Chris Lancelot: Being anti-private firms in the NHS is hypocritical

I'm having a logical problem with one of the arguments used by opponents of the Health Bill - that private firms shouldn't be allowed to tender for NHS contracts because they will put the interests of their shareholders before their patients.

The GP Record, by Fran Orford www.francartoons.com
The GP Record, by Fran Orford www.francartoons.com

I can see the point entirely - but then we GPs are private firms, aren't we, with partners as shareholders? So if we object to other private firms taking on NHS work on the grounds of self-interest, shouldn't we say that we ourselves aren't fit to do NHS business either, for exactly the same reason?

There are several potential solutions to this conundrum. The first is to agree that GPs aren't fit persons to hold NHS contracts; therefore to be consistent we should all resign, and on ethical grounds ask the DoH to set up a new primary care division of directly employed NHS GPs. I can't see that happening, somehow.

Maybe we think we are true professionals, so steeped in the NHS ethos that we can rise above mere selfishness? In which case, under GMS why have so few practices offered partnerships to up and coming GPs? (It is cheaper to employ salaried doctors, even if bad for potential GPs' career development.)

And why have the financial incentives of the QOF resulted in a relative de-emphasis on the non-QOF diseases? Maybe we GPs are more self-orientated than we care to admit.

The final alternative of course is to admit that private firms are potentially just as reliable as GPs, and can therefore tender for NHS work: but this approach would imply that our previous objection to third-party contractors in the NHS was unsound.

You can see the problem, can't you? Mind you, I don't have to face it myself: I've never worried about private firms doing NHS work. I'm sure they can be trusted the same as anyone else, especially if the DoH keeps a careful watch on their contracts, volumes and standards.

But if the profession continues to oppose using private firms to do NHS work, then to the outside world we risk appearing to be either illogical or hypocritical. Surely it is far better to graciously accept that third party suppliers could be just as good for the NHS as we GPs are?


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