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Norman Tebbit: Don't let David Cameron destroy our NHS
IT is not often the Daily Mirror and I find ourselves on common ground but we are both staunch
supporters of the principles of the NHS, whatever its difficulties and problems - some of them
, I fear, of its own making.
I have known the Secretary of State, Andrew Lansley, for 30 years. In his day he was a very
able civil servant, and it seems to me that if anyone could unravel and reform the tangled
bureaucracy which holds up the devoted professionals of the NHS, it ought to be someone
with his experience.
What worries me about the reforms however is the difficulty of organising fair competition
between the state-owned hospitals and those in the private sector.
In my time I have seen many efforts to create competition between state-owned airlines, car factories
and steel makers.
They all came unstuck. The unfairnesses were not all one way and they spring from the fact that
state-owned and financed businesses and private sector ones are different animals. I have long
been a customer of the NHS and although I've never worked in it, for 15 years I was chairman
of a charity which supported an NHS teaching hospital (to the tune of £14million) and saw it go
through the agony of a PFI scheme.
I also saw the damage done under the Blair government when it lost a lot of its bread and butter
work to a private hospital.
I believe there is nothing wrong with people choosing to spend their own money, or pay outs from
health insurance companies, on health care in private hospitals. It simply eases the load on the NHS.
But it is different when the NHS or the taxpayer (you and me) pays for NHS patients to be treated
in private hospitals on anything more than a very small scale in special circumstances.
One problem is that within the NHS there are teaching hospitals, often centres of excellence,
which apart from treating patients, also have the responsibility of training doctors and nurses.
That all takes time and costs money.
Private hospitals are under no obligation to do training and do not have to carry those costs.
Even worse for the teaching hospitals, if the private hospitals can hoover up all the straightforward
routine surgery, like hip joint replacement, where can the young surgeons gain the experience which
would allow them to move on to more difficult surgery?
Another problem for the NHS hospitals is that they cannot refuse to treat patients.
Whether it is a drunken fool with a cut face from a street brawl, or a young mother with cancer or a
heart attack, no one can be turned away, but the private hospital can pick and choose.
However, it is not all one way. When an NHS hospital fails in its duty to patients - be it from botched
surgery, poor hygiene allowing MRSA to spread, or the neglect of vulnerable, sick people - it may
be fined. That can be a very big sum, or it might be £250 a day each time they keep male and female
patients on the same ward. In similar circumstances a private hospital might be taken to court and
have to cough up a lot in compensation.
At the very least it would hit profits, and at worst, the company could go out of business.
Either way it would be the owners of the business who lost their own money.
When a failing NHS hospital is fined, it finds the money by cutting back somewhere and it is the patients
who lose out.
When a new NHS hospital is built, or an old one is modernised, it is the taxpayer who pays up one
way or another.
When a private hospital is built, it is private money that has to be found, put at risk and paid for.
On the other hand, the NHS will most likely be cursed with a PFI scheme, which is even worse
than either a credit sale or a hire purchase scheme.
With this system, the NHS doesn't even own the hospital for 30 years. Instead it pays rent for all
that time and all maintenance has to be carried out by the PFI contractors who regularly rip off the
NHS. So who gets the worst deal - the NHS or the private hospital? At any particular time or place
it could be either, but one thing is sure - one is using and risking our money and the other is risking its own.
More importantly, I am not at all sure that the patients are better off in the long term.
I can understand why the Coalition is in a hurry to get all this through so that it is up and running
before the next election, but as my grandfather often warned me, more haste can mean less speed.
I think NuLabour played fast and loose with the NHS, pouring money in but getting little back for it
except hordes of "managers", but fewer nurses beside beds.
That is no reason for my friends to follow Blair's bad example. We need to listen and persuade
, especially those who treat patients, that we have got it right, or to change it where we cannot.
The inefficient NHS is a long way from perfect. There is much it could learn from the private sector
, but there is a lot of good in it that should not be put a risk.