The Risks Of The Market

The 'any willing provider' approach in an expanded NHS market will see many new entrants, including transnational corporations, competing to treat NHS patients. There is a proven threat to equity, value and quality of care from involving profit-led companies in the provision of healthcare. ISTCs, for example, have cherry-picked the less complex patients. [12]

The quality of work done in private treatment centres has been seriously criticised by NHS surgeons and their professional bodies - while costly repair work has had to be carried out by the NHS. [13]

Precedence of these private companies is that they do put profit before patients. This was evident with the company Take Care Now, employers of the German locum GP, Dr Ubani, who killed patient David Grey in 2008 by giving him ten times the normal dose of diamorphine. Investigations by the Care Quality Commission showed that Take Care Now operated with dangerously low staffing levels and focussed on 'cutting costs to the bone'. A report by the Commission even before the death of Mr Grey stated that "finance, operations and HR were at the heart of Take Care Now's function, rather than clinical quality and response". One ex-staff member said, "The commercial element took over and began to cut corners in the pursuit of profit." [14]

There is a real danger of a two-tier service developing. While providers will compete for contracts in more affluent areas, poorer communities could struggle to sustain a comprehensive range of healthcare of a comparable standard. The increasing trend to allow personal top-ups to the funding of NHS care will widen the divisions between those who can afford to pay and those who can't.

This is what markets do. They create hierarchies of service, not universal excellence.

Click on each statement to link to its source, or go to sources for the full list.