How and why has the Private Sector become more involved in Public Health Care?
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How and why has the Private Sector become more involved in Public Health Care? Labour plans to treat 100,000 more NHS patients each year in private hospitals, build more hospitals under the private finance initiative and extend public-private partnerships to provide more choice for patients in how and where they receive NHS treatment. Does this amount to total privatisation of public health care? Labour insists that it does not want to privatise the NHS; merely use private hospital capacity in the UK and Europe (to ensure NHS patients are treated more quickly), bring in private sector expertise (to run treatment centres for high-volume routine operations such as cataract removal) and use commercial money and expertise to build and maintain new hospitals under the private finance initiative (PFI) or Public-Private Partnerships (PPPs). For Labour, the important thing is not who provides the service to patients (it could be the private, public, or voluntary sector) but that the service is swifter and treatment is of equal or superior quality to the NHS, represents value for money and is paid for, free at the point of delivery, by the NHS, which is its principle duty.
Labour traditionally believes that health provision should be paid for by the NHS entirely out of central taxation (although people should be free to take out private insurance if they wish), whereas the Tories believe the NHS budget should be supplemented by encouraging individuals, through tax breaks, to take out private health insurance. Partly through necessity, Labour has learned to love the Private sector. In order to kick-start its massive hospital building plan, Labour had little choice but to fund it through PFI, thereby transferring a swathe of NHS support workers to the private sector. It has broadly kept to its '97 manifesto pledge of "opposition to the privatisation of clinical services" but has been continually forced to hire private hospitals to carry out thousands of routine operations in order to meet its election pledges on reducing waiting lists. The prime minister, Tony Blair, has been frustrated by the alleged unwillingness of many parts of the public sector to reform inefficient and outdated practices and he regards private expertise as a useful catalyst to help transform NHS performance.
First, using private hospitals to perform operations on NHS patients; second, using private hospital providers to build and run standalone surgical centres; third, using PFI not only to build new hospitals, but to construct new health centres and procure expensive equipment; and fourth, using private sector expertise to provide IT systems. Critics of the private health care scheme worry that this is the thin end of the wedge. The fact of the matter is, the wedge is already quite thick: the private sector runs the bulk of residential homes for the elderly and disabled, as well as half of all medium secure units for the seriously mentally ill. The voluntary sector provides a wide range of NHS services for the mentally ill and people suffering from learning disabilities. The NHS spent £1.25bn in 1998-99 treating patients in private hospitals, around 4.6% of the NHS budget. The government argues that it is not heralding a revolutionary expansion in the provision of private health care, merely formalising an ad-hoc contribution that is already formidable.
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