financial and organisational imperatives built into the NHS infrastructure.
HSJ’s exclusive that US healthcare giant Humana is leaving these shores after five years is totemic of these difficulties. The company is leaving for “strategic” reasons, but they do so in the belief that the Department of Health’s focus is on finding roles for existing PCT and SHA staff, not developing a market for commissioning support.
KPMG has secured a consortia development contract from NHS London and United Healthcare has done a referral management deal with a consortium in the west of the capital, but – for the reasons above - anyone expecting a rash of such moves is likely to be disappointed/pleased (delete to suit prejudice).
The private sector will grow in influence over NHS service delivery – but that growth will be incremental. The success of the government’s health reforms will depend much more on the efforts of those receiving a NHS pay cheque.
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Readers' comments (5)
Anonymous | 18-Jan-2011 9:05 am
Let's hope that the headline is true; however many current events would seem to point in the opposite direction. For instance:
- the government's brainless rush towards downsizing the public sector
- the wholesale clear-out of experienced NHS managers, so that when complex decisions are made there is no-one with experience and confidence left to take them
- the handing over of commissioning to untried beginners, despite the last GP fundholders experiment being a disaster and PBC being almost wholly unproductive
- the continuing refusal to include acute clinicians in most commissioning decisions about their area of expertise.
Without NHS staff left to make the decisions, it will either be the private sector fatcats or politicians who will take them. No wonder the private sector is standing alongside, hiding in the shadows, just waiting to pounce on their NHS prey when it is offered up on the rubbish heap of political dogma.
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Patrick Newman | 18-Jan-2011 9:18 am
Foundation trusts combined with privatised commissioning and contract management will complete the marketisation of the health service that was more than a twinkle in Blair's eye. Does anyone believe that GP management of the private consortia can be effective. GP's will have to employ managers and admin staff to manage the contracts that govern the work of the reborn but private pcts whose remit will be at the end of the day to profit from health. So I agree with the first contributor.
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Anonymous | 18-Jan-2011 9:29 am
Wake up! As usual, the HSJ puts its head in the sand and adopts a sycophantic approach to those in power. There was a time when we could look to it for objective , professional opinion which could be freely expressed by mangers without fear of reprisal.
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Anonymous | 18-Jan-2011 11:38 am
I am not at all sure that Humana's contract in EoE was a resounding success....but fault would lie on both sides.
What is a fact is that invoice validation does not actually save money. Yes it may save commissioners some expense but there is no actual reduction in the costs of the health system. It is only a worthwhile thing to do if it is used as part of broader change management programmes.
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Dr Paul Worthington | 19-Jan-2011 11:26 am
anon 9.29
Do you know, I've read and re-read both the article and your comment and still don't have any clue what you're on about. It's a straightforward and well-written news story.
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