I was asked a few weeks ago whether, all things being equal if I had any problem with a private company providing health care instead of the NHS, to be honest I do not care how the health service is sourced as long as it is free at the point of need and puts patients care as its primary objective. The problem is a ‘free market’ solution does not, and cannot do this, the motive is profit not care.
Whilst competition will, theoretically, produce improvement as people can shop around for healthcare it will always find the lowest common denominator, it will also tailor its product to its customer, which is not the people it is treating, but the Government, therefore it will tailor its treatments to producing figures. The German health service has already found this, it will provide the simple, cheap, operations to say ‘this is how many patients we have treated’ rather offer the complex time consuming operations.
Profit also has to be a motivation, this can be achieved through efficiency – which is both laudable and desirable – providing the bare minimum of care and cutting costs to patient care. It’s Key Performance Indicators (KPI’s) will be at the forefront of its methodology, not patient care, it must be profit before care.
The problem with the Government’s strategy of market reform of the Health Service is surprisingly that is that a company can simply ‘give the keys’ back if they are not making a profit, it then the State that has to step in and ‘pick up the pieces’. The default of National Express East Coast franchise shows that the Government cannot leave utilities to the mercy of market forces, so theoretically they cannot fail, and there is no incentive to invest and ensure that a franchise is inherently stable. The same mentality that caused the Banking Crisis of 2008 is now being forced upon the Health Care system.
The ‘Free Market’ appears to be taking no risks, only profit.
Before the privatisation of Health Care earlier on this year we were witness to a Retirement Home going into liquidation, and it was the State that was the ultimate guarantor of public health. Healthcare is not a free market, and it should not be there to make a profit.
As with NHS111 it is the State that takes the risks and the private takes the profit.
The question that needs to be answered is why does the Government want a system that does not necessarily benefit the end user and that does not ensure that the risk remains where the profit is? This is the question that needs to be answered now that several operators of the NHS 111 service have literally told the Government ‘we don’t want it, we can’t make money’. What is even more strange is that the operators of the services that have decided the operation is not profitable will be able to bid for more contracts.