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Last Updated: Friday, 27 January 2006, 08:55 GMT
Can privatisation help our health service?
By Matthew Hill
Health Correspondent BBC West

Stethoscope
The government is looking to use more private hospitals
Is using the private sector the answer to the 28m overspend facing the NHS in the West?

The jury certainly seems to be out at the moment.

The government is pinning its hopes on treating NHS patients in hospitals owned and run privately.

At the new Shepton Mallet diagnostic and treatment centre the cost of every operation is 20% more than the NHS tarfiff.

That is because the multi-national company that owns the hospital needs to re-coup the cost of building the 35-bed unit.

At the end of five years, primary care trusts could decide to take over the hospital. But then they would have to compensate its owners, the New York Presbyterian Healthcare System.

Private sector 'reliance'

So in Shepton's case it could be bad value for money.

But a senior NHS manager told me that the NHS has ingrained working practices, which makes trying to make staff work in a more efficient manner very difficult to achieve.

She sees the private sector has merits in this respect. It can dictate to staff when, how and where they should work.

But the great danger, she told me, was relying too much on the private sector.

She forsees a situation where patients left with complications from operations going wrong have to battle with the private hospitals for redress and correction.

'Perverse incentive'

And with NHS trusts competing with the private sector for business, the long-held NHS ethos of co-operation will mean give and take will disappear.

By cutting waiting lists using extra capacity outside the NHS, the government gets rid of the main reason patients pay to go private.

It also removes the perverse incentive for NHS consultants to keep long waiting lists in order to have a healthy private practice.

But if we carry on cutting waiting times by using the private sector, this very success could prove disastrous for NHS finances.

With more patients using the private facilities - paid for by the NHS - that is more patients the NHS will have to pay for.



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