Really big questions over critical issues such as privatisation still remain unanswered: just how will the government prevent \”cherry-picking\”?
Experience of independent sector treatment centres shows that they cherry-picked patients with the least complex operations and left the NHS to deal with patients suffering multiple complications.
How will the government stop private health companies from picking the most profitable services and leaving areas such as mental health, patients with long-term conditions and elderly care to a financially weakened NHS?
No, seriously, why would we want to stop cheap and cheerful medical care in those cases where cheap and cheerful medical care is appropriate?
Think about it for a moment. Take some relatively simple procedure. Cataracts say.
We\’ve two ways of doing this.
1) A place which specialises in doing simple cataracts. They run an assembly line procedure, don\’t have vast amounts of complicated kit, they just slice and dice eyeballs all day long. Anything complicated, more than a simple cataract, is sent off to option 2.
2) A place which has lots of expensive kit and can do any and every possible eye operation. There staff chop and change between those various different operations and must be trained with and have all of that expensive kit all the time: even when they won\’t use most of it to do cataracts.
Now, option 1) would seem to be cheaper overall. Mechanisation, the division of labour and specialisation, is thought to reduce costs and or increase output for the same resources expended.
So, umm, what is the argument that we should not allow private companies to \”cherry pick\”?
We do in fact already do this all over the NHS. There are dentists who work in hospitals and they do all the really complex work, rebuilding shattered jaws etc. Fillings are done by the private sector with a chair and a drill, not an operating room full of nurses and kit.
Hospital pharmacies sort out the horrendously complicated drug mixtures needed by those with weird cancers and diseases. The private sector, the local pharmacy, issues the cough drops.
A&E does not do the primary health care for the population. A&E has lots of expensive kit, nurses coming out of the walls and immediate access to operating theatres for those who need their skulls reattached. A child with the sniffles goes to the private sector, to a GP.
We already contract out, we already not just allow but insist that the private sector should cherry pick. That we should not have all health care done in one place, but that those simple bits that can be done simply are so.
So what actually is the medical (as opposed to political) complaint that these people are making?