Gradual privatisation of the NHS

www.everydoctor.org.uk/nhs-privatisation-map

This has been going on for some time. I worked in an NHS Maternity Unit and outpatient appointment letters for various clinics started being printed on headed notepaper bearing private companies names, Virgin Healthcare being just one. There will be a two-tier system at some time in the future, I think. The medical people in the NHS have been crying out for many years for a thorough root and branch investigation of this organisation but no Health Secretary or Government have ever bothered. They just increase taxes and thrown more money at it. It isn't the answer.

Looking at the map in my area it mainly lists GP surgeries as private but I seem to remember another thread which talked about GP surgeries always being outside of the NHS. However, many of our local GP surgeries have grown into 'health centres' providing an increasingly lateger range of care. So, are services being moved into the private sector by stealth? The health care provided is still free but does this mean that a profit is being made from our tax money!

My DD has just had a baby so is entitled to free dentistry on the NHS but can't find an NHS dentist that will treat her. But we're all aware of the demise of dentistry being offered through the NHS.

DaisyAnne

www.everydoctor.org.uk/nhs-privatisation-map

? thanks?

GP surgeries have always been outside yet inside the NHS. Before my GP daughter went to work in New Zealand (for two years) she had bought into her surgery and was a partner. Her husband chose to be a salaried GP in another surgery. However the NHS funded both surgeries to deliver health care to their patients.

Agree that there needs to be a root and branch review of how healthcare should be funded in the UK, and one that prob can't get anywhere within the term of a single parliament. There's the stumbling block..

But then the culture of 'Reform, reform, aren't things bad enough already' is sadly all too true in the NHS, the result of a procession of new Secretaries of State all wanting to implement their own new blueprint.

I have had treatment organised by the NHS in two or three private clinics. I think that most people do not really care where they have treatment as long as it is done without too much delay.

Susie42 I agree the place doesn't matter but "free at the point of need" has raised many health standards, benefiting the country. It does matter.

I suggested in a thread a while ago that the 'model' the government used for Care appears to be the same one in place for "free child care", dentistry and hearing, and possibly others I haven't come across. If this is a standard model they find is working, they will repeat it elsewhere in parts of the NHS and slowly in all the NHS. The government payments for those on benefits, who will become the only ones paid for by our NHS insurance, are underfunded in these areas. It is reasonable to assume we will see much the same in GP surgeries with direct patient payment and maybe one doctor who sees "NHS" patients and those "NHS" patients being only those on benefits.

This will mean those who can afford the various insurances will start to buy them if they don't have them already. I feel that a surprising number who think they manage well on "enough" income will find they cannot afford all the basics currently available.

The underfunding of the remaining NHS/benefits patients will be supplemented, as it is now in the areas already under this regime. Charities will try to help, people who can pay may be charged more and some treatments will simply not be available for these patients. Not being able to get a white filling on the NHS may not matter; not being able to get a kidney, or fast cancer treatment will.

The website shows that the "extended access" service in this town is run by a private company. I was talking to a GP friend about this a few weeks ago because I was puzzled by it. It's not possible to refer directly. Patients need a referral from the GP, but the GP surgery won't refer unless patients push for it (and know about it in the first place). Apparently, the surgeries lose funding whenever anybody is referred, which is why they're reluctant to do it. It's almost impossible to get an appointment with the GP, especially face to face, (and it's been like that since before Covid), so only pushy people are being seen. Apparently the out of hours service can't see anybody with chronic conditions, so GP surgeries are being left with the patients with long-term conditions, which are expensive to treat on a long-term basis.

There are also a number of fairly new private GP practices, which don't show up on the website.

I feel GPs are being set up to fail through underfunding.

Quite agree, Growstuff, esp re GPs and general hospitals treating mainly costly long-term conditions with no quick profits.

These are major issues about which local patient participation groups or health overview committees can do nothing.

I don’t think it’s the funding that’s the major reason why GP practices are failing. They are paid on a fee per service provided primarily, based on their list size. The real problem is in a lack of doctors and other health professionals to maintain the service. Demand is increasing exponentially, but working in primary care is isolated and tough, so not many UK graduates choose it above their other options. This has been an issue since the start of the NHS, but now is much worse because less foreign doctors want to work in the UK.

Casdon I agree that it's not a popular specialty. However, the service is being affected by funding. GPs are being left with the expensive patients. The majority of adults, especially males, rarely see their GPs and they subsidise those who do - children, the elderly, those with chronic conditions and pregnant women. If the "cheaper" adults are being lured into using privatised services, there will be fewer resources for the remaining patients.

Even before Covid, it was almost impossible to get a GP appointment at my practice, people couldn't make follow-up appointments (especially with the same GP) and were often fobbed off with a practice nurse. I have nothing against practice nurses, but they don't have the same expertise as doctors and I was always referred to the GP anyway, which is an incredible waste of my and the surgery's time and money.

The funding model means there's tension between primary and secondary services and GPs sometimes have to work to a "tick box mentality" rather than dealing with their patients holistically.

It's not helped when funding is siphoned off to the cheaper and more straightforward services.

I have just check my area on the map
It shows Treatment Centres that are privately owned but all referrals are NHS.
They have been around this area well over 15 years.
If you need an routine type XRay you will be referred to one, so not clog up the local Hospital.
I'm a NHS professional, we have been doing satellite clinics in GP Surgeries for years. We can do a clinic outside of the Trust, so capacity can be maintained and help with waiting lists.
I know it's enhancing the services we give not take away from them.
I was told on a course once "The NHS is a victim of its own success"

Yes it is definitely being privatised by the back door, it started with the change in contracts with dentist , look how difficult it is to get any treatment under the NHS it is now , most dentist won't do a scale and clean on the NHS now you have to see the hygienist. I just seen online that one of the vaccine manufacturing places based in Oxford has been sold to an American company after receiving £215 million in government funding. This is just the things we find out about what about the ones that to under the radar.

Visgir1

I have just check my area on the map
It shows Treatment Centres that are privately owned but all referrals are NHS.
They have been around this area well over 15 years.
If you need an routine type XRay you will be referred to one, so not clog up the local Hospital.
I'm a NHS professional, we have been doing satellite clinics in GP Surgeries for years. We can do a clinic outside of the Trust, so capacity can be maintained and help with waiting lists.
I know it's enhancing the services we give not take away from them.
I was told on a course once "The NHS is a victim of its own success"

How does the cost of a private X ray compare with the cost of a NHS one? If private companies can do them more cheaply - and pay to have their staff trained from scratch - great! I have been told by somebody who also works in the NHS (for the local commissioning group) that there is no cost benefit, which is leaching money from the NHS.

How much profit are the privately owned treatment centres making?

Have GP private surgeries been set up in places where there were viable GP services already in place in England growstuff? We don’t have privately run practices in Wales, so I’m a bit in the dark, but I thought contracts had been let to private companies in England only where the NHS GP service had failed due to recruitment difficulties? Our model is increasingly different to the English one though so I’m not sure on that.

I don't know what the rules are. I do know that there are at least two private GP surgeries within a few miles of where I live. They're staffed by people who used to work in existing NHS practices. They're contributing to staff recruitment difficulties.

They charge £120 for a standard 20 minute appointment, with medications, tests and follow ups as extras. They're used by people who can afford to queue jump.

Nuffield Health also offer private GP appointments.

They're different from GP surgeries owned by big companies contracted to the NHS.

Wales does have private GPs.

www.theindependentgeneralpractice.co.uk/

In France there is an excellent health service which is a combination of state and privately-owned provision. Treatment is prompt. Treatment is free except for a modest contribution which can be claimed back from cheap mutual insurance. But doctors are paid less than in the UK. Domiciliary services and rehabilitation are provided according to need. What can we learn from them without getting hung up on political ideology?

It is not only the NHS. For example, in Plymouth, Adult Social Services now come under the umbrella of a Community Interest Company called Livewell Southwest along with the Community Health Team, Plymouth Hospital and others. When a family member becomes VERY seriously ill we experienced appalling communications and lack of coordination between services. The sloppy use of acronyms caused near fatal decisions. So much so that we had to arrange for the person concerned to be move hundred miles to the North of Scotland for effective care

I misunderstood what you meant growstuff, hence the confusion. GPs who operate privately are everywhere, the difference in Wales is that no contracts are let to private companies for the running of NHS services as they are in England,

This is a list, compiled in 2021 and possibly increased since then, of GP practices in England owned by US health insurance giant, Centene, through its UK subsidiary, Operose Health.

weownit.org.uk/blog/here-are-gp-practices-taken-over-us-health-insurance-giant-centene