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Monday, 10 December, 2001, 10:08 GMT
Should private companies run NHS hospitals?
A private hospital is to act exclusively as an "express surgery centre" carrying out routine NHS operations as part of a drive to cut waiting times.

The unnamed Bupa-owned hospital in the south east of England will perform 5,000 routine operations such as hip and knee replacements each year.

Health Secretary Alan Milburn is due to announce the hospital's location today and the scheme could start as early as April 2002.

It will be the first of 20 diagnostic treatment centres promised by 2004 in the government's NHS Plan.

Would you be happy for the private sector to be more closely involved in the running of the NHS if it meant that waiting lists were cut? Or do you feel that it would be totally unacceptable under any circumstances?

This debate is now closed. Read your comments below.

Your reaction:

I have been treated in hospitals in both the US and the UK. There was no comparison in the quality of care, facilities, medical technology, promptness, and follow-up - the US was far superior. However, I had insurance. So from my standpoint, privatisation is useful and beneficial. If I was one of the 40 million other Americans who did not have insurance, then I would definitely think otherwise.
Naveen, USA/UK

It is a really bad idea!

Arri London, EU/US
Private companies should most definitely not run NHS hospitals. I might have thought it was a good idea in the past. However since being subjected to corporate medical care here in the US, I can now see it is a really bad idea! No money, no treatment or second-rate treatment. As a self-employed individual, I cannot afford any insurance at all, but don't qualify for any government schemes. A simple visit to a GP costs me about half a day's earnings for about 5 minutes or less in the office. People in the NHS are at least interested in providing the best care possible, given the resources. My health centre here in the US is run by people who need to make a profit, no matter what it takes.
Arri London, EU/US

The reason I pay for private medical healthcare is because when I get ill, I know that I can have almost next day treatment. If, as is proposed, private hospitals are to be used to treat NHS patients, then what happens to the availability of beds, doctors and operation theatres if they are all being used by non-private patients? Will I now have to pay and wait on a waiting list?
Liam, UK

I don't think Bupa or any other parasitic private company should be allowed anywhere near the NHS. I also don't think they should be allowed to steal trained NHS staff like they do - remember taxpayers pay for their training so taxpayers should benefit from the treatment not company directors.
George, UK

Should private companies run our NHS? You mean like private companies running our rail network? Do me a favour!
Dan, UK

It is time to tackle these issues

C.P., England
As a manager and nurse in the NHS it is clear that private sector collaboration is essential in order to revitalise the health service. Though additional funding is needed, it (as has already been seen),is not enough. Wastage of taxpayers' money due to poor performance and high sickness is endemic. It is time to tackle these issues and through collaboration with the private sector provide additional private finance and introduce systems which reward excellence in performance by healthcare workers rather than condemning all though mediocrity of pay to mediocrity in performance. The public, patients and staff will benefit.
C.P., England

As a short-to-medium term stop-gap, yes if necessary. As a long-term policy, no. I do, however, believe, that the public must be informed on the costs of using BUPA services. And commercial sensitivity be damned. Because we have a right to know whether our Government is delivering value for money to its taxpayers. It's that democracy thing which Tony and George are so keen on defending!
Rhys Jaggar, England

We have already learned a lesson with the railways and it would be unwise to let the NHS go down the same route. I welcome private involvement in hospital infrastructure such as building and other allied services but not medical aspects such as treatment and patient care. I also think allowing accountants to run hospitals as managers is not in the best interest of patients.
Vijay K Vijayaratnam, United Kingdom

You still have the long waits, but you also have a massive variation in standards across the board

Mark Scott, Brit in the USA
This is just the thin end of the wedge - from allowing some private companies to run parts of the NHS to splitting it up and it becoming fully privatised. Then my compatriots will know the horror of private health care - you still have the long waits, but you also have a massive variation in standards across the board - for instance, I had a blood test last year in a place that was absolutely filthy here in California.

There are interminable waits in doctors' offices even though most doctors have an appointment system. It's no joke to wait three hours in your doctor's office, then be sent into another room to wait another hour, and then hear that the doctor has gone for lunch. I have even sat in that second waiting room and listened to the doctor talk about his golf handicap to his nurse for half an hour, in the corridor. And to add insult to injury they make you pay for this. If you stay in hospital you are charged $500 a night just to stay there, and that's before you pay for any treatment! It's an abysmal "system", and that's where it will go in the end in the UK, so get ready.
Mark Scott, Brit in the USA

Hello! Has everyone forgotten the trains already? Are you insane?
Simon Soaper, England

My health insurance rates just went up 45%, my family deductible is $1000.00 per annum and I still have to pay $3000.00 a year out of pocket. Do not let the private sector anywhere near health care. Just look at US costs and mortality and morbidity rates You have been warned
Loay, USA

Why treat medical care as something special? Would you do your weekly shopping at a government-owned store? Can you imagine what that would be like? Would you want to queue for hours, only to be told that they forgot to buy in bread and baked beans yet again? If people would just step back and start thinking of health care as a service industry, and not as a constant struggle to rescue a little bit of Old Labour ideology from the dustbin of history, then a lot fewer people would be dying. It's crazy that so many people argue in favour of a shambolic government-run system when they would never dream of leaving their dog or cat to the mercy of a government run veterinarian service.
Jon Livesey, USA

This is the first example of real, progressive change I've seen in health care in the UK recently

Jeff, UK
Is outsourcing certain specialised treatment functions a solution for all the woes of the NHS? No, but it's a very strong start. Why keep pouring money into a system that is admittedly broken, unless the spending is accompanied by major changes on how that system delivers its results? This is the first example of real, progressive and substantial change I've seen in health care in the UK recently, and is hopefully a sign of more and better changes and improvements to come.
Jeff, UK

As a patient, I don't care who treats me as long as they are qualified, the treatment is available quickly and freely, and any backup or emergency facilities are there if necessary. For the unions to object on ideological grounds, I think shows a fundamental disrespect for the suffering of the patient. It can only do them harm and lose them support.

If you want a decent health service then the only way to have one would be to increase taxes by 5p in the pound

Eric Connor, Belgium/UK
Here we go again. After two decades of an under funded NHS, and a couple of years of reinvestments everyone expects the service to be much improved already. I suppose it must take years to rebuild a service that's in crisis. So if it means using an private service then so be it. Let's not get caught up with the political arguments from the unions. They at the end of the day are representing their members and not the public at large. If you want a decent service then the only way to have one would be to increase taxes by 5p in the pound.
Eric Connor, Belgium/UK

Private companies should not run anything. Bring back state control - then the politicians would be accountable for everything that goes wrong in any given institution.
Dave, UK

Using private hospitals paid for by the NHS may offer a short term solution and cut down waiting lists as many people hope, but in the long term it will push up the cost of health care for the state and the NHS will end up funding private sector inefficiency. Let us not forget that the reason for the NHS being in a pitiful state is the lack of funding.
Robert Fawkes Jenkins, UK

The NHS is in crisis. People are dying because they cannot get a date for life saving operations. If I were waiting for a bypass I could care less where my treatment is done as long as it's done in time. Successive governments have treated the NHS as a point-scoring entity and it seems they have forgotten that those that have paid tax all their lives cannot be sure that when they need it, it will be there. It is staffed by some very committed people, they'd have to be to work for the wages they get, and they always seem to be let down by the bean counters and the politicians. Free at the point of use, but who cares where. Let's stop being so precious about the NHS. It's supposed to be a service that delivers health not a holy cow.
Pete, Wales, UK

The NHS should not subsidise the private sector either in doctors' time or with NHS facilities

Consider this: Your "overworked" NHS consultant can't treat you, so you go private. Then that very same consultant, now working super "overtime", can fit you in immediately in the same NHS hospital as a private patient. Something is fundamentally wrong there! The NHS should not subsidise the private sector either in doctors' time or with NHS facilities or by putting patients in the private sector.

This is different from using spare BUPA beds for NHS day cases. For BUPA to run a hospital cheaper than the NHS and still make profit, they must spend less. Since over 85 percent of a hospital's budget is taken up with staffing costs that means they must either pay less or work people harder. Which will they be doing?
Guy Chapman, UK

Ideally no, but if it's free to the poor and it provides something that the NHS doesn't, ie a health service, I say bring it on.
Wendy, UK

Routine operations don't always remain routine. A production line operating facility will get through the treatments quickly and efficiently but when things go seriously pear-shaped the resources to deal with a crisis aren't necessarily always at hand.
Malcolm McMahon, York, UK

This is just a scheme to get people used to the idea of the coming privatisation of the health service.
John McVey, Scotland

All this will do is stretch the existing staff levels to breaking point

Margaret, UK
The utilisation of any spare resources should be investigated to reduce waiting time in hospitals. However, the professional staff needed to support these initiatives cannot just be plucked from thin air. Consultants cannot be in two places at once offering care on both sites. Surgical specialties usually have at least some of their team with them, so who is left manning the fort in the NHS hospitals? All this measure will do is stretch the existing staff levels to breaking point. If the proposal means additional payments as per current waiting list initiative operations, we know where the consultants would rather be. The NHS hospitals will be left in chaos and it will take years for the figures to emerge as to how detrimental this move might prove to be. Think again, Mr Milburn.
Margaret, UK

I cannot say what the state of British hospitals is, but I have utilised both government and private healthcare in the US, and I would take the private healthcare provider any day.
Nathan, USA

When I'm sick, all I care about is how quickly and how well I am treated - who treats me is not important. The dog-eared approach of the public service unions is really disturbing. Perhaps they just don't get how awful things are for NHS patients.
Andy, London, UK

The irony here is that the NHS will be helping the private sector to survive

Steve, UK
The irony here is that the NHS will be helping the private sector to survive, because if it has that amount of spare capacity it can be only a matter of time before large swathes of it become unviable. Perhaps it is this that upsets the objectors most. Unfortunately the rest of us have not got time to wait for some kind of collapse that will lead to private doctors and nurses returning to the NHS.
Steve, UK

It's worth a try even as an experiment in just a few hospitals initially. It can't be any worse than the current shambles.
Will Lever, UK

The government should decide on the following. Does it want an NHS or does it want people to go private? You can't have it both ways. I would happily pay for private medical treatment when I am able to afford it - but only with a cut in tax and national insurance. I see this as the fairest way. Young people don't necessarily want private health care - they think they will never get ill. Therefore, the government are getting money from a low risk group, and the majority would probably start paying for private care when they start a family. Therefore, I feel there would be less strain on the NHS.
Sandra, UK

Alan Milburn should be congratulated for taking this step

Barry, England
This decision has been too long in coming. The scheme should be extended immediately to hundreds of other private hospitals across the UK. Dave Prentis the General Secretary of Unison should be ashamed of his opposition to this plan. He obviously has no regard for the thousands of people who are in agony, waiting for operations that the NHS has failed to provide. Alan Milburn should be congratulated for taking this step, against unions and politicians who are against it. They constantly keep bleating that the NHS should stand on its own, but none of them can tell us just how this will be done.
Barry, England

What a fabulous idea. If we have spare resource in private hospitals then let's use it. It has got to be a better plan than sending our OAPs over to Europe to have their hip replacements. In my opinion, ANYTHING that cuts waiting times and prevents unnecessary deaths is a great idea.
Will Faulkner, Hale, Cheshire, UK

If a private hospital has spare capacity, why should it not treat NHS patients? It may cost more per operation but the NHS lacks resources. It is better for tax payers to pay more for those operations than not have them done.
Pascal Jacquemain, UK (French)

Let's take politics out of the equation. The only answer is a mixture of both public and private resources combining their strengths and expertise together to provide the health system that the people of this country deserve. The health service (along with education and transport) has been wrecked by politicians following political dogma instead of doing what's best.
Colin Mackay, UK

The unions oppose any attempt at getting the health service to actually treat the sick. For too long the NHS has been a top-heavy red tape factory. If some of the millions wasted on administration costs can be directed to actually getting some operations done then terrific. Colin Mackay is correct - let's get dogmatic ideology out of things like the NHS. Any source of potential progress should be looked at.
Gerry Anstey, England

See also:

03 Sep 01 | ppp
NHS's private plans
28 Nov 01 | Health
Will money cure NHS ills?
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