Privatisation of the NHS

[Pubey]

Why would I bother doing that? You are a typical Guardian reader so it is hardly suprising that other typical Guardian readers have reached the same conclusion despite there being no evidence for it.

If you position is genuinely that there is a conspiracy to eradicate the NHS and replace it with a US style model based on private health insurance then there is absolutely no evidence for it whatsoever.

There is a feeling that if many providers are responsible for components of care, then the overall care package for a patient (especially one with a complex or chronic condition) is likely to be complex, probably more expensive, and liable for cherry-picking.

Also, where did you find your stat for 18th world-wide? I'm assuming the 2000 WHO report which is both old and widely discredited. The Commonwealth Fund provides a good independent set of analyses and metrics (spending, access and outcomes) for comparisons of health systems, and the UK has done pretty well.

 

[Neil_F]

fragmentation between service providers is a concern, I agree. Were I in charge (thankfully not a possibility), I would focus on trying to increase competition within the current system.

One of the problems with public policy in this country is that we always go for national solutions because politicians are obsessed with equality of input (they fear the "postcode lottery" headline). It therefore means that solutions are usually untested and performance measurement is impossible. It would be better to devolve public policy to regions whereby successful structures and innovations could be copied between the regions.

I mention this as one of the few areas where this does happen is health policy. NHS England did introduce some very modest competition in the system based on quality whereas NHS Scotland and NHS Wales did not. I'm sure there must be a study somewhere of the NHS England approach using Scotland and Wales as controls (adjusting for regional differences). I haven't seen it though.

On the 18th place, yes it was the WHO study. I don't know anything about it so I'll take your point on its weaknesses. I haven't looked at the other study you referred to.

 

[Uncle Leo]

As far as I'm concerned Branson is just the latest in a long line of self-styled millionare "philanthropists"(Freddy Laker anyone?)who the right wing media in the UK venerate because he knows how to make a quick buck.

To be fair to Branson (not something I enjoy doing) he's not exactly a fly-by-night is he? He's been running successful businesses for about forty years.

 

[Pubey]

fragmentation between service providers is a concern, I agree. Were I in charge (thankfully not a possibility), I would focus on trying to increase competition within the current system.

One of the problems with public policy in this country is that we always go for national solutions because politicians are obsessed with equality of input (they fear the "postcode lottery" headline). It therefore means that solutions are usually untested and performance measurement is impossible. It would be better to devolve public policy to regions whereby successful structures and innovations could be copied between the regions.

I mention this as one of the few areas where this does happen is health policy. NHS England did introduce some very modest competition in the system based on quality whereas NHS Scotland and NHS Wales did not. I'm sure there must be a study somewhere of the NHS England approach using Scotland and Wales as controls (adjusting for regional differences). I haven't seen it though.

On the 18th place, yes it was the WHO study. I don't know anything about it so I'll take your point on its weaknesses. I haven't looked at the other study you referred to.

Interesting point about the differences between the devolved countries. A good idea I agree.

 

[Perth Bambi]

As someone who works in the NHS this is already happening for various services in various places. Physiotherapy in East Kent is now provided by 'any qualified provider' Therefore GPs can send their NHS patients to any of these AQP's who all have to provide physiotherapy for a set price per patient. The patient's pay no money to anyone, they do not have to have private healthcare. Obviously this is of benefit for patient's as it provides more choice and more competition.
On the down side GP's have jumped on referring patients to these new providers (i feel mainly because all these new providers hire space in the GP surgeries so the GP in essence makes some money back per patient). This means that (in our trust and area) a patient may have to wait 6-8 weeks to see one of these private companies whereas our waiting lists are fairly low (for an NHS patient)
The more reputable companies and providers are hiring a real mix of experience of physios and peer support, however it seems that most of them are all employing physios straight out of Uni, who don't really know what they are doing and because they have no senior support they do not improve and learn anything new.
The upside of this is that when none of their patients get better they end up getting sent to us up at the hospital and we make them better. The down side is from what we gather most of the large GP's have signed contracts with these AQP to send their patient's over to them. The upshot of them sending the patients there and then ending up sending them to us as well has meant that in the first quarter of this year they have overspent by £250,000. hey ho.

 

[Tangled up in Blue]

You are a typical Guardian reader

Thank you.Praise indeed.:winking: