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Last Updated: Wednesday, 18 May, 2005, 10:05 GMT 11:05 UK
Private treatment on NHS?
Surgeons and theatre staff performing an operation
The new health secretary Patricia Hewitt has announced plans to extend the use of private contractors to carry out NHS operations.

Mrs Hewitt outlined a 3bn plan to pay for 1.7m operations over the next five years.

Critics say that ministers are trying to break up the health service but Mrs Hewitt insists that her aims are to reform the NHS and reduce waiting lists.

What is your opinion of the reforms? Should NHS patients receive private treatment? How would you like to see the NHS changed?

This debate is now closed. Read a selection of your comments below.

The following comments reflect the balance of opinion we have received so far:

This topic was suggested by David Caulfield, Scotland
Patricia Hewitt has announced greater use of the private sector for NHS operations which the NHS will pay for? What are your views?

My mother was due her second hip replacement operation a couple of years ago. Should she have not been sent to a private hospital she would have been badly addicted to anti-depressants and painkillers from the pain she was suffering. From seeing my mother suffer in this way I am all for NHS patients being sent to private hospitals.
Ali, Wolverhampton, England

Diverting patients to private sector will have a major effect on the future of many NHS hospitals. Furthermore, as a surgical trainee, I feel this will have a serious impact on training, which is already compromised by the cut in the number of work hours.
Mr Jayanthi, Wrexham, UK

So private operators make a profit. What on earth is wrong with that? The same motive that generates profit will also deliver value for money - something an organisation like the NHS which hails from a socialist ideal can never deliver
Duncan, London

I pay for Private Health Care so I'll be most annoyed if I can't be seen asap because there are so many NHS patients blocking the beds.
Adrian, UK

The main tenet of the NHS is free delivery at the point of care. It does not specify who delivers it. I support this if it reduces the time patients have to wait. There are however only so many health care professionals. The NHS is already fighting in recruit and retain staff in an increasingly competitive age. Where will the extra resources of health professionals come from to deliver this? Surgeons, nurses and allied health professionals cannot be in two places at once!
Val Long, Harrogate, England

The government keeps telling us we want more choice. This is rubbish. We all just want our nearest hospital to be properly staffed and funded. I'd challenge the government to find one single person in this country who wouldn't make that their first "choice".
Matt Southall, Nottingham, UK

A greater use of the private sector will only encourage more NHS staff to enter the private sector and leave the NHS
Amy, Colchester, UK
No, a greater use of the private sector will only encourage more NHS staff to enter the private sector and leave the NHS. As a tax payer I don't want my hard earned cash to end up as part of the bonuses given to shareholders and fat cats, I voted for my money to be reinvested into public services, shame on Labour.
Amy, Colchester, UK

As a doctor hopefully about to enter surgical training, the way the NHS is heading deeply, deeply concerns me. This push towards privatisation is a very dangerous thing. All the private sector is interested in is making money, don't for one second think that anything else matters to them. As it is pointed out in "the Corporation" documentary, private corporations are legally bound to put their shareholders above all other interests including that of the end purchaser or in healthcare terms, the patient. The last thing we need in this country is to ruin the NHS, the greatest single creation of any government of this century, or create a US style system with a huge underclass with little or no healthcare and terrible level of care.
Simon Donald, Aberdeen, Scotland, UK

This is very welcome. For decades the NHS has allowed waiting lists to grow and grow, despite numerous waiting list initiatives funded by the taxpayer. We now pay as much for our public health services as other European countries. We are entitled to expect the same levels of service. And that means no waiting lists. The NHS had its chances and blew them every time.
David, London

It is all down to choice, perhaps it is better to provide a list of hospitals, both private and NHS and then allow the patient to decide which one they would prefer. This policy was from the Conservative manifesto, and in theory makes sense and can work.
Sebastian Hobot, Barry

The ideals behind the NHS should remain and treatment should be free from the point of delivery, and all people should be treated. However who does the work really does not concern me, as long as its done quickly, professionally and by a doctor who is qualified.
John Gearing, St.Helens UK

The real solution is for the UK to move to an Australian-type system which sees the user making a larger contribution
Stephen Fox, Sydney Australia
The proposal as it stands will just cause taxes to rise rapidly as more funding will be needed to pay for the high costs that the NHS will be forced to pay to private hospitals for the sub-contracting work. The real solution is for the UK to move to an Australian-type system which sees the user making a larger contribution - this gives people an incentive to develop a healthier lifestyle through not smoking and the avoidance of obesity etc.
Stephen Fox, Sydney Australia

This is absolutely crazy. The work in the private sector will be carried out by NHS consultants who will get the financial reward for providing the service, yet in the NHS we are applying the European working time directive and cutting the number hours consultants and junior doctors work. Will the EEC directive take into account the work done by NHS consultants in the private sector.
Mohammed, Newcastle, UK

As long as it doesn't delay the treatment for "paid up" private hospital members.
Alfie Noakes, North of England

There is nothing wrong with subcontracting the work. The ethos of the NHS has always been "free at the point of delivery" and so long as this continues what does it matter who does the work? My experience of private hospitals has been good in the past anyway... perhaps those who want all patients in NHS hospitals are worried that when people see what can be done that they might start to expect more from them!
Alex Bailey, Corby, England

The NHS is a 1950s dinosaur that offers third-rate treatment at premium cost. Privatise it and offer treatment through a mixture of personal insurance and means tested treatment for the poor.
Mark, London

It's the most straightforward admission I've ever heard that the NHS management is badly wanting, and that it is predicted to decline.
Steve, UK

I'm a Labour voter not happy with this, but it's a bit unfair to say this idea is as bad as the Tories'. Their proposal was to give a discount to those who would already go private and it wouldn't have taken anyone out of the queue because those getting half price operations weren't the sort of people who would be in it anyway! At least this will take people off waiting lists and out of hospital beds.
Paul, Guildford, Surrey

Yes, not only may it help to clear the backlog, but in some cases private companies may be able to do certain operations more cheaply. The NHS needs to specialise more to bring down costs especially in major centres such as London, eg a hospital doing heart operations all day every day and nothing else. It would be more cost efficient. No transplants should be publicly funded on people over 40.
Martin Porter, London

NHS reforms have to address the backlog of work, the limited choice, and the need for innovation
P Dardenne, London, UK
NHS patients should be treated within the NHS. NHS reforms have to address the backlog of work, the limited choice, and the need for innovation. But the use of the private sector to shore up these problems will ultimately lead to a decline and destruction of the NHS. I have worked in the NHS for nearly 40 years. This government is not listening to the people any more than the Tories under Mrs Thatcher.
P Dardenne, London, UK

3bn over 5 years is not a huge amount in NHS terms. It doesn't threaten the NHS. But if the NHS is worried about it then they know what they have to do. Improve their productivity. What I'd like Mrs Hewitt to do though is extend the same logic to dentistry.
Dick, Scotland

I have been told by my local hospital that I will have to wait up to six months to have some day surgery done, however thanks to NHS reform they immediately got in touch with another NHS hospital which is fairly local and said I could get the treatment in two months time. Clearly reform is working, and no-one who is ever likely to need hospital treatment should knock this. The hospital in question even gave me a choice of days - minimising disruption to my working week. I couldn't ask for a better service!
Anon, UK

Labour criticised the Conservatives for planning to "take out" 1.2 billion from the NHS by paying half of what it would cost the NHS for the operation towards the cost of an operation in the private sector. Labour is now taking 3 billion out of the NHS. It just does not make sense! The Tory plan would have saved money whilst the Labour one seems to be spending more!
Mark Richards, Nottingham, UK

The NHS seems to be moving in the direction of the Canadian system, which is well liked by patients and doctors. What we have here is not public health care but public health insurance. It is extremely effective and efficient.
Jim Garner, Ottawa, Canada

Ah another Tory policy gets implemented! And I thought Labour won the election.
Samster, London

Surely people are more concerned with seeing a consultant ASAP, rather than who employs that consultant?

As an NHS employee (Biomedical Scientist) I fail to see the logic in rewarding the private sector with larger sums of money to do the same job. Why not just ensure that adequate funding is reaching patient care in the NHS and stop creating so many management non-jobs.
Jane T, Worcester, UK

These reforms are surely what is needed to help cure such a sick NHS
Jack Lankester, Luton, England
So long as the operations remain free and they are given to people in equal priority, then who cares whether or not it is done privately or not! Everyone should accept that these reforms are surely what is needed to help cure such a sick NHS.
Jack Lankester, Luton, England

Whether this plan works in the short term or not, we will regret it in the long term! It is foolish, expensive and ill-considered.
Lawrence Brown, Sheffield, UK

Surely this is a logical way forward, like a traffic jam on the motorway, the only way to get rid of the queue is to have more people leave than join. So by using private hospitals to clear the backlog it will get the NHS back on track, then they will be able to deal with all cases again.
Matt, Preston, England

The problem is that usually the same surgeon carries out the private operation as well as the NHS operation and all NHS patients' scheduled operations get pushed to the back of the queue. Having been a visitor in the cardiac unit of a local hospital during the past few weeks this has happened in more than one case.
Aimie, Bristol

So now I am going to pay for people to be treated at private hospitals, instead of the NHS. If the government has the cash spare to send NHS patients to private hospitals, can I have a reduction in tax and NI contributions?
Martin, Bath

I despair! If anyone in the government could just realise for a second how insane this sounds. The private sector pays the same NHS surgeons to do these operations. The only difference is that the NHS will now also be lining the pockets of rich shareholders at the expense of the tax payer.
Ark, Norwich, UK

If this proposal will bring down waiting lists, then I am all for it
Alan, Denton, Manchester
If this proposal will bring down waiting lists, then I am all for it, this will mean more is invested in our health and may save lives, but I agree if the money was invested in the NHS then there would be no need to pay for private.
Alan, Denton, Manchester

Wasn't one of Labour's election platforms based on an opposition to the Conservatives doing this very thing?
Rachel, Leeds, UK

If this money is available to be paid to the private sector, to fund operations, why is it not simply re-invested in the NHS? It's ludicrous to assume that a private company is inherently better value for money when its purpose is to generate profit. Like most of the government's Private Finance Initiatives, isn't this more about Labour trying to stimulate the economy by paying huge chunks of our taxes to private companies?
John, Hove, England

Excellent idea - anything which can deliver quicker treatment for those needing it must be a good idea. For those who fret that health care must be free (eg via the NHS) do you buy your food and pay your mortgage? If so, why not contribute towards your health care?
Barry Rochfort, Assac, France

What exactly is the problem? The surgeon is more than likely the same one who would treat you in the NHS - if he had a theatre slot. Every patient treated this way comes off the waiting list which benefits all of us.
John, UK

Labour was obviously thinking what the Conservatives were thinking.
James, Flint

Isn't this the very same thing that the Conservatives planned and Blair complained up in the run up to the election?
Steve Price, East Grinstead
Isn't this the very same thing that the Conservatives planned and Blair complained up in the run up to the election? Yet another reason why the country was mad to trust Blair in a third term.
Steve Price, East Grinstead

Can we get one thing straight - the NHS is not free! Billions of tax payers' money is spent running it, and by common consensus it can consume an almost limitless amount of cash, which long term is untenable. Why are people hung up on the dogma that the NHS has to be run by the state, who by the way have an appalling record of running businesses like the NHS and wasting vast amounts of our money. We're happy to buy any number of goods and services from private companies, so why not healthcare?
John, Northwich, UK

I have no philosophical problem with making best use of private sector expertise and resources. However, look at the mess the railways and buses are in and then convince me that increasing private sector involvement in the health services is a good idea.
Xerones, York, UK

Why not extend the use of existing (and very skilled) NHS staff to carry out these NHS operations? Surely the recently contracted raft of trust managers are competent enough to arrange this? Paying NHS overtime to its staff must be far less expensive than paying them to do private work? Also whatever happened to 'pro bono' work?
Mark, Cardiff, Wales

I think we should learn from the private sector
Sharon, UK
I was 'lucky' enough to hear Mrs Hewitt speaking earlier today and I'd just like to express mine and several other NHS employees' dismay at this announcement. The private sector will cream off the quick and easy procedures leaving the NHS to shoulder emergency and complicated cases. Sounds OK but then how are these units going to be staffed? With highly skilled staff from the NHS! I think we should learn from the private sector - and even emulate their processes but I'm totally against a 'profit' motive in the health sector.
Sharon, UK

Private hospitals do not have a high dependency unit or intensive care, what about if any complications happen during surgery? It is a disgrace that Labour are now putting this forward as an option after calling Tory policy that was almost the same!
Sandra, Manchester, England

I'm not sure about this at all. I am a huge supporter of the NHS, and while this seems a good way to cut down waiting lists, I am fearful that this could be the start of a shift to a lot more private healthcare. Which I am 100% against.
Gareth Beal, Exeter, Devon

I have been waiting over a year for an appointment for minor surgery. I would welcome the chance for a private operation paid by the NHS.
Martin Husbands, Monmouth Wales

The NHS is getting waiting lists down and is receiving massive ongoing investment. Using the private sector is the only option to improve matters while the NHS has the opportunity to get fully up to speed.
Anon, Stratford-upon-Avon

Healthcare is simply too important to be left to the private sector who are only interested in a fast buck. If there's money to pay for this then why isn't it being given to the NHS ?
M, Bristol, UK

This is a false economy
Darryl, Paderborn, Germany
This is a false economy - those who promote the idea that private interests would introduce competition and hence lower the costs don't mention that these lower costs tend to come in compromises to patient care, and a considerable chunk of government money still ends up in shareholders' pockets whichever way it goes. Spend half the money, but get a quarter of the results.
Darryl, Paderborn, Germany

There is nothing wrong with subcontracting medical care when the NHS's own facilities are overloaded or when subcontracting would provide services which are more efficient and at lower cost to taxpayers. However, the NHS should be careful to control costs by limiting fees to "reasonable and customary" and to be certain that the providers are certified and performing up to standards by conducting periodic audits.
Mark, USA

This is privatisation by the back door and anyone who wants it should look at USA and see how their system works (not). The NHS is not past its sell by date it has its problems but privatisation will not solve them but only make them worse!
Adrian Cannon, Edinburgh, Scotland

Yes, why not? If the private hospital is able to accommodate. I have just paid a lot of money for my daughter-in-law to see a private consultant. She has three small children, the youngest was 6 months. To avoid a long wait, we paid - perhaps I could have a refund. Including tests it was a hefty bill, and she saw the same consultant she would have seen if she had waited months.
Edna Lanning, West Sussex

No, I currently pay for private dental treatment and am looking into other private care, why should I pay that and my taxes so other people who don't pay get a better treatment? I'm not being selfish but I'm sick of subsidising everyone else. The government need to stop treating illegal immigrants etc (apart from the genuine ones) pull out of the EU and then they'll see just how much money we have floating around to put into the NHS service for the British people!
Lianne, Cannock, UK

The public sector contracts out work to the private sector all the time, where's the problem? This is a much better approach than the Tories suggestion of charging half-the-cost to go private - that would have simply allowed the better off to jump the queue.
Kevin, West Midlands

Some people seem to forget that the NHS is a service - not a work scheme run for the benefit of civil servants
Steve, UK
This is the wrong question. The right one should be 'what is more important - putting money back into the NHS or patients getting the treatment they need as soon as possible?' Some people seem to forget that the NHS is a service - not a work scheme run for the benefit of civil servants.
Steve, UK

What about all the hidden charges? Have they mentioned that?
Joe, London

Publicly funded, free at the point of delivery healthcare is a nice idea in principle but it is simply not viable in today's society. The government should bite the bullet and privatize the running of all hospitals, at the same time introducing a system of compulsory health insurance for those in employment and government aid for those who aren't. The NHS served its purpose well but its time to allow it to retire with dignity
Joe, Newcastle-Under-Lyme

NHS patients should get quality care, but not by giving profits to private companies. The NHS is a non-profit organisation so should be able to do anything a private companies does cheaper, it doesn't have to think of shareholders for instance. NHS money should not be used to make the fat cats fatter. Rather we should ensure the NHS is run as smoothly and efficiently as a private company; there is no reason why this should not be so. Perhaps there should be bonus incentives for all NHS staff to improve things; at least then any savings will be going to help the kittens, rather than the fat cats.
David R, Plymouth UK

Private treatment is better than no treatment
David, Cornwall, UK
Certainly. If the NHS has not the capacity to handle its workload, then it should subcontract some of it out while demand is high. Private treatment is better than no treatment.
David, Cornwall, UK

What does it matter who or where people are treated as long as it's effective. Sounds like some people on here are more concerned with political ideology than people's health.
David, England

Pay less tax and NI and pay for your own healthcare.
Dave, UK

These are almost the exact same plans that Labour were criticising the Conservatives over. Labour always has held the Tories links with the private sector against them and now they are doing just the same
Christian, Lancashire, UK

Taxpayers' money should not be used to fund private treatment, but to make genuine improvements to the NHS. But I'm afraid nothing this government can do surprises me any more.
Harry Lee, London, England

This is privatisation by stealth. The private companies get all the hassle free routine operations and the NHS is stuck with all the messy difficult ones. Pure profit for the private company - but if anything goes wrong after the operation it will be the NHS that gets to clean up the mess !
Chris, Telford UK

This is privatisation by the back door
Vish, UK
No! This is privatisation by the back door. How can a private company provide cheaper services than a public one? This is just like the trains, taking public money and shifting it into private hands. If I was given the choice of waiting 6 months for an NHS doctor or having an immediate op with a "private clinic" I would wait, not only out of principle but because time and again it has been shown that NHS doctors have better survival rates than the private sector. Mrs Hewitt should resign for this stupidity!
Vish, UK

Vish asks "How can a private company provide cheaper services than a public one?" Would have thought the answer to this one is easy. Private companies have an incentive to cut unnecessary costs in a way that the state doesn't seem to be able to do.
Nathan James, Liverpool

I would have no argument with this approach as long as it is in addition to NHS spending. If it takes any resources from the NHS to pay private companies, some will end up in shareholders pockets, and not spent in treating people. This would be a clear reduction in patient care.
Steve Tymms, Welwyn Garden City, England

Absolutely not, the people that pay for private health pay twice for healthcare and should not have to wait behind NHS patients for treatment.
Chris, UK

Good grief - after all the fuss they made before the election, about the Tories plans for pretty much the same thing!
David, London, UK

As the Labour Party invented the NHS, you would have thought it would support it. How can paying for people to go private be considered supporting the NHS? This is another nail in the coffin as what should be, but isn't, one of Britain's greatest achievements.
Dave Godfrey, Swindon, UK

What would really help is if the government would match the cost of the operation in an NHS hospital
Pauline Yates, Kesgrave
I pay NI and for private medical insurance (through my employer). What would really help is if the government would match the cost of the operation in an NHS hospital, allow people like me to contribute to it and go private. Therefore freeing waiting lists and not leaving tax payers who have medical cover feeling like they are paying twice. Oh wait - that was a conservative idea in the last election - silly me.
Pauline Yates, Kesgrave

Personally I don't care whether I am treated on the NHS or privately so long as the treatment is effective. But I find it strange that the government is going down this path a week after winning an election based on a manifesto including rejection of "Tory plans to privatise the NHS".
Brian W, Chelmsford, UK

Yes, of course patients should have private treatment. If the NHS has not got the capacity what sense is there in delaying treatment? I would like to see the NHS providing only those services required for basic health, A&E and emergency cover, basic needs. Anything more - including all research - should be in the private sector funded centrally by government. This would concentrate resources on the most important areas.
Terry, Epsom, Surrey, England

What improvements? Cut the waiting lists, improve the hygiene (get rid of MRSA bug) in hospitals and give more money to the staff who deserves it !
Yanushka, Reading, Berkshire, UK

At what cost to the tax payer though?
John, Manchester

To use the private sector is like admitting the NHS is not viable
Richard I Stone, Lowestoft, UK
This is an absolute outrage - the main charge Labour threw at the Tories during the election was that the Tories wanted to undermine the NHS - and now we hear that Labour thought it was such a good idea they are going to do the same. Any inadequacies with the NHS can be addressed by funding it properly; to use the private sector is like admitting the NHS is not viable. It makes we weep to think that one of Britain's greatest and most noblest of achievements (the NHS), is given such a low priority by 'New Labour'.
Richard I Stone, Lowestoft, UK

I am ashamed to have voted labour. Taking public money and putting into the private sector is completely illogical and a waste of tax-payers money. Profit will now be made from tax-payer's money and not returned to the public. This is a scandalous practice which has become a norm in modern day life. Something needs to be done about it.
Mark Semple, Bristol, England

Sounds good to me. Why not go the whole hog and have the NHS purely as the payment-agency then let patients take their treatment from whichever hospital best suits them, public or private? There's no reason why the NHS should run the hospitals.
David Moran, Nr. Aberdeen, Scotland.

If I'm in need of surgery I don't care one jot about the method of employment of payment procedures by which the government pay the surgeon (with my money). I don't care whether they're employed or contracted, I just want my op carried out quickly and efficiently.
Paul Sealey, Cannock, England

So let's get this straight. Offering to pay some of the cost of a private operation for someone is bad as it creates a 2-tier health system that undermines the NHS (criticism of Conservative election manifesto) but offering to pay all of the cost of a private operation is a good thing and to be encouraged (latest New Labour proposal). I'm not entirely sure that this all makes sense. Oh, silly me, it is the Labour party cherry-picking everyone else's manifestoes rather than having good ideas of their own again.
Tim, Fareham, UK

It encourages more NHS staff to go private, further depleting the resources available
Katie, London
If it is free to the patient, and the private sector can do it more cheaply and more quickly than the NHS, then fine. The problem is that it encourages more NHS staff to go private, further depleting the resources available for the majority.
Katie, London

Perhaps this is the way to go. The government are useless at running hospitals, and even should not be dabbling in something so important. Lets make National Insurance exactly what it says on the tin, insurance that can be used at private sector companies when a claim is made.
Tony Humphreys, Prestatyn, UK

I don't have a problem with the policy itself, but I'm astounded at the hypocrisy of the Labour Party which would be screaming to the rooftops if this was being done by a Conservative government.
Alex Swanson, Milton Keynes, UK

Health secretary's in-tray
07 May 05 |  Health


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