‘Middle-Class Lefties’ Won’t Stop Lab Using Pvt Sec in NHS

But private companies’ offers are being backed up by political rhetoric. Both the Conservatives and Labour have promoted the use of the private sector to clear the NHS backlog, saying it eases pressure on NHS services and helps individuals. “People… are being failed,” Dr Rosena Allin-Khan, the shadow mental health minister, recently told Spotlight. “If they can get the operations they need, while bringing waiting lists down and having their lives saved? Of course, there is a place for that.”

No one should be blamed for seeking a rapid cancer diagnosis or a hip replacement when they cannot on the NHS. But there is a danger in the belief that private healthcare should be the first port of call. Union chiefs have flagged how prioritising private healthcare creates a “two-tier” system, siphoning off valuable staff and resources to better-remunerated jobs in private clinics. When NHS doctors and nurses face appalling hours, pay and staffing levels, what are they going to choose?

While the government shouts about its pledges for the NHS, it is neglecting to fix the systemic issues that would enable it to achieve these. Take cancer care; last week NHS England announced that it was streamlining its waiting time targets, including a new aim to either diagnose or rule out cancer for three-quarters of patients within 28 days of a referral. But how will the NHS achieve this when 97 per cent of its cancer centres are understaffed?

Rather than relying on private care, efforts need to be made to improve the NHS’s capacity to treat people in the first place. This includes assessing staff working conditions and pay; improving recruitment and retention through vehicles such as bursaries and specialist training places; and reforming regulatory bodies like the General Medical Council (GMC), which has been found to cause doctors under investigation stress, mental health issues and to leave the profession.

Forcing people into private care is short-termist – it may help people now, but in the long run everyone will be worse off when a withered NHS is gasping for its last breaths.

Abstract

A decade of low investment in the English National Health Service (NHS) resulted in strong headline productivity growth but undermined the health system's resilience and left it exposed during the COVID-19 pandemic. Projected demographic pressures, driven by the aging of the baby-boom generation and the rise in multi-morbidity levels in the population, will add pressures to already stretched health care resources. As the NHS faces the twin challenges of recovering services after the pandemic and meeting care needs from an aging population, our projections of demand for care indicate the NHS almost certainly needs significantly more beds as well as more staff. Productivity improvements in hospital care can reduce the amount of additional resources needed, but this will require significant concomitant investment in community-based health and long-term-care services.

The role of the private sector

Enlisting the help of the private sector is one of the measures the Government has taken to reduce pressures on hospitals and help cut waiting lists.



Purchasing private capacity is not new, but the pandemic has demanded unprecedented block-booking arrangements.



A recent BMA survey found that under these arrangements, 60% of private practice doctors who responded were unable to provide care to their patients at the time.



The extent to which private hospitals will be able to take on NHS waiting list initiatives going forward is unclear given the increased demand in the self-pay market and the backlog of private sector patients.



Given that the NHS and the private sector largely draw on the same pool of doctors, additional capacity may be less than it initially appears. This was made clear in the 2020 block-booking arrangements, which saw the NHS gain facilities rather than the workforce to run them.







What the BMA is calling for

Given the immense strain on secondary care, the BMA is calling for immediate actions to be taken to prevent waiting lists from growing faster than they already are and to prevent increased pressure on hospitals. Actions can be found in our weathering the storm report.

The BMA is advocating for measures to prevent attrition of doctors, including:



stopping punitive pension tax rules

flexible working options for all staff

retention strategies across all grades of doctor as outlined in our rest, recover, restore report

longer-term measures to grow the medical workforce which can be found in our medical staffing analysis.
The Government must develop a credible plan to meaningfully increase NHS hospital capacity and ensure that the NHS is not reliant on private sector capacity in the long-term.

Over the longer term, the BMA has called for increased measures to support effective collaboration between primary and secondary care.



Read more in our report Supporting effective collaboration between primary, secondary and community care in England in the wake of Covid-19.