Tuesday, October 09, 2007

Private Practice in the UK

The great debate on health service financing has produced an array of mutually exclusive solutions. The one that is most laughable is the suggestion that private health care as currently practised in the UK might expand to fill the gap. It is perfectly possible to argue that some form of compulsory insurance, perhaps related to employment, might generate money more acceptably than direct taxation, but to suggest that the shortfalls in care for the elderly, hip replacements, accident and emergency departments, kidney transplants and anti-cancer drugs can be made good by the stately pleasure domes of BUPA hospitals is to betray a crass misunderstanding of why such palaces make their money and what the health service really needs.

In Britain, the private sector thrives on exclusivity. This is the Virgin Upper Class of health care. You have a room to yourself, a telephone, china cups and Sky TV. You don't have to strap hang with hoi polloi. Who would want to go private if everybody did it?

Private practice is a form of alternative medicine and is successful for the same reason. Make the patient feel special. Your disease is not something that any doctor can deal with. It requires my personal attention.


Anonymous said...

I'm sure I'm missing the point here, but the private system in the US works fine with little wait and little delay.

Those in the UK probably wish they could have the response time that exists in the US.

Once Hillarycare destroys this, though, where are the world's unhappy medical consumers going to go? Nowhere!

Anonymous said...

Private practice in the UK is often the last resort of the frightened patient. After waiting nearly 5 months to see a clinic after a high white cell count, I went private. Yes, I know that now we have government dictated short waiting times that isn't supposed to happen, but this was 2004.

Terry Hamblin said...

This was supposed to be a slightly humerous posting. Private practice is vitally necessary to keep the NHS honest, but too often private practice is just an excuse to make money in the UK. The hospitals are more like luxury hotels. There are certainly consultants who are making more than a million pounds a year in private practice who have a vested interest in prolonging waiting lists. There is a perverse incentive to do unnecessary investigations and procedures. There is a large placebo element to it - it must be better if it costs so much.

The good things about private practice - more time to spend with an individual patient, certainty of seeing a consultant and not a junior, certainty of seeing the same person, are all worth having, but there is no reason that they should not happen in the NHS.

Since I retired from the NHS there have been 40% more consultants appointed, which should give consultants more time with patients. Waiting lists should have all but disappeared. However, the big lesson to learn from yesterday's report on the Maidstone Hospitals Clostridium difficulties is then you let the bureaucrats set priorities at your peril. Reading between the lines it seems that a bullying chief executive wishing to curry favor with government ministers gold-plated the targets and rolled over objections from nurses and doctors.

Andy said...

"I'm sure I'm missing the point here, but the private system in the US works fine with little wait and little delay."

Your anonymous commenter should have added -

"if you can afford to pay"