Is our NHS already lost

Agreed. I suspect that continuing advances in treatment will see increased involvement of the private sector - and why not? Does anyone offered private treatment through the NHS refuse it because public money will thereby go into private pockets? I doubt it.

I suspect that continuing advances in treatment will see increased involvement of the private sector - and why not?

On the other hand, one could ask 'Why?'

I was looking at a story in the financial Times this morning, albeit written from a different angle.

This is the start of it:

Immunocore is a success story for the UK’s ambitions in biotechnology. Spun out of Oxford university in 1999, it is pioneering a new generation of medicines to treat cancers, viral infections and autoimmune diseases from the leafy market town of Abingdon-on-Thames.

But for Sir John Bell, the Canadian-British chair of the company and one of the world’s leading immunologists, its story stands out for a less distinguished reason. “Immunocore is, I fear, a classic example of what the UK has been losing,” he says.

The story is about the company's failure to attract UK private investment, but it links in my mind to the book I've recently reading by economist Maria Mazzucato. Her book is about the large investment successive US governments have made in supporting R & D in various fields, and in start ups seeking to use the resultant new technologies. The US governments take the risks because private investors are unwilling to.

I don't exactly know what 'advances in treatment' GSM is referring to, but it seems to me that some may very well emanate from our universities, as did the work Immunocore is developing. It strikes me that if a pioneering UK company cannot get private investment in the UK why isn't our government investing? Why is it being left to find overseas investment with the potential for much of its profits to leave the UK. Additionally, new treatments resulting from state investment could be used in the NHS at a lower cost than via a private company.

It's not as though the NHS has never implemented new treatments and technologies in the past. It's mainly the obsession with the 'in efficiency ' of the market that has led to increased use of private services.

Oh. Link for anyone else that has a subscription to FT

www.ft.com/content/03280cd7-8013-4212-a98e-e0c35194d009

I think one factor in poor government support for science based innovation is the lack of politicians and senior civil servants with science degrees and research backgrounds. Too many PPE graduates. Of course there are a few scientific advisors to government but is what they say understood? I recall we lost the chip company Intel to the US as a result of inaction: there's an Intel chip in almost every computer. Government should step in when private investors hesitate. The French and Germans have no qualms about State support when it suits them, nor does the US government.

You forget, Maizie, that the government invested hugely in the development of ‘the Oxford vaccine’.
Who can say what advances in treatments may come along, but they will probably be developed by private initiatives. Maybe in the UK, maybe not. I would rather see the NHS paying the private sector to administer an approved treatment than the government investing in research which may or may not be successful - in other words, taking a gamble as shareholders and venture capitalists do with money they can afford to lose.

The NHS was designed as an insurance system, with premiums to be paid for from contributions from every working person and a bit extra to cover people unable to work. We now have a situation where massive immigration has led to more people having access to the NHS without having contributed to the common pool so no wonder it is underfunded. It is also unfair to those who have contributed all their working lives who can't get their hip replacements or whatever because there is a person with greater need but who has never contributed. I am not anti-immigration - quite the opposite, I am proud that Britain is generally a welcoming and cosmopolitan place to live, but practically, the additional burden on the NHS has to be accepted and paid for somehow. I think the answer lies in ensuring that for every legal immigrant there is an injection of capital into the NHS equivalent to whatever a person of that age should have contributed to date. That money should be taken from our foreign aid budget.

All GPs are private providers contracted to the NHS. That's how it works. As long as we have free access to healthcare does it matter who provides it? I've had a cataract operation, two carpal tunnel releases and a colonoscopy done at private providers under NHS contracts, and generally had a much better time than when an NHS hospital was dealing with me. Almost no other country in the world thinks the government should be in the business of providing healthcare; governments should make sure people can get healthcare, which is a different thing and seems, in most European countries, to get a better outcome. We made a huge mistake in the 1940s when health was politicised and the sooner we come to terms with reality the better, as far as I am concerned.

Farzanah If you are happy with dental services as they are, then you may not mind health service transfer from public to private. As I previously mentioned it was a political ideological choice, to run down the NHS, not a necessity.

I think this a very valid point. Slowly but surely, NHS dental services have disappeared. There is no dentist in my area taking NHS patients, and my dentist, with whom I've been a patient for years, now has got rid of its one dentist giving NHS treatment. I've had no choice but to become a private patient. I can see the rest of the NHS going the same way.

taking a gamble as shareholders and venture capitalists do with money they can afford to lose.

I think you missed the whole point of the article which I condensed for you. This company, developing treatments on the back of work by a UK university can't get UK private investment. It is a fact, however much you might like to argue with it, that economists (and the FT) will tell you that private investors are, in the main, risk averse.

The key feature of state investment is that it can sustain loss without detriment to the state finances. Because that is the nature of the 'money' it creates.

It's ideology that holds the government back from investment, not financial constraints.

I understand that Maizie. Which is why I said ‘money they can afford to lose’. You are clearly in favour of the creation of money by the state ad infinitum, and using it like gambling chips. If private investors see something as too risky, why should the state step in?

Germanshepherdsmum

You forget, Maizie, that the government invested hugely in the development of ‘the Oxford vaccine’.
Who can say what advances in treatments may come along, but they will probably be developed by private initiatives. Maybe in the UK, maybe not. I would rather see the NHS paying the private sector to administer an approved treatment than the government investing in research which may or may not be successful - in other words, taking a gamble as shareholders and venture capitalists do with money they can afford to lose.

Private companies, supported by research departments in universities are best placed to develop new drugs, which have worldwide applicability when they succeed. However much of the innovation in patient care is instigated by clinical teams, who follow through on new techniques they have experimented with. If you read the medical journals you will see how much of this type of innovation is started in the NHS. Clinicians don’t experiment with private patients, because private medicine is risk averse, dealing mainly with routine procedures.

One of the big problems here is that some take up a lot of time going to hospitals with fairly minor issues like earaches and sore throats because it is free. They get seen to and triaged but it slows up the queues for more urgent issues. Another issue is those who create a big fuss like druggies and drunks get seen to quickly to get them out of the way. Totally unfair but I can see their point!

I think the first thing that needs to be done is a proper audit to discover who is being paid what and what contribution that is making to the survival of the service.
GPs have always operated as private providers and there seemed to be little problem with that. So perhaps one of the initiatives might be that any private provider has as its primary executives only doctors.
But if private clinics and hospitals are using NHS money in order to make sure they survive then they should immediately be nationalised. Perhaps a percentage could be set. Less than 50% private health care it becomes a public service.

pen50

All GPs are private providers contracted to the NHS. That's how it works. As long as we have free access to healthcare does it matter who provides it? I've had a cataract operation, two carpal tunnel releases and a colonoscopy done at private providers under NHS contracts, and generally had a much better time than when an NHS hospital was dealing with me. Almost no other country in the world thinks the government should be in the business of providing healthcare; governments should make sure people can get healthcare, which is a different thing and seems, in most European countries, to get a better outcome. We made a huge mistake in the 1940s when health was politicised and the sooner we come to terms with reality the better, as far as I am concerned.

This.
So long as care remains free at the point of need and is provided by, or through the NHS, then I’m fine with it. If certain patients are outsourced to private health providers but paid for by the NHS I don’t see a problem.

If it costs so much to treat people how do private health companies make a profit?

They charge enough to ensure there is a profit!

I think, generally, NHS staff are doing a good job in very difficult circumstances, but obviously there are more and more people experiencing less than good treatment.

People were warned, before the Conservatives got in, that the NHS would be at risk. Jeremy Hunt even contributed to a book that suggested the NHS was inefficient and should be replaced.

More and more services have been hived off to private providers - who generally take on the least time-consuming, least complicated, and therefore most profitable procedures.

People who have been referred by the NHS to private companies are often impressed by superficialities - more attractive premises, more flexibility of appointments, etc. - but, as has been said, if the NHS no longer existed they might not be so obliging.

pen50

All GPs are private providers contracted to the NHS. That's how it works. As long as we have free access to healthcare does it matter who provides it? I've had a cataract operation, two carpal tunnel releases and a colonoscopy done at private providers under NHS contracts, and generally had a much better time than when an NHS hospital was dealing with me. Almost no other country in the world thinks the government should be in the business of providing healthcare; governments should make sure people can get healthcare, which is a different thing and seems, in most European countries, to get a better outcome. We made a huge mistake in the 1940s when health was politicised and the sooner we come to terms with reality the better, as far as I am concerned.

Not all GPs are private providers contracted to the NHS. An increasing number of GPs are private providers contracted to nobody but themselves.

I know a number of people who use private GPs. The GPs themselves also work in local practices for a couple of days a week. Until a few years ago, they worked exclusively in NHS practices.

The situation now is that it's almost impossible to get a GP appointment and certainly not one face-to-face. People who want a traditional way of working without a wait just have to pay a couple of hundred pounds for a private appointment with a GP they would have seen for free until recently. That's absolutely fine for those who can afford it. Meanwhile the NHS practices are having difficulties finding staff to replace those working in private practices, so those who can't afford it are having to wait even longer.

Incidentally, healthcare is fundamental to people's well-being and is a political issue.

I’m afraid Gloriana and Farzanah are absolutely right : The NHSis a cash cow for all these companies , Sadl.y our journalists have not been on to this ; Once these companies get contracts they have a license to extract monies from the NHS with very little checks and balances
It’s very nieve to think any differently ; There are more and more GP private practitioners the average fee is £50 a consultation then paying for any drugs prescribed ,
Some of the worst offenders are those running homes for specialist care . Ie learning difficulties , mental health units ; sadly it’s never mind the quality we have the contract we don’t have to provide training or indeed give any compassion it’s about MONEY the NHS is a bottomless pit . How some of our ministers and MPs sleep at night is a mystery

My NHS dentist referred me to a private hospital for surgical removal of a broken tooth. Also a family member had surgery there also referred by NHS as it was urgent spinal surgery.
I think it's good for urgent cases as NHS has v long waiting lists.

Germanshepherdsmum

You forget, Maizie, that the government invested hugely in the development of ‘the Oxford vaccine’.
Who can say what advances in treatments may come along, but they will probably be developed by private initiatives. Maybe in the UK, maybe not. I would rather see the NHS paying the private sector to administer an approved treatment than the government investing in research which may or may not be successful - in other words, taking a gamble as shareholders and venture capitalists do with money they can afford to lose.

GSM The investment in the "Oxford vaccine" was a one-off. Have you listened to Sarah Gilbert talking about the problems her researchers face with funding? Research is long-term, but they don't know from one month to the next whether they will receive money to complete projects. UK research used to receive huge amounts of money from the EU, but this hasn't been replaced.

The UK is a world leader in biotechnology, but it's losing out. In the brave new post-Brexit world, it's an area which the government should be investing in, but it hasn't replaced the money bio-tech companies lost from Brexit. The money doesn't come from the NHS budget. Money invested might not always result in successful treatments, but scientists share methods and results and very often even unsuccessful research is used to advance knowledge and then leads to success in other areas.

This is not really that relevant to the NHS because the funding isn't directly connected to the healthcare budget.

Yes, I know the Oxford investment was a one-off and leaving the EU has resulted in a huge loss of investment opportunities, but I’m not in favour of the government creating money in order to act as a venture capitalist when the actual venture capitalists consider a project too risky to invest in.

They're not acting as venture capitalists in the normal sense. They're investing in research, which is all interconnected.

Small private research labs are the ones who take on the risk. If their research shows promise, they then look for funding from the big pharma companies or research grants (or. in the past, the EU).

University research doesn't operate in isolation. Any techniques developed can be used for a number of purposes and contributes to general scientific knowledge. It is only when it becomes obvious that something looks as though there is a reasonable chance that it will be successful that government funding is sought.

This is still one of the UK's main strengths and it is blinkered not to invest in a success story.

If the usual sources of investment don’t want to know that says a lot. Too much risk. The labs are only taking on risk to the extent that they invest their own money.