Letters

If ever there was a case of shutting the stable door after the horse has bolted it is David Hunter's piece 'Private thoughts, public services', ('Live from Leeds', 14 October).

The independent sector already provides a huge and growing volume of health and social care services funded by taxpayers - like it or not. Leaving aside community care - where the independent sector providers 85 per cent of all places, and supplies more accommodation than the NHS and local authorities combined - the independent sector is also a major provider of acute healthcare.

According to the health select committee, 20 per cent of elective surgery in the UK is undertaken in the private sector. The sector operates on around 850,000 patients per year, including almost a third of all hip replacements. Half of all abortions are carried out in the independent sector, and last year the NHS commissioned 29,000 elective ordinary admissions and 62,000 day cases from independent providers. In mental health, the sector provides 67 per cent of non-acute psychiatric care beds and almost 55 per cent of medium and low-security acute beds. The NHS funds about 30 per cent of independent acute psychiatric beds.

There are excellent private facilities, lousy public ones and vice versa . Nor would a mixed economy in healthcare provision inevitably be inconsistent with the principle of universality. Why should it be?

Professor Hunter's explanation that public-private partnerships could 'unleash forces which would be difficult, if not impossible, to control' sounds like the rhetoric of an ideologue, not a contribution from a professor of health policy.

Public, private, charitable, voluntary and co-operatively owned services all have a contribution to make. The 'third way' has to be about developing a regulatory framework that harnesses the strengths of each and minimises their weaknesses.

Caroline Quest Executive Director Independent Healthcare Association London