Wednesday, 13 February 2008

Private treatment initiative underutilised by NHS, rollout halted.

It seems that Independent sector treatment centres (ISTCs), created in a bid to cut waiting lists, to take care of minor surgery and diagnostic tests such knee and hip replacements, hernias and cataract operations, are being under utilised. Some are being passed only half the work they agreed to handle.

This is hardly surprising when you realise that it is not in the interests of cash strapped NHS hospitals to pass them patients - as they are paid per person treated and have to compete for the patients.

Under this arrangement It makes economic sense for NHS hospitals to hang on to as many patients as possible, even though this may disadvantage the patient, as it may involve, at a minimum, much longer waits for treatment.

Thus the contractual arrangements have the, presumably, unintentional side effect of sabotaging the initiative.

David Worskett, representing private health providers, pointed out that part of the problem was also due to GPs being reluctant to utilise them in some areas.

There have been two waves of ISTCs opened since they were announced in 2003. Health Secretary, Alan Johnson, has scrapped some of the second wave because of ‘lack of demand’, despite waiting lists. He has also pulled the plug on the third wave.

This may not necessarily be seen as entirely bad, or to be avoided, by NHS supporters who are vehemenently opposed to any private sector involvement on ideological grounds. It is also likely some employed within in the NHS may closely identify their interests with it’s remaining as it is.

Karen Jennings, of Unison stated: "This is money that should have gone into the NHS."


Simon Fawthrop said...

Surely this is an ideal opportunity to test market forces in health provision? All that the Govt needs to do is tell Doctors to send patients to the clinic that offers the lowest price, but with neither being able to go below cost.

What we need is national health provision, not a national health service.

CFD Ed said...

I tend to agree Re: national health provision. This initiative, if it had been set up properly, should have taken up the excess of a lot of basic run of the mill surgery, freeing up hospitals for more serious stuff and reducing waiting times across the board.

There is no doubt that the waiting times need reducing despite the Government and NHS administrators fiddling the lists and stats.

Instead it is being under used and abandoned, because of the skewed contractual arrangement, possibly exacerbated by prejudice. It still provided the holy grail of ‘free at the point of delivery’.

If they didn’t actually financially incentivise NHS hospitals to not use the ISTCs they might be able to do the job they were intended to do.