The UK talks privatisation of the National Health System

Together with the Scottish referendum another heated debate that has been taking place in the UK for the last couple of years is the one concerning the extensive reorganization the National Health System (NHS).

The outset of the debate was primarily the 2012 Health and Social Care Act. One of the crucial aspects of the Bill is that, although not explicitly, it made NHS funds available to private service providers through the Clinical Commissioning Groups (CCGs), the bodies deciding where to spend the money on behalf of patients.

The idea behind it is the same as the one behind the public sector privatisation trend that is widely found across the world today: competition goes together with efficiency. To say the truth, the NHS might be one of the world’s best healthcare systems but it is in need of reform. This was painfully evident after the Stafford Hospital scandal, following which the government put several hospitals into special measures because of poor performance. Moreover, the number of services provided by the NHS is speedily increasing, putting great pressure on the system.

Yet, several possible consequences make many worry.

Firstly, when the Bill was passed its real significance was not very clear to many people. Indeed, only a little clause explaining regulations that would be issued gave away the fact that the Bill was potentially going to result in the privatisation of the NHS.

Secondly, there is something inevitably worrying in the idea of having a public good, such as healthcare,provided by private companies whose prime aim is, essentially, profit. The most obvious fear is that the private sector will not invest in those services that are not profitable. Similarly, in the attempt of increasing their competitiveness, private companies might conduct reducing costs measures that might affect the quality of the service. In that case, as health policy academic Lucy Reynolds told Save Levisham Hospital in February 2013, firms could profit by first using the NHS logo, which the Bill enables them to do, and, when the service has worsen, leave it together with the bad reputation attached to it. Dr. Reynolds also points out that countries in which the national healthcare system has been privatise, such as Sweden, have witnessed a shrinkage of service in rural areas (fewer patients, lowerrevenue), and in poor areas compared to rich areas.

Those in favour claim that competition can provide healthcare at the cheapest cost. This is the result of a market model in which transactions take place between consumer and supply. One fundamental assumption is that both parties are in possession of the same amount of information. This is clearly not the case for doctors and patients who, presumably, are not knowledgeable about medicine. If the consumer has to rely on the supplier then we have a market that does not clear down to minimum price and leaves room for abuse (such as overtreatment etc.).

Those protesting that the NHS is being sold to the market might be precipitous(Dr Steve Kell, one of the chairs of the group NHS Clinical Commissioners, made clear that the CCGs have no privatisation agenda), but the fact remains that the Bill does not include enough safeguards against private companies exploiting the NHS.

The primarily purpose of a healthcare system should be to treat patients, not to create profit. The balance between the two is difficult to maintain and the NHS is going down a risky path.

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