For many years the NHS has been used a pawn in political games and the upcoming election is no exception. With Labour’s discovery of the ‘NHS for sale’ dossier, there has been a huge debate around the NHS being vulnerable to privatisation and secret deals with Trump to sell off parts of the NHS.
As a company founded by a practising GP, we understand that the complete privatisation of the NHS can be a daunting thought. However, it is important to understand how much the NHS is already privatised, as the NHS relies heavily on private companies to provide various services. In 2018/19 the NHS spent £9.2 billion on independent service providers and if you include non-for-profit this increases to £13.7 billion. The phrase non-for-profit may indicate to a charity, however, many private hospitals like BUPA are actually registered as ‘non-for-profit’, yet they make a substantial amount of profit. The fact is the NHS is under tremendous strain and needs to outsource to external partners to supply this growing demand.
American firms providing private services is not a new concept, contrary to the perception given by the election campaign. US-based firms have a particular stronghold over software and data platform services used by the NHS. A lot of these provide a vital service to the NHS and there is no need for political parties to be tarnishing their reputation for their own political gains. Take for example, Cerner, who is a US-based company that provides a range of health information technologies, in particular, electronic health records. Cerner is currently operating in 17 NHS Trusts across the country, and the system is collating and storing hundreds of patient’s electronic health records. It provides an important service to many of these trusts. The problem is less about outsourcing to private companies and more around the fact that the public is unaware of who is providing their service and holding their health records. It should be standard practice for patients to be made aware of where their data is being stored and who by.
Even though some private companies like Cerner provide a vital and excellent service to the NHS, there is still a lot of inefficiencies when it comes to outsourcing to the private sector and there have been multiple NHS contract failures. For example in 2015, a £800 million contract was awarded to UnitingCare, only 8 months into the contract it withdraw, stating it was not financially viable. Contract breakdowns like these are causing the NHS millions and are causing serious negative impacts on patient care. The most alarming fact is that no one currently accountable when these major million-pound contracts go wrong. If there is no one accountable, how are improvements meant to be made?
This is the type of privatisation that needs to be investigated and prevented to ensure the best level of service is given to patients. Currently, all of the failings are landing on the NHS’s head, whereas these private companies should be taking responsibility. There needs to be serious improvements to the NHS contract process, and it needs to be more selective of the chosen affiliates. There currently isn’t enough front-line expert staff being involved in the negotiation of sensible and suitable contracts, and these are the individuals who understand how the NHS operates better than anyone. Recent studies have shown that hospitals that have doctors in senior leadership positions were more efficient and provided a higher level service, up to 25% more than non-doctor led hospitals.
Political parties need to stop playing tug of war with the NHS and using statements indicating that the NHS is being sold. The outsourcing to private services is very prevalent within the NHS, however we need to be more concerned with who the services are being outsourced to and ensure NHS contracts are only being awarded to companies that can fulfill their obligations. There needs to be stricter guidelines around who the NHS can outsource to and transparent contracts that clearly state expenditure regulations. There should also be less of a focus around these private firms country of origin and more focus on which companies can provide the overall better standard of care to patients.
