Yyou can only assume that Wes Streeting’s recent hug of the private hospital sector as a solution to the current health crisis stems from naivety about how UK private healthcare works, or is part of attempts by Labor leaders to turn it into a centre-right party.
It’s certainly not evidence based.
Famously described by the deceased Julian Tudor Hart As the “red light district of medicine”, evidence about the parasitic and risky nature of private healthcare in the UK has been accumulating for decades.
As anyone in the health service knows, private hospitals don’t have extra doctors to help reduce the NHS backlog: in all private hospitals operating in the UK, the doctors are NHS doctors working on their spare time. In commercial terms, because the private sector does not contribute anything to the training of the 17,500 doctors who work in its hospitals, this equates to a free subsidy to the private sector of around £8 billion.
And because these consultants operate independently, hospitals do not pay any associated national insurance costs and are notoriously able to use this employment agreement to deny liability if a doctor harms a patient, as they are simply “renting them a room”.
Since the main constraint to eliminating the backlog is not the operating rooms but the consultants, surgeons and anesthetists, it makes no sense to suggest that the private sector can come to the rescue of the National Health Service.
There is only one group of healthcare professionals in the UK, and unless that group expands significantly and rapidly, a policy of pushing NHS patients to receive treatment in the private sector will not make a significant dent in the number of patients waiting to be treated, working class or otherwise.
Undoubtedly, what will push more NHS patients to be treated in private hospitals is exposing them to a greater risk of harm. Anyone who has followed Ian Paterson in horror scandal – a surgeon who, for financial reasons, maimed potentially thousands of women mainly in the private hospital sector by telling them they had cancer when they didn’t and then removing their breasts and other internal organs – will have seen how badly regulated the UK private sector hospital sector is
Even though the Bishop of Norwich’s inquiry into the Paterson scandal released a series of recommendations almost three years ago designed to prevent something so terrible from happening again, neither the government nor the private hospital sector has done anything substantial to implement the recommendations or address systemic risks to patient safety that have been posed by medical examiners, regulators and official inquiries going back more than 20 years.
These safety risks include the fact that the vast majority of private hospitals do not have ICU facilities to care for patients if something goes wrong after an operation. Even at the height of the pandemic, 6,600 patients they were transferred to NHS wards after treatment at a private hospital, a fact that suggests that, far from helping the NHS during the pandemic, support went the other way. It’s also a fix that costs the NHS an estimate £80 million a year.
The private hospital sector not only does not have ICU facilities, but also places the postoperative care of patients in the hands of a junior doctor (a resident medical officer, or RMO) they often work 168-hour weeks, well in excess of the European directive on working time, without the supervision of a medical consultant and often without the necessary expertise in how to care for patients in an emergency.
in nothing less than five forensic investigations, the RMO model has been cited as a contributing factor in patient deaths, including the tragic case of Peter O’Donnell, an NHS patient who died after receiving treatment at a private hospital. O’Donnell’s death and the subsequent forensic investigation led former health secretary Jeremy Hunt to write to the private health sector telling them “to put your house in order and improve security” – again, without success.
Ironically, since Labor has suggested that the NHS needs depend less about “foreign doctors”, a recent BBC File on 4 exposé found that many of the RMOs working in private hospitals were brought to work in the UK from countries such as Nigeria by recruitment agencies that require them to operate under the conditions of employment outlined by the British Medical Association and UK Physicians as a “disgrace” and by the doctors themselves as “borderline slavery.”
And it’s not just a couple of private hospitals operating this model: A review by the Center for Health and the Public Interest patient safety in the private sector found that this reliance on agency-employed junior doctors was common to almost all private hospital companies operating in the UK.
Given these known systemic security risks, it is not clear why any health minister, Workforce or Conservative, I would look to use private hospitals to treat more NHS patients. But it is not the only issue of concern that they must take into account.
Despite all the seemingly benevolent offers of support made by the private hospital sector to clear the NHS backlog, their record during the pandemic suggests that the only (and legitimate) concern is maximizing revenue and profit.
It must never be forgotten that at the darkest point of the Covid pandemic in January 2021, when London’s NHS was being overwhelmed, the medical directors of the main London trusts publicly pleaded with the private sector to stop treating more profitable private patients and focus its attention on treating urgently ill NHS cancer patients. This was despite the fact that many of these same hospitals had a contract with the NHS to provide pandemic response support worth more than £2 billion a year.
It should also never be forgotten that in addition to this £2 billion brochure: so they provided comparatively little healthcare activity – Several of the hospital companies also considered it appropriate to claim a plus £72 million from the public purse in the form of license payments.
Add the fact that several private hospital companies have been found to be operating recently in the UK. responsible for pricingparticipation in US Health Care Fraud and connections with alleged accounting fraudand it is clear that Labour’s decision to go private without major reform of the for-profit sector is taking a huge risk with public health and taxpayers’ money.