by Stephen Tall on March 13, 2012
There is no doubt that putting some services out to tender has vastly improved certain standards over the years, broken the power of vested interests and brought in competition that has sharpened up results. Just look at how hospital consultants’ waiting lists plummeted when a few Independent Treatment Centres were set up nearby. Suddenly, long waiting lists for hip and cataract operations fell because patients had a choice. The wholescale mass privatisation of a service is rarely needed, but a little gingering up round the edges has an electrifying effect on sleepy outfits. Often, private provision makes sense where small units need to buy in some expertise or back-office work they can’t develop themselves.
Most toxic is the role of commercial competition, with Monitor acting as enforcer. By opening every NHS corner to “any qualified provider”, the whole service can be taken over by private companies, with a few token charities and mutuals. NHS hospitals, cherry-picked of lucrative work, risk bankruptcy when left with only complex cases. Stroke care surged ahead by creating pathways so ambulances take patients to designated units, open on rota, working together. Cancer and heart results improved dramatically, due to collaboration. Commercial competition prevents that – and drains away cash.