Private firms should have bigger role in care says NHS leader

A senior NHS leader has sparked controversy by urging ministers and health service bosses to let private firms treat more patients in a bid to cut hospital waiting lists.

Stephen Dalton, the chief executive of the NHS Confederation, said Theresa May and Jeremy Corbyn should stop denying that private sector health companies are “a force for good” in the NHS. They are not “bogeymen”, look after patients well and should start treating more than the 10 million patients a year they are already paid for out of the NHS’s budget, he said.

The service is under such intense pressure that private firms should urgently be handed a greatly enhanced role, just as Tony Blair’s Labour government did in the early 2000s, in order to help it cope with fast-rising demand, Dalton argues in an article in Tuesday’s Guardian.

“What was seen a decade or so ago as a sensible way of attracting investment, and helped get average waiting times down from 18 months to 18 weeks, is now seen as a political no-go area, with the Tories and Labour locked in an arms race over who has used the private sector the least while in office”, Dalton writes.

“This is a con-trick, when the reality is that the private sector has been used for decades to help sustain a health service which is free at the point of use and available to all based on need and not ability to pay. So let’s stop pretending that private sector involvement in the NHS is a uniformly bad thing; it isn’t.”

Dalton also wants private firms to help provide the “billions” of pounds needed to build a new generation of hospitals and clinics as part of the NHS’s Sustainability and Transformation Plans, though acknowledged that lessons should be learned from Labour’s use of the discredited Private Finance Initiative.

The Confederation represents most of England’s 238 NHS acute, mental health, ambulance and community services trust but also, through its NHS Partners Network, private firms who have been awarded contracts to treat patients.

But Dalton’s views prompted warnings that the private sector’s track record in the NHS made it unfit to expand its role and that handing it more contracts would pose “serious dangers” to patient care. The firm Coperforma recently lost its contract to ferry tens of thousands of patients in Sussex to and from hospital after a string of blunders sparked huge concern.

Two former health ministers said they shared Dalton’s belief that private firms can deliver real benefits for patients and his belief that “the public sector doesn’t have the monopoly on caring.”

“What matters is what works best for patients”, said Conservative MP Dr Daniel Poulter, who was a health minister until May 2015 and is also doctor in the NHS. The fact that GPs and pharmacies work closely with the NHS but operate outside it shows that the NHS has always been a public/private partnership, he added.

Liberal Democrat MP Norman Lamb, who was also part of the health ministerial team during the coalition, said: “We should focus on the quality of care and equal access rather than on who provides it. Around the country there are good collaborations between statutory and independent sector, which I welcome.”

But both MPs said they feared that a greater private sector role could threaten the drive to integrate NHS and social care services, which the government has pledged to deliver by 2020. “While there is undoubtedly considerable benefit to the approach taken by Tony Blair of using the private sector to help the NHS to increase capacity, the history of wider private sector NHS commissioning tells us that private providers tend to ‘cherry pick’ the most profitable services to deliver,” said Poulter.

“So there is undoubtedly a serious danger that widespread commissioning of alternative – private – providers will result in greater fragmentation of the health and care system at the very time when there is need for increasing integration of services.”

Lamb warned against relying on private capital to build new NHS premises. “We must never again allow the outrageous profiteering under the last Labour government’s Private Finance Initiative, which has mortgaged the future of the NHS to the tune of tens of billions of pounds.”

Labour rejected Dalton’s call and said that problems with contracts previously awarded to private firms meant they could not be trusted to expand their role.

“In recent times private providers have utterly failed to offer patients the quality of care they would expect. What’s more when the priority should be public investment in the NHS, privatisation such as the selling off of NHS Professionals announced last week could very well end up costing the taxpayer more”, said Jon Ashworth, the shadow health secretary.

Dalton’s plea was prompted by ministers denying the NHS enough money to do its job properly, he added. “It is indicative of the government’s neglect of our NHS that senior figures are saying we now must resort to the private sector for the investment our NHS so badly needs”.

At last month’s Conservative annual conference Theresa May used her set piece speech to deny Labour claims that her government was privatising the NHS. “Every election, they say we want to privatise the NHS – and every time we have protected it. In fact, the party that expanded the use of the private sector in the NHS the fastest was not this party, but the Labour Party”, she said.

The Department of Health said only that “Any decisions about use of the private sector are taken by local doctors who know their patients best. We are clear that patients should be able to access the best possible treatments based on quality of care not the provider.”

Private firms should have bigger role in care says NHS leader