Experience shows that for-profit hospitals try to avoid the responsibility for comprehensive healthcare
Sir, Shirley Williams (Opinion, Feb 28) gives a perceptive analysis of the catastrophic effect that awaits health care if Andrew Lansley’s proposals become law. Those who wish to use market forces in the health service must realise that the regulation needed to ensure co-operation in a multi-unit competitive health service run for profit will be both very difficult and very expensive.
Experience shows that for-profit hospitals try to avoid the responsibility for comprehensive healthcare. Existing private hospitals in the UK regularly transfer patients requiring intensive care to NHS hospitals. Some private hospitals in the US have declined to provide services such as obstetrics, have tried to avoid accepting patients with complex problems and have exploited loopholes in necessarily complex regulations to maximise profits.
GP fundholding would be a very expensive and probably misguided experiment with destabilisation effects, and with costs that in the short term have to be taken out of patient care. Allowing commercial organisations to take over any of the hundreds of NHS hospitals or GP groups will be a privatisation that will dwarf that of the railways in scale and in regulatory problems.
The taxpayer will pay for the huge administrative costs and the company profits, as well as for the healthcare, while the general practice consortia and the hospitals will be primarily motivated by a requirement to concentrate on patients with illnesses where they can make the biggest profit.
For the Conservatives and the Liberal Democrats to form a coalition when the country’s finances were critical is understandable; for the MPs and peers of both parties to support a measure based on unproven theory that was not in either manifesto, and would introduce expensive and irreversible changes to the detriment of patient care, would be unforgiveable.
Professor Sir Dillwyn Williams
Cambridge
Sir, The handing over of control of local medical practices to GPs, who are not democratically accountable and have neither the time, inclination or the accounting experience to manage their practices properly without costly administrative help, is a crude step towards privatisation that will further distance NHS patients from the personal attention from their doctors that they have a right to expect.
I do not understand how David Cameron and Nick Clegg have allowed the Government they run to be hijacked by Mr Lansley in this way. His reforms are ideologically motivated and organisationally flawed. They should be opposed by all parties. The country has higher priorities at present.
Adrian Slade
London SW14
Sir, My colleague Shirley Williams echoes criticisms I made of the Government’s Health Bill during its recent second reading. For Ministers to believe that they can push through the biggest reorganisation at the same time as seeking the greatest efficiency gain in any health system in the world shows that they have allowed their ambitiousness to become megalomania.
The Government is leading our NHS into an avoidable high-speed train crash. Although the easy pickings from the wreckage will be gleefully picked up by the private sector, most informed observers are warning that the core of the NHS may be fatally wounded.
Andrew George, MP
Liberal Democrat member of the Health Select Committee
A Better NHS 
Glad to see some are growing back their spines, but I do fear that it may be too late. In a style reminiscent of a putsch, most of the ‘reforms’ are well under way long before hitting Parliament. Those of working in health (and social care for that matter) have been astounded at the rapidity of the ideological dismantling of the system, rushed through by a horribly politicised cliquey and imperiously remote Dept of Health. Let’s charge ahead while ‘consultations’ are still allegedly ongoing (any who attended one of the road-shows last autumn can recount how bogus an exercise that was), let’s peddle demonstrably false statistics, let’s promulgate falsehoods and let’s use blitzkrieg tactics to stun people into acceptance. It’s the speed, which I suspect is to make as many irreversible changes as possible in as short a time-frame as possible that is so worrying, because it makes opposing the changes more difficult (oh, and bugger democracy and accountability seems to be their mindset. By the time the mainstream media began to pick up on this, a lot of the damage had been done.
Man just came in – said he had appt for Orthopod at DGH via choose and book – someone rang him next day to tell him could be seen quicker at local private facility – private facility cancelled his appt 2 days before appt – he rang them – they said underlying heart problem – he had to go back on to waiting list for local DGH – next appt with GP, GP said he would never send anyone to that particular hospital – (UK-SH)
“Existing private hospitals in the UK regularly transfer patients requiring intensive care to NHS hospitals.”
This is one of the secret shames of private medicine in the UK. I’ve lost count of the number of patients I’ve seen transferred after private surgery to the NHS, not just to ICU but also just for management of complications, often under the same consultant they had their private operation with, only this time at the tax payer’s expense. There is no way that private healthcare should be able to transfer these costs onto the NHS the way they do, yet nothing is done about it.
In the same way, private health providers are just going to pick the lucrative easy work and the rest of the NHS will go to pot. And the morons in government will be surprised one day when they go to A+E after an RTA and find a service run into the ground.