Forget privatisation, this is nationalisation

I do wish people would use words less emotively. Ever since independent healthcare providers appeared, the BMA has been talking about 'the privatisation of the NHS'. Nothing could be further from the truth; indeed, in trying to raise the public's indignation by underhand means, its tactics have backfired.

Just because a surgery is run by an independent company doesn't mean that the NHS is being privatised: after all, existing GMS and PMS practices are independent providers, and certainly don't consider themselves to be 'private'. The government has been at pains to point out that all providers - whether GP principals, consortia or healthcare companies - supply NHS services which are free at the point of need and operate under NHS regulations. In this, for once, it is being open and truthful.

It won't help the public to think clearly about the problems associated with the Darzi clinics if we divert their attention by constantly and inaccurately referring to their introduction as 'privatisation'.

In any case, many people consider 'private medicine' to imply 'consultant-led, no expense spared, delivered in a personal way' - these are not exactly attributes that will apply to franchised APMS supersurgeries.

If the public thinks we are wrong to talk about 'privatisation' (and by implication, are spinning), why should it trust us on other matters? No wonder the BMA is losing the media war. How do we convince the public of the immense threat to traditional primary care from the imposition of additional supersurgeries?

Clearly the threat isn't about 'privatisation', but that they will destabilise local healthcare supply. Supersurgeries are deliberately being introduced by the politicians as underhand competition. Privatisation doesn't come into it: creating impersonal healthcare does.

Paradoxically, the imposition of franchised APMS surgeries nationwide will be more like nationalisation than privatisation.

If we want to alert the public we should talk about sacrificing quality for quantity, warn about the impersonal, conveyor-belt delivery of healthcare and ask how patients will cope when their local practice is gone. These statements might not have the same emotive ring as 'privatisation' but are more truthful.

Dr Lancelot is a GP from Lancashire. Email him at GPcolumnists@haymarket.com .

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