Moving the NHS from public sector to private sector Essay

The National Health Service (NHS) is a state run entity set up by the Labour government afterwards 1948 as part of the welfargon state. It was originally run by topical anesthetic authorities with funding from public money allocated by central government. Though in recent old age this money has been moving to the buck semi clandestine sector and many be possessed of speculated that this is privatisation by stealth. In this essay I volition attempt to understand this process by giving some historical context to the stock-stillts of the destination few decades while pointing out some of the advantages and disadvantages, and the forms it could take, of privatisation. In conclusion I hope to point to a future where the NHS after part exist with public money and private focusing.It came out of a working order movement. The powers that be introduced various health and welfare reforms after the Second World War in solution to working class agitation and mobilisation health sche ma seemed a better option than a Russian revolution1 This is a institution that does non fit easily into the world of trade liberalisation and globalisation, but it is a right many people feel should be free and is even recognised by the U.N. as a fundamental human right. Selling off the NHS, as anterior Tory governments have done to other parts of the U.K.s infrastructure would be politically unacceptable especially give the general popularity of the NHS and its entrenched public nature.2But reform and change have accrued. The first change, by the Tories in 1983, was in the way funding was allocated. For example, budgets where previously allocated on the basis of geographical areas needsNow funding is allocated as payment per patient3 This change allowed for the transfer of money from the public to the private sector.This mickle be seen in the provision of private long frontier care which grew from 175,000 places in 1985 to 650,000 in 1998. This growth was funded or so enti rely out of the public purse4 This has led to a system where money is instanter thrown at the private sector through arrangements such as Independent treatment centres (ISTCs) and the private finance initiative (PFI). One such arrangement Ravenscourt Park cost to set up and unsympathetic with a deficit of. These are figures that have to be borne by the NHS5Clearly the NHS is now a half-way ho consumption mingled with the public and private sectors. While the present Labour government seems set on pushing frontwards with more ways of privatisation.John Carvel noted thatHealth secretary Patricia Hewitt is preparing to transfer NHS hospitals buildings into the private sector as part of a bn scheme to promote competition in the health docompanies bidding for contractswill be allowed to take over NHS premises, doctors and nurses.6The implementation of this document are already in motion. Recently DHL gained a contract worth 6bn to provide non pharmaceutical supplies for ten years. P ayment will be made harmonise to the savings it can make, which the government estimates at some n.7So while this whitethorn seem like a good idea Effective implementation of grand investment projectsis hardly the governments strong point.8 So to make this work DHL would have to be finely baffled. Given enough freedom so that they can destroy cosy past relationships, but not be allowed to bully suppliers and lower standards due to a need to please shareholders and make profit.To see what paradoxs a health service run for profit creates we just have to look at the USA and its private health system. The system of HMOs was set up in the 1970s by the Nixon administration. We can see from these comments recorded on the Nixon White House tapes, (Nixon quotes), that this system was created not to look after patients but to make profit.While the US may have the most advance(a) health care system available, if a customer does not have enough money or adequate insurance their options are limited. These problems where highlighted in Michael Moores documentary Sicko, which compared the US system to that of Cuba, Canada and the UK. It could be said that the storyteller was unabashed in his bias against the HMOs, but the case shown, that healthcare will become unaffordable for average people, may arise here if privatisation becomes widespread.At the same time though because of the lack of reinvestment in the NHSs infrastructure and Gordon Browns bond certificate to EU spending targets, alternative funding methods must be found. A recent study by the European Health Consumer Index (EHCI) showed the UK at 17th place behind Ireland, Czech Republic and Estonia in provision of healthcare. Three countries a long way behind the economic development of the UK. In situation while per capita spending placed the UK in 12th place, the Czech Republic placed 21st showthat efficiency targets are possible if money is spent wisely.9This of course is the main argument for the involve ment of the private sector in the provision of health care. That they will cut bureaucracy, while subjecting spending plans to stringent management oversight and thus provide better services for cheaper.Unfortunately the reduction in public provision of long term care, NHS dentistry, optical services and elective surgery shows the trajectory for the NHS under the PFI.10 We sole(prenominal) have to look to Austria to find a publicly funded health system that allows patients who ..regardless of salary, are entitled to use the services of the health system for free although they do pay higher income tax.11 While smell at the EHCI tables we see Austria ranks in first place but only spends (figure here) more than the UK per capita. This suggests that the UK could indeed modify services without the need of the private sector but this would involve raising taxes, a strategy both political parties seem wary of due to likely lose of electoral support.One new potential direction for the h ealth service could be the internet. The main advantage of the internet is the access to knowledge that it can provide the customer while providing savings within the administration of the NHS. Unfortunately there is one problem that would need to be overcome, computer illiteracy. In most cases those with health problems will be the older members of society, those who are the least computer literate. This suggests to me that while saving could be made, they would not be worthwhile while we have a generation of customers who do not feel comfortable with computers or the the internet. In the long term there is potential, but unfortunately it does not provide any solutions in the short.In does seem that the disadvantages of privatisation on its present course do seem to outweigh the advantages. The present government though has already started shovel in a path that appears to be irreversible. While many within the service would agree that reform is unavoidable the problem is that hea lthcare is seen as a fundamental right provided by the NHS, a endowment to the citizens of the UK after the trauma of World War 2 and the sacrifices they had endured. The UK government has also shown on many occasions that it cannot regulate private companies, that are funded through public funds, toput the general public before profit. Looking at past privatisations of industries we can see, even in the case of the most successful, telecommunications, that this sector lags behind other European countries such as France where for example broadband infrastructure is far ahead of that provided in the UK.Thus in conclusion the only solution that I can see is a single payer system with strong enough legislation that creates European wide regulation in the shape of pharmaceutical charge controls and levies on research and education12 In effect creating a new framework that allows the private sector to provide to provide healthcare. This way the tax payer can benefit from the private sec tors adroitness in delivering increased productivity and value for money, while protecting against its overwhelming desire for profit.1http//www.thecornerhouse.org.uk/gatsprivatiationhealth.htm2ibid3http//www.healthmatters.org.uk/issue 41 p12-134ibid5http//www.guardian.co.uk/uk_news/story/0,,1931236,00.html6http//www.guardian.co.uk/guardianpolitics/story/0,,1575243,00.html7http//store.eiu.com/product/1860000186-sample.html8 ibid9EHCI 2007 study10Bmj.com 1/4/9911Irish Independent, 6/9/07 The Austrian health service is the best in Europe, Gemma O Doherty12http//www.healthmatters.org.uk/issue 48 summer 2001 p 11