By Adebusuyi Adeyemi.
In the latest installment of the Focus on Health and Society Series by the Health Network, Adebusuyi Adeyemi argues it doesn’t really matter who provides your healthcare.
A few weeks ago the Health Network held a debate around the ideology of private sector involvement in the NHS. The best compliment I can pay (and it is a compliment) is that I had such a massive headache afterwards. Rarely has my mind been so stretched, by so many sharp minds. Or maybe it’s all the daytime Judge Judy turning my brain into slush? Regardless, arguments for and against the motion of whether it matters if [more] private enterprise supplies healthcare were keenly exchanged, whilst the House of Lords voted for Section 75 down the corridor. Can you can guess what end of the spectrum I sit on…?
The NHS has always relied on private contractors. Many GPs are self employed and hold contracts, either on their own or as part of a partnership with the NHS. Dentists, Pharmacists and Opticians are nearly all privately owned. Similarly, it is private contractors who provide almost all of the IT equipment, build the hospitals and make the drugs. All our health related data is held on private companies’ machines. Heck, when the government tried to deliver a coherent IT vision, it failed. Admittedly because the private sector had already delivered on a lot of it and fought hard to maintain its share. Still, ‘privatisation’, strictly speaking should be viewed as what it is: the transfer to the private sector, of services which were previously provided by a struggling public sector.
Not sure where I stand yet? How about if we consider the hypothetical of owning a clothes shop. This is the only clothes shop in the city. Our clients/customers have no choice but to shop here, irrespective of the choice and quality of clothes we offer. If, however, we find that another shop is opening next door to us, providing nicer clothes for the same price or cheaper, with more choice, then that will force us to change the quality of the garments and the level of service that we offer; otherwise we’ll rapidly go out of business as our competitors will take customers away from us. If you haven’t figured it out yet, I support the idea that it doesn’t really matter who provides your healthcare, as long provided (and regulated) well it is.
Now, for all my spiel of corporate involvement, I don’t worship at the feet of the private sector, nor advocate the full disembowelment of the NHS. ‘Slippery-Slope’ arguments aside, regulating private providers properly in any sector is the responsibility of the government and this must be done, and done well. We can’t trust the Coalition Government to regulate private providers so that only people in the south are looked after, or that health inequalities increase. Still, we must give the principle of private-provider involvement a fair hearing.
The Health Network and guests recorded a draw for the motion on the night, which was in stark contrast to the votes counted from the wider community online. As a strong supporter for the motion, I was pleased to see a few people warm to the philosophy of increased private sector involvement, proving discussion is key to advancing thought in this space.
Introducing competition will mean the NHS will be forced to increase the quality of the work that it does otherwise an external provider delivering a better quality service may be appointed instead. From a business perspective (and the government’s perspective) this makes sense as it weeds out poor performing providers, replacing them with better ones (and if there are no better providers, then the current providers will remain in place).
There are many caveats to add to this piece that time (read word limit) doesn’t permit. From ensuring the principles of greater equality of power, wealth and opportunity are maintained, to detailing how our value(s) of collective action and public service do have a place alongside a more competitive NHS, there’s more I wish I could say. But this brief piece is only to stimulate thought, I hope it does.
What if only one chain of universities supplied doctors? Or only one drug company was allowed to make N-acetyl-p-aminophenol (paracetamol #Geek)? Unions, Socialist Medical Groups and others are right to assert the Health and Social Care Bill will result in increasing privatisation of the English NHS. In fact, this is in keeping with the “supply side” economic policies of this government, which promote privatisation throughout the entire public sector (Royal Mail, Urenco and the Met Office to follow soon).
However, there is an idea that needs to be considered seriously, that it doesn’t really matter who provides your healthcare.
Adebusuyi Adeyemi is Chair of the Health Network.
The debate was organised by the Secretary for the Health Network – Lauren Milden and chaired by Ivana Bartoletti of the Fabians Women Network.