Chris Lancelot: The BMA is blind to the financial world of GPs

I am fed up with the BMA harping on about the government 'privatising the NHS'. I wish it would argue more logically.

The GP Record, by Fran Orford:
The GP Record, by Fran Orford:

It's all very well talking about 'the dangers of privatisation' were it not that we are all - GPs especially - making a profit out of healthcare. Doctors work to make money: so do nurses. Few of us can afford not to practise our profession for monetary gain.

But what about independent healthcare companies working for profit? That's different, surely?

Yet isn't this exactly what GP practices do? Indeed, the independent, self-employed status of GPs is the reason for the efficiency of primary care, because all unnecessary costs inevitably reduce partners' drawings.

Unfortunately, GPs' profit awareness has made some go too far, delivering services about which they should be ashamed - such as those practices which are content to have a profitably high patient-doctor ratio, but have found 'creative' ways to get round the accessibility targets, thus delivering a substandard service but still being paid for it.

So for the BMA to rail against the evils of privatisation smacks of hypocrisy. Of course there is a danger in letting the profit motive take centre stage - but this warning applies to 'ordinary' general practice just as much as healthcare provided by commercial companies.

Although healthcare isn't primarily about profit, individuals and companies delivering high quality healthcare should be rewarded for their efforts. Nor should the benefits of the marketplace be ignored: healthy competition can lead to a more economic and better delivery of healthcare, but only if there is a level playing field - and it is this that presents the real problem.

Hiving off NHS services to private providers can be beneficial - but only if it is performed equitably: there must be no differential tariffs, no preferential treatment and no cherry-picking of easy cases.

In turn, this requires standards which are clear, measurable, non-discriminatory, and universal. Privatisation of healthcare in itself is not the problem: it's the unfair way contracts have been handed out and monitored in the past which has caused the real difficulties and injustices - and the subsequent concern.


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