Retain UK healthcare as a primarily publicly funded service, argues leading doctor

October 25, 2017, British Medical Journal

A growing proportion of public monies are not going into front-line healthcare, but into profit margins, warns Neena Modi, Professor of Neonatal Medicine and President of the Royal College of Paediatrics and Child Health.

In The BMJ today, she argues that a mixed public-private healthcare system "ultimately reduces the effectiveness of healthcare for everyone" and says "it makes sense on grounds of equity, effectiveness and cost-efficiency to retain UK healthcare as a primarily publicly funded, delivered and accountable service."

Professor Modi points to figures from the NHS Confederation showing that, in addition to NHS (publicly owned) providers, some 853 for-profit and other independent sector organisations now also provide healthcare services in England.

Yet there is no evidence that healthcare is better when delivered by non-NHS providers, she says. "Indeed evidence to-date indicates care is compromised when organisations with no prior experience of local contexts take over from NHS providers."

Some say the growth in private for-profit healthcare will take the pressure off the NHS, but Modi argues that in the UK "the overwhelming majority of doctors work in the NHS; take them away and the NHS, already reeling from the adverse impact of Brexit on migrant workers, suffers further."

The NHS doesn't need to be discarded, nor does it need to go back in time; it needs to evolve, she writes.

She calls for "visionary leadership" to translate its founding principles into 21st century , and "investment coupled with equitable cost-containment" for example through further development of pioneering mechanisms initiated by the National Institute of Health and Care Excellence.

The UK has also long punched above its weight in biomedical and life sciences research "but now needs to address its weakness in exploiting this for public gain," she argues.

And wiser public-private partnerships than the NHS has hitherto seen "could stimulate innovation directed primarily at health and wellbeing from infancy into old age, rather than disease and profit."

Government must be honest, the media must explain, the public must protest, and the professions must speak out, she concludes. "If we do not, future generations pondering upon the demise of the NHS, will be legitimate in asking whether our silence reflected ignorance, denial, fear, or self-interest."

Explore further: Junior doctors' contract should be scrapped, argues leading doctor

Related Stories

Junior doctors' contract should be scrapped, argues leading doctor

October 4, 2016
The junior doctors' contract "should be discarded and replaced with one drawn on a clean sheet," argues Neena Modi, Professor of neonatal medicine and president of the UK Royal College of Paediatrics and Child Health.

Private top-up insurance could help pay for the NHS, argues expert

October 13, 2016
Private top-up insurance could help prevent the declining healthcare standards in the NHS, argues Christopher Smallwood, an economist and former chair of Kingston Hospital NHS Foundation Trust, and St George's University ...

Private healthcare no more efficient, accountable or effective than public sector in LMICs

June 19, 2012
A systematic review conducted by Sanjay Basu of the University of California, San Francisco and colleagues re-evaluated the evidence relating to comparative performance of public versus private sector healthcare delivery ...

Restraining health care prices requires workforce productivity gains, not wage cuts alone

June 8, 2015
A new study by NYU Wagner Dean and Professor of Public Service Sherry A. Glied and two additional researchers sees little evidence to support the belief that healthcare workers' wage levels are responsible for the rising ...

The NHS is far safer inside the European Union, argues public health expert

May 4, 2016
The NHS is far safer inside the European Union, argues a leading public health expert in The BMJ today.

Recommended for you

A co-worker's rudeness can affect your sleep—and your partner's, study finds

December 14, 2018
Rudeness. Sarcastic comments. Demeaning language. Interrupting or talking over someone in a meeting. Workplace incivilities such as these are becoming increasingly common, and a new study from Portland State University and ...

A holiday gift to primary care doctors: Proof of their time crunch

December 14, 2018
The average primary care doctor needs to work six more hours a day than they already do, in order to make sure their patients get all the preventive and early-detection care they want and deserve, a new study finds.

Teens get more sleep with later school start time, researchers find

December 12, 2018
When Seattle Public Schools announced that it would reorganize school start times across the district for the fall of 2016, the massive undertaking took more than a year to deploy. Elementary schools started earlier, while ...

Large restaurant portions a global problem, study finds

December 12, 2018
A new multi-country study finds that large, high-calorie portion sizes in fast food and full service restaurants is not a problem unique to the United States. An international team of researchers found that 94 percent of ...

Receiving genetic information can change risk

December 11, 2018
Millions of people in the United States alone have submitted their DNA for analysis and received information that not only predicts their risk for disease but, it turns out, in some cases might also have influenced that risk, ...

Yes please to yoghurt and cheese: The new improved Mediterranean diet

December 11, 2018
Thousands of Australians can take heart as new research from the University of South Australia shows a dairy-enhanced Mediterranean diet will significantly increase health outcomes for those at risk of cardiovascular disease ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.