Health Service Focus

Confed boss: Private firms should not be ‘bogeymen’ for the NHS

Stephen Dalton, the interim chief executive of the NHS Confederation, has sparked debate by urging healthcare officials to consider greater private sector involvement in the NHS so that waiting times can be brought down.

In an article in today’s Guardian (Tuesday 22 November), Dalton wrote that private sector health companies are not “bogeymen” but a “force for good” in the NHS as he offered numerous examples of beneficial private sector involvement such as quicker access to treatment, more rapid hospital discharge and access to community diagnostic facilities, all at NHS prices

Around 10 million NHS patients per year are already treated by private sector firms at 2,000 sites, and Dalton argued that private companies should be given a larger role to help the NHS cope with rising demand, as was the case under Tony Blair’s Labour government in the early 2000s.

“What was seen a decade or so ago as a sensible way of attracting investment, and helped get average waiting times down from 18 months to 18 weeks, is now seen as a political no-go area, with the Tories and Labour locked in an arms race over who has used the private sector the least while in office,” Dalton wrote.

“This is a con-trick, when the reality is that the private sector has been used for decades to help sustain a health service which is free at the point of use and available to all based on need and not ability to pay. As long as this political negativity exists, it will be patients who feel the consequences.”

Dalton suggested that “significant private investment” could be used to help transform NHS services as bodies draw up their STPs. However, he acknowledged that lessons should be learned from Labour’s failed use of Private Finance Initiatives (PFIs) which used private capital to build new NHS premises, leaving the NHS in severe debt.

The views from the boss at NHS Confederation drew mixed responses from politicians with two former health ministers sharing his views, while others warned that the private sector’s recent track record after being awarded NHS contracts meant that they could not be trusted to expand their role.

“What matters is what works best for patients,” said Conservative MP Dr Daniel Poulter, an NHS doctor and a health minister during the 2010-15 coalition government. He claimed that the NHS has always been a partnership between the public and private sector, highlighting the independent nature of GPs and pharmacies.

However, Poulter also mentioned the “serious danger” that widespread commissioning of private providers would actually lead to greater fragmentation of health and care services rather than the greater integration the government has pledged.

“While there is undoubtedly considerable benefit to the approach taken by Tony Blair of using the private sector to help the NHS to increase capacity, the history of wider private sector NHS commissioning tells us that private providers tend to ‘cherry pick’ the most profitable services to deliver,” he said.

Labour expressed even more caution in response to Dalton’s call, suggesting that it was prompted by ministers ideologically denying the NHS funding.

“It is indicative of the government’s neglect of our NHS that senior figures are saying we now must resort to the private sector for the investment our NHS so badly needs,” Jon Ashworth, the shadow health secretary, said.

“In recent times private providers have utterly failed to offer patients the quality of care they would expect. What’s more when the priority should be public investment in the NHS, privatisation such as the selling off of NHS Professionals announced last week could very well end up costing the taxpayer more.”

A DH spokesperson commented that any decisions about private sector involvement are taken by CCGs who benefit from local knowledge. “We are clear that patients should be able to access the best possible treatments based on quality of care not the provider,” they said.

(Image c. NHS Confederation)

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