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Private business and the NHS

Private business and the NHS

The NHS has always used private contractors. GPs, Dentists, Pharmacists and opticians are almost all privately owned. There have always been private providers of various services in mental health.

It can make a difference if private companies deliver services:

  • instability: they may move out when profits drop
  • cost: they may have to pay shareholders
  • transactional processes: charging, billing, all that
  • ethos: can be very different
  • unaccountability

The NHS would fall apart without private companies’ input. They provide all the equipment, build the hospitals, make the drugs. In the IT world, the whole of primary care IT is run privately – all your data is held on private companies’ machines. When the state tried to deliver a coherent IT vision, it failed, partly because the private sector had already delivered on a lot of it and fought to maintain its share. There is ample evidence that alternative providers can challenge state delivery and improve ideas, vision, relationships with users of the services.

Privatisation, strictly speaking, is the transfer to the private sector of services which were previously provided by the public sector. or as  the World Health Organization has defined it privatisation in healthcare is “a process in which non-governmental actors become increasingly involved in the financing and/or provision of healthcare services”.   Clive Peedell argues, very persuasively that “Further privatisation is inevitable under the proposed NHS reforms“.

Marketisation is the introduction of market principles and commercial competition into a sector previous run on other principles, and need not be associated with privatisation (though it usually is).

Equally a centralised planned economy need not be run through public sector organisations, though it usually is.

Maps to illustrate the extent and the growth of NHS privatisation in England.

Hattie Jacques with a clipboard

Websites of organisations involved (actually or potentially) in providing health services in the UK, or commenting on them:

Pharmaceutical companies are not listed here.

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