Head to head: Private sector NHS role

The NHS is using the private sector more and more

MPs are concerned that increasing use of the private sector may damage the NHS.

They have warned that NHS hospitals may become too dependent on help from the private sector, and that this could undermine the service in the longer term.

BBC News Online presents the arguments of two leading players on either side of the debate.

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Mary Maguire represents the healthcare union Unison:

"For the sake of patients, there should be value for money and that means making sure that money is not siphoned away from front line care to line the pockets of private contractors.

But that is exactly what happens with the Private Finance Initiative. It may be building new hospitals, but at a massive cost.

"Millions of pounds are spent on complex contracts with inherently higher costs and excessive interest charges. PFI is not value for money.

"When costs escalate, the hospital has to devote a larger share of its budget to buildings and services, so there is less to spend on patient care.

"Manchester mental health services face a £2m cut in funding this year as the PFI project in South Manchester takes £40m from the local health economy.

"And the new Wakefield PFI hospital will cut acute beds by 24%.

"The Chancellor announced massive funding in the NHS in the budget. We don't want to discover in three or five years time that the money was siphoned off by the private sector - into the hands of multi-nationals where 18-30% profits are being made from contracts with no improvement in services.

Headline grabbing wheeze

"We worry that the Department of Health announces its latest wheeze to involve the private sector just to grab the headlines.

The answer lies not in more sticking plaster solutions, but in building up capacity

"For example, using private hospitals' spare capacity to treat NHS patients. Those hospitals are tiny and they couldn't possibly take over the load of a complex NHS hospital treating serious and acute illness and trauma patients.

"And if the private sector is so efficient, why does it have spare capacity?

"Nice money if you can get it. This is merely scratching the surface.

"And let's just look at what happened when hospital cleaning was privatised - dirty hospitals, increased infection rates, people's lives put at risk.

"Why? So a private company can make a profit.

Fragmentation

"Another nonsensical headline grabbing suggestion is to push out to the private sector hospitals which have become successful under the NHS.

"Fragmenting the NHS won't improve patient care - look at what happened when the railway was broken up.

"The answer lies not in more sticking plaster solutions, this week's big idea, but in building up capacity at home - more investment, more doctors and nurses, more beds in better equipped, well run hospitals.

"In creating an NHS that has the capacity to tackle not only existing waiting lists, but has some to spare, in order to deal with blips in demand like a Winter flu crisis."

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Peter Fermoy represents the Independent Healthcare Association:

"The Independent Healthcare Association is delighted with the Health Select Committee report.

"Supporting the idea of public private partnership, the Committee rightly concludes that the Concordat between the NHS and the independent sector is a good idea and that it delivers best value solutions for patients.

"The success Concordat in treating more than 100,000 NHS patients is already clear for everyone to see.

"The IHA is delighted that the Health Secretary, Alan Milburn, wants independent hospitals to treat more than 150,000 NHS patients this year.

over time PFI will increasingly be deemed to be value for money

"The Association believes that the independent sector has the capacity to treat 200,000 a year: more than 1,000,000 in the full life of a parliament.

"Overall, these figures are large enough to make a real difference to the lives of many people, but will not destabilise the health service in any way.

PFI

"Turning to the Private Finance Initiative (PFI), the IHA is mindful that the NHS is Britain's most successful PFI.

"It is important to remember that to create the NHS in 1948 the state had to take into public ownership some 3,118 independent hospitals, homes and clinics.

"Most NHS hospitals that exist today trace their roots back well beyond the late 1940s.

"Turning to the private sector to design, build and operate new NHS hospitals is therefore nothing particularly new, if anything it is business as usual.

"IHA is therefore confident that over time PFI will increasingly be deemed to be value for money, it will not adversely impact on the tax payer in any way and it will deliver the increased capacity and higher quality that we all want to see for the NHS.

Trade unions

"Today out of the TUC¿s 6.8 million members 3.5 million trade unionists have various forms of private health scheme. Many have private medical insurance whilst others are members of the private health cash plans.

"Most trade unionists understand that historically the independent sector is deeply rooted in the not-for-profit traditions of cooperation and mutuality.

"That is why so many trade unionists continue to work closely with organisations such as BUPA, Standard Life, Simplyhealth, Hospitals Savings Association and Medicash to name but a few.

"Therefore, the IHA is astonished at trade union opposition to partnership. For IHA, the future is clear. The future for health is partnership."