The NHS and private treatment

Triggered by reading: Does going private hurt the NHS?, Financial Times, May 2024.

“In February 2024, 10.6 per cent of all NHS elective care was delivered by private sector providers”.

The majority of private ops are hip and knee. This makes a lot of sense to me, because if your mobility is impaired, potentially waiting 6 months isn’t an option. This isn’t necessarily insurance, it could be self-pay, which has grown:

With this: “increased demand for private work could take doctors and nurses away from the state’s free-at-the-point-of-use NHS”. Staff do work in both private roles and NHS roles. Does having access to (presumably) additional income effectively subsidise NHS staff? I don’t know, and it sounds problematic even if true.

It seems there are bunch of questions tangled up when you ask about NHS and private care:

• Should you be able to access private care if you need to?  Sure, and depressingly The Observer reports that most people now budget for this because of the waiting times. That echos the FT numbers, above.
• Should the NHS become a mostly private enterprise? I don’t know who would argument for that, but no: it doesn’t work as The Lancet reported earlier this year.
• The trickier question: should the NHS make use of private providers, even given the evidence that you don’t get better care?

On that last point, the perspective from Victor Adebowale, the chair of the NHS Confederation, is helpful. From Pod Save the UK (29 July 2024) on the subject of private care or not:  

The NHS already, through the way in which we employ GPs, has private contractors working for it. So, it’s the wrong argument. The argument, if we’re going to have one, has to be about value for money, and how we get value for money, rather than point A or point B that provides the service.

The whole segment is worth watching.

Related to this is the problems of the NHS described in Critical: Why the NHS is being betrayed and how we can fight for it. The solutions are what you may suspect: pay staff, invest in the buildings, pay off the PFI debit, fix the IT, stop out-sourcing.

The money involved, the staggering sums, are difficult to estimate [...] But to my mind, this is not a question of costs, it is one of priority.