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.

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.


  1. Caroline Molloy says:

    It is highly misleading to label GPs as ‘privately owned’. In the current context this argument is largely used by the right in a flawed attempt to soothe our anxieties about NHS privatisation. As for suggesting that dentistry and IT are indications of why NHS privatisation is not too much to worry about, either, what can I say?! Anyone who’s struggled to get an NHS dentist…. or who noticed the last government throw away £20 billion (ie, the entire ‘Nicholson cuts’) to IT contractors, might wonder if they’ve entered topsy turvy land, finding this article on the SHA website!

  2. Val Hudson says:

    What a ridiculous blog. All it serves to illustrate is enough privatisation is enough. One of our local trust chairs tried to reduce the PFI debt by paying it off with an interest free loan from the LA pension fund so that the money could be used to provide a better #nhs. The government put up every obstacle possible. Privatisation will only ever benefit people who are in to make a profit

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