Chris Lancelot on... profiting from ill health

I do wish people would be more logical over the provision of healthcare in the NHS.

It is so easy to adopt the simplistic mantra that the only proper way is publicly, that involvement of private firms is anathema and that 'you shouldn't make a profit out of sickness'.

A moment's thought shows how false this assumption is. Everyone in healthcare works for personal profit, from the lowliest student nurse to the highest paid manager or consultant. Pharmaceutical companies and appliance makers also contribute hugely to the quality of patient care. I for one do not begrudge appropriate rewards given to the staff and shareholders of companies that manufacture artificial hips, antibiotics or anaesthetic equipment.

The real question is not 'Are people making money out of the sick?' but 'Are their rewards individually justified?' Is healthcare delivered to a high standard? Is their remuneration in proportion to the good they do to patients, bearing in mind the risks taken and the responsibilities held? Do the underpinning contractual arrangements damage the wider interests of the NHS?

By applying these standards we can see where the NHS needs to make changes. Is healthcare delivered to an appropriate standard? It certainly isn't in a large number of publicly owned hospitals where MRSA is rife.

There are too few nurses and the toilets are bereft of paper towels. Is the remuneration appropriate? Not in the case of that sizeable percentage of NHS managers whose salaries are matched only by their incompetence.

Are services provided without detriment to any other part of the NHS? In other words, do we have a level playing field? Inequality here harms and destabilises the whole NHS. Any involvement of an individual or company in healthcare must be even-handed: there can be no preferential treatment for individuals, firms or organisations, whether public or private. No one should cream off the easy or more profitable cases, be offered sweeteners, or be given more favourable terms.

The debate over the private supply of healthcare to the NHS is a complete red herring. It really doesn't matter who supplies the healthcare, provided it is delivered to an appropriate standard. By following these rules we will obtain the best possible healthcare for NHS patients.

- Dr Lancelot is a GP from Lancashire. Email him at

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