Recent proposals for routinely using the private sector in healthcare delivery beg the question: are publicly funded services, rather than publicly owned and operated services, the most appropriate way of ensuring fast and effective treatment for patients?

An important factor in this debate is that public services are accountable, and seen to be accountable, in a way that privately run services are not. Clinicians and managers in the public and private sectors will need to develop much greater trust if clinical governance and standards are to be effective - and this will require a major cultural change in the NHS.

Nick Forbes Service development manager Riverside PCG North Shields